According to a recent study, depression causes an 23% drop in productivity at work. The drop is almost 45% for treatment resistant depression, defined in that study as depression that has not responded to 2 adequate trials (i.e. adequate dosage for adequate duration) of antidepressants.
My gut, based on clinical experience, tells me that even when depressed, people devote lot more of their emotional resources to trying to not let work suffer, which in turn tells me that their performance at home suffers much more than at work. For the sake of keeping it simple, let’s assume however, that the performance at home is impaired to the same degree as at work, i.e. about 25%. But how can we know the dollar value of that 25% impairment.
Fortunately for us, economists have long been working on placing a dollar value on activities not related to paid work – including household work (e.g., cooking, cleaning, grocery shopping), caring and helping (e.g., taking care of kids, parents, friends) and personal time and leisure activities. They consider many variables to place different dollar value on the same activity depending on when it is done by a man or woman doing paid work vs a stay-at-home person, and depending on the age of the person. It gets pretty complicated.
For our purposes, to keep it simple, let’s just look at one example from 2006. In this example, the dollar value of the day of “a married American male working full time with youngest child under 18” was estimated at just under $400/day. This included the value of household services, caring and helping, personal time, leisure activities and paid work. Typically, in similar calculations for women working part time or for women who are full-time housewives, the dollar value of work is lower than for the above man, but that of household services, and caring and helping is greater.
Once again, for the sake of keeping our discussion simple, let’s assume that the dollar value of an entire day for all working age Americans is $400/day or $146,000. If depression causes a 25% impairment in performance across the entire day, that translates into just over $35,000 lost annually. If the depression is treatment resistant, these losses climb to about $70,000 annually.
Bear in mind, that these calculations don’t even try to estimate the dollar value of reputation lost at work due to impaired performance, thus hurting career prospects, or the value of long-term impact of depression on one’s children/spouse/family. These calculations also don’t place a value on the loss of life that can occur when someone with depression ends his or her own life.
So, there we have a rough estimate – the dollar value of the impairment caused by depression suffered by an average working age American is $35,000/year if the depression is not treatment resistant. However, if the depression requires more than 2 adequate trials of antidepressants, the damage jumps to about $70000/year. And remember, in STAR-D – probably the most generalizable study of depression treatment – about 44% of patients needed more than 2 adequate trials of antidepressant medications to achieve remission of depression.
Dheeraj Raina is a psychiatrist who practices at the Depression Clinic of Chicago.
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