How do depression, anxiety and bipolar disorder affect work and socializing?

Mental health problems can have a huge impact on lifestyle, affecting employment, socializing and family relationships.

Working and feeling productive provides financial and social benefits as well as a means of structuring and occupying time. But health conditions such as depression, anxiety and bipolar disorder can make it difficult for people to do their jobs or even go to work.

Certain elements of the workplace can also exacerbate depression or anxiety: excessive workload and too much pressure with deadlines and overtime; unsociable hours; an unsupportive working environment; bullying and harassment; lack of or excess responsibility, and lack of job security.

People may be worried about what their boss and colleagues would think if they talk about having conditions like depression, but it can be better to ask for time off to recover, rather than struggling on. If work-related issues are causing stress and making an illness worse, it’s a good idea to let someone in management know about them, or get help from other organizations that offer information and support.

A research study on work and depression found that employees with depression were more likely to become unemployed, find themselves limited in their ability to perform their jobs, and miss time at work. The researchers write, “By any measure, employees with depression did worse than those in the comparison groups.” The researchers believe the reasons for this may be poorer job performance, discrimination, low seniority, difficulty coping with job pressures, and poor quality medical treatment.

Better support from employers and co-workers has been found to be linked to lower depression scores. Researchers say, “supervisor support may have the effect of buffering depressive symptoms.”

Anxiety disorders can also be exacerbated by the work environment. If work starts to feel unfulfilling and negative, then considerable worry can arise. As a result, anxiety about going to work can become quite strong. Social anxiety, or social phobia, can be particularly debilitating at work. The condition is characterized by social withdrawal, caused by a fear of talking in groups, being watched by others, public speaking, and similar situations. People with social anxiety are at high risk of employment difficulties.

Mental health conditions can also impair a person’s ability to socialize normally. Feeling disconnected from other people and feeling a lack of belonging bothers everyone, but anxious or depressed people can be particularly sensitive to these painful social encounters.

In studies, those with depression tend to report more negative than positive social interactions and to react more strongly to them. Experts suggest that depression sensitizes people to everyday experiences of social rejection. A team from Colorado State University found that “depressed people’s social information-processing biases appear to make it less likely that they will perceive cues of acceptance and belonging in social interactions.”

For example, in lab studies, clinically depressed people give more attention to sad faces, adjectives, and emotional words. “Evidence suggests that depressed people often fail in their quest to satisfy their need for belonging in relationships, with potentially severe consequences,” the researchers write, adding, “Depressed people report fewer intimate relationships, and elicit fewer positive, caring responses and more negative, rejecting responses from others.”

The researchers say that clinicians and therapists should recognize that “some part of this bleak, social landscape is created through clients’ interpretations of events,” and help clients “revise and rehabilitate their interpretations.” They should also encourage depressed clients to seek out and achieve positive social interactions, and discuss these interactions, “to help clients capitalize on their experience and further enhance their well-being.”

Bipolar disorder can also have a negative impact on a person’s work, family and social life, beyond the acute phases of the illness. High levels of unemployment are reported by many with bipolar disorder. Relationships within the family are often severely affected, and stigmatization and rejection within the family are important issues. A hostile attitude is often due to misinformation and a lack of understanding.

On the other hand, well-informed, supportive relatives can play a significant role in recovery. Treatment approaches that have benefited individuals include cognitive-behavioral therapy, family-focused therapy and psychoeducation.

Dr. Rodney Elgie of the Global Alliance of Mental Illness Advocacy Networks in Europe says, “There is a real need for better education, information and awareness programs aimed at physicians, family members and the public. This will aid diagnosis, reduce stigmatization and prejudice surrounding the condition, and assist the reintegration of patients into the community.”