Depression at Work: Signs, What to Do, and How to Talk to Your Manager

“I used to be the person everyone relied on in the office. Now I read the same email five times and still don’t understand it. I just sit there.”

Sentences like this are common among professionals in Karachi, Bengaluru, Dhaka and the Gulf. People who feel this way often assume they have become lazy or “kaam chor”. Sometimes, what they are actually dealing with is depression at work.

Depression is common. The World Health Organization estimates that about 5.2% of adults worldwide live with depression, and that it can lead to problems at school and at work (WHO). WHO also estimates that around 12 billion working days are lost every year to depression and anxiety, at a cost of about US$1 trillion in lost productivity (WHO). Behind those numbers are real people who keep turning up to work while quietly struggling.

In this guide I will cover the signs of depression at work, what to do about it, and how (and whether) to talk to your manager.

If you’re struggling right now

If you are feeling hopeless, or you are having thoughts of ending your life or harming yourself, please talk to someone today. You don’t have to carry this alone.

If you or someone else is in immediate danger, call your local emergency number or go to the nearest hospital emergency department. Free helplines:

• Pakistan: Umang mental health helpline 0311 7786264; in an emergency, police 15 or Rescue 1122
• Saudi Arabia: emergency 911; counselling line 920033360 (8am–8pm, Saturday 1pm–8pm; not 24 hours)
• India: Tele-MANAS 14416 or 1-800-891-4416 (emergency 112)
• Bangladesh: Kaan Pete Roi +880 9612-119911 (3pm to 3am daily)
• United States: 988 Suicide & Crisis Lifeline, call or text 988 (24/7)
• Canada: 9-8-8 Suicide Crisis Helpline, call or text 988 (24/7)
• UK and Ireland: Samaritans 116 123 (free, 24/7)
• European Union: emergency number 112
• Anywhere else: call your local emergency number, or find a free helpline at findahelpline.com.

Depression is not the same as a bad week

Everyone has weeks when work feels pointless, a deadline crushes them, or a manager’s comment stays with them all weekend. That is normal stress.

Depression is different. WHO describes it as a depressed mood or a loss of pleasure or interest in activities for long periods of time, and it is different from ordinary mood changes and feelings about everyday life (WHO). It affects how you think, feel, sleep, eat and function, including at work.

It is also different from burnout, though they can overlap. WHO describes burn-out as an occupational phenomenon, not a medical condition. It results from chronic workplace stress that has not been successfully managed, and it has three features: exhaustion, mental distance or cynicism about your job, and reduced effectiveness at work (WHO). Burnout is about work. Depression tends to spread into everything: weekends, family, hobbies, even things you used to love.

If you are not sure whether you are exhausted or depressed, my article on emotional exhaustion vs. laziness can help you think it through.

Signs of depression at work

These are the workplace signs people describe most often. Having one or two does not mean you have depression. Having many of them, most days, for two weeks or more is a reason to take it seriously. For the signs that show up at home and in the body as well, see my guide to depression ki alamat (the signs of depression).

• Concentration problems: reading things repeatedly, losing track in meetings, forgetting tasks
• Slowed thinking: decisions that used to take minutes now feel impossible
• Loss of interest: projects you used to enjoy now feel meaningless
• Low energy: feeling drained before the day starts, even after sleeping
• Withdrawing: eating lunch alone, skipping chai breaks, avoiding calls
• Irritability: snapping at colleagues or juniors over small things
• Lateness or absence: struggling to get out of bed, more “sick days”
• Harsh self-talk: “I am useless”, “they will find out I am a fraud”, “everyone is better than me”
• Physical complaints: headaches, body aches, stomach problems, changes in appetite or sleep
• Hopelessness: a feeling that nothing will change or that there is no point

The last one matters most. If hopelessness has turned into thoughts that life is not worth living, please use the helplines above and speak to someone today.

A composite of common situations (not a real person). Imran, 34, works in a Gulf company’s finance team and sends most of his salary home to his parents and younger siblings in Faisalabad. Over a year he stops calling home as often, eats alone, and stays in the office late not because he is productive but because he cannot focus during the day. His family only notices that the transfers are a few days late. Composite situations like this show how depression at work can stay invisible: the person keeps functioning on the outside while emptying on the inside.

Why depression at work is so often missed in desi workplaces

Several things make it harder to notice and admit:

• “Log kya kahenge.” Mental health is still stigmatised in many families and offices. People fear being labelled weak, “pagal”, or unfit for promotion or marriage.
• Salary pressure. When a whole family depends on one salary, or a visa depends on one employer, people keep going long past the point of exhaustion.
• Long hours are praised. Staying late is often seen as loyalty, so warning signs look like dedication. In men, depression often hides behind long hours like this; my guide to male depression symptoms explains the other hidden signs.
• It shows up in the body. Many people first go to a doctor with headaches, stomach pain or fatigue, and depression may not be asked about.

What to do if you think you have depression at work

1. Check your symptoms with a screening tool

The PHQ-9 depression test on this site is free and private. The PHQ-9 is a nine-question questionnaire that was validated in primary care and obstetrics-gynaecology clinics as a measure of depression severity (Kroenke et al., 2001). If you are pregnant or have had a baby in the past year, the postpartum depression test uses the same PHQ-9, with guidance on reading it alongside a newborn’s broken sleep.

It is a screening tool, not a diagnosis. A high score means you should see a qualified professional for a proper assessment. And if you answer anything other than “not at all” to the question about thoughts of being better off dead or of hurting yourself, please talk to someone today, whatever your total score.

