Mental Problems: Depression, Anxiety

Depression and anxiety can wreak havoc on a person’s ability to work or function in daily life. Severe depression is not simply feeling blue. It is a pervasive and debilitating condition. Severe anxiety is not simply feeling nervous sometimes. Severe anxiety can cause a person to refrain from participating in even simple activities of daily living such as shopping. A person who suffers from severe depression might need to spend days at a time in bed from physical and emotional exhaustion, while a person who suffers from anxiety might need to leave the work station several times a day due to panic. In both cases, a person’s ability to interact appropriately with others and maintain a regular work schedule could be significantly compromised.

If you suffer from depression and anxiety and you are trying to get disability benefits, first of all know that you are not alone. Many people who get disability benefits have some component of depression or anxiety as part of their disability. Even if your depression or anxiety alone is not what is putting you out of work by itself, depression and anxiety could still be affecting your ability to concentrate and focus enough to be productive at your job.

The problem is how do we prove how depressed you are? How do we prove how often you have a panic attack?

Like all mental health issues, depression and anxiety are highly subjective. In other words there is no blood test for how depressed you are. The is no x-ray to show how severe your anxiety is. The only way to prove that you are severely depressed or that you have severe anxiety that is preventing you from working is for you to be in regular treatment with a mental health care provider who can attest to the severity of your problem. It is also critical for you to be compliant with treatment. You should be seeing a counselor, but you should also try to be seen by a psychiatrist who is a medical doctor specializing in mental health issues. The judge is required to pay attention to the opinion of a treating specialist, such as an M.D. psychiatrist. The longer your relationship with the specialist, the more credibility the specialist will have with the judge.

The Social Security Administration’s listing of impairments covers the rules regarding how severe your depression or anxiety needs to be for you to be considered disabled on the basis of your depression or anxiety alone. Those rules are copied here:

12.04 Affective disorders: Characterized by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome. Mood refers to a prolonged emotion that colors the whole psychic life; it generally involves either depression or elation.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.

  1. Medically documented persistence, either continuous or intermittent, of one of the following:
  2. Depressive syndrome characterized by at least four of the following:
  3. Anhedonia or pervasive loss of interest in almost all activities; or
  4. Appetite disturbance with change in weight; or
  5. Sleep disturbance; or
  6. Psychomotor agitation or retardation; or
  7. Decreased energy; or
  8. Feelings of guilt or worthlessness; or
  9. Difficulty concentrating or thinking; or
  10. Thoughts of suicide; or

 

  1. Hallucinations, delusions, or paranoid thinking; or

 

  1. Manic syndrome characterized by at least three of the following:
  2. Hyperactivity; or
  3. Pressure of speech; or
  4. Flight of ideas; or
  5. Inflated self-esteem; or
  6. Decreased need for sleep; or
  7. Easy distractibility; or
  8. Involvement in activities that have a high probability of painful consequences which are not recognized; or
  9. Hallucinations, delusions or paranoid thinking; or
  10. Bipolar syndrome with a history of episodic periods manifested by the full symptomatic picture of both manic and depressive syndromes (and currently characterized by either or both syndromes);

AND

  1. Resulting in at least two of the following:
  2. Marked restriction of activities of daily living; or
  3. Marked difficulties in maintaining social functioning; or
  4. Marked difficulties in maintaining concentration, persistence, or pace; or
  5. Repeated episodes of decompensation, each of extended duration;

OR

  1. Medically documented history of a chronic affective disorder of at least 2 years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
  2. Repeated episodes of decompensation, each of extended duration; or
  3. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or

 

  1. Current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

12.06 Anxiety-related disorders: In these disorders anxiety is either the predominant disturbance or it is experienced if the individual attempts to master symptoms; for example, confronting the dreaded object or situation in a phobic disorder or resisting the obsessions or compulsions in obsessive compulsive disorders.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in both A and C are satisfied.

 

  1. Medically documented findings of at least one of the following:

 

  1. Generalized persistent anxiety accompanied by three out of four of the following signs or symptoms:

 

  1. Motor tension; or

 

  1. Autonomic hyperactivity; or

 

  1. Apprehensive expectation; or

 

  1. Vigilance and scanning; or

 

  1. A persistent irrational fear of a specific object, activity, or situation which results in a compelling desire to avoid the dreaded object, activity, or situation; or

 

  1. Recurrent severe panic attacks manifested by a sudden unpredictable onset of intense apprehension, fear, terror and sense of impending doom occurring on the average of at least once a week; or

 

  1. Recurrent obsessions or compulsions which are a source of marked distress; or

 

  1. Recurrent and intrusive recollections of a traumatic experience, which are a source of marked distress;

 

AND

 

  1. Resulting in at least two of the following:

 

  1. Marked restriction of activities of daily living; or

 

  1. Marked difficulties in maintaining social functioning; or

 

  1. Marked difficulties in maintaining concentration, persistence, or pace; or

 

  1. Repeated episodes of decompensation, each of extended duration.

 

OR

 

C. Resulting in complete inability to function independently outside the area of one’s home.

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