Liza and her husband, James (not their real names), own a successful small business. A few years ago they got hit with the perfect storm--a personal crisis, the recession, Liza's undiagnosed thyroid problem and depression.

Liza's depression made it all the more difficult to recover from the personal crisis and the recession. Predictably, the business suffered. Liza, who does the bookkeeping and content writing for the graphic design business said, "During the years I battled depression, a lot of the writing had to be done by a contractor. That meant more money out the door. The bookkeeping suffered tremendously as well. I got more and more behind because I could only do the bare minimum. Sales taxes got filed late, statements didn't get reconciled for months, receipts and expenses stacked up and didn't get entered into the accounting program. A lot of our invoicing was done haphazardly and I'm sure we just didn't bill some of our clients at all."

It's everywhere

Depression isn't something that just affects other people. And it's not simply a personal problem that is handled in off-hours. It affects businesses, and it probably affects your business. The Integrated Benefits Institute estimates that for every 100 employees, businesses spend $62,000 because of depression.

For Liza, the exact costs of her depression will never be known. Lost business, lost revenue, late fees, and perhaps clients who would have come on board but didn't due to Liza's inability to respond to things quickly. When depressed, says Liza, "Everything feels bigger than it really is. The drive to the office, the bother to get ready, getting the day's tasks ordered (or even just written down) -- it all just seems impossible. I didn't eat much when I was depressed, and what I did eat was definitely not the most nutritious food. Poor nutrition and sleep just compounded the depression."

Liza says if she weren't a business owner, she surely would have been fired. Patricia (not her real name) also faced depression, an ever-increasing workload, and an unhelpful boss. Unlike Liza, she was fresh out of college and facing her first "real" job. Before she started work, her boss told her that she was his "third or fourth" choice for the position, which meant she started the job feeling less than competent.

The depression plus the micro-managing boss meant that Patricia developed bad habits that were difficult to overcome even when she started receiving treatment for her depression 18 months into the job. By that time she'd decided to resign. When she did, her boss informed her that they had been planning to fire her anyways. When she disclosed her struggles with depression, the very boss who had treated her poorly said, "Well, why didn't you tell me sooner? We could have helped you!"

Patricia doubts that this boss, whom she describes as the biggest thorn in her side, could have helped her if he had known. She's moved on and switched careers altogether and continues to treat her depression with medication.

How to respond

The Americans With Disabilities Act (ADA) requires businesses to make "reasonable" accommodations for people with qualifying depression. That can vary from job to job and person to person, but the person suffering from the depression needs to speak up in order to get help. Patricia's boss may have been able to help her if she'd declared her problem, and if he were aware of the laws around people with disabilities.

For small business owners, a depressed employee may be even more debilitating than he or she would be for a larger business. Whether it's the boss or an employee, the costs to the business can be high. Even small businesses may find it worthwhile to invest in an Employee Assistance Program, which can help people navigate through depression by helping them find appropriate therapists and doctors. According to the Integrated Benefits Institute, medication and psychotherapy can be successful in 70 to 80 percent of  cases.

Remember that the law requires "reasonable" accommodations. Even to the extent that some accommodations are not reasonable, most depression, when treated, is temporary. You don't want to lose an otherwise top employee who is suffering from a treatable illness. Proceed with caution and compassion.