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Why Employers Should Care about Depression

Depressive illnesses, including major depression and bipolar disorder, are highly prevalent in the United States, affecting nearly one in five adults at some point in their life (1). These conditions are also among the top five causes of disability globally (2), and depression ranks as the #1 contributor to disability in the U.S. and Canada. An estimated 6.7% of adults in the U.S. had at least one major depressive episode in the past year (3). Depression is one of the most costly health conditions for American employers (4). The annual cost of depression in the U.S. is estimated at $210.5 billion, with approximately 45% attributable to direct costs, 5% to suicide-related costs, and 50% to workplace costs (5). A majority of these workplace costs are due to lost productivity in the workplace from both absenteeism (missed days of work) and "presenteeism" (reduced productivity at work). Presenteeism represents nearly 75% of workplace costs and 37% of the overall economic burden of depression (5).

Effective treatment has been shown to not only reduce depressive symptoms for workers but also improve workplace outcomes, such as employee retention and productivity. Unfortunately, many employment policies regarding depressive disorders and chronic health conditions, in general, are not informed by clinical understandings of these conditions and the role that employment can play in helping improve recovery.

Studies have shown that workers who return to work soon after depressive episodes have better outcomes than those on long-term disability leave. Employer policies that limit voluntary leave-time may also promote presenteeism by forcing workers with depression to come to work even when this could hamper their treatment plan. Employers may also feel constrained by litigation concerns, and adopt policies that discourage employees from seeking treatment for depressive disorders.

Finally, employers can act as a strategic resource for addressing (or, unfortunately, unintentionally promoting) stigma associated with depressive disorders by their policies regarding returning to work following an episode.


  1. Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve‐month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International journal of methods in psychiatric research, 21(3), 169-184.
  2. Whiteford, H. A., Ferrari, A. J., Degenhardt, L., Feigin, V., & Vos, T. (2015). The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PloS one, 10(2), e0116820.
  3. SAMHSA. (2015). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
  4. Birnbaum, H. G., Kessler, R. C., Kelley, D., Ben‐Hamadi, R., Joish, V. N., & Greenberg, P. E. (2010). Employer burden of mild, moderate, and severe major depressive disorder: mental health services utilization and costs, and work performance. Depression and anxiety, 27(1), 78-89.
  5. Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). The Journal of clinical psychiatry, 76(2), 1-478.