Registration open for 2023 AAPL Annual Leadership Conference in Chicago, Illinois. | Early Bird Pricing
American Association for Physician Leadership
American Association for Physician Leadership

How to Manage an Employee With Depression

by Kristen Bell DeTienne | Jill M. Hooley | Cristian Larrocha | Annsheri Reay

May 12, 2020


Depression is the leading cause of disability worldwide. One in 5 Americans are affected by mental health issues, with depression being the most common problem.

Depression is the leading cause of disability worldwide. One in 5 Americans are affected by mental health issues, with depression being the most common problem.

A recent report by Blue Cross Blue Shield found that depression diagnoses are rising at a faster rate for millennials and teens than for any other generation. All told, the disorder is estimated to cost $44 billion a year in lost productivity in the U.S. alone.

Yet despite this enormous and growing toll, many employers take an ad hoc approach to handling depression among employees. Many managers become aware of mental health issues only when they investigate why a team member is performing poorly. Ideally, employees should feel empowered to report a mental health problem and ask for reasonable accommodations so that their manager can intervene to minimize the damage to the organization and help the employees return as quickly as possible to full health.

Here is a guide for managers on how to negotiate work arrangements for individuals with depression.


It’s often assumed that an employee with depression would first speak with human resources about work accommodations. However, it is also likely that your team member (or one of his or her colleagues) will address the topic with you first.

Because an employee may come to you without warning, you need to prepare ahead of time and learn about depression and its symptoms . These include loss of interest, decreased energy, feelings of low self-esteem, disturbed sleep and poor concentration.

If you understand the symptoms of depression, then you will be able to anticipate work performance issues and the types of accommodations an employee might request.


For many companies, a normal work schedule implies a 9-to-5 workday. However, an employee with depression may come to you and ask to come into the office later in the day. Sleep problems are common in depression and can involve oversleeping as well as difficulties falling or staying asleep. Helping an employee with a work schedule is therefore a reasonable accommodation and is supported by research that suggests flexible work hours actually increase productivity, commitment to the organization and retention.

However, if you allow flexible hours, recent research makes two recommendations. First, if needed, set a window of “core hours” or “core days” in which all team members must be at the office. People dealing with depression benefit from having structure but often find it difficult to create structure for themselves. You can help by facilitating this in a sensitive and responsive manner. Second, don’t let employees with depression stop interacting with you or other team members. Be on the lookout for avoidance behaviors from your employee. Withdrawal only exacerbates the sense of isolation that depressed employees already feel.

When left alone, people with depression are more likely to dwell on the negative effects of the condition. If you suspect that this is happening, check in with the person. What is key here is that you reach out in a supportive and nonjudgmental manner. Research suggests that social relationships at work can act as buffers against depression , and that stronger relationships with managers and peers can lower depression.


Depressed employees may tell you their workload feels too overwhelming or complicated. Consider that depression can affect cognitive function .

As a manager, you can help by breaking up large projects into smaller tasks. The benefit of giving smaller and more manageable tasks is that it allows employees to complete their work faster and therefore experience success more frequently.

Additionally, depression has been associated with a diminished ability to process rewards. The more you, as a manager, can do to reinforce success, the better. Emphasizing people’s small “wins” increases their confidence that they can accomplish future tasks.


By sharing fewer, shorter-term deadlines, you can reduce negative emotions by reducing the input of stressors . Shorter-term deadlines allow employees to see large projects as a set of achievable tasks, which research shows creates higher levels of work adherence and productivity. As noted above, this approach can also facilitate a sense of agency — something that is frequently compromised in the context of depression.


People who are depressed can be highly self-critical. Rather than highlighting failures, focus on supporting and celebrating moments of achievement, such as when employees meet deadlines.

Also consider that motivation in depressed employees plummets in the face of threats and punishment. Research suggests that explaining the positive necessity of assignments as a motivation tool is far more effective than emphasizing the detrimental costs of an unfinished project. Framing assignments in terms of benefits and importance increases their perceived appeal. Remember to check in with your employees regularly and make sure the work assignments match the abilities and talents of your staff.


Coping with a mental illness like depression is difficult, not only for the person with depression but also for those with whom the depressed person interacts. So, you should be attentive to how interacting with a depressed employee might make you feel. Does such a situation make you feel angry, frustrated or powerless? If so, remind yourself that the person with depression is dealing with symptoms that make every day a struggle. This is not about you. This is about how you can demonstrate leadership and help create a positive work environment that results in better outcomes for all your employees.

Copyright 2020 Harvard Business School Publishing Corp. Distributed by The New York Times Syndicate.

Topic: Leadership, Management, Wellness

Kristen Bell DeTienne

Jill M. Hooley

Cristian Larrocha

Annsheri Reay

For over 45 years.

The American Association for Physician Leadership has helped physicians develop their leadership skills through education, career development, thought leadership and community building.

The American Association for Physician Leadership (AAPL) changed its name from the American College of Physician Executives (ACPE) in 2014. We may have changed our name, but we are the same organization that has been serving physician leaders since 1975.


Mail Processing Address
PO Box 96503 I BMB 97493
Washington, DC 20090-6503

Payment Remittance Address
PO Box 745725
Atlanta, GA 30374-5725
(800) 562-8088
(813) 287-8993 Fax



AAPL providers leadership development programs designed to retain valuable team members and improve patient outcomes.

American Association for Physician Leadership®

formerly known as the American College of Physician Executives (ACPE)