Unemployment and depression

Depression and
Unemployment
David Oddie, B.Sc., M.A., M.S.W., R.S.W.
Social Worker, Social Determinants of Health
Service, Access & Transitions

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Topics of Discussion
 Scope – Mental Illness and
Depression
 Characteristics of Depression
 Unemployment / Employment
 What is the connection between
Unemployment and Depression?
 How could it happen?
 What to do?
 Treatment Options
 Resources

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Scope – Mental Illness
 Mental illness is about our moods,
thoughts, perceptions and behavior.
 Mental illnesses can have few or many
symptoms.
 Symptoms can have varying degrees of
intensity, from negligible to extreme.
 1 in 5 people in Ontario / Canada will
experience some form of mental illness.
 Only about 30% of these people seek
assistance.

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Reasons for Not Seeking
Assistance
 Not recognizing there is a problem
 Not knowing what help is available
 Barriers to Service ( transportation, access,
language)
 Feeling ashamed or embarrassed that
they need assistance
 Trying to handle the symptoms on
their own
 Lack of support
 Stigma and stereotyping

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Mental Illnesses
4 general categories including Mood Disorders,
Schizophrenic Disorders, Anxiety Disorders and
Personality Disorders.
Depression is a Mood Disorder.
Also included in Mood Disorder are
•Bipolar Disorders (often referred to as Manic –
Depressive Disorder)
•Dysthymic Disorder (has been referred to as
Melancholy)
First written about in “The Anatomy of Melancholy”
published in 1621 by Robert Burton.

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Depressive Symptoms
 Prolonged feelings of sadness and despair
 Anhedonia – serious loss of interest in activities
(can include hobbies / leisure, work tasks, social
events) – sometimes defined as “disengagement
from goal-related behaviors” (Durbin, 2014)
 Changes in eating and sleeping patterns
 Hopelessness and helplessness
 Fatigue, lack of energy
 Slowed thinking, difficulty making decisions
 Agitation or slowed physical movements
 Recurrent thoughts of death / suicide

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Diagnosis
Diagnosed (as are all Mental Illnesses) by interview
and observation using the DSM (Diagnostic and
Statistical Manual of Mental Disorders) now in it’s 5th
Edition (June, 2013).
A person who experiences 5 or more (out of 9)
symptoms, for 2 weeks or more can be diagnosed as
having a “Major Depressive Episode”.
Symptoms cause “clinically significant distress or
impairment in social, occupational or other important
areas of functioning.”
Symptoms not attributable to physiological effects of
a substance or another medical condition.

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Difference between being sad and a
psychiatric diagnosis of Depression
Having occasional sad or depressive feelings is a
normal part of all lives given normal life events
including losses (personal, monetary), ages and
stages and environmental events.
The difference comes down to # of symptoms,
severity of symptoms, length of time experiencing
these symptoms and impact on the person’s life /
normal functioning.
E.g. Bereavement (uncomplicated) or “normal” grief
From DSM 3 (1980) – the feelings are less than 2 months
and that, during this period, there are no more serious
symptoms developed (such as suicidality).

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Types of Depression
There are a variety of Depressive Disorders
including:
•Major Depression with mild, moderate or severe
levels.
•Biological based Depression such as Seasonal
Affective Disorder or Post-partum Depression.
•Depression with Psychotic Features.
•Depression associated with personality disorders
and psychological vulnerability.
•Dysthymia – associated with lower number of
depressive symptoms but consistently present over 2
years (for adults) or 1 year (children).

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Causes of Depression
A variety of factors and / or circumstances can
contribute to a person developing a major depressive
event.
•Genetic or family history
•Childhood adversity (poverty, neglect, abuse)
•Psychological or emotional vulnerability
•Biological factors such as issues of brain chemistry,
endocrine issues or immune system problems
•Major stress

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Prevalence
Depression is a worldwide phenomena with reported
rates higher in U.S., Canada and Europe than
reported rates in East Asian countries.
Affects 10-25% of women and 10-15% of men. Other
studies have shown a 2X higher chance of women
developing depressive symptoms and disorders.
By 2020, depression will rank second (behind heart
disease) as a cause of disability in the world.
General estimate of 25% of those with depression
will make at least one, non-fatal suicide attempt in
their lives. Highest risk of suicide is for older adults
(5X more likely over age 60). Also high in young
adults.

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Unemployment
 The Unemployment Rate is probably the
most frequent statistic used when reporting
news about our economy or any job-related
news. We should understand what it really
means.
 The definition is related to the supply of labor
as a factor of production (of any kind). This
means that it does not relate to anything that
is unpaid (including unpaid housework or
volunteer work).
 It does relate to the activity of job search and
the availability to take a job within a given
period of time (a reference week).

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Unemployment
 Unemployment Rate = # of unemployed people
# of people in the labour force
X 100%
 Ontario employment increased by 81,100 jobs
(both full & part) from January 2012 to January
2013 resulting in a decline in the unemployment
rate to 7.7%. Sounds good!
 However, in January of 2013, Ontario lost 31,200
full time jobs (goods-producing and service-
producing sectors). Sounds bad!
 Since there was a sharp decline in the number of
people looking for work which removed 22,200
unemployed people from the calculation. This
results in the unemployment rate remaining at
7.7%. December, 2014 the rate was 7.0%.

