America’s Most Depressing Jobs?

By Neuroskeptic | June 10, 2014 3:54 pm

An interesting study just published examines the rates of clinical depression experienced by workers in different jobs.

It turns out that people involved in ‘Local and Interurban Passenger Transport’ are most likely to be treated for depression. By contrast, those employed in ‘Amusement and Recreational Services’ are less than half as likely to experience it – at least, in Western Pennsylvania, where the research was conducted.

Here’s the paper: Prevalence rates for depression by industry: a claims database analysis, by Cincinnati researchers Lawson Wulsin and colleagues.

The data were anonymized care records from Highmark Ltd. which is “a Blue Cross Blue Shield insurer providing health insurance for the majority of the working population” in Western Pennsylvania (and elsewhere).

Highmark’s data included the occupations and medical claims for 214,413 working adults over the period 2001-2005. Depression was defined as two or more claims using disease-specific cost codes such as ‘major depressive disorder’. Note that the unemployed, disabled, and retired, were not included in this dataset.

There were 55 industries with at least 200 employees. Here’s the rates of depression for the top 10 and bottom 10 job categories (the overall average rate was 10.5%):


Is there a pattern there?

Although there are a couple of exceptions, a glance reveals more ‘service’ industries amongst the 10 most depression-prone, while the bottom 10 is dominated by ‘manufacturing’ or ‘blue-collar’ jobs. Wulsin et al examined the predictors of depression rates in much more detail and concluded that

Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress, and low levels of physical activity.

Which makes intuitive sense if you go with the idea that those are actually more depressing jobs, i.e. that they cause depression, rather than (a weaker claim) just being correlated with it or (weaker still) being correlated with people reporting it to their doctors.

However, is that true the world over or is it just a Westsylvania thing? It’s interesting to contrast this paper to one I blogged about in 2012. That study showed that, in the UK, blue collar occupations were amongst those with the highest rates of suicide, over the period of 2001-2005. Coal mining occupied the #1 spot in the British suicide rankings but in Western Pennsylvania, remember, coal miners had amongst the lowest rates of treated depression.

It’s true that we can’t directly compare treated depression rates and suicide rates, but this does seem like a dramatic contrast. Presumably the answer lies in the sociology and history of the two areas; but that raises the question of whether Wulsin et al’s results would generalize to other parts of the USA – or other time periods.

ResearchBlogging.orgWulsin L, Alterman T, Timothy Bushnell P, Li J, & Shen R (2014). Prevalence rates for depression by industry: a claims database analysis. Social Psychiatry and Psychiatric Epidemiology PMID: 24907896

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  • Hominid

    Productive people are happy; people who run their mouths or sit on their behinds (nonproductive people) not so much.

    • Toxteth O’Grady

      I think your explanation is better than the authors

    • Neuroskeptic

      The “Atlas Smiled” theory?

    • Gandolfication

      What about people who post comments in online chat forums?

      • Hominid

        They weren’t broken out for analysis in the study. Didn’t you read it before asking your question?

        • Neuroskeptic

          I think you’ve missed the point somewhat…

          • Hominid

            I think YOU’VE missed my point by a mile.

          • Barbara Alsop

            Productivity is a relatively small part of the problem. I was a high producer in my stressful job, and I fell apart because I put too much into the job.

    • Peter McIlhon

      But does happiness drive production, or the other way around? I think you’re right either way.

      • Hominid

        Good point! I think they go hand-in-hand.

    • calling all toasters

      So no one produced anything sitting on their behinds? Shakespeare and Einstein were just moochers, I guess.

      • Hominid

        Gee!! You got two out of hundreds of billions! We’re talking GENERAL population here, dummy. And, we’re talking about what leads to a happy life for the average Joe, not Einstein, Einstein.

        Of course there are people who achieve without physical labor – there’s nothing wrong with mental labor – and who never produced a tangible product. How many humans do you think fall into that category?

