It was a year or two into her first job that Pamela Ingram started feeling the blues. Her grandfather had just died, and she was having trouble getting out of bed in the morning.

As a patient escort at Jamison Hospital in New Castle, Pa., the 21-year-old would push patients’ wheelchairs around and chat with them, and then hide away in a broom closet and cry, soon having to emerge and pretend to be happy until her shift was over.

“You just feel like you’re behind a window, like you’re all alone, like you can’t reach the other people,” she said. “You keep asking yourself, what are you here for?”

Her workplace set her up with a counselor, but she eventually needed to take a break. When she returned from being hospitalized for her depression, she was demoted from her job as a supervisor and was not allowed to move up on the career ladder.

Experiences like Ingram’s might be the reason many employees fear the stigma of depression and don’t seek help for years. But a handful of employers are beginning to realize that this is bad for business, and are providing employees with resources to get confidential help for their illness.

About 3 to 4 percent of men and 6 to 8 percent of women are depressed at any one time in the general population, and these numbers can probably be transposed to the workplace as well, said Dr. Michael Thase, a professor of psychiatry at the University of Pittsburgh Medical Center’s Western Psychiatric Institute and Clinic in Pittsburgh.

Costly problem

Depression costs employers $44 billion per year in lost productive time, not including labor costs associated with disability, according to a study published in the Journal of the American Medical Assn. in 2003. Workers with depression reported 5.6 hours a week in lost productive time, compared with 1.5 hours a week in lost time reported by non-depressed workers.

Depression also can cost money in health care bills as well.

“There’s very good, consistent evidence that depression worsens the impact and prognosis of many general medical conditions,” including diabetes and high blood pressure, Thase said.

Some employers, from BankOne to Union Pacific to PPG Industries, have decided to roll up their sleeves and help their depressed employees rather than ignore the problem and pay the price. Even the Pentagon announced recently it will spend $100 million to screen returning troops for mental health problems.

It might seem like a paradox that employers worried about the escalating cost of health care are actually encouraging their employees to go to the doctor. But doctors say that it makes business sense too: Diagnosing and treating depression will make workers more productive and healthier, as long as their treatment is managed well.

“If we can keep people healthy and happy and fully engaged, that has a profound impact on their health and also in their ability to be engaged with the company,” said Dr. Alberto Colombi, PPG’s corporate medical director.

Increasing productivity

PPG’s employee assistance program has been encouraged to provide depression screening for PPG workers, Colombi said. The company wants to make employees familiar with the idea that it’s possible to screen for depression in a way similar to screening for high blood pressure and cholesterol.

The company adopted a comprehensive health program in 2003 that identified five priorities in the workplace, including diabetes and depression. The following year saw the number of employees using the assistance program double.

Omaha-based Union Pacific saw the same increase in traffic after an independent firm implemented a depression screening process for the company’s 49,000 employees and their spouses last year. The company has been offering an online wellness assessment, which more than 60 percent of its employees have taken. If employees are identified as being at risk, there are a number of ways that the firm follows up, said Marcy Zauha, Union Pacific’s director of health and safety.

So far, it seems that treating depressed workers increases productivity and reduces absenteeism, according to a study published in the journal Medical Care in 2004. A two-year program in which depressed employees were treated in primary care practices found that productivity increased 6 percent and absenteeism decreased 22 percent, saving companies more than $2,000 per depressed employee.

Still, there are concerns. Many employees worry that something like what happened to Ingram might happen to them. A study released by the University of Michigan’s depression center last year found that only 41 percent of employees felt that they could acknowledge they had depression and still get ahead in their careers.