Can a psychotherapist give me sick leave? Do they give sick leave for depression? Possible consequences of a nervous breakdown

Not all Russian workers and employers know whether they give money in case of depression. At the same time, depression is a rather dangerous disease that can affect both the effectiveness of an employee’s work activities and his general condition, not only mental, but also physical health. Therefore, each party to the labor relationship should know how sick leave is issued for depression, how long it lasts and whether it is needed in principle.

Sick leave for depression - basic information about the disease

Depression is a mental disorder that is expressed in a person’s loss of interest in life, decreased productivity and motivation, constant depression and other associated negative manifestations. At the same time, depression has many causes and ways of occurrence - it can be either a consequence of any actually occurring events, or have a purely physiological or biochemical basis, developing as a result of other diseases or disorders of nervous activity.

It is necessary to understand that depression is an extremely long-term state of lack of initiative, will to live, motivation and positive emotions. Short-term fatigue and a feeling of depression can be an absolutely natural state of mind and do not require any treatment, and therefore no sick leave. While symptoms lasting more than two months indicate the presence of depression, which is a real disease and for which mandatory treatment is necessary.

One of the biggest problems associated with the recognition of depression as a disease is the poor awareness of the population about this disease, its causes, development factors and consequences, as a result of which there is a widespread opinion in society that depression is not a disease at all, or at least it can be easily ignored. At the same time, in severe forms, depression can lead to the inability to carry out even normal daily household activities, to the person causing harm to himself, mutilation, or even to the manifestation of suicidal tendencies.

Accordingly, this disease definitely needs treatment. And the presence of additional burdens and responsibilities, including those related to work, can seriously interfere with the process of treatment and rehabilitation of a person. Therefore, it may be necessary to take out sick leave for depression.

The diagnosis of “clinical depression” is made exclusively by a doctor specializing in psychiatry. The need to visit a psychiatrist or the possibility of obtaining a certificate, even a sick leave certificate from him, seriously frightens many citizens, which drives them into an even more depressed state. However, in fact, there is nothing wrong with treating depression - it is a disease, the same as a common household injury or bronchitis, and in the same way requires treatment to improve your standard of living and increase your ability to work.

Sick leave for depression - legislative standards and legal regulation

Before looking directly at the legislation relating to depression, it is worth considering general principles legal regulation of the provision of sick leave. Thus, it is ensured by a number of regulatory documents and acts, including federal laws, government regulations and orders of the Ministry of Health, which regulate most aspects of the functioning of the insurance system during the period of a citizen’s incapacity for work.

The right to release a worker from work without any consequences during illness is directly enshrined in the Labor Code. At the same time, during sick leave, the employee is also paid compensation - determined depending on the maximum permissible amount, the presence of a certain insurance period for the patient, as well as his average earnings and the duration of sick leave.

However, in addition to these standards, there are still separate principles that ensure legal regulation conducting psychiatric examinations and treatment. First of all, it should be noted that when clinical depression is diagnosed, compulsory treatment is not prescribed - a person can be forced to stay in a psychoneurological dispensary or other closed institution only by a court decision if his condition poses a threat to society or the person himself.

Also, dismissal of an employee diagnosed with depression is not allowed - but in some cases it may be necessary to transfer him to another position, temporary or permanent. Especially if the patient works with dangerous and harmful factors or is in public service. But in general situations, a diagnosis of depression by a psychiatrist should not in any way affect the work activities of most people. Russian citizens, so there is no need to be afraid to seek the necessary treatment.

All antidepressants for depression should be prescribed exclusively by a doctor and include regular monitoring of the patient's condition. Some of today's antidepressants may also reduce concentration levels and the ability to operate precision machinery and work in hazardous positions - which should also be taken into account when managing and issuing sick leave.

How long does sick leave last for depression and other nuances?

It is almost impossible to accurately predict the duration and possible consequences of a disease such as depression. This pathological condition, even with modern specific treatment, can last for several years - and for such a period, sick leave for depression, of course, will not be issued. However, the final decision on the need to grant exemption from work is always made directly by the attending physician who examines the employee.

In some cases, working can be extremely difficult or even impossible due to depression. In other cases, socialization may be one of the ways to solve this problem and the doctor may not issue sick leave precisely for the purpose of rehabilitating the patient, including through staying in a certain society and conducting regular work activities.

Employers should remember that depressed employees’ productivity can decrease by up to 90%, while no repressive or administrative methods of influence on such employees may have any effect, but only aggravate their condition. Considering the long-term nature of depressive disorders and the significant decrease in a depressed person’s ability to work, the decision to send an employee on sick leave can be much more beneficial for the enterprise than forcing him to continue working and ignoring the existing problem.

In general, the duration of sick leave for depression is rarely less than 14 days, since this disease requires long-term observation and professional therapy. However, over a month, extension of sick leave for depression can be made solely by the decision of a separate medical commission, and not just the attending psychiatrist.

