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Depression is an illness that involves feelings of sadness lasting for two weeks or longer, often accompanied by a loss of interest in life, hopelessness, and decreased energy. Such distressing feelings can affect one's ability to perform the usual tasks and activities of daily living. This is considered to be clinical depression. It is very different from a temporary case of "the blues" triggered by an unhappy event or stressful situation. Depression affects the mind, but this does not mean "it's all in your head."
Depression is a medical illness linked to changes in the biochemistry of the brain. Depression is not a weakness of character. Being depressed does not mean a person is inadequate. It means the person has a medical illness that is just as real as diabetes or ulcers. Like other medical disorders, clinical depression should not be ignored or dismissed. A clinically depressed person cannot simply "snap out of it" any more than a person with an ulcer could simply will it away.
JAN's Accommodation Solutions: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.
Depression and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Depression
People with depression may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with depression will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
An employee with major depression and bipolar disorder was having difficulties working in a busy central banking office.
He needed to manage a large staff of workers, provide customer service, and oversee the daily office management. As an accommodation he requested and received a transfer to a smaller and less busy branch office. The employee maintained his salary and the responsibilities of his leadership role.
A county employee who works in the property records room has bouts of depression that are intensified when he is busy, under deadlines, and has frequent interruptions.
He then finds it difficult to concentrate and get his work completed. The employer rescheduled a part-time worker to help during the busy times, allowing the employee to go to a specified desk behind a partition where he could concentrate more fully on the records he was responsible for.
A guidance counselor for a large high school experienced severe bouts of irritable bowel syndrome, depression, and fatigue as a result of fibromyalgia.
He experienced difficulty in opening the heavy doors to the entrance of the school and had to make frequent trips to the bathroom. The individual's employer complained that he was spending too much of his time away from his office and therefore was not available for students. The employer moved the employee's office to a location closer to the faculty restroom, added an automatic entry system to the main doors, and allowed flexible leave time so the employee could keep appointments with his therapist.
Jude, an applicant with a depression and anxiety, is applying for a customer service position that requires a pre-employment test.
Due to medication that Jude takes for both conditions, his processing speed is a bit slower. He feels he can only do his best on the test if he has the accommodations of extended time as well as taking the test in a private location to help limit distractions. In order for the employer to even consider those accommodations, the employee will need to disclose the mental health impairments and be prepared to provide medical documentation.
A customer service representative working in a call center was experiencing limitations associated with generalized anxiety disorder and depression.
He began treatment with a new healthcare provider who adjusted his medications and recommended bi-weekly counseling sessions for one month. He exhausted his accrued paid sick leave but was FMLA eligible. He applied FMLA leave intermittently in order to attend counseling appointments.
A construction worker had Huntington’s disease related depression.
He requested ADA leave to get treatment and a reduced work schedule when he returned back to work, he was accommodated with leave and a modified schedule.
A middle school teacher with chronic depression asks for the accommodation of leave one afternoon a week for a sixteen-week period so she can attend an intensive out-patient therapy program recommended by her mental health practitioner.
The physician feels this treatment is necessary to prevent a depressive episode requiring further leave. Her employer finds no hardship in providing her with a substitute for those sixteen afternoons and provides the requested accommodation.
A driver with seasonal affective disorder (SAD) who picks up and delivers clients to various appointments began to forget waiting clients as well as the routes she needed to travel in order to deliver them to the appropriate facility.
When her employer mentioned the mistakes, the driver broke down. She described her depression and anxiety with the change of seasons and how it affected her memory. The use of reminder apps, as well as those to help with directions, were discussed as possible accommodation solutions.
An employee returning to work after a stroke was dealing with depression.
As a result, the employee’s performance was impaired and the previous supervisory method was no longer effective. The supervisor agreed to meet with the employee weekly to discuss performance and conduct issues that were becoming problematic, as well as put accommodations into place. Among the accommodations: a flexible schedule for health care appointments, a diagram to help with the flow of duties, templates to assist in report writing, and a move to an area with more natural lighting.
An employer, trying to accommodate an employee returning to work after a leave, had questions about the stress of required travel that escalated the employee’s depression and anxiety.
The employer was advised to continue on in the interactive process to discover what specifically about the travel was stressful so they could determine accommodations for those identified issues. Examples of questions to ask could include what particularly about the travel causes the stress that heightens the depression, such as the length of the travel, the distance, the planning process, or even specific modes of travel and/or locations.
An employee voluntarily admitted herself to a hospital inpatient unit due to severe depression.
Her mother called the employer to let them know what had happened and to tell them her return date was uncertain at that time. The employer provided leave under the ADA for the employee and requested her mother to keep them informed about the employee’s progress and possible return to work date.
A grocery store bagger with seasonable affective disorder (SAD) had difficulty working an early schedule due to oversleeping.
She also experienced fatigue and depression during late fall and winter months. She was accommodated with an afternoon schedule and was moved to the front of the store, which had windows that let sunlight enter her workspace.
An electrician with severe depression needed to attend periodic licensure trainings.
The person had difficulty taking effective notes and paying attention in the meetings. The individual was accommodated with notes from remote Communication Access Realtime Translation (CART) service.
JAN Publications & Articles Regarding Depression
Accommodation and Compliance Series
Consultants' Corner Articles
- Cognitive Impairment and the Interactive Process
- I Understand You Are Stressed...But Aren’t We All?
- Postpartum Depression
- Return to Work After Hospitalization for Mental Health Treatment
- Suicidal Ideation in the Workplace
- Supporting Employees with Mental Health and Cognitive Conditions while Teleworking
- When Support Persons Hamper the Process They were Brought in to Facilitate