By Hara Estroff Marano, published on December 1, 2003 - last reviewed on June 30, 2005
Depression is a major mental health issue in America. But it
is also, increasingly, a major workplace issue. A landmark 2003 study
draws the sobering conclusion that depression costs employers $44
billion a year in lost productivity alone. Those are strictly indirect
costs; they don’t even begin to reflect medical costs.
The vast majority of that $44 billion loss in productivity
comes not from absenteeism due to the disorder. It’s the product
of so-called presenteeism, the many people with depression showing up
for work but not functioning at anywhere near full
capacity—failing to return phone calls, turning in poor-quality
work, missing deadlines altogether, not following up on new business
leads, being paralyzed with indecision, inability to face work at all,
coming in late, leaving early, or not even returning from lunch,
difficulty getting along with coworkers, withdrawing from the social
environment at work.
Absenteeism, presenteeism, $44 billion—these are all
abstractions. Depression, however, always wears a human face—the
face of Mary Jo West, for example. A broadcast journalist, West became
the first TV anchorwoman in Phoenix, in 1976. She produced
award-winning features. She was a celebrity around town, instantly
recognizable to everyone. Within a year, the pressure of breaking
barriers along with her perfectionist professionalism collided with a
deep vein of vulnerability.
West’s story is perhaps unusual because of the
visibility. But in many ways it is business at its most usual.
Depression affects 5 million American working women—21 percent of
women in the workplace.
Shortly after college, I began working for KOOL Television, a CBS
affiliate that was the number one station in Phoenix. In 1976, the
longtime solo anchor—who had one of the highest ratings in the
country, because his time slot was right after Walter Cronkite—was
suddenly told that this young blonde woman was going to sit next to him.
There was hell for me to pay. He made my life difficult. For six years I
sat next to a man who despised my being next to him. At an anniversary
party a couple of months ago he even admitted, “I didn’t need
her; I had a fifty share!” I don’t think he ever got over it.
But when I left, he said goodbye to me on the air: “This is the
hardest-working person I’ve ever met, and she’s earned my
I was very visible. When Arizona State University did a survey
asking: “What person do you trust most in TV news?” Walter
Cronkite came in first, and I came in second. I was so proud of that,
because I was everywhere, doing a lot of groundbreaking work. I did a
series on rape in which my co-anchor didn’t even want to say the
word, because he didn’t like it. I actually went into a prison and
interviewed rapists, something that had never been done before. I did the
first series on incest, the first on domestic violence.
In 1980, satellite technology evolved to the point where a local
anchor could cover a national story and send back reports. I was sent
with a cameraperson to the Democratic Convention in Detroit. That was
exciting. But because the station was trying to get the biggest bang for
its buck, I was asked to feed reports to KOOL radio as well as to KOOL TV
several times a day, including late at night and early in the morning. I
was working against a three-hour time difference. The only way to get
everything done was not sleep.
Perhaps another person in a different mindset might have said this
was a little too much. But I didn’t know how to tell them no. And
then the same thing repeated itself two weeks later when we went to
Madison Square Garden in New York, when Reagan was anointed.
Terrible things happen as a result of sleep deprivation. It kicked
off the only episode of mania I ever had. It was a nightmare. I got back
to Phoenix, left my husband and lived in the Biltmore Hotel. From
September through November, I was a totally different person in a totally
different lifestyle. It was frightening, not only for me but for my
colleagues. I went from being this girl from Georgia who was very Baptist
to a kind of wild woman. I bought another house. Sometimes I was driving
around at 4 a.m. and getting to see a whole other side of Phoenix. I
remember meeting new friends at 4 am at a coffee shop.
To this day, when I run into people who were in my life during that
time, I feel great shame. The other day, a woman said, “Mary Jo, I
remember you were kind of living out of your car, we were riding at 1,000
miles an hour, you opened up your trunk and there were all these clothes
there. We just didn’t know what to do with you. We’re just so
glad you survived.”
At the same time I was anchoring three newscasts a day. When the
red light went on, I was totally professional. The mania gave me energy
and ideas, some of which were good and some of which were off the wall. I
was having delusions. I had done a series with the Air Force. I thought
they were spying on me. My work in some ways was suffering. I remember
putting together a behind-the-scenes piece on the Democratic convention.
Afterward, the producer was embarrassed; it was too personal.
The mania made me picky. Normally I’m very easy to work with,
but now I was yelling a lot. One young producer actually had the courage
to call me on my behavior. I want to contact her now, 22 years later, and
thank her. She said, “This is not my fault, Mary Jo, this is you.