If you suspect work stress is the main driver, you can also take the burnout test, which uses the Copenhagen Burnout Inventory, a burnout questionnaire published by Kristensen and colleagues in 2005 (Kristensen et al., 2005).

2. See a professional

Depression is treatable. WHO states that there are effective treatments for depression, including psychological treatment and medicines, and that psychological treatments are the first treatments for depression (WHO). In the UK, NICE’s guideline on depression in adults recommends treatments for first episodes of depression and for depression that has not responded to first treatments, and gives advice on preventing relapse (NICE NG222).

I don’t give medication advice here. If you and your doctor or psychiatrist consider medicine, that is a decision to make together, with proper follow-up.

3. Self-care that actually helps (alongside treatment)

WHO’s self-care advice for depression includes trying to keep doing activities you used to enjoy, staying connected with friends and family, exercising regularly even if it is just a short walk, keeping regular eating and sleeping habits, avoiding or cutting down on alcohol and drugs, and talking to someone you trust (WHO). At work, that can look like:

• Shrink the day. Make a list of three essential tasks. If you finish them, the day counts as a success.
• Use “small starts”. Commit to just ten minutes on the hardest task. Starting is usually the hardest part.
• Protect your lunch break. Step outside, walk, eat away from your desk.
• Reduce after-hours messages. Mute work groups after a set time if your role allows it.
• Keep one connection alive. One colleague or friend you can be honest with makes a real difference.

If anxiety comes along with it, see how to handle anxiety.

How to talk to your manager about depression at work

This is one of the hardest questions, and there is no single right answer. You are not obliged to share a diagnosis with your employer, and in some workplaces it may not be safe to do so. Think it through first.

Questions to ask yourself before telling your manager

• Is my manager generally fair and discreet?
• Does my company have HR policies, an employee assistance programme, or health insurance that covers mental health?
• What do I actually need: time off for appointments, a temporary change in workload, more flexible hours, or just understanding?
• Could disclosure affect my contract, visa or promotion? If you are unsure, read your contract and company policy first.

What you can ask for

WHO’s guidance on mental health at work describes reasonable accommodations that can help workers with mental health conditions, such as flexible working hours, extra time to complete tasks, modified assignments to reduce stress, time off for health appointments, and regular supportive meetings with supervisors (WHO; WHO guidelines). Not every workplace in South Asia or the Gulf offers these formally, but many managers will agree to reasonable, specific requests.

A simple script

You don’t have to use the word “depression” if you are not comfortable. You can focus on the impact and the solution:

“I wanted to let you know that I’m dealing with a health issue and I’m getting treatment for it. It’s affecting my concentration at the moment. For the next few weeks, would it be possible to [leave early on Thursdays for appointments / move the deadline for X / have a short weekly check-in to agree priorities]? I’m committed to my work and I want to keep doing it well.”

Keep it short, focus on solutions, and if possible, follow up in writing with what was agreed.

If disclosure isn’t safe

If your workplace is hostile, focus on what you can control: get professional support outside work, use your annual leave for rest and appointments, and quietly build options, such as updating your CV or learning a new skill. If you are facing bullying or harassment at work, keep a written record of incidents and seek advice from HR, a trusted senior colleague or a legal professional.

If you have lost your job

Losing a job can hit very hard, especially when family expectations are high. Unemployment is one of the adverse life events WHO lists as making depression more likely (WHO). If this is your situation, please be extra gentle with yourself, keep a daily routine, and reach out for support early rather than waiting until things feel unbearable.

When to get professional help

Please see a psychologist, psychiatrist or doctor soon if:

• your low mood or loss of interest has lasted two weeks or more
• you are struggling to function at work or at home
• your PHQ-9 score is in the moderate range or above
• you are using alcohol, pills or other substances to get through the day
• you feel hopeless, or you have any thoughts of harming yourself (use the helplines above today)

If you’d like to work with me, you can book a consultation. If you’d prefer someone local, choose a qualified, registered professional. You can read more about the mind and mental health in the Mind section.

Quick FAQ

Can I be fired for having depression?
Employment protections differ by country and by contract. I’m not a lawyer, so check your contract and company policy, and get legal advice if you are worried.

Should I quit my job if I’m depressed?
Try not to make big, irreversible decisions while you’re severely depressed, because depression colours how everything looks. Get support first, then decide with a clearer head.

Is depression at work just burnout?
Not always. Burnout is linked specifically to work stress. Depression tends to affect your whole life, not just your job. They can overlap, which is why a professional assessment helps. For a side-by-side comparison, see burnout vs depression.

References

1. World Health Organization. Depressive disorder (depression) (fact sheet). https://www.who.int/news-room/fact-sheets/detail/depression
2. World Health Organization. Mental health at work (fact sheet). https://www.who.int/news-room/fact-sheets/detail/mental-health-at-work
3. World Health Organization. WHO guidelines on mental health at work. 2022. https://www.who.int/publications/i/item/9789240053052
4. World Health Organization. Burn-out an “occupational phenomenon”: International Classification of Diseases. 28 May 2019. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
5. National Institute for Health and Care Excellence. Depression in adults: treatment and management (NG222). 2022. https://www.nice.org.uk/guidance/ng222
6. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine. 2001;16(9):606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x (PubMed 11556941)
7. Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work & Stress. 2005;19(3):192-207. https://doi.org/10.1080/02678370500297720

This article is for education only and is not a diagnosis, legal advice or a substitute for professional care.

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Dr. Malik Sherjeel Awan

Dr. Malik Sherjeel Awan is a clinical psychologist based in Makkah. PsyD (Clinical Psychology), University of Karachi.
He writes practical, evidence-based psychology for everyday life.

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