Missing work due to depression

SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

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“We don't hire people like that. What if you hang yourself at the object? Minsk men tell how they experience depression

There are over 475,000 people suffering from depression in Belarus. According to experts, we are becoming a depressed nation. And if Belarusians more or less willingly go to therapy, then for men everything is very, very bad with this.

“There is a strong persecution, especially from the older generation”

Andrey (23)

decorative plasterer

– Depression is like diving into a whirlpool. It starts off smoothly. You deny the existence of this very scattered state, when there is no possibility to fully function. You lose motivation, you lose strength to work. And then there comes a moment when it becomes impossible to deny that you feel bad.

My depression began at the age of sixteen. At first I convinced myself that it was laziness. It's not bad for me - it's so boring to me. For a while, I just ignored that I had any problems.

When I was studying, it was easier to deny difficulties. Yes, everything fell apart at school. But the feeling that you are in some kind of system where you need to perform specific tasks gathered me internally.

By the age of eighteen, my functionality had dropped so much that the place where I live turned into a garbage dump. I felt I needed to take a "Fort Boyard" level action to get out of bed.

I have a strained relationship with my parents and could not ask them for help. There were (and are) a couple of close friends to whom I told something. But I tried to limit the amount of negativity that I merge. Everyone has their own problems. In addition, depression is a condition in which just talking does not help much.

Most of the time I felt dissatisfied. I didn't like where I was and what I was doing. But I didn't have the strength to change anything. I felt helpless and depressed.

Trying to think about what makes me happy, I stumbled upon the fact that my brain twisted it so that it became even worse. It was difficult to talk about my condition, because thoughts were like porridge.

In addition, the performance has dropped a lot. Previously, I could work for two hours, but now I worked for half an hour at best. A lot of useless advice around only increased the annoyance. People advised me to take a walk, watch a comedy, listen to cheerful music.

Therefore, I myself began to look for the reasons for what was happening to me. I came across a center for borderline conditions, from where I was redirected for medicines.

At nineteen, I was diagnosed with recurrent depressive disorder through the draft board. A psychiatrist from the military registration and enlistment office, when I was hospitalized, told me: “You are a man! How can you, as a girl, suffer for all sorts of nonsense!

It's hard to trust doctors after this. But I still followed them. Periodically they had to be changed. We, especially in public hospitals, have a rather primitive attitude towards depression and depressive disorders. Sometimes a doctor can tell you: “Who is it easy now?”

Of course, there are people who are worse than you, why are you whining here? This is how you devalue your emotions

After receiving the diagnosis, I felt relieved. I had a piece of paper with which I could fend off all the advice to take a walk. I started going to both paid psychotherapists and free ones.

I was not afraid to go to the doctors. I was afraid that they would be incompetent. For some time I had a very good specialist who helped me a lot. But then she left Belarus. And now I'm still looking for a new doctor.

On the other hand, the diagnosis made it difficult to find a job. For example, I came to get a job. The employer takes the documents from me, is already ready to draw up. Then he looks into the help and says: “Oh, you have some kind of incomprehensible code here, let me try it.” It breaks through and gloomily reports: “We don’t work with people like you. What if you hang yourself at our facility?”

Our men generally endure to the last. The matter has already reached alcoholism, and they all do not seek help. It's easier to convince yourself that there is no problem than to start treatment. The stigmatization is tough.

Our society treats any manifestation of emotions as leprosy. And there is a strong persecution, especially from the older generation. They like to repeat that suicide is a weakness, depression is a weakness, bipolar disorder is not a diagnosis but a fiction.

People need to realize that there is another experience, there is another reality. After all, there is the World Health Organization, which has a Medical Classification of Diseases. And this is not some personal quirk.

“It is psychologically and emotionally difficult to trust a stranger, it is not customary with us”

Mark (25)

works in the field of communications

– For a long time I considered going to a psychotherapist solely as a preventive measure. Find out if everything is okay with me, if I need to do something differently at this stage of life. The more my friends asked for help, the more I wanted to try.

Everyone around me said how it helped them in life. I was happy for them, but I did not quite believe that this would somehow help me. I thought, after so much time and money spent, no one would say that everything was in vain.

I saw therapy as a last resort. After all, somehow I coped with everything before, why should I change something? In addition, from the stories around, I heard that people go to therapy when they have money, time, and a desire to change and work on themselves. If something is missing, therapy will not be effective.

For a long time I had a job that I did not like. I had many months of overtime after six. I did not see the results of my work, I was dissatisfied with myself.

I forgot what it's like to feel normal. I constantly felt acute loneliness. The last straw was parting with a loved one. After that, problems with sleep and appetite began. There was apathy for everything. It was difficult for me to concentrate. I was very exhausted and just wanted someone to help me.

The stigmatization of psychological help scares men away, I think. Many people do not want to admit that there may be something wrong with them. It is psychologically and emotionally difficult to trust a stranger, we do not accept this.

Being defenseless for a man is an exceptional situation. Many men are raised with the mindset “you’re a man, be patient,” and they endure. I myself went through this and saw many who still live by this principle.

