The three major factors that lead to depression
Psychological Health

The three major factors that lead to depression
31% of the total absence and productivity losses are accounted for by depression and stress

Our work usually shapes our daily routine, affecting how we socialise, who we meet, and what we accomplish throughout the day. If an employee is depressed at work, it will not only impair their performance and mood, but often that of their co-workers as well.

Depressed employees are known to have lower productivity and increased absenteeism. A recent study showed that employees with clinical depression had 4 times greater work limitations and 2.5 times greater absences when compared to their peers¹. Depression and stress together account for 31% of the total absence and productivity losses experienced by employees, making it a major preventable risk in terms of performance for the company².

Moreover, the costs incurred by the company are fairly high; employees who are suffering from depression can cost their employers $44 billion per year due to lost productivity as documented by the Journal of the American Medical Association³. That’s nearly $300 for every member of the US labour force.

In order to deal effectively with depression in the workplace, companies and employees need to understand the underlying causes and mechanism of depression. Forty years ago, Dr George Engel changed the way depression was perceived and treated by introducing the Biopsychosocial Model.

As the name depicts, the model suggests that depression is caused by a myriad of biological, psychological, and social factors.

Engel initiated the transition from the biological model to the Biopsychosocial Model, insisting that complex conditions like depression cannot be treated through a one-dimensional model, and that a more dynamic and complex model is required⁴.

Depression v0.1

Previously, most psychologists considered the mind and the body to be independent entities, which is clearly not true. Both are highly interconnected and interdependent. What affects one will often impact the other, just as depressed employees can impact the mood of their co-workers.

Biological factors such as genetics and disease can lead to depression. A person with a physical illness or disability is more likely to develop depression over the course of the disease. Moreover, research shows that some genes are known to increase predisposition to depression, so it can run in families⁵!

Psychological factors can increase vulnerability as well. Some people are able to cope with trauma, stress, and change quite easily while others cannot. The coping skills of an individual can determine their chances of developing depression, an individual who cannot cope with, or adapt to stress, is more likely to develop depression in the long run. Similarly, confidence levels and emotional intelligence (the ability to deal with and express emotions) can play a role too⁶.

The link between stress and depression is interesting. The graph below shows the Stress and Depression scores for a group of nearly 10,000 participants from the Generation Scotland study.

Although there is a weak trend for increasing stress to be accompanied by increasing depression (the red “line of best fit”), there are a significant number of people with a high depression/low stress profile (blue box) and low depression/high stress profile (green box). The two are related, but the relationship is quite weak.

Last but not the least; social factors such as a loss of loved one, dysfunctional families, bullying at work or school, or lack of social support, can trigger the onset of depression. Especially if an individual is already genetically predisposed to depression and does not have the required coping skills, a social stressor or trauma can be the final straw.

The Biopsychosocial model suggests that biological, psychological and social factors are highly interdependent and can influence each other to cause depression. In order to understand and deal with depression, all factors that can trigger it need to be taken into consideration.

Mental health has evolved to be a critical issue at the workplace, which is why SHAPE uses the globally validated and highly reliable DASS (Depression, Anxiety and Stress Survey) in the Psychological Health explorer. Managers may also consider the Psychological Safety Climate of the organisation (The PSC-22 in the SHAPE Survey) and plan to evolve the culture of the company towards a psychologically low risk environment. Individuals suffering from stress or depression are also given recommendations and insights on effective coping strategies to deal with any mental health issues faced.

__¹__Lerner, Debra et al. American journal of health promotion : AJHP vol. 24,3 (2010): 205-13. doi:10.4278/ajhp.090313-QUAN-103

__²__Goetzel, R., et al. (2004). J. Occ. Env. Med., 46, 398-412.

__³__Stewart, Walter F. Jama, vol. 289, no. 23, 2003, p. 3135., doi:10.1001/jama.289.23.3135.

__⁴__Fava, Giovanni A., and Nicoletta Sonino. Psychotherapy and Psychosomatics, vol. 86, no. 5, 2017, pp. 257–259., doi:10.1159/000478808.

__⁵__Shadrina, Maria et al. Frontiers in psychiatry vol. 9 334. 23 Jul. 2018, doi:10.3389/fpsyt.2018.00334

__⁶__Garcia-Toro, et al. Medical Hypotheses, vol. 68, no. 3, 2007, pp. 683–691., doi:10.1016/j.mehy.2006.02.049.

Psychological Health