+ Employment
 Toronto’s workforce represents 20% of
Ontario’s total. We, like the rest of Ontario,
are linked to American economic shifts.
 Manufacturing jobs, such as those involved in
the car industry, are a prime example of this
relationship. Declines in this sector have
been the most significant in Toronto area.
 In Toronto, 8.04% work in finance and
insurance compared to 4.61% for Canada.
 230,000 people are employed in financial
services (Toronto) representing 64% of
Ontario’s and 31% of Canada’s sector
employment.
 Other positive employment sectors (Toronto)
are Public Administration, Health Care /
Social Assistance and Professional /
Technical / Scientific Services.

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Importance of Work
 Sense of purpose
 Feeling useful
 Values
 Independent
 Salary & Benefits
 Structure
 Being with People
 Productive
 Control
 Stay out of Hospital
 Chance to Dream

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Interaction between Depression
and Unemployment
 Overall rate of depression in those working
full time is approximately 7%.
 In Canada, depression costs $51 billion
annually with a third of that due to lost
productivity.
 Overall rate of depression registered by those
unemployed is close to 13%.
 Loss of employment ranks similar to serious
injury, loss of a loved one or going through a
divorce in terms of the level of stress.
 Unemployment doesn’t “cause” mental health
disorders but it can amplify or trigger pre-
existing issues.

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How could it happen?
 Most common responses to becoming
unemployed are shock, anger, frustration
and denial. It may include physical
symptoms.
 Loss of self worth, drop in self-esteem,
questioning abilities, questioning friends.
 Over time, family problems including loss
of position (e.g. breadwinner), loss of
pride / contribution.
 Possible increase in use of alcohol,
drugs, smoking plus drop in energy.
 Without a network, social isolation can be
your worst enemy.

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How could it happen - continued
 As time goes on the depression may
work itself in a negative cycle – less
activity gives rise to rumination /
negative thoughts, energy goes down,
rejection during job search increases
in impact.
 Imagine – if you have a poor or fragile
self image, you are engaging in an
activity that requires you to market
yourself and invite strangers to accept
or reject you.

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Options & Actions
 Find out whether you are eligible for
Employment Insurance, welfare or other
subsidies. Keep some income flow and
benefits going.
 Consider joining self-help / job seeking
groups that are available in the
community.
 Consider investment in new / updated
skills whether related to your work or just
job searching.
 Reach out to your family / friends for
support of all kinds (e.g. food, money,
childcare).

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More Options & Actions
 If you have structure / routines, keep
some of them going (e.g. house cleaning,
exercise, taking the children to
appointments, eating, regular meeting
with group / friends) Remember,
depression is time limited.
 Tell everyone you know that you are
looking for work. Tell them exactly what
kind(s) of work you are looking for. This
may include a large network that exists or
creating a new one (e.g. tell the guy at
the corner store).

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Still More Options & Actions
 Organize yourself as much as
possible.
 Have an organized spot in your
home / apt. to do your job search.
 If isolation or issues at home interfere,
go to your nearest Employment
Resource Centre (free, many
resources, free groups, computers,
etc.)
 Use a job log to keep track of efforts /
results / places you should follow up
with.

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Treatment Options
 If you are having problems functioning,
talk to your doctor / medical professional.
 Medication – anti-depressants, anti-
anxiety.
 Psychotherapy – e.g. Cognitive
Behavioral Therapy.
 Psychoeducation.
 Self-help groups in the community.
 Electroconvulsive therapy.
 Treatments are used individually or in
combination.

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Remember
 You do not need to be alone in this
time.
 Depression (unless it is a severe,
biological, long standing issue) is time
limited. Keep important routines going
as much as possible.
 Be organized and structure your days
as much as possible.
 Do not be afraid to approach medical
help if you are having problems
functioning.

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Help
 Crisis and Emergency: Your local
emergency department or 911
 Telehealth Ontario: Speak to a nurse at 1-
866-797-0000
 Phone support at CAMH: 416-595-6111 or
1-800-463-6273
 CAMH Switchboard: 416-535-8501, Option
2
 Mental Health Helpline: 1-866-531-2600
 Drug & Alcohol Helpline: 1-800-565-8603
 Ontario Problem Gambling Helpline: 1-
888-230-3505

+ THANK YOUTHANK YOU
Sources
•Depression 101 (C. Emily Durbin, Springer
Publishing Co., 2014)
•DSM 5, Diagnostic and Statistical Manual of Mental
Health Disorders (American Psychiatric Association,
American Psychiatric Publishing, 2013)
•Local Labor Market Update 2013 (Toronto Workforce
Innovation Group Top Report)
•www.investtoronto.ca
•www.statcan.gc.ca – Guide to Labor Force Survey
•www.camh.ca – Depression
•http://www.camh.ca/en/education - Mental Health
and Addictions 101

Unemployment and depression

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