I knew I needed help when I felt there was no way out. I had no one to share this with. I called my current therapist, whose phone I had kept close at hand for a year. She quickly made an appointment. So I took the first step on the road to recovery.

I have had about 15 therapy sessions to date. I'm even glad that this whole situation happened, because it was the impetus for change. In therapy, you work with the request you came with and begin to pay attention to your irrational attitudes and behavior.

In my case, it helped me to cope with temporary problems and, more importantly, changed my attitude towards myself and others.

My self-esteem has improved. I began to voice my boundaries, and for the first time in a long time, the joy of life appeared.

I was glad when I met the support of almost all my relatives. This experience strengthened our relationship.

But there were also such relatives who looked askance at the therapy. They can still joke about my therapy, but I can't stand them anymore. These people have become more distant. While I still maintain contact with them, but if necessary, I am ready to stop it.

"I had hallucinations and tantrums for a while after that"


musician and journalist

– Now, after therapy, I understand that I have always been depressed. As a child, I was sensitive, melancholic, hard to experience bad events. But I thought everyone did.

At sixteen, my family was in crisis. At the height of the conflict, I was beaten by my uncle. We called the police, filmed the beatings. For a while after that, I had hallucinations and tantrums. But then it seemed to let go.

I felt really bad after breaking up with my girlfriend. Even now I feel it sounds primitive. But all my motivation to live was built around her, and then she left. And I didn't have time to cry. For the first time I was in a foreign country where martial law was introduced, and I had to somehow get home.

After coming home for a couple of months, I ruined my health and cut off almost all social ties. I developed substance abuse.

I skipped university hard because I couldn't bring myself to go there. Everything has lost its meaning. Need to have breakfast? Go to the toilet? Wash up? What for? It doesn't make sense, because I'm already dirty, miserable and disgusting.

All this feels like constant fatigue and pain. You don't know what hurts because everything seems to hurt. One can only lie and think: when will all this end?

My close friend, who was watching all this, said that I needed psychotherapy. I thought I was going to counseling. It won't get any worse for me. That's how I found out I was depressed.

I am lucky to have a close circle. Most of them are sensitive enough not to laugh at depression and advise against going to the factory. With strangers, everything is much more complicated. From one psychiatrist I heard that you need to pull yourself together, start doing something actively with your life, so that there is a “real masculine character”

My depression has not disappeared yet. I take antidepressants, go to therapy, try to take care of my health more. I also do psychoactivism. I write about mental disorders and participate in events so that people can better understand how it all works.

People cope with depression for years. I definitely feel better now than before the treatment.

“When drinking with friends, something broke through”

Vitaly (25)

freelance lawyer

– I can’t say exactly when it all started. Probably tenth grade. But then I did not know what was happening to me. I did not fix this state in any way, I did not think that something was wrong. It was only later that I realized that I was depressed then.

I usually got worse on weekends. There was a lot of time that I spent alone. I felt very lonely. If during the week I interacted with people, then at the weekend I remained in complete isolation.

We had family problems. I couldn't talk about it with anyone. I just lay there for hours. There were many sad thoughts. I often thought about suicide.

I tried to talk about how I feel with my mother. I described my condition to her - she began to talk about the fact that she had some familiar herbalist in the village, to whom we could go. It is clear that I refused. That was the end of my attempts to tell my parents.

At some point I started having panic attacks, I felt very restless. Especially didn't tell my friends about it. When I drank, of course, something broke through. But I had an image of such a depressed dude who jokes about suicide. It was a reason to laugh.

I didn't make any attempts to talk seriously. I guess I wanted some support, since I joked about it so much. But consciously I would never tell anyone what was happening to me.

I didn't have a turning point when I realized that I couldn't put off seeing a psychotherapist any longer. I was lucky with the information field: many of my friends talked about therapy. Therefore, since the university I knew that I needed to go to a specialist, but I had no money.

As soon as I started working, I immediately went to therapy. I asked my friends who they go to. Then I started looking on the Internet. I wrote to several specialists about my problems and immediately clarified that I had depression. Then I was diagnosed with it.

I went to therapy for eight months. The psychologist referred me to a psychotherapist, who gave me medication. Medicines gradually helped to stabilize the condition.

At first it was not clear to me why I left therapy. Over time, I felt that this was because the psychologist devalued one of the problems I came in with. It shattered my confidence. Now I understand this, but then it seemed to me that everything, I had already coped with everything.

It seems to me that the topic of mental well-being is very taboo for men. If you have any problems, you get drunk. Now I see it on my friends.

A person can understand that he has a problem. But he will say: “psychologists are charlatans, I myself know better what to do”, “the best medicine is fishing and moonshine.”

They endure for a long time and then die quickly. There is an attitude that it is a pity and a shame to come to someone and talk about your problems. You need to decide everything yourself.

A lot of things need to change around us for men to start asking for help.

I would continue to go to psychotherapy, but so far I have not managed to find someone. I see value in talking about my condition. Now I do not have suicidal thoughts and some of the anxieties with which I came to therapy.

