Depression, women, and the workplace.

Depression is a highly prevalent disorder that causes much personal distress and difficulties in functioning at home and in the workplace. In the workplace, as elsewhere, depression can manifest as a variation in normal mood, as a symptom, as a disorder, or as a disease. Occupational health professionals are more concerned with clinical depression, a term used to signify any type of depression that causes significant personal distress and/or problems in functioning. Clinical depression is manifest in the workplace and adversely affects the employee's work satisfaction and performance. For most types of depression, women are at a higher risk than men. A number of events and variables related to women and depression were reviewed. Although the effects of some of these events, such as menopause, can be manifest in the workplace, they are not associated with an increased incidence of clinical depression. Other events, such as victimization (e.g., childhood sexual abuse or battering by an intimate partner), are associated with higher risks of depression in women. Women derive substantial satisfaction from interpersonal relationships but also are at greater risk for depression when strains and conflicts in these relationships occur. In the workplace women who have no difficulty in arranging for child care and whose spouses share in the care of children show lower rates of depression. When marriages are unhappy, women are three times as likely as men to be depressed. These findings speak to the importance of relationships to women. In the workplace, when women are depressed, problems with relationships are likely to be involved. Clinically depressed women are not difficult to identify in work settings. Dejected mood and loss of interest in usual activities are noticeable, along with numerous other symptoms that accompany depression. The effective treatment of depression depends on careful diagnosis and assessment. Both drug therapy and the more structured psychotherapies, such as cognitive-behavioral and interpersonal therapy, have demonstrated effectiveness in treating depression. For mild depression, pharmacotherapy is likely to be the treatment of choice. In cases in which the depressive symptomatology is moderate to severe, a combination of drug therapy and psychotherapy is likely to be the most effective treatment and to provide the best prophylaxis. Drug therapy seems particularly effective in promoting rapid reduction of vegetative and physical symptoms. Psychotherapy enhances coping skills at home and at work and also focuses on problem-solving, relationship difficulties, and dealing with stressors. In the area of prevention, occupational health practitioners currently can have the greatest impact in secondary prevention.(ABSTRACT TRUNCATED AT 400 WORDS)