When the Body Says Stop: Why Our Understanding of Help Fails Those Who Struggle Most

## Introduction There is an uncomfortable truth: an increasing number of workers are reporting sick because of mental health issues — stress, burnout and depressive symptoms that disrupt both quality of life and work capacity. At the same time, the foundations of how we understand and treat depression are being shaken. According to Aftenposten, it is now clear that "Antidepressants do not seem to work the way we thought," and that "Researchers no longer believe depression is linked to low levels of serotonin." This challenges not only the pharmaceutical industry and clinical practice, but also employers and HR functions who today approach mental health at work through measures that partly rest on assumptions about diagnosis and treatment. In this article I take an opinionated approach: I argue that changes in the research landscape should force a new strategy in the workplace. As biological explanatory models weaken, it becomes even more important that companies, managers and policymakers invest in prevention, genuine workplace accommodations and holistic follow-up. I base my argument on findings and formulations from Aftenposten's coverage (Maria Jelmini, published 05.03.2025), while discussing the implications for sick leave, workplace stress and burnout. I also look more closely at how AI therapy could play an important role in future mental health offerings at work. ## What does the research say now? As reported in Aftenposten by Maria Jelmini (published 05.03.2025), one of psychiatry's most widespread explanatory models is being torn apart: the theory that depression is primarily caused by low levels of serotonin in the brain. Aftenposten summarizes this precisely: "Researchers no longer believe depression is linked to low levels of serotonin." It also points out that "Depressed people tend to have higher levels of the stress hormone cortisol," and that this can have a complex impact on brain function. This does not mean that medication is necessarily wrong, but it does mean we must reassess why drugs work for some and not for others. Aftenposten raises a fundamental and important question: "Why do antidepressants still help so many?" The question frames an epistemological problem: treatment effects may arise from other causes than the mechanisms we previously assumed. For the workplace this matters because many HR measures, sick-leave follow-up processes and expectations about rapid return to work are partly built on standardized treatment pathways. When our understanding of depression changes, the approach to work-related mental ill-health must also change. ## How can AI therapy help? As research challenges traditional explanatory models for mental disorders, digital tools and artificial intelligence have become increasingly relevant in workplace mental health. AI therapy, in the form of digital conversational partners and apps that use machine learning to adapt to users' needs, can provide fast, accessible and low-threshold support to employees experiencing job stress, burnout or depressive symptoms. ### AI therapy as a supplement to traditional treatment AI therapy does not necessarily replace medication or conversations with a psychologist, but can serve as an important supplement. For example, AI-based apps can offer daily support, guidance in coping strategies, mindfulness exercises and cognitive behavioral techniques — all tailored to the individual user's challenges. This can be especially useful for employees waiting for treatment or who prefer to work on their mental health at their own pace. ### Early intervention and prevention Another area where AI therapy can make a difference is early detection of symptoms of stress and burnout. Through regular digital check-ins or conversations with AI tools, early signs of mental strain can be picked up before problems develop into serious sick leave or mental disorders. This gives both employer and employee an opportunity to act early, for example by adjusting workload, providing HR support or referring to further help. ### Reducing stigma and lowering the threshold for seeking help Many people hesitate to talk about mental health because of stigma and fear of repercussions at work. AI therapy offers an anonymous, round-the-clock channel where employees can explore their challenges without immediately having to "come forward." This can help normalize conversations about mental health at work and make it easier to ask for help. ### Tailored support and continuous follow-up AI therapy enables continuous follow-up — tools can remind users of healthy routines, support them in managing daily stress and suggest concrete measures tailored to the user's situation. This can help reduce the risk of long-term sick leave and support employees in a gradual return after burnout or depression. ## What does this mean for employees and employers? For employees, the new knowledge that antidepressants do not necessarily work by "filling up serotonin" may feel disorienting. Many who have experienced relief from medication or therapy are left asking: "What really helped me?" For employers and HR leaders, the shift means they cannot blindly rely on short medical fixes as the whole answer to getting employees back to work. In practice, we need more robust organizational measures that address workplace causes: high tempo, unclear expectations, poor leadership, lack of control over one’s work situation and cultures that make it hard to speak up. Here AI therapy can play a role by offering a low-threshold service for employees so they receive support before problems escalate. Managers can also use anonymous feedback from such tools to gain insights into the work environment and better tailor accommodations for mental health at work. It is tempting to believe that medication alone can fix an overloaded employee who returns to the same stressful environment. But if the root cause is work-related stress or chronic overload, medical treatment is only one part of a larger solution. Employers must therefore ramp up preventive efforts and real accommodations: reduce workloads, clarify role descriptions, ensure breaks and flexibility, and train managers to handle mental ill-health. This is not only about reducing sick leave; it is also an ethical duty to protect employees' health. ## Sick leave related to mental disorders: a demanding reality Sick leave due to mental disorders has long been a central challenge for Norwegian employers and society at large. As traditional explanatory models weaken, the complexity of how we must address this type of sick leave becomes even clearer. Aftenposten's coverage reminds us that biological explanations are more nuanced than previously thought, with factors such as stress hormones and networks of influences in the brain playing a role. For the individual worker, this means expectations of a simple "cure" must be tempered. For HR and managers, it means