Depressed, Anxious, and Unable to Work? Start Therapy Soon

New research shows that delaying treatment leads to longer sick leave.

Posted Sep 01, 2017

High levels of depression and anxiety can interfere with our ability to take care of things, including going to work. Being out of work results in additional stress and financial strain, which can compound a person's anxiety and depression. 

The longer a person is on sick leave, the greater the cost to the employee and the employer, and the bigger the risk that the person will not return to his or her job.

Source: Concord90/Pixabay

Effective treatments exist for both anxiety and depression, but people often wait a long time before seeking help. A new study examined whether starting psychotherapy sooner would lead to less time out of work.

The researchers looked at a sample of over 2400 men and women who had taken sick leave with anxiety or depressive disorders. The average time out of work was about six months, and participants typically waited two months before starting therapy.

Older participants took somewhat longer to return to work, as did those who were in therapy longer, however, those associations were fairly weak. The strongest predictor by far of time out of work was the length of time before starting psychotherapy—those who got treatment sooner were able to return to work more quickly.

Accordingly, the study authors cited multiple benefits to starting therapy sooner rather than later when a psychological condition requires taking time off from work, including:

  • Relieving patients' suffering.
  • Minimizing economic costs of sick leave.
  • Reducing employees' isolation from the labor market.
  • Decreasing the likelihood of permanent disability.
  • Reducing costs to the company.

Unfortunately, it is common to delay seeking treatment for a psychological disorder. One study found that only 40 percent of people in the general population sought help within the first year of developing a mood or anxiety disorder; the average lag for the other 60 percent was eight years. Typical reasons for delaying included:

  • Embarrassment about seeking help.
  • Not being able to afford treatment.
  • Not knowing where to turn.
  • Wanting to handle it on one's own.

Thus, efforts to decrease stigma, increase awareness about effective treatments, and improve access to treatment are likely to decrease delays.

More work needs to be done to identify how quickly treatment needs to begin to minimize time away from work; typical recommendations are sometime within the first 2-4 weeks of leave. 

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Alonso, S., Marco, J. H., & Andani, J. (2017). Reducing the time until psychotherapy initiation reduces sick leave duration in participants diagnosed with anxiety and mood disorders. Clinical Psychology and Psychotherapy. doi:10.1002/cpp.2134

Christiana, J. M., Gilman, S. E., Guardino, M., Mickelson, K., Morselli, P. L., Olfson, M., & Kessler, R. C. (2000). Duration between onset and time of obtaining initial treatment among people with anxiety and mood disorders: An international survey of members of mental health patient advocate groups. Psychological Medicine, 30, 693-703. Chicago

van Beurden, K. M., Brouwers, E. P., Joosen, M. C., Terluin, B., van der Klink, J. J., & van Weeghel, J. (2013). Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: Design of a cluster-randomised controlled trial. BMC Public Health, 13, 193.