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When a serious mental health disorder such as major depressive disorder has led to impairment, the ability to function on the job is significantly hindered. Depression can cause debilitating symptoms that interfere with cognitive and physical functioning and the capacity to cope with job stress. Someone struggling with depression may arrive at the conclusion that taking a break from work is the only plausible solution.
Requesting a medical leave for depression treatment and rehabilitation is a viable option for many. There needs to be a coordinated effort between employee and employer to access health benefits offered by the Family and Medical Leave Act and other sources of support available for the employee. Navigating the system can be challenging, so it helps to understand the steps that make the process go smoothly.
What Are the Signs of Serious Depression?
Depression is the second most common mental health disorder experienced by Americans. According to the National Institute of Mental Health, over 17 million Americans are afflicted with this condition each year. The effects of depression are costly to the overall economy, with an estimated cost of tens of billions of dollars annually. Most of this cost is due to the lost work productivity associated with absenteeism and impaired work performance.
Depression comes in several different forms, each with unique features. Treatment for depression will be based on which particular type of depressive disorder is presenting. The types of depressive disorder include:
Major depressive disorder
MDD is the most commonly diagnosed type of depressive disorder. A diagnosis of MDD involves five or more of the following symptoms for two weeks or longer:
- Persistent feelings of sadness, despair, or emptiness
- Feelings of guilt or worthlessness
- Loss of interest in activities once enjoyed
- Difficulty making decisions or concentrating
- Sleep disturbances
- Changes in eating habits, weight changes
- Thoughts of suicide or death
Dysthymia, or persistent depressive disorder, is a type of depression that persists for more than two years. Someone with dysthymia may experience periods of severe depression alternating with periods of milder depression symptoms lasting for more than two years.
Postpartum depression is a type of depression a woman experiences during or after giving birth. The symptoms may be so severe that the mother is unable to care for her child or for herself. They may experience severe fatigue, exhaustion, anger, and anxiety in addition to the intense sadness.
Premenstrual dysphoric disorder
PMDD is related to a woman’s hormonal cycle, and features severe PMS symptoms, such as angry outbursts, hopelessness, irritability, hypersomnia, excessive crying, and being hypersensitive.
Seasonal affective disorder
Climates further from the equator may lead to depression symptoms caused by a lack of sun exposure during the winter months. The individual may experience the symptoms of sleeping too much, weight gain, and isolation behaviors in addition to other depression symptoms.
This type of depressive disorder features alternating dramatic and unpredictable shifts between depressive and manic moods. The low mood episodes are classified as bipolar depression
On rare occasions signs emerge that depression has become a psychiatric crisis. When the individual’s symptoms appear to have deteriorated, the following signs would constitute grounds for hospitalization:
- Becoming incommunicative, catatonic
- Extreme mood swings
- Cognitive impairment
- Unable to function at even basic daily tasks
- Aggressive or violent behaviors
- Psychotic symptoms, such as paranoia, hallucinations, or delusions
- Neglects personal hygiene
- Not eating or sleeping normally
- Threatening suicide
When some of these signs are present it is important to discuss a voluntary mental health admission so they can receive acute stabilization assistance.
What Steps Should You Take to Prepare for a Medical Leave for Depression?
When you approach your employer to request an accommodation, such as a medical leave of absence, it is important that you have taken the proper steps that bring you to this juncture. If you are seeking just a short period of time off, there is no need to go into detail about the mental health disorder. In this case, you will appeal to management to arrange for a couple of weeks off to get some rest and therapy.
However, when requesting an extended leave, up to 12 weeks duration, there will be a need to provide documentation regarding the illness. You will need to show that you are being treated for the depression and for the mental health records to be forwarded to the company’s disability insurance provider. It is important to note that there are limitations on the FMLA eligibility. The Act applies to companies with 50 or more employees and that you have worked at least 1250 hours in the past month to qualify.