Can you see how you’ve been behaving recently? You’re
yelling; you’re not yourself. I don’t understand what’s
going on. Don’t make me the villain here.” She was
Thirty percent of working women suffering from depression
either quit or lose a job as a result of symptoms.
Some people did the obvious; they dropped out of my life.
I’ll never forget November 12, 1980. I was totally alone on my
birthday. No one called. My husband was with another woman because
I’d left him. There was no happy birthday. It was horrible. The
illness makes you feel unloved anyway. You can’t feel love, even
though people are probably right there.
The first of December, my husband and I got back together. Then I
started becoming a zombie. Eventually, I stopped functioning. I was
hosting a big series on Vietnam vets for the February ratings book. I
came to work on a Friday night, stayed 18 hours a day, and at midnight on
Sunday, there was still nothing on the page. For the first time in my
life, I had to go to my boss and say, “I can’t write this
piece.” They had to get someone else to write it, and to do
stand-ups and voice it. I was humiliated. I didn’t have a reason.
If I had said, “I’m mentally ill and I have this
illness,” that would have been easier.
They sent me on a story, a simple voiceover on Nicaragua. I
couldn’t write it. I erased the tape. I blamed it on technical
problems. I feel pretty terrible; you don’t blame it on some poor
videographer. It goes back to being unable to say to your boss: “My
brain is broken.”
The television station sent me to the top psychiatrist in Arizona.
I remember Dr. McGrath reaching out across the desk and saying, “I
promise you with all my heart, you’re going to feel better, and
you’re going to get your life back again.” I believed him. He
gave me various medications. None worked.
One day I did the five o’clock newscast, called my husband,
and said, “I just can’t do this anymore. I can’t act
one more second. I can’t pretend one more minute to be healthy. I
can’t get this face out anymore.” I couldn’t write a
check, I couldn’t read a newspaper. In March of ’81, the same
day President Reagan was shot, I was secreted into Camelback Hospital for
two weeks to get shock treatment—I wasn’t forced, I signed
the papers. The station circled the wagons and protected me. It was
beautiful. Most stations would have fired me. The station owners felt I
was worth the investment.
I was back on the air in two weeks. I was not completely out of the
depression, but I was functioning. I didn’t start feeling normal
again until January of ’82, when I remember smiling frankly for the
first time and feeling it.
A year and a half after I had shock treatment, in October 1982, I
was hired by CBS network news. I moved to New York and went on the air in
December ’82, on a show called Nightwatch.
I anchored from 2 to 6 a.m. My husband had just divorced me. I
didn’t know anyone. And I worked in the middle of the night. Unlike
Phoenix, it was cold. The darkness came back ten-fold. There was no way I
was going to go to CBS and say “I’m ill.” They would
have never hired me if I had told them the truth.
By March I knew that I couldn’t stay. The depression kept
getting worse. I thought it was New York. That might be a pattern with
people with the illness. There was a 12-year period where I lived in 11
different houses. I have two ex-husbands. You think if you change houses
or change husbands or change jobs you’re going to feel better, but
it’s the illness.
Only 47% of women diagnosed with depression seek help right
away. Most think they can deal with the symptoms on their own. Further,
they do not know where to go for help.
I wasn’t bombing professionally in New York. It was the
struggle inside. I couldn’t handle the cold. I couldn’t
handle anything about New York. But I somehow managed to get to work on
time, do my job and perform. But that was all I could do.
I came back to Phoenix to work for the competition, a local station
that was last in the ratings. They had heard that I wasn’t happy in
New York. They flew up and asked me to come back to Phoenix and make them
number one. They offered me more money than I was making at the network,
which was unheard of.
It was a disaster professionally. A local anchor is seen as the
girl next door and the people let you in their homes each night. When I
went to New York, my look totally changed. I went from wearing my hair in
a pageboy to a new, short, chic haircut. I dressed differently, and the
local people hated that. An ex-friend betrayed me, went to the press, and
told them about my salary. I was portrayed as making big salary
The station’s promotional campaign was all about me, so my
old station developed an award-winning campaign called,
“we’re the team” and showed all these team people
playing together to play off the prima donna. The ratings got worse. I
went to the owners and told them I couldn’t do it alone, that I
needed a really good captain to head the ship.
After three years of my asking, they finally went across the street
and hired my former boss to build a new team. He brought a lot of my old
friends with him, and built the new station into a powerhouse. Within a
month or so of his arriving, he took me out to lunch and said,
“We’ve done some focus groups, and we can’ t keep
you.” So, they fired me, or, they didn’t renew my contract.
That was devastating, especially because I had become my job. I thought
other people got fired, not me. During that three years, I kept winning
awards, I was doing really good work, it’s just that no one wanted
to watch, and that’s kind of important!
