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Despite depression at work
Mental illnesses, including depression, not only lead to long-term sick leave, but are also one of the main reasons for early retirement. According to the Deutsches Ärzteblatt, every third early retirement is caused by a permanent mental illness.
People with depression suffer from symptoms that make a regular working day difficult or impossible: among other things, listlessness, fatigue, extreme sleep disorders or even fears. Affected people may have difficulty concentrating, suffer from their partially reduced performance, fear criticism, communicate less or at times not at all and shy away from taking on responsible tasks. Coordinated time management is also often impossible.
Return to the job as therapy
Doctors agree that returning to work is good for people with depression, reduces relapses of depression and can even be considered part of therapy. Rationale: Work is an essential part of adult life. The daily rhythm of life and the structure of everyday life can give those affected a feeling of security. In addition, a job can gain recognition, strengthen self-esteem and give life new perspectives.
People with depression are often taken on sick leave for a long period of time because they feel unable to cope with everyday work. If a person concerned wants to return to the old job, gradual reintegration (also known as the 'Hamburg model') can be an option. This measure, which is even provided for by law (Section 74 of the Social Code Book V, Section 28 SGB IX), is usually recommended following rehabilitation or a longer stay in hospital.
The attending physician and the employee define a gradual integration plan that is individually tailored to the patient's situation. This reintegration plan includes, among other things, the daily number of working hours and a medical prognosis as to when the sick person is expected to regain his or her full ability to work. It is planned that those affected start with a few working hours each day and then gradually increase them to full working hours. This can take up to several months.
During this reintegration phase, the employee either continues to receive sick pay from his or her health insurance company or transitional allowance from the pension insurance. During this time, the person concerned is still considered unable to work, the employer is not entitled to work. However, the employer is only fundamentally obliged to this agreement in the case of severely disabled persons. If the old job is no longer available, the nationwide professional development agencies or integration specialist services also offer reintegration measures. In addition, there are psychosocial institutions that help those affected to find the right way into the world of work for them. These institutions are mediated, among other things, by the employment offices and the pension insurance, which in many cases also cover the costs of reintegration measures.
How can reintegration take place?
An orientation phase lasting several weeks can help people who have left their job for a long time because of their depression. With the help of tests under the guidance of educators and psychologists, they should find out what professional interests and skills are available, what the resilience is like and what type of work is suitable at the current time (this may be a different activity than the previous one learned). It is also about finding out key competencies, i.e. recognizing personal strengths.
Under certain circumstances, those affected are provided with a personal coach (usually a psychologist) with whom all experiences on personal problems and health impairments can be exchanged. In order to test and train the ability to work, reintegration institutes often arrange company internships that can extend over several months. The internships show which field of activity is suitable and provide information about performance. As part of the measures, seminars on work-related topics and application training are also planned.
Requirements for a successful re-entry
If someone with depression wants to return to work, they should be able to structure their day, get up at a specific time, and perform in a certain way. This is usually only possible with accompanying therapy, which includes regular psychotherapy, but also taking medication (antidepressants) in the case of moderate and severe depression. It is also important to get insomnia under control: Experts advise getting up early and not sleeping during the day in order to increase sleep pressure in the evening and make it easier to fall asleep.
Above all, consideration is required on the part of the employer and colleagues: Despite therapy, those affected have depressive phases in which they are sometimes only less productive. In these phases, pressure to perform and criticism would be counterproductive. For example, it is better to agree who will take over the tasks on these days and how the person concerned can organize his working day differently on such days.
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