Can You Be Discriminated Against if you take a Medical Leave for Depression
Fortunately, laws are in place to protected leave employees from repercussions should they need to take a medical leave for a mental health issue. The Americans with Disabilities Act offers legal protections against discrimination in the workplace due to a mental health disorder like depression. The ADA defines a disability as “a physical or mental impairment that substantially limits one or more major life activities.”
Under the terms of the law, employers are prohibited from requiring employees to disclose the nature of their disability. However, in order to qualify for the accommodation request, the employee will have to share their medical records, although the information related to the depression diagnosis must be kept confidential.
What Types of Leave Are Available?
When time off is needed to meet the needs of a serious mental health event there are some avenues to explore. In addition to asking for the medical leave for depression reasons, consider these options that may offer protections and even some paid benefits:
Family and Medical Leave Act
The Family and Medical Leave Act (FMLA) is a federal program that allows employees up to 12 weeks of unpaid leave from work to obtain treatment for a medical or mental health condition. The law protects your job until you return from the leave, ensuring that your job or an equivalent job is waiting for you.
Paid leave from employer benefits
Some employers offer short-term disability benefits that will pay a portion of your income why you are on the medical leave for depression. Others may offer a certain number of paid time off days in the form of vacation pay or sick days.
State disability insurance
Some states deduct disability insurance premiums out of the paycheck to cover short-term leaves for mental health purposes. In California Assembly Bill 402 passed in 2014 providing coverage for severe mental illness.
Social Security Disability
Section 12 of the SSA Blue Book is dedicated to mental health disorders. To qualify for benefits you will have to show you meet the criteria, such as providing medical documentation that you are undergoing treatment for the depression.
While on a medical leave for depression you may continue to receive the outpatient care or you may decide to shift to a higher level of care. A residential depression treatment program will provide a much more intensive approach. The residential mental health center offers continual monitoring and support, as well as a wide range of therapeutic activities.
The psychiatric hospital provides the highest level of care, with acute stabilization services, 24-hour monitoring, medical care, and intensive psychiatric treatment. These facilities may be a state psychiatric hospital, a private psychiatric hospital, or a general hospital with a designated psychiatric floor.
Treatment of major depressive disorder follows a specific protocol involving antidepressants and psychotherapy:
Antidepressants. Medication remains the first line treatment for severe depression. There are four categories of antidepressants on the market, including SSRIs, SNRIs, tricyclic antidepressants, and MAOIs. With about 30 different antidepressants available, the doctor will attempt to select the one that is best aligned for the patient’s specific diagnosis. There are various types of depressive disorders and each one may correspond to a particular type of antidepressant. Generally, antidepressants take about 4 weeks to begin alleviating the depression symptoms. It is common for a patient to trial 2 or 3 drugs before finding the right fit with the least side effects.
Psychotherapy. Psychotherapy is prescribed in tandem with the antidepressant drug therapy to provide an opportunity for the patient to work through any contributing emotional or psychological issues, such as grief and loss, a history of trauma or abuse, or relationship struggles. A therapist often uses cognitive behavioral therapy (CBT) in depression treatment, as this type of short-term therapy can help patients reshape their thought patterns toward more positive self-messaging.
Complementary Therapies for Depression
Complementary therapies can enhance the effects of the traditional therapies by helping the individual achieve a more relaxed and peaceful state of mind. Residential programs now routinely add holistic therapies to the treatment plan, such as mindfulness meditation, yoga, acupuncture, massage, gardening therapy, equine therapy, mental health retreats, and art therapy.
Other self-care measures that can be focused on during a medical leave include:
- Improving sleep quality
- Getting regular exercise
- Shifting to a healthy diet
Although depression is very difficult to experience, it is manageable with intensive and targeted treatment combined with some important lifestyle tweaks.
Mental Health Hope Guidance for Depression Treatment
Mental Health Hope is an online resource that specializes in providing free information and treatment options for mental health disorders, including major depressive disorder. When battling depression that prevents you from functioning at your job, you will need comprehensive depression treatment. Reach out to the compassionate and knowledgeable team at Mental Health Hope for guidance about finding help for depression. Call us today at (877) 967-9274.