I was remarried to a lovely man. The depression just kept getting
worse. Fortunately, I had saved enough money to take a year off. I went
back to the psychiatrist and from August 1986 through 1987, nothing
No one in Phoenix would hire me, so I started my own video
production company. In 1989, I landed a wonderful job with the city of
Phoenix, running their television station. Again, I lied on my employee
form, when they asked, “Have you been treated for mental
I got to do a documentary on Mother Teresa, which led to the
adoption of my daughter, Molly. There came a period when I was adopting a
child, getting a new job and then getting a divorce, and entering into a
new relationship. A lot was going on. I was performing like you
wouldn’t believe, but going home and dying. I had many lost
weekends that I just slept through when Molly was with her grandparents,
aunts or Dad.
In 1992, the man in my life left. I dropped 30 pounds. Here I am
running a TV station and I’m walking the streets because I
can’t sit at my desk. A colleague at work would cover for me at
meetings. Finally I went to my boss and said, “I have an illness. I
lied about it. I had shock treatment in ’81. Will you help
me?” He was wonderful.
I couldn’t fake it anymore. It wasn’t fair to my staff,
to my daughter, to me, to anybody. A friend said, “I want you to
drive to the University of Arizona in Tucson. I want you to go to the top
psychiatrist there, because I went to him. He’s $300 an hour,
insurance won’t pay for it, but you’ve got to
I went for one session and he wanted me to go on Prozac. I said I
had tried Prozac and it didn’t work, it made me crazy. He taught me
how to take it, putting a little bit of the powder in cranberry juice,
over a month building up the amount to one pill. The lights came on, and
I became the girl I was as a senior in high school. The relaxation came
back, the humor. It was like taking off dark sunglasses. Prozac gave me
my life back. After seven years it stopped working. A new doctor gave me
Effexor. It’s given me even more wellness than Prozac, maybe
because it was developed later and there are fewer side effects.
Forty percent of working women with depressive symptoms
While the experiences in the workplace were very stressful, my
illness started a lot earlier, during my freshman year at college. I
didn’t know what it was called, I just knew that there was
something going on in my brain, a great sadness that I accepted as the
way I have to live. I didn’t realize it was truly a brain
I was at Florida State University. I was active socially and
academically and involved in community projects. I was a music major,
performing in college shows. And one summer I was paralyzed. I would go
to bed at 7 in the evening, stay in bed the next day, and barely make it
to a 4 p.m. class. I was so ashamed. Those of us with this illness
don’t want people to think that we’re lazy. But you feel like
you’re paralyzed when these chemicals shut down.
There was always a darkness and a sadness inside me, but I’m
truly a professional actress with a Protestant work ethic—you carry
on. We can be functional and achieve. On one hand, I was an overachiever
with tremendous drive, but on the other hand, I had a darkness. I got
really good at lying. Being with people is work for me when I’m
ill. I would lie about why I couldn’t come to a party, or come to
class. I was afraid if I told people that I wanted was stay in bed, they
would accuse me of being lazy. And I knew it wasn’t about
While I was in school, I won the Miss Atlanta pageant, and was
runner up in the Miss Georgia contest, which I believe is tied in with
the depression. I also had an eating disorder. After a while, everything
is related. My father died an alcoholic homeless person at the height of
my career in Phoenix; nothing could save him. It’s a horrible
sadness in my life. He was crossing a street and was hit by a car. He had
been thrown out of the family years earlier, because of the drinking. He
would call me from a phone booth in 10-degree weather asking me to wire
I was always out there, whether it was the Miss Atlanta contest, or
trying to get scholarship money, or wanting to get into network TV. One
psychiatrist told me, if you want the depression to go away, you’ve
got to change your profession—but it was my life.
Even while I was achieving, this illness kept me from being
satisfied. People would say, “My God, Mary Jo, you’ve got
this wonderful husband, you’re attractive, you’re making a
good salary, why aren’t you happy?” It wasn’t that I
didn’t want to be happy; I just couldn’t, because the
chemicals weren’t going to the right place. That was a cause for
There was a tremendous cosmetic burden of being a broadcast
journalist. I wasn’t ugly, but I wasn’t perfect looking.
Today most of the people hired have model-perfect looks. I remember being
so proud of becoming a broadcast journalist and one day while covering a
fire I heard one police officer yelling to another a few feet away,
“Yeah, Joe, you’re right, she does have fat legs!” I
was a journalist, but that was allowed to matter. I was bright and I
worked around the clock. The number one pressure for me was getting the
story right, because the worst thing a journalist can do is get the facts
The combination of getting the facts right, being the first woman,
and being under a magnifying glass and not ever feeling pretty enough
were the pressures that triggered my depression.