        • calling all toasters

          You really need to familiarize yourself with post-Pleistocene society.

        • anthony van dalen

          In America today? Most.

    • marc

      Myself I saw in my work many people always sitting ontheir behind always in depression and tired of their work ( pain on desk,pain on head ! ) . Myself a little bit more active working some days 18 hours,on week end,hollidays, and nearly all time standing up ,without any problem at all and in good health ( at least I think ) . Lazyness and self compassion are not always the best path to fellow .

  • Alan_McIntire

    I suspect that PART of the reason involves economic or social factors. Those closer to the top may be making more money to SPEND on depression, and depression may be an accepted mental problem. Those closer to the bottom rung may make less money, can’t afford to waste it on treatment for “depression”, or alternatively, “depression” isn’t considered a valid treatable illness among their peers.

    • Neuroskeptic

      But all of the people in this study were enrolled in the same health plan so they could all afford treatment (or rather, it was paid for). In theory anyway.

    • JH

      The problem is, the relative income has nothing to do with the order..for example ‘Oil and Gas extraction’ although at the lower end as far as depression rates, make far more income than most of the industries in red.

    • marc

      FULLY RIGHT . Not to forget people who don’t work who will ,maybe,enjoy the “depression” of any kind of decent work . Of course not if you are a working poor ……………

  • Someone

    #1? Dentists.
    Because they’re always down in the mouth.

    • Neuroskeptic

      *boom boom*

  • Michki067

    That’s it! Give Millennials even more excuses for not wanting to work like their parents and grandparents did. It’s depressing. Boo hoo hoo.

    • Bronwyn (デイ)

      I fail to see what that has to do with anything. Considering they didn’t measure for depression rates in the unemployed (and because that area’s fraught with confounds besides), your “point” is moot at best, and irrelevant besides.

    • Atwood

      Yeah, quit asking questions and looking for answers because maybe the results will give some group you don’t like some kind of information you think they’ll misuse!! Psht, science, don’t you know better than to do that?!

  • Brian williams

    I don’t see fast food restaurant or wal mart employee at the bottom of this list.

    • Sarah Brilliant

      Yep, and it seems to me that some of the most depressing jobs are the ones that don’t provide health insurance, so basing the study on data provided by an insurer is going to miss a lot.

      • Neuroskeptic

        Good point.

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  • Bronwyn (デイ)

    “It’s interesting to contrast this paper to one I blogged about in 2012. That study showed that, in the UK, blue collar occupations were amongst those with the highest rates of suicide”

    Not that interesting, actually. Suicide does not equal depression, and depression does not equal suicide. There are many causes of suicidal behaviours, and only only of them can sometimes be severe depression. Take into account suicides to escape family debt (i.e. the reason getting hit by a train is no longer covered by Japanese life insurance) and other social pressures, as well as the severity of depression when it occurs (who knows, dysthymia may be more common than severe depression in the service industry as opposed to more blue-collar jobs, which would increase the rate of depression but not suicide) and you’ve got a very differently painted picture than is being assumed in the above statement.

    • Lyz Orodcan

      I believe some sicities are more prone to look for self worth in people’s reactions to what they do. Americans, in my experience, can be hypersensitive and overreactive, so the result of the service provider’s social interactions is unlikely to help his sense of selfworth. On the other hand producing something people need or want can be a more objective source of self value

      • Bike Pretty


    • Krusty_From_Oz

      Just being in the UK would do that.

  • emmanuelozon

    My sister is “depressed”. When she went to her doctor about her ‘depression” he gave her lots of pills. She now weighs 320 pounds; up from 145. And all the pills that her doctor has given her are causing her to feel suicidal. So she doesn’t work anymore because her “depression” is an excuse to collect disability. Thanks doc.

    • Barbara Alsop

      Why do you put the word depression in quotation marks? Are you suggesting that your sister is not clinically depressed? I would more trust the doctor’s diagnosis than yours.

