Mark Meier, a onetime manager for a Minneapolis medical clinic, has the tickets to talk to business people about depression.

Meier, 41, the married father of three, quit a job and nearly killed himself several years ago during a deep bout that rendered him indecisive, despondent and self-loathing.

There's a human and a business case to be made for prompt treatment of depression, which if left unchecked can become chronic and debilitating for the sufferer and costly for employers.

"Being depressed is still filled with lots of stigma and anguish," Meier said this month to an acknowledging group of managers and merchants from Patina, the Minneapolis retailer.

"Productive people can check out for a few days to weeks. It gets to the point that they can't seem to do things you know they can. It can impact everybody. But let's recognize it and refer people who need help.

"I mean, you can get a prescription for a good, generic medication from a doctor for as little as $4 at Wal-Mart. That's not much compared with calling in sick several days a month, or showing up and not producing."

Meier calls that "presenteeism.'"

Depression is a leading cause of suicide. And there are more than twice as many suicides as homicides, according to the federal Centers for Disease Control and Prevention in Atlanta. We've all heard of folks who have died by their own hand, due to an inability to cope with depression.

Meier's story is encouraging. And it's interesting to note that since he's learned to manage his illness, Meier has turned down a couple of six-figure corporate job offers to focus on his one-man business. That allows him to collaborate with doctors, nurses, educators, businesses and others to present the problem and common-sense solutions to those extended periods of doubt and darkness.

His business is called "Equalicare," and he expects to gross about $100,000 in 2008 revenues.

At first, denial

Twenty years ago, when Meier first sought help from a college campus doctor, the physician deduced that the otherwise-healthy hockey player was suffering from anxiety and depression.

"I headed to the Foul Play bar and had a couple of beers," said Meier, who associated that diagnosis with being a wimp. He told nobody and tried to cope by himself with bouts that could last days or weeks.

Most of the time Meier, who earned a master's degree in social work, could be an energetic manager and colleague. One client he helped named a child for him.

In 2000, Meier was a $75,000-a-year manager of a DaVita kidney dialysis clinic and suffering from increasingly severe rounds of despondence.

"I started to miss deadlines and I was increasingly difficult to work with," Meier recalled. "No sense of humor. I couldn't make routine decisions. I told my wife [Amy] and went to a psychiatrist, but refused to take any medication. I got it in my head that if I quit my job as administrator my depression would subside."

He did quit, then spent the next few weeks at home "trying to get my life in order, continuing to refuse any treatment, and getting by. I took a job with Renal Network 11 in late March or early April of 2001."

Sinking deeper

He struggled through the following year and a half, getting progressively worse. "It gets worse, if you don't do something. It was Labor Day weekend of 2002 that I finally lost it," he said.

Meier had borrowed a gun and was contemplating suicide. His wife found him with the gun one night after she got home from a nursing shift after midnight. Their three kids were sleeping. He was a miserable mess.

She insisted he go to Hennepin County Medical Center. He was hospitalized, counseled and put on medication. Meier continues to take a common, low-cost medication and leads a healthy lifestyle. He's able to handle stress better. He talks about his illness, punctuating sentences with endearing chuckles.

I am glad he's with us, working, raising kids, paying taxes, helping folks.

Depression, like heart disease and other illnesses, can be managed. The earlier the intervention, the better. The alternative can be devastating in human and economic costs.

Meier's one-hour presentation at Patina was well received. A Patina manager asked whether an employer could get in trouble or at least violate privacy or comfort zones with questions or a depression-awareness campaign.

"It's not your job to diagnose but to be aware," Rick Haase, a Patina owner, told his managers. "Sometimes people may just need a card or a brochure to inform them where to get help. Bring the issue out in the open: 'We at Patina care about you and want you to have the resources to get better.' "

Many employers, through health plans or employee assistance programs run by third parties, provide discreet ways for employees to get help. And there are telephone hot lines and nonprofit clinics for employees who lack those benefits.

For more information: www.equalicare.com; the National Institute of Mental Health (www.nimh.nih.gov); and the Depression and Bipolar Support Alliance (www.dbsalliance.org).

Neal St. Anthony • 612-673-7144 • nstanthony@startribune.com