This is an archived article that was published on sltrib.com in 2006, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

At first, it seemed as if little things were going wrong. Bonnie Harris forgot about sales appointments; she couldn't recall colleagues' names. But as her job in sales became more stressful, Harris developed intense mood swings and moments of terror. She saw psychiatrists, who prescribed various medications, but the drugs only made things worse, she says.

At one point, she tried to throw herself out of a window.

It wasn't until Harris, an earlier victim of violent crime, was diagnosed with post-traumatic stress disorder, or PTSD, that she began to recover with the help of therapy and meditation. But through her entire 1991 episode, she kept working, trying to camouflage what was going on.

''I went to work every day. I was a top salesperson, working 60-hour weeks,'' says Harris, 44. ''Co-workers knew I was moody, but no one knew how bad it was. You don't tell people at work that you have this mental illness. It's so shameful.''

Today, Harris runs her own firm, Wax Marketing, in St. Paul and knows how to manage PTSD when symptoms creep up. Despite its stigma, a growing number of employers and employees are addressing a topic that has long been taboo - mental illness in the workplace.

Employees' emotional health, a topic that once seemed incongruous with the survival-of-the-fittest corporate arena, is getting attention as a real bottom-line issue. Employers are beefing up mental health services as new research shows the staggering cost of mood disorders - depression, anxiety and panic disorder, bipolar disorder, schizophrenia and obsessive-compulsive disorder - can have on businesses.

For example:

l High costs. Untreated mental illness costs the United States $105 billion in lost productivity each year, with U.S. employers footing up to $44 billion of the bill, according to the National Mental Health Association, an Alexandria, Va.-based nonprofit.

l Threat of litigation. Federal guidelines issued in 1997 explain how employers can make accommodations for employees with serious mood disorders. Those who don't make accommodations, such as changing an employee's work hours, could be sued. The guidelines are further explanations of the Americans with Disabilities Act, issued by the Equal Employment Opportunity Commission. In fiscal 2004, the EEOC took in $469,000 in financial settlements for employees who complained that they'd been discriminated against because of their depression. Nearly 900 cases were filed. By 2005, that amount ballooned to more than $3 million, and there were 1,005 cases filed in that fiscal year.

l More emphasis on employer help. A number of employers are enhancing mental health coverage or programs. Seven in 10 offer mental health insurance. Eighteen percent have grief-recovery programs, up from 12 percent in 2002.

But companies' mental health coverage often lags behind coverage for physical ailments. Health plans may restrict the number of times an employee can see a mental health provider, for example, thus limiting care. Americans battling depression with limited access to mental health care could face bills of $18,000 annually to cover health-related expenses, according to the National Alliance on Mental Illness. Those with limited access were four times as likely to quit their jobs.

In recent years, famous business and entertainment leaders have given a public face to mental health issues. "60 Minutes" reporter Mike Wallace and newspaper humorist Art Buchwald shared that they've fought depression. Actress Brooke Shields documented her postpartum depression. Actress Ashley Judd revealed she went to a treatment facility for depression and other emotional problems.

Despite the attention, some employees with mental health issues say they struggle with how to tell managers what's going on.

Sara Kobiela, 26, of Livonia, Mich., obtained a master's degree in social work but has struggled to keep jobs because of a depression so severe it left her unable to care for herself or do little more than sleep. She has held a variety of jobs, such as file clerk at a medical office and waitress.

Like Kobiela, many of those with mental illnesses are younger. Mental illness is highest among those 15 to 44, says Joseph Calabrese, a psychiatry professor at Case Western Reserve University and director of the mood disorders program at the University of Cleveland. Depression ranks at the top. Mental health problems can erode work performance and lead to absenteeism.

''These people go to work, but they're the working wounded,'' Calabrese says.

In many cases, those with mood disorders qualify for employment protections under the federal Americans with Disabilities Act, which means employers must make accommodations to help with work.

For a mood disorder to be a disability, it must limit a major life activity, such as an employee's ability to sleep or take care of himself or herself. Some types of accommodations have included allowing employees to work from home, modifying supervisory methods, reassigning them or changing a work schedule.

But employers can ask for documentation of mental illness to be sure a disorder is legitimate, and they can argue whether that disorder is truly a disability under the ADA. Traits such as irritability or chronic lateness are considered behaviors, not mental impairments requiring accommodations. Employers don't have to make accommodations if doing so would impose an undue hardship, and they cannot retain an employee if that worker poses a direct threat.

Lucinda DuToit, director of human resources at Digineer, a technology consulting firm in Minneapolis, says the shift from ignoring to acknowledging mental illness has come as employers become more aware of the link between personal and professional lives.

She also says employers stand to gain valued loyalty from these workers if they make accommodations.

''There's much more of an understanding of mental illness. In the past, it was just, 'We'll see you, bye,' '' DuToit says. ''Now it's, 'We'll get you help.' ''