Want to talk to your loved ones about depression?

We have made a video on how to do it comfortably and safely.

Reprint of CityDog.by materials is possible only with the written permission of the editors. Details here.


how to deal with a sick employee / Habr

"I'm sorry, I think I should have said this earlier - I'm dealing with depression." I received such a letter in the morning from one of the employees, who for a couple of days could not close a simple ticket.

Context: I work as a team leader in a large corporation, subordinate to a remote team of 50 people (territorial spread - from New York to Tokyo). The employee who faced depression is my age (+- 30 years old), has been working at this place for 5 years. One of the best members of the team, consistently showing excellent results, there were no problems with motivation before. The working day is irregular: sometimes thick, sometimes empty.

No, this is not professional burnout. His work has always driven him, he doesn’t want to change anything in it (neither the location, nor the team). "I'm looking for a therapist."

Some dry statistics . According to the World Health Organization, 264 million people worldwide suffer from depression. In severe cases, the disease can lead to suicide: 800,000 people die every year as a result of suicide. Depression and anxiety disorders cost the global economy $1 trillion a year.

Remote work creates additional risks for the development of depression. According to a 2017 UN report, 41% of distributed team members reported “high levels of stress.” For comparison, only 25% of workers in traditional offices experienced this condition.

How are they?

In the United States, a person with a disability (depression is on the list of diseases) is protected by the Americans With Disabilities Act (ADA). The employer in this case is obliged to provide the employee with “acceptable conditions” for his work in the circumstances. For example, he might offer a depressed person a flexible schedule, the opportunity to be away during work hours to see a doctor or group therapy, a quiet workplace, work from home, and so on.

The superiors may ask (or may not ask) a subordinate for a medical certificate with a diagnosis. An employer cannot fire a confessed employee unless he has “objective evidence” that the person cannot do his job or is a danger to others.

At the same time, according to the law, the employer does not have the right to ask the employee if he is sick with something, if he himself did not say. Whether or not to tell your boss about depression is optional. Here is what Ronald Riggio, a professor of psychology at Claremont McKenna College, told me about this topic:0003

“This is a very sensitive issue. In the US, it is illegal to ask about an employee's health status. So the best strategy is to send him to the so-called employee assistance program. Many companies have them (or have a contract with an external agency): within the framework of such a program, a depressed person can receive the help of professional consultants.

How about us?

Do your companies have such "programs"? We have a full-time psychologist, but, frankly, there is about as much trust in him as in a corporate therapist (once I came to him with, as it turned out later, advanced sinusitis, and he dripped vasoconstrictors, they say, “there is no temperature, what else sinusitis). Much more useful is the ability to turn to external specialists with whom the company has a contract. Not for one visit (as many are provided for by VMI), but for the entire period of treatment. In Russia, by the way, there are services with which you can agree on the provision of such services to employees, of course, on an anonymous basis. I won't name it here, it's easy to google.

Unfortunately, most people in Russia do not consider depression to be a serious illness, although in severe cases a person is physically unable to get out of bed. How many sick people get sick leave (and this, by the way, is technically possible)? And this despite the fact that in our country about 8 million people suffer from depression - and these are only those who fall into the field of view of doctors. That is, in fact, there are much more sick people. According to statistics, depression is experienced by approximately 8-12% of the world's population.

3 tips for managers:
  • Don't discount the problem. Comforters in the spirit of "It will pass!", "Do not hang your nose!" and phrases like “Well, not cancer and thank God!” out of place here
  • Offer help. Allow the employee to sometimes work from home (if he is not a remote worker anyway) or change the situation (internship, vacation). If you let an employee go on time off, do not overwhelm him with tasks - let him rest. Do not overload with tasks. Ask an employee what else they can do to help
  • Create a trusting environment in the team so that employees are not afraid to share with the manager the problems that affect the work process. Maintain confidentiality - conversation "between us" should not be leaked

Personally, I told my employee the following:

“You are a great fellow for what you said. In our country, this problem is hushed up, many do not take it seriously, they say something like “Get together, rag!”, “Oh, I also have problems”, “You are mad about fat”, etc. With ARVI, people are on sick leave for a week, and for some reason depression is not considered a reason for taking time off. In general, if we, for our part, can help you with something, speak up. We can try to unload you a little and free you from the N project - you always called it routine. We know you love business trips - would you like to go to M for a conference? We can still try to transfer you to another country, if, of course, there is such a desire.

In response, I received gratitude that the company cares, the latest treatment news (I have already found a specialist and started taking antidepressants) and a couple of very modest wishes regarding the work schedule and tasks.

I am giving a link to the material on the study of the interaction of managers with employees with depression. The main conclusion is that we need to talk.

Top tip for sick employees:

Let the management know about a difficult period in life. It is optional (but possible) to name the diagnosis. Tell us how this may affect the workflow, ask for understanding, it may be worthwhile to outline the approximate time frame that the process of getting out of the situation may take.

Learn more