should you tell your boss if you’re struggling with mental health issues?

by Alison Green on October 28, 2021

Conversations about mental health are increasingly commonplace, but we don’t necessarily have a shared understanding of how to broach the topic at work… which means people don’t always get the support and help they need. Here’s a beginner’s guide to talking about your mental health at work.

Should I disclose my mental health condition to my boss?

While increased openness about mental health is a good thing, the reality is that there can be real risk to disclosing a mental health condition at work. Too many people who confide in a boss about depression or anxiety end up getting wrongly labeled as too fragile to handle a particular project, denied a promotion that they were perfectly qualified for, or discriminated against in other ways.

Because of that, the safest course of action is to disclose a mental health condition—or any health condition, for that matter—at work only when you want to ask for a specific accommodation to help you manage it. In part that’s because there’s not really anything (ethical) that your boss can do with the information otherwise. Plus, she might assume that you’re looking for her to help in some way… and then go looking for ways to help that aren’t aligned with what you’d actually want (like taking you off a project that she deems too stressful).

That doesn’t mean that disclosing mental health struggles will always go badly, of course! Sometimes it doesn’t, and if you have a manager with a strong track record of handling mental health well, you might make a different decision.

What if I just want time off work for therapy?

Go ahead and ask for it! The easiest way to approach it is the way you would with any other standing medical appointment. You don’t need to explain that it’s for therapy, just like you wouldn’t need to explain that a recurring medical appointment was for allergy shots or chemotherapy. You can just say something like, “I am going to have a recurring weekly medical appointment for the foreseeable future. I’ll need to leave about an hour early every Thursday for it. Could I come in early on those days so my hours balance out?”

For a lot of bosses, that’s all it will take. But if your boss probes for more details—which could happen if she’s concerned about whether everything’s OK or just because she’s nosy—you don’t need to share more if you’d rather not. It’s enough to just respond with something like, “It’s nothing to worry about, just something I need to get taken care of.”

What if I need a different kind of accommodation?

Just like you might need workplace accommodations for a physical condition (like a stool if you can’t stand for long periods or screen reading software if you’re visually impaired), you might also need accommodations for a mental health condition.

The Americans with Disabilities Act (ADA) is a federal law that requires employers to work with employees with both mental and physical disabilities to provide “reasonable accommodations” to help you perform the essential functions of your position—which could be anything from an altered work schedule, to specific steps to reduce distractions and stress, to time off for treatment, to even changing the way you’re given feedback. If you’re not sure what would help you, the Job Accommodation Network is an excellent source of specific accommodations to consider for a wide range of conditions.

You can kick off that process by letting your HR department know that you’re making an official request for accommodation under the ADA. They might ask you to put the request in writing or have your doctor complete paperwork, but neither you nor your doctor should need to disclose your specific diagnosis in doing this. From there, your employer is required to enter into an interactive process with you to determine what accommodations will work. They’re allowed to suggest a different accommodation than the one you requested, but if their suggestion won’t work you’re allowed to explain that and ask for something else.

One big caveat: While some state laws provide additional protections, the ADA itself only covers employers with 15 or more employees and your condition must “substantially limit one or more major life activities,” which include interacting with others, communicating, eating, sleeping, caring for yourself, and regulating your thoughts. The law doesn’t list specific conditions it covers, but depression, PTSD, anxiety, and other common mental health disorders frequently do meet its bar.

What if I’m getting into trouble for my work performance and the reason is related to mental health?

If your mental health is causing you to fall behind on projects or struggle to produce the quality of work your boss expects, in some cases it can make sense to let your boss know what’s happening. Crucially, though, this should be accompanied by an explanation that you’re actively working on it—that you’re seeking help in therapy, from medication, or so forth. You don’t need to—and shouldn’t—go into the details, but an acknowledgement that (a) you see it’s a problem, and (b) you’re working on solutions can reassure your boss that you’re on it. Having that conversation can get you more of a grace period to work on the issues than you might get if your boss didn’t have that context.

Caveat: There’s a risk to doing this, particularly if your boss isn’t terribly empathetic about mental health issues. But there’s a risk to not doing it too, particularly if you’re not going to be able to solve the work problems overnight.

What if I think I’m being discriminated against because of my mental health?

The ADA also makes it illegal for your employer to discriminate against you because you have a mental health condition. That means they can’t fire you, change the types of projects they give you, or otherwise deny you professional advancement simply because of your mental health. They can only take action based on your mental health if you’re truly unable to perform those essential functions, even with reasonable accommodations.

