Finding Depression Care That Fits a Packed Executive Calendar : The American Centinel

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.

Ask a busy executive when they last had an hour to themselves, and many will laugh. Back-to-back meetings, travel, client dinners and family obligations fill every slot. So when depression sets in, treatment can feel like one more appointment there is no room for.

That reasoning makes sense on paper. It becomes dangerous when depression begins to include thoughts of suicide. At that point, care is not a calendar item to be fit in someday. It is the priority, and the schedule has to bend around it.

Treat it like any urgent matter

Leaders know how to clear space when something truly matters: a major client issue, a family emergency, a crisis at a plant. Depression with suicidal thoughts belongs in that category. The same skills used to handle a business emergency, such as delegating, rescheduling and asking for help, apply here.

A composite example: a managing partner in his forties might block two mornings a month for appointments and label them simply as personal time. No one at the firm needs to know more. That small act of protection can make ongoing care possible.

A physician who runs a busy practice could do something similar, setting aside the last hour of one clinic day each week. The point is not to hide care forever. It is to give it a protected place on the schedule.

Practical ways to make room

Ask an assistant or trusted deputy to protect certain blocks without asking why
Look for clinics that offer early morning, late afternoon or virtual visits for some appointments
Choose a clinic close to home or the office to cut down on travel time
Bring a spouse or friend into the planning so the logistics do not fall entirely on you
Shorten or move travel for a season if needed

Privacy is part of fitting care into a calendar. A leader can decide exactly who needs to know about appointments, and that list can be very short, perhaps a spouse and one assistant. Most people at work only need to know you are unavailable at certain times, which is true of every busy executive anyway.

Know the warning signs

Scheduling should never delay help when someone is at risk. Warning signs include talking about wanting to die, feeling hopeless or trapped, withdrawing from people, sharp changes in sleep, more drinking, or a sudden sense of calm after a long low period, which can be a warning sign. Any of these call for prompt attention.

If you are worried about a colleague, ask them privately and directly if they are thinking about suicide. If they say yes, stay with them and help them reach 988, and call 911 if there is immediate danger.

A treatment that takes planning

For leaders whose depression includes suicidal thoughts, one option a clinician may discuss is Spravato. Spravato (esketamine) is a nasal spray the FDA has approved, taken along with an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. It is also approved for treatment-resistant depression. It is not a crisis treatment: it does not replace emergency care or a hospital stay when one is needed, and it has not been shown to prevent suicide or to reduce suicidal thoughts or behavior. It is given only in a certified clinic under a safety program called the Spravato REMS. The patient takes it there under supervision, stays at least two hours to be monitored, and does not drive until the next day after a full night of sleep. It is never dispensed for home use. Whether it fits is a clinician's decision after an evaluation.

Recovery is worth the time

Depression is treatable, and recovery is possible for busy leaders as much as anyone. Care takes time, and it is possible to schedule it with discretion.

Thirty minutes is shorter than most board calls. Some clinics that provide this treatment offer a free 30-minute consultation, scheduled around your week, where you can ask questions and see whether an evaluation fits. A family member is welcome to attend with you.