Depression and work

How depression can affect work

Depression can affect concentration, memory, energy, decision-making and confidence. Tasks that used to be easy can take much longer. Some people keep working but struggle quietly. Others need time off.

Both are common, and both are valid. What matters is finding a way to recover that works for you, whether that means some changes at work, a period of sick leave, or a gradual return.

Should you tell your employer?

You do not usually have to tell your employer about a mental health condition. It is your choice. There can be good reasons to share, though:

• your employer can only make reasonable adjustments if they know you need support
• it may explain changes in your work or absence
• many employers have support in place, such as an employee assistance programme or occupational health

If you decide to tell someone, you can choose how much to share. You might say you are being treated for depression, or simply that you have a health condition affecting your concentration and energy. You could speak to your line manager, HR, or occupational health.

Acas encourages employers and workers to talk openly and work together on the right support. It may help to think in advance about what would make the biggest difference to you.

Sick leave and fit notes

If you need time off, GOV.UK explains that for absences of 7 days or less you do not need a fit note. You can self-certify instead. The 7 days include weekends and bank holidays.

For longer absences, you need a fit note (Statement of Fitness for Work). Fit notes are free from the NHS and can be issued by:

• doctors, including GPs and hospital doctors
• registered nurses
• occupational therapists
• pharmacists
• physiotherapists

A fit note will say that you are either not fit for work or may be fit for work with some support. If you may be fit for work, the fit note can suggest:

Your employer should talk to you about whether these changes are possible. GOV.UK says that if you cannot agree on the changes, you must be treated as not fit for work.

You can go back to work before your fit note ends if you feel able to, without seeing your healthcare professional again. This guidance applies in England, Scotland and Wales.

Reasonable adjustments

GOV.UK says employers must make reasonable adjustments so that workers with disabilities, or physical or mental health conditions, are not substantially disadvantaged when doing their jobs.

Examples that may help with depression include:

• more flexible hours, or a later start if medication makes mornings hard
• extra rest breaks, as suggested by Acas
• help to prioritise workload, for example a short daily check-in with a manager
• a quieter place to work, or a regular desk instead of hot-desking
• time off for medical or therapy appointments
• a phased return after sickness absence
• temporarily passing some tasks to colleagues

There are no fixed rules about what is reasonable. It depends on your job and your employer’s circumstances. The best adjustments are usually worked out together.

When depression counts as a disability

Under the Equality Act 2010, which covers England, Scotland and Wales, you are disabled if you have a physical or mental impairment that has a substantial and long-term negative effect on your ability to do normal daily activities.

• Substantial means more than minor or trivial.
• Long-term means it has lasted, or is likely to last, 12 months or more.

Depression can meet this definition, particularly if it is long-lasting or keeps coming back. If it does, you are protected from disability discrimination, and your employer has a legal duty to make reasonable adjustments. You do not need to call yourself disabled to ask for support, and many employers make adjustments either way.

In Northern Ireland, disability discrimination law is different. nidirect has guidance on mental health and work, and the Labour Relations Agency can advise.

Access to Work

Access to Work is a government scheme that can help you get or stay in work if you have a physical or mental health condition or disability. GOV.UK says you must:

• be 16 or over
• be in paid work, or about to start or return to paid work within 12 weeks
• live and work in England, Scotland or Wales

Northern Ireland has a separate system.

Mental health support

Access to Work offers a mental health support service. GOV.UK says it can provide one-to-one sessions with a mental health professional and a tailored plan to help you get or stay in work. You apply directly to one of two providers named on GOV.UK, Able Futures or Maximus, and you can only use one. GOV.UK also notes that if you have had mental health support through Access to Work before, you cannot apply again.

Access to Work grants do not affect other benefits and do not have to be paid back. They do not pay for reasonable adjustments, which remain your employer’s responsibility.

Returning to work

Going back after time off with depression can feel daunting. Some things that can help:

• Keep in touch with your employer while off, in a way and at a frequency that suits you.
• Plan the return together. A meeting before you go back can agree hours, duties and support.
• Use the fit note. Ask your GP or other clinician whether a phased return or amended duties would help.
• Consider occupational health, if your employer has it, for independent advice on adjustments.
• Review regularly. nidirect suggests more frequent catch-ups and workload reviews after a return.
• Keep up treatment. Don’t stop medication or therapy just because you are back at work.

Burnout or depression?

Burnout is often used to describe feeling worn out by work. The World Health Organization describes burn-out as a result of chronic workplace stress that has not been successfully managed. It is classed as an occupational phenomenon, not a medical condition. It has three features: exhaustion, feeling mentally distant or cynical about your job, and feeling less effective at work.

Burnout and depression can look similar, and they can overlap. These general differences are often described, but they are not a diagnostic test:

If low mood, loss of enjoyment or hopelessness spread beyond work, or last more than 2 weeks, speak to a GP. See symptoms of depression. Whatever the label, you deserve support.

Read about treatment for depression and self-help for more ways to support your recovery.