Of course, that doesn’t mean that illegal discrimination doesn’t happen. If you think you’re being discriminated against, you can file an official complaint with your company’s HR department (make sure you put it in writing and use the words “official complaint of discrimination under the Americans with Disabilities Act”). You can also consult with a lawyer about your options. That doesn’t mean going straight to a lawsuit; while sometimes that ends up being necessary, often a lawyer will be able to negotiate with your company on your behalf, or even guide you on how to navigate the situation yourself from behind the scenes.

Originally published at Vice.

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{ 164 comments }

{ 164 comments… read them below }

  1. Elly*

    Don’t do it. I shared with a boss I thought I trusted – who seemed very kind and understanding about it at the time – only to find out he was gossiping about it behind my back, and later on weaponized the “accommodations” I’d been granted against me when I expressed my disappointment about not getting a raise after nearly tripling my duties. I put “accommodations” in quotation marks because I’ve never taken more than my allotted sick days.

    Sorry if I’m a bit cynical. But your boss is your boss, and their obligation in the end is to the company, not you – and that’s who they’ll choose when push comes to shove.

    1. birdie*

      This exact situation happened to me too, so I understand how you must have felt/still feel. I was lucky enough to get a new job, but that boss totally destroyed my confidence and trust. He made a difficult time exponentially worse by making me jump through all kinds of hoops to prove that I needed accommodations.

      1. Elly*

        That’s how I feel – complete loss of confidence and trust in management. I thought we had a great relationship for 3 years, so to have him throw that back in my face was really shattering – all in service of making himself look better in front of his own boss to justify why I hadn’t gotten a raise or a promotion that I’d been promised. On the one hand, I think it’s probably healthier to go into manager/employee relationships with a certain degree of skepticism and an unflinching understanding of the power dynamics at play. But on the other hand, I feel so completely disillusioned with the exploitation inherent in office culture that I’m seriously considering going freelance and not subjecting myself to it anymore.

        1. birdie*

          I’m so sorry this happened to you. I learned never to share that degree of personal information ever again, and that’s how I’ve managed to survive. Best of luck to you however you decide to go forward.

    2. SaffyTaffy*

      Just as a counterpoint, I’ve had extremely good experiences with being forthright about my mental health diagnosis with bosses. I am lucky that mine is a pretty “sympathetic” one, but I also have had 2 good experiences disclosing it. I don’t see evidence that I was penalized for disclosure.

      1. Katurah-Ari*

        I recently reported to my Mgr that part of my issues were medical related and that I was working on those issues. This helped me keep my job since I was still on probation. This also allowed them to inform me of the company’s employee assistance program that provides counseling resources and other resources I didn’t know were available. Including 7 free counseling sessions!

        I do not intend to be more specific in my mental issues though bc I feel it’s a trap. Considering my family doesn’t really respect the impact of mental health on everyday life, expecting a Mgr to do so is risky. You may run the risk of having to defend yourself and ur diagnosis by revealing more info then u need or want to.

        At the end of the day, mental health is still behind the 8 ball in being accepted by society. So on one hand, when we can claim it out loud: ” yeah my adhd makes it hard to focus, so please don’t interrupt me”, it can help remove the stigma. On the other hand, stating you need time off for a weekly chiropractic appt is more acceptable than needing the same accommodation for therapy.
        So I leave it all under ‘medical’ when talking to mgmt and then claim it in casual settings with coworkers to help educate others.

        1. Elly*

          Yep – this is exactly what I mean. You might run into a sympathetic manager (who doesn’t, years later, suddenly backtrack and screw you over) but I would say that it’s still too big of a risk, even if they seem nice. The fact is just that a manager has a lot of power to make your job (and life) very difficult, and that risk often outweighs the benefits of keeping mum. Not to say that no one should ever ask for accommodation, but I really agree with your approach – leaving it under “medical” and not giving any more detail than you need to.

      2. Sylvan*

        Mine are about as unstigmatized as it gets — anxiety disorders and ADHD — and yet I’ve not had good results from talking about it at work. (I’ve had ONLY good experiences talking about it outside of work.)

      3. Kimberly*

        Same. Mine isn’t really “mental health” so much, but I recently found out I have ADHD. I was seeing a therapist for just general therapy, and she suggested I might have ADHD, and she was right. I had been telling her I was worried I might be disciplined at work because of my performance. She urged me to disclose for my own protection.

        It was actually really perfect because: (1) I was diagnosed and getting treatment, so I was able to say I was seeking help and should see improvements; (2) I do think it may have prevented discipline; (3) my boss was extremely understanding and has a better understanding of me personally and why I do some things I do. If I forget something she literally said one second ago, it’s not so annoying to her – she knows why now. It has helped both of us to better work together.

        I don’t want my entire office to know, but letting my direct supervisor know was a great decision for me.