Is sick leave given if a person is suddenly overcome by depression, and what diagnosis will be written down on the sick leave? Such questions were asked during a direct line on the topic “Autumn depression: how to get real help. The event took place at the Public Reception of the Head of Komi and was dedicated to World Day mental health.

The invited experts immediately explained that autumn depression is not much different from any other depression. It’s just that in the fall the number of people who are in a depressed state of mind increases. This is largely due to the lack of sunlight and gloomy weather.

The first person from Syktyvkar to call listed the symptoms of depression familiar to many: constant fatigue, drowsiness, bad mood, don’t want to go anywhere, don’t want to see anyone.

– The main thing is that I don’t want to go to work. And this is not out of laziness,” the woman convinced her interlocutors.

Having learned that a city resident had been in this state for a month, the psychotherapist of the Komi Republic psychiatric hospital Sergei Zaborovsky advised to contact a specialist - a psychotherapeutic center, which is located in the Syktyvkar town of Kochpon at the address: Naberezhnaya, 9/1. Sergei Zaborovsky emphasized that everyone has a bad mood from time to time, but if symptoms of depression are observed for more than two weeks, this is a reason to seek medical help.

The caller complained that it was hard for her to get out of bed, and she couldn’t even run from work to the hospital and back to work again. Sergei Zaborovsky assured that even depression, which many Russians do not consider a disease, can become a reason for issuing a sick leave, which will free the patient from the need to “run” to work and give the opportunity to concentrate on treatment.

A call from a good friend took me by surprise. Through tears, the girl with whom we once studied on the same course said that now some kind of total “dark streak” had begun in her life. There was a divorce with my beloved husband, conflicts with my parents, and even a bag with documents and money was snatched out of my hands on the street. One joy is that there is a new job. But the situation is such that it is absolutely impossible to work. What to do? Is it possible to take sick leave for a while? And who should I contact?

To find out the answer, I got on the phone and immediately called several familiar organizations. (let me clarify that we are talking about St. Petersburg realities). After some time, based on various leads, we managed to reach a city psychotherapeutic center. And it was there that a specialist named Eleonora Fedorovna said: sick leave for acute conditions can actually be obtained. But not at their place, but... at a psychoneurological dispensary - from their area.

One of these dispensaries is within five minutes’ reach, so it will be faster to walk than to call. By luck, the chief doctor was on the spot. “Breslav Boris Emmanuilovich,” said the sign on the door.
The conversation did not go as planned from the very beginning. In any case, the owner of the office asked to turn off the recorder. I had to do it the old fashioned way with notes in a notebook and a natural recording device based on gray cells...

The main question is this: if a person has prolonged apathy or a nervous breakdown, is this grounds for taking out a certificate of incapacity for work?

Psychiatry is a field of medicine - like any other. Therefore, let’s say the “nervous breakdown” you mentioned is a common expression. As, for example, with a cough - it can be caused by acute respiratory infections, bronchitis, pneumonia, tuberculosis and even cancer. Therefore, the doctor must listen to a person who comes with a specific complaint regarding a serious, acute condition, understand what is the matter, make a diagnosis and determine one of three options. This can be either “sick leave” for a while, as in any other clinic, or hospitalization, if we are talking about the possibility of suicide. Or just recommendations when none of this is required, Boris Emmanuilovich explained.

The period for which sick leave of this kind is given is from two weeks to two months or more. And the new medical classification involves a wider range of formulations than before. Therefore, such a familiar word as “depression” may not appear there, although it hides one of the depressive states.

In essence, our dispensary is a clinic, only its profile is special. There are not only psychiatrists here, psychotherapists and psychologists also work here. But due to the peculiarities of perception of this area in society, people do not come to us for early stages, worsening your condition over time. The abbreviation “PND” still scares many, which is a pity. After the terrorist attack, they contacted us, yes, the interlocutor noted.

The key answer seems to have been received. Yes, if a person is literally “torn from the inside”, if it is impossible to work, then it is quite possible to get that very piece of paper. And the diagnosis will not be written down there (although in electronic form, the database still assumes this). But, alas, the “PND” stamp and the card issued in such an institution are an almost indelible mark in many respects. Including in terms of profession. A medical examination or a driver’s medical examination is one thing, filing a specific complaint is another. After this, you can “fly” from some places of work.

True, there is good news. As we also managed to find out, as a last resort, there is a way out - to go to a regular district clinic, to a neurologist. Moreover, according to one of the orders of the Ministry of Health, psychotherapists must also work in medical prevention rooms. But, frankly speaking, this is not implemented everywhere. And there was no such specialist in the nearest clinic. But, in any case, with the seal of such an institution, the certificate of incapacity for work should not affect the image and future career. But whether, in the absence of a psychotherapist, it will be possible to convince the doctor of the need for a forced pause, and how effective the treatment will be, is a matter of a purely human factor.

Elena Petrovskaya