Diane Coutu had suffered from depression for most of her life, but the revelation that compelled her to seek treatment occurred, surprisingly enough, in the workplace.
While growing up, Coutu coped with periodic feelings of sadness and hopelessness well enough to become a high achiever—captain of her high school's cheerleading squad, a Rhodes scholar, and a Yale graduate with a degree in literature.
By the time she was working as a reporter for The Wall Street Journal Europe (%22NWS%22), however, the problem had grown to full-fledged clinical depression, a debilitating illness.
Clinical depression is not merely a matter of feeling sad or depressed for a few days and then rebounding. The National Institute of Mental Health describes the illness as having symptoms that can include insomnia or excessive sleeping, overeating or appetite loss, loss of interest in "activities once pleasurable," difficulty concentrating, feelings of worthlessness, fatigue, and decreased energy, and thoughts of suicide or suicide attempts. The poet Emily Dickinson said depression felt like "a funeral in the brain."
"At times, I was unable to do any work or get out of bed," Coutu says. "I don't like to talk about the worst of it. It's a very bleak situation."
Around this time, her boss at WSJE, Norman Pearlstine, asked her to sit down for a talk.
"Norm noticed I was in trouble—I never told him," Coutu recalls. "He said: 'I think you need medical help,' and that if I needed time away, he'd always keep a job open for me so long as he was still with the Journal. It lifted a huge burden from me. And it destigmatized my problems."
With the help of antidepressants and psychoanalysis, Coutu was able to return to an office job a few years later, although by that time she wasn't as interested in reporting. Instead, she got a job as a communications specialist at McKinsey, a global management consulting firm.
When she opened up to her bosses about her depression at her new job, she once again received understanding. "McKinsey is tough and demanding, but it is a company that really stands up for its people," she says. "It was a very humane place to work."
Later, as a senior editor at the Harvard Business Review (and an eventual contributor to its blog at harvardbusiness.org), Coutu made the decision to let on about her depression there, in 1998. "I realized I needed to talk about who I was, and having depression was part of who I was," she explains. "There was a coworker named David I was close to. I told him over dinner that I had depression. He said something like, 'Fine. Are you going to order dessert?' He was unfazed."
Understanding from Colleagues
Likewise, a co-worker named Sarah, who started her job on the same day Coutu did, was understanding when Coutu told her about her depression. "We started out at the same job level, and then she got promoted to management, so I never had to 'come out' to my manager."
On Mar. 13, 2008, Coutu went truly public, by writing about her situation in her blog. She admits in her entry that at times she has regretted the decision to reveal her problems to her colleagues. She worries there will be negative repercussions down the road. Nonetheless, the overall benefits of letting go of the secrecy and isolation have made the disclosure worthwhile, she says.
Mitigating the risk of disclosure was Coutu's ability to keep pulling her weight on the job, depression or no. "I get very stressed out at times—that's part of depression," she says. "So I have my own way of getting work done, and people need to understand that. I do a lot of work at home, and I've made sacrifices in my personal life for my job. But I've always gotten my work done well and finished my projects on time."
She also acknowledges fate's hand in placing understanding co-workers in her path. "I've had so much luck, the sheer luck of meeting Norm Pearlstine and of going to McKinsey and ending up with the manager I have at HBR," she says. "When it comes to depression and the workplace, the smartest thing you can do is to be very lucky."
Indeed, good fortune aided Coutu's decision to disclose her illness. But what about other people with depression, people who don't work at a McKinsey or a Harvard? Should they risk going public with their depression on the job?
Assess the situation before discussing depression with your supervisor and peers
In the 10 years since Diane Coutu came out to her current employer about her clinical depression, the only negative result she has experienced is her own occasional fear that her colleagues will react badly. So far, not one has.
Quite the opposite, Coutu, a senior editor at Harvard Business Review, has found supervisors and peers alike to be sympathetic and understanding. They make no big deal about her illness. And letting go of the secret has lifted a tremendous burden from her emotionally, making her job easier. Still, she concedes that the decision to go public doesn't necessarily make sense for everyone with depression.
"It depends enormously on your employer's character and personality," says Andrew Solomon, author of The Noonday Demon: An Atlas of Depression (Scribner), a personal account of his own struggle with the illness and a study of depression in general. "Lots of people have their own madness, and that makes them uncomfortable with other people's illnesses."
Must Antidepressants Be a Secret?
Misunderstanding of the illness itself contributes to the risk of disclosing it. In her book Medical Myths That Can Kill You (Crown Publishers, 2008), Dr. Nancy Snyderman writes that many people still think of the need for antidepressants as a weakness. "We talk a good game about recognizing depression as a real illness, yet we still think people who suffer from it should be able to just 'buck up,'" Snyderman says. "You the employee really need to think this thing through before you tell your employer."
"If you feel your workplace in general is savage and backstabbing, you may not want to tell people about your depression," says Gabriela Cora, a psychiatrist and MBA who practices at the Florida Neuroscience Center in Fort Lauderdale.
Those who seek and receive successful treatment for a bout of depression aren't necessarily safe from workplace doubt afterward. "If you're up for promotion, there could be the legacy of people wondering, 'Is she going to have another episode?'" Solomon says.
It is not unheard-of for employees to pay the entire cost of their antidepressant drugs themselves, rather than using their company-paid insurance, because they fear their employers will find out about their illness and discriminate against them. "I'd like to be able to say you should always use your employer's insurance, but I don't think it's appropriate in all situations," Solomon says.
Fortunately, however, for those who wish to disclose their depression at work, conditions have been steadily growing better.
For example, Norwegian Prime Minister Kjeli Magne Bondevik's 1998 disclosure that he was leaving office to undergo treatment for depression didn't stop him from serving in the same office again, from 2001 to 2005.
Young people today have a more sophisticated view of conditions such as depression than their parents did. "The new generation is more open about these difficulties in general," Cora says. "Even school kids talk about how 'stressed' they are."
Acceptance of depression as a legitimate illness is also growing. Medical professionals often make an analogy between depression that comes from a chemical imbalance and diabetes, which comes from a lack of insulin. The National Institute of Mental Health says one in five adults in the U.S. will experience a diagnosable mental disorder at some point, and the Americans With Disabilities Act classifies mental illnesses as a category protected from job discrimination.
"Assuming your employer is understanding, it's always better to tell about your depression," says Solomon, noting that if your company provides mental health coverage, there's a better chance you'll get a positive reaction when you disclose your depression.
"A good relationship with your boss is an indicator you can go public," Cora says.
Both Cora and Solomon believe employees who are up-front about their illness give their employers little reason to worry about possible compromised performances. "If someone is open and channels energy into getting help for depression, it's a sign that person is going to be a good employee," Cora says. "Also it's great if people get help early instead of waiting until full-blown depression occurs and debilitates them."