Seasonal Affective Disorder and the Healthy Workplace
This is the time of year when we tend to see a lot of glib reminders about the effects of Seasonal Affective Disorder (SAD). Some authors even tie “leadership by example opportunities” (Iste, 2017) to the disorder. Most of these reminders seem to be compassionate and certainly well-meaning reminders about this phenomenon, and that there are considerable numbers of individuals among us (especially those of us who live above the 37th. parallel) who are affected by this disorder.
Unfortunately, most of these shiny, graphic-laden (but still pithy) reminders do not seem to place enough emphasis on the real culprit lurking behind SAD: depression. While the cause of this particular type of depression may allow us to be tempted to deal with it in a rather glib manner (e.g. “it is just transitory--therefore it doesn’t really count as depression”), the reality of living with any kind of depression (even in “just” the winter months) is a quite a different manner. Unfortunately living with depression can be seriously debilitating and this type of mental challenge is often grossly misunderstood.
According to the DSM-V (APA, 2013), the symptoms of depression include at least five of the following nine symptoms which are present nearly everyday:
1. Depressed mood or irritable most of the day: (either because the person states that they are sad or depressed or others notice this)
2. Decreased interest or desire for pleasure: in most activities, most of the day, every day
3. Significant weight change or change in appetite: often seen as a 5% or more difference in weight, skipping meals or eating much less at meals
4. Change in sleep patterns: which can include difficulty getting to sleep, staying asleep, or too much sleep and difficulty getting out of bed
5. Change in activity: sometimes observed as restless behaviors, fidgeting, or a significant slowing down of activity
6. Fatigue: or complaint of a loss of energy
7. Guilt/worthlessness: the individual expresses feelings of irrational worthlessness or an excessive or inappropriate guilt
8. Concentration difficulties: often accompanied by a diminished ability to think, concentrate, make decisions, be efficient and complete work correctly
9. Suicidality: thoughts of death or suicide or an actual suicide plan
SAD is more likely to affect individuals who live above the 37th. Parallel, and the farther north you live, the more likely you are to suffer from Seasonal Affective Disorder (Johnson, 2010). Seasonal Affective Disorder is related to Vitamin D deficiency and in areas like our Pacific Northwest we have a significantly increased risk and prevalence of SAD than in other areas of the United States. Vitamin D (or cholecalciferol) is made naturally by our bodies when our skin is exposed to sunlight. Vitamin D is utilized for multiple functions in our bodies such as calcium regulation, bone health, lung health, immune system regulation, and cancer inhibition, but probably most noticeable in the workplace is mood regulation.
Researchers have suggested that Vitamin D stays in our bodies for about three weeks after it has been “made” (Garland, 2003). Anecdotally, for the almost two decades in which I worked as a psychotherapist in Seattle, I would notice a significant increase of individuals coming into my office complaining of depression during the last two weeks of November and the first two weeks of December. For years I misattributed this occurrence to difficulties with the holidays. When I learned about the importance of Vitamin D and the effect it has on mood, I began asking my clients to have their doctors test them for Vitamin D deficiency. Eventually, a physician with whom I worked asked me to stop asking my clients to do this as insurance companies would no longer pay for tests for Vitamin D deficiency in Seattle because the tests “almost always come back as being positive.”
The good news is that Vitamin D supplementation is a very easy way to address Vitamin D deficiency and often eliminates many of the symptoms of SAD. Some researchers suggest that most people who live in Seattle should probably be taking a Vitamin D supplement during the winter to help avoid mental illness symptoms (Cannell, 2008). However, individuals should always check with their primary care physician before taking any vitamin supplement.
The unfortunate reality is that women are diagnosed with SAD nearly four times as often as men (Melrose, 2015) and, according to the US Department of Health and Human Services (2005) SAD also disproportionately affects individuals with darker skin tones. Ironically, these are the same populations that tend to be at greater risk due to inequitable social practices.
What can be done in the workplace?
It is strongly inadvisable (not to mention illegal) for workplace leaders and managers to attempt to “play doctor” and start diagnosing employees with specific mental health diagnoses. However, many of the classic HR admonishments to “refer the employee to the EAP (Employee Assistance Program)” may simply not be effective enough (especially if the employee chooses not to visit the EAP).
I am proposing that a more effective solution may be found in standard HR practices that sometimes tend to go unfollowed or devalued in busy companies. Take a moment and humor me and scroll back up to the list of nine criteria for Depression. Now, think of specific ways that an employee’s work in your organization might be affected if the employee was navigating any one (not to mention five) of these symptoms. I suspect that most of us would be able to develop a rather significant list of concrete behaviors (or lack of behaviors) which could then be connected to the specific requirements of a job description.
One of the best ways that companies can maintain a healthy and productive environment for its workers with both treated and untreated mental health challenges is by creating and maintaining a ROBUST performance management system. In particular, at 2Human Strategies, we strongly favor performance management practices that focus specifically on employee strengths.
An effective performance management system is comprised of a couple of crucial components. First of all, consistent manager observation and subsequent documentation. Without regular observation and documentation managers and evaluators are subject to a few types of bias that virtually eliminate the validity and reliability of a performance evaluation. By following a robust performance management system, most of these biases can be eliminated. Secondly, and just as importantly, employees need to be given feedback on their performance on a relatively frequent basis. This will not only help employees and managers identify potential problems, but will also reinforce desired behavior/performance and assist in the employee’s professional development.
By following these classic--and necessary--HR practices related to performance evaluations, it will be much easier for managers and leaders to identify behavioral (and sometimes seasonal) indicators that something is wrong. It is not only rude, but also illegal for a manager to make a statement such as, “I think you have Seasonal Affective Disorder, you should go get that treated.” It may, however, be appropriate for the manager to observe performance with the employee and state, “The data here indicates that for the last three years your performance has dipped in January and then we see a significant improvement in March. What are your thoughts about what is going on here?” Quite often an employee will bring up symptoms that are associated with SAD. At this point, it would be appropriate for a manager to express compassion and concern (without diagnosing!) and recommend a visit to an EAP. Because this conversation occurred within a constructive discipline context (e.g. coaching), the employee may be more willing to seek, and follow through with, getting assistance.
At 2Human Strategies, we are excited about helping companies create a performance management system that not only works for their employees but has the potential to help the company increase its bottom line by increasing employee mental health, satisfaction, and productivity. Please contact us for more information.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Cannell J. (2008). Vitamin D and Mental Illness. [whitepaper] Retrieved from http://www.vitamindcouncil.org/mentalillness.shtml.
Garland, C. (2003). Sun avoidance will increase incidence of cancers overall. British Medical Journal, 327.
Hoffman, R. (2010). What lies behind the vitamin D revolution? The Clinical Advisor: For Nurse Practitioners, 13(3), 31-37.
Iste, C. (2017). 3 ways understanding SAD makes you a better leader. Multibriefs:Exclusive [white page] Retrieved from: http://exclusive.multibriefs.com/content/3-ways-understanding-sad-makes-you-a-better-leader/business-management-services-risk-management
Johnson, L. (2010). Vitamin D Insufficiency Due to Insufficient Exposure to Sunlight and Related Pathology. Inquiries Journal 2(12).
Melrose, S. (2015). Seasonal affective disorder: An overview of assessment and treatment approaches. Depression Research and Treatment. Vol. 2015.
U.S. Department of Health and Human Services (2005). Dietary Guidelines for Americans. 19, 20.