Depression caused by job loss or changes warrants attention

SINGAPORE: The higher number of retrenched workers in the last few years has caused a spike in the number of depression cases experts see here.

In 2016, job redundancies in Singapore hit a seven-year high since the 2009 global financial crisis. A total of 19,170 workers were retrenched that year, compared to the 9,800 in 2010, according to the Manpower Ministry’s latest labour market report. 

Think Psychological Services, which sees three or four new cases every month, has seen an approximately 18 per cent increase in individuals who are affected by job changes in the last five years. Most of them present with various symptoms of depression and anxiety, said Vyda S Chai, Think Psychological Services' clinical psychologist.

More than just a loss of financial security, retrenchment and other job-related changes can have a knock-on effect on mental health and well-being too.

"Many people are conditioned from a young age to define themselves by what they do and how much they earn. I see many patients who experience a loss of self-esteem, feelings of worthlessness and guilt when they lose their job," said Dr Adrian Wang, consultant psychiatrist at Gleneagles Medical Centre.

MIDDLE-AGE CONCERNS

In the last six months, Dr Wang has observed more middle-aged patients expressing concerns about financial issues and job security. Middle-aged to older adults tend to be more susceptible to job-related anxiety as they worry that it is too late to start over or re-train themselves, he said.

One of them was a middle-aged man in his 40s who had sought treatment when he could not cope with the reality of losing his job. Despite knowing six months in advance that he would be retrenched, the patient became increasingly depressed as the clock wound down to his last day of employment, said Dr Wang.

“It was very much like a grief reaction. He experienced denial, anger, bargaining and depression - all the stages of grief - as he tried to understand why the irreversible job loss had to happen to him,” he said.

Like Dr Wang, Ms Chai has also seen an increasing number of individuals and families who have difficulties coping with job-related changes or retrenchment amid today’s fast-changing economy.

“Due to difficulties in coping with their (job) loss, we are also seeing a number of individuals who resort to drinking excessively. A few of them suffer symptoms similar to post-traumatic stress disorder such as high levels of psychological distress and fear."

“For instance, they may experience recurring nightmares of the day they were laid off. This makes it challenging for them to apply for new jobs as they grapple with significant levels fear of rejection or failure," said Ms Chai.

UNEMPLOYED TWICE AS LIKELY TO BE DEPRESSED

Research has shown that retrenchment and job changes can increase the risk of developing anxiety and/or depression, said Ms Chai.   

Unemployed individuals (12.4 per cent) were more than twice as likely as those with full-time jobs (5.6 per cent) to report being treated for depression, according to a study based on telephone surveys with over 350,000 Americans conducted in 2013 as part of the Gallup-Healthways Well-Being Index.

In a separate study from Sweden, which was published in BMC Public Health in 2015, job loss consistently predicted subsequent major depression, with a somewhat greater effect in men.

Dr Wang said people who define their sense of self with their jobs tend to feel pressured and anxious when things do not go well at work.

In general, job-related anxiety can affect people from all walks of life and ages. However, the extent of the impact of a job change or loss generally depends on the individual’s situation such as financial liabilities and family support, said Gilbert Tan, CEO of e2i (Employment and Employability Institute), an initiative of the National Trades Union Congress (NTUC).

“For example, if the person is the sole breadwinner, he may feel more anxious to get back on track,” said Mr Tan.

Other factors include the duration of time they have been with the company and the job role they held at work, Ms Chai added.

The stress of losing a job may also manifest differently in each individual. “When removed from the role as a provider for the family, men may feel depressed and a loss of identity and purpose. Women in general experience higher rates of anxiety when their jobs are in jeopardy,” said Dr Wang. 

VICIOUS CYCLE OF ISOLATION  

Months after he was laid off in 2016, Mr Harold Smith (not his real name), 62, began withdrawing from social activities and lying about his employment situation.

“I started lying to family and friends, telling them that I was fine or that I was working on something else at the moment. I could not bear to say I was doing absolutely nothing. Hiding my depression made me feel even more isolated,” said Mr Smith, a former senior director in a multinational company.

Unemployment and depression tend to feed off each other, resulting in a vicious cycle of isolation that can make it hard for people to bounce back. The Gallup study found that the longer people remain unemployed, the more likely they were to report signs of poor psychological health. The rate of depression was nearly one in five (18 per cent) in individuals who have been unemployed for 27 weeks or more.

Ms Chai advised people who experience severe emotional stress or symptoms that go on for more than two weeks to seek professional help. If there are thoughts of self-harm or suicide, seek help immediately.

Other warning signs include the inability to function or carry out daily tasks, and/or resorting to using alcohol or other substances to cope.

For Mr Smith, seeing a psychiatrist helped him cope with his low moods. He recently found a new job and is thankful that the fog of depression has lifted.

“When you’re in a state (of depression), it’s good to talk to someone who is a neutral party. It brought me clarity. But it was getting a new job that made a huge difference to my mood. All of the sudden, my self-esteem is back. It feels like a whole new world when I wake up these days,” he said.

HOW TO BOUNCE BACK

While losing a job can be distressing, remaining positive will make it easier to cope. Here are some tips from Ms Chai on staying grounded in the face of job-related changes.

• No man is an island 

Connect with family and friends who can help you remain positive. Try to maintain contact with your former co-workers as they can be a source of support and friendship, and direct you to opportunities.

• Have an open discussion with your family

Discuss how your job loss may affect household spending, but emphasise that this is likely to be only for a limited time and isn’t anyone’s fault.

• Set a routine for yourself 

Make lists of things to do every day, including your job-hunting plans. This will help you feel that you have some control over the situation. Schedule regular exercise, eat well and get adequate sleep.

• Maintain your personal appearance 

Keep your appearance neat and tidy, like you used to when you were working. It lifts the mood and you never know when you may meet someone who can change your future.

• Accept reality 

Remember that life is about changes, and it is what you are going to do about the changes that will count. Moving forward, it is also important to keep up-to-date with work knowledge and skills as business needs are changing, said Mr Tan of e2i. 

To remain up-to-date with work skills, Mr Tan of e2i recommends tapping on avenues such as employability workshops and coaching sessions to help identify and plug gaps.