  • Truth

    Humanity has allowed all to happen, That is the choice everyone has made. Depression has nothing to do with responsibility of actions, and non actions.

  • Barbara Alsop

    I spent years as a lawyer and the last two years of my career as an asylum officer. Not only is is stressful for the reasons you mentioned, it is doubly stressful hearing tales of torture and discrimination from people from other parts of the world. No one in the office was happy, and some of us caved to the secondary emotional trauma enough to have to leave the job.

  • ralph Cramden

    In the rapid transit line of work we do not see passengers as customers anymore but creatures that can’t afford a car or the bike creatures who are in the DUI club.

    • Bike Pretty

      “the DUI club”, that’s hilarious! I definitely have mixed interaction with the transit workers. Glad they are providing a service, happy not to use it, and occasionally terrified that they are going to run me over. As a bike rider, I think of buses as “spiders”.

      Also, very glad not to have to ride the bus anymore. I’d rather bike in the rain than take the 15.

  • GivesItThought

    I can testify working in the publishing industry is incredibly depressing for all involved.

  • SisyphusRolls

    Is this controlled for male-female? It doesn’t look like it.

    Women are more likely to be in service jobs. Women also generally report depression at a higher rate than men (“report” being the most important aspect there, as incidence might even run the other direction). That one confounding variable might explain most of the differences in this chart.

    However, I don’t think it is likely to explain the local passenger transit category topping the list. Although there are plenty of female commercial drivers, I suspect it is not a majority female field. Although it would require at least a multivariable regression to have a better sense of it, I suspect there might actually be something specifically depressing about local passenger transit.

  • Katherine Hill

    It looks to me like the folks at the top of the list are generally in sedentary jobs and the folks at the bottom on in more physically active jobs. That alone could explain the difference in my experience.

    • dianegordon

      I think you’re right, Katherine!

  • Larry Maher

    I think you have to fit the wrench to the nut. I was a carpenter and hating every f’in day of it. Soooooooo, I took a personality test moons ago and it rank my job 499 out of 500 on my personal likes. Enlisted navy swabby was 500:) Ho hum.

  • LionelN

    I would think that gender might play a large role here. Most of the professions reporting less treatment are male dominated. it’s quite possible that they are self treating in male ways (e.g., drinking to excess) rather than seeking therapy.

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  • anthony van dalen

    In case it has not been mentioned, I would have guessed that a lot of this has to do with the sort of jobs already depressed people can get and non-depressed people favor. On the face of it, what is so depressing about selling people houses? Perhaps the answer is that instead lots of depressed people who find regular hours difficult become agents.

    In response to the correlation with physical activity, well, duh. People who drill for oil are young and energetic with a willingness even enthusiasm to go to the often curious places oil is found, and then get well paid for it. Shock and surprise, these people are rarely depressed. On the other hand, if you are in a certain kind of job because of your poor physical condidion, guess what, people in poor health get depressed a lot.

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  • Heather Twist

    Ok, so I am in a rather well-paid profession that is all about serving the client. I’m talking software. You tell me what to write, and I write it. I DO regard it as a service … but I don’t notice that my fellow servers are depressed. We rather enjoy what we do. We are well-paid, respected, and it’s easy work (if you are into programming).

    I think it may more be about CHOICE. I mean, if you don’t like one client and can just go to another, that is way different than working for, say, a coal mine which is the only game in town.

    Software developers, right now, have it super good, because they can contract all over the world. How can a coal miner do that?

  • Krusty_From_Oz

    People in direct contact with the public are more likely to be depresses, ‘cos the public are rude and behave badly.

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  • FieldingBandolier

    Superimpose this graph on a graph of firearm ownership by occupation and suicide rate by occupation, and much will become clear to you.

  • M Joan Massat

    Nothing in this article suggests that researchers controlled for the sex of the individuals treated. Many people do not seek treatment and a disproportionate number of those who go untreated are male.



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About Neuroskeptic

Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.


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