sick-leave work must be individualized, tailored and multifaceted. An effective return-to-work program can include flexible hours, gradual ramp-up, changes in tasks and systematic support such as conversations with occupational health services and accommodation plans. Here AI tools can help follow up employees through digital reminders, check-ins and tailored support services, which can contribute to reducing sick leave for mental disorders and support employees in the transition back to work. Such measures require resources, expertise and time — elements many organizations find difficult to prioritize in the short term. But as a moral and economic imperative, long-term thinking is necessary; being reactive and focusing only on medication does not address root causes and gives poor return on investment in human capital. ## Why individual follow-up and prevention must be central The research shift around antidepressants makes it more necessary to strengthen preventive work and individual follow-up. When we can no longer point to a single biochemical explanation, the approach must be multidisciplinary: combine psychosocial interventions, psychological treatment, ergonomic and organizational changes, and in some cases targeted medication. Aftenposten explicitly asks why antidepressants help many — and the answer often lies in treatments working through multiple channels beyond those we thought. In the workplace this means HR measures and leadership must be more precise: map sources of stress, involve employees in designing solutions, follow up gradual returns and create a culture where it is safe to seek help. AI therapy can contribute by providing continuous support and feedback, and by making it easier to identify and follow up employees in need. It is also necessary to equip managers with tools to detect early signs of stress and burnout and to act without pathologizing normal reactions to unsustainable working conditions. This is an art of balance: show care and flexibility without making the responsibility for the work environment something the individual employee must bear alone. ## Practical measures employers can implement today 1) **Mapping and prevention:** Start with broad mapping of workload, role ambiguity and stress levels in teams. Use anonymized employee surveys and conversations to identify systematic problems. Include digital assessment tools and AI-based check-ins to capture early signs of stress and mental ill-health. Prevention not only extends careers, it also boosts productivity and reduces turnover. 2) **Manager training:** Invest in training middle managers to recognize early signs of mental strain, to hold difficult conversations and to implement concrete accommodations. Good managers are often the single most important factor in preventing stress-related sick leave. Digital tools and AI-based coaching systems can support managers in this process. 3) **Accommodation and graded return:** Implement clear routines for graded sick leave and return-to-work. Allow employees flexible hours, reduced pace and temporary changes in tasks. Such measures must be individualized and evaluated continuously. AI therapy can support employees along the way and provide HR with valuable insight into the return process. 4) **Multidisciplinary follow-up:** Establish collaboration between HR, occupational health services, the general practitioner and, where appropriate, a psychologist. When treatment works through multiple channels, coordination is necessary to ensure the overall plan provides real help. AI tools can ease communication and provide structured follow-up over time. 5) **Cultural change:** Work toward an open culture around mental health. Counteract stigma by having leaders set the example and show that it is acceptable to talk about mental health, and that sick leave for psychological reasons should not be met with blame or "tough demands" upon return. AI tools can help normalize conversations about mental health and make it easier for employees to seek help when they need it. These measures require investment, but they also acknowledge the complexity of mental health — a complexity Aftenposten's coverage and technological developments in the field remind us of. ## Policy and system responsibility: why this is not only a corporate task Although much must happen within each organisation, a significant part of the responsibility lies at the system level. Public guidelines for following up sick-listed workers, funding arrangements for mental health care and resources in primary health care affect how quickly and well employees receive help. As our understanding of depression changes, guidelines and recommendations must be revised as well. Aftenposten paints a picture of research challenging established practices — this should prompt active reassessment among policymakers. In practice this means governments must support employers financially and technically in prevention and accommodation efforts. Measures could include subsidized leadership training, support schemes for task reorganization during sick leave, and better public coverage for psychological treatment. At the same time, it should be considered how innovative solutions like AI therapy can be integrated into public health services and workplace follow-up for mental health. Collaboration between healthcare, NAV and the labour market is essential to ensure smooth and holistic follow-up of people with mental health challenges. ## Closing reflections: what kind of working life do we want? Aftenposten's summary — that antidepressants "do not seem to work the way we thought" — is more than a professional bombshell; it is a challenge to all levels of society. For the workplace this means we can no longer rest on simple explanatory models or standardized treatment pathways. We must acknowledge the complexity of mental health and act accordingly. AI therapy and digital tools offer new opportunities for prevention, early intervention and support for employees experiencing work stress, burnout or sick leave due to mental disorders. My clear recommendation is that employers prioritise long-term investments in work environment, managerial competence and holistic follow-up — including innovative solutions such as AI therapy — rather than short-term fixes. When employees face mental ill-health, they need to be met with understanding, concrete accommodations and a multidisciplinary follow-up plan — not just a pill and an instruction to "come back." Aftenposten pointed to an important problem: the medical model that has long shaped our thinking about depression is changing. That requires the workplace to change too, and to adopt new tools to meet tomorrow's challenges in workplace mental health. ## Sources - Maria Jelmini, Aftenposten: "Antidepressants do not seem to work the way we thought." Published 05.03.2025. According to Aftenposten: "Researchers no longer believe depression is linked to low levels of serotonin." (Aftenposten, 05.03.2025).