        Also, in line with mental health issues, she was the first person to basically clear the air and point out the elephant in the room – that I had anxiety and needed to relax (in nicer terms than that) before my ADHD diagnosis when I was still a new employee. She let me know I didn’t need to be so worried all the time. My anxiety was clearly caused by my ADHD looking back, but just her having that conversation with me really helped me not be so anxious all the time. Well, also my anxiety was caused by a horrible prior boss, but that’s another story.

    3. Jill of All Trades*

      I told mine I had bipolar and she proceeded to call me “Jekyll and Hyde” when I said I needed to use another FMLA period (I had used 4-6 weeks that year and needed more time because it was 2 months into lockdown and I was not doing well).

      I quit that job a week later after working there for nearly 5 years.

      1. Nethwen*

        Name calling is horrible! And to someone already struggling! I’m so sorry you were treated like that.

      1. Elly*

        Sorry this happened to you too. You’re exactly right – every time you share with someone in a position of power over you, it’s a risk.

    5. BasketcaseNZ*

      I dared to mention to my boss that I’m finding communication hard when we are in a week-on-week-off rotation and I’m the only member of the three teams I work across on my rotation.
      I got a lecture about how much harder some people in other teams are having it at the moment.
      I felt like a rejected child, the way she spoke to me was exactly the tone of voice my parents used to use when they were disappointed in me but didn’t want to deal with me at the same time.
      Yeah, not worth it.

    6. Machine Ghost*

      I once told a boss about my mental health stuggles because he seemed understanding and sympathetic (and was curious about it). He threw it back in my face when a conflict arose and even used it against me (causing three days of mental agony) when I tried to set boundaries. I still hate him after ten years.

      1. Elly*

        This is almost exactly what happened to me!! I’m sorry it happened to you too. I’ve had bad bosses before, but it seems to hurt even worse when they seem understanding and you think you can trust them.

    7. Sylvan*

      I shared with a boss and was put on a PIP virtually immediately. :/

      Don’t do it, folks. A reasonable person won’t have a problem with it, but you may not be working with a reasonable person.

    8. Science KK*

      THIS.

      Mentioned to my manager just off hand, I don’t usually keep it a secret. Then I started having problems with a coworker. Guess who got treated like an unreasonable five year old, who couldn’t play well with other kids in the playground? Well, it wasn’t the person who was claiming 8 hrs but working 5, throwing temper tantrums, and refusing to do basic duties of the job.

      Twas I, the mentally ill one. I had to just be unreasonable and unable to work well with others, it couldn’t POSSIBLY be the fact that everything I said happened. (This coworker has gone on to come to work drunk/possibly drugged, saying she’s running a daycare to the the students she’s supposed to be helping, and will take naps in the middle of the floor in shared workspaces. Supervisor who treated me that way quit and new supervisor is trying to scramble to figure out how to do something about it without this coworker escalating even more).

      I’m weighing my options currently.

    9. Meep*

      I think it really depends on the company culture. The owner of my company suffers from extreme anxiety and is very sympathetic to mental health days as long as you don’t abuse them. His #2 is a horrible, evil woman who mocks people with chronic health conditions and bashed people’s mental health. I would never confide in her. In fact, when I am sick at all, I go over her head and tell the owner. Else, I will end up being told how inconvenient it is for HER (#2) that I am pregnant*. Ma’am, that is the flu.

      *I had the flu, food poisoning, and strep over the span of 2.5 years (2017-2019) needing exactly 3 sick days. Dr. Jerk diagnosed me as “pregnant” as I was a woman in a relationship. I have never given birth. Recently, she tried to claim that a fever of 99.9 degrees that I had was “ovulation” so sexism does play a part. And these are very minor incidents compared to what she did/said to the people with chronic medical conditions in our office. She is pure evil and nothing will convince me otherwise.

  2. Talula Does the Hula From Hawaii*

    Excellent article.
    Sometimes i wish Alison was available to answer custom questions offline at an hourly rate (or per question rate).

    1. This is not my first time.*

      I believe she answers some questions privately, so if you indicated that in an email, she might get back to you!

      2. Ask a Manager* Post author

        Just to manage expectations — no promises! I get way more mail than I can answer. If I can answer something really quickly, I try to but that still leaves a lot that goes unanswered, unfortunately.

        2. Talula Does the Hula From Hawaii*

          Good to know, thanks.
          I may send you a question one of these days, its been one of those weeks.

  3. Lurking Tom*

    My org has monthly “how are you doing?” type check-ins where we rank various things like how we feel about work, work relationships, and non-work life & use that to kinda gauge when staff on the whole or an individual might need some support or a break. I’ve actually thought that it’s been a pretty good system . . . until my most recent one. There’s been a lot of kinda crap events lately (dealing with a parent’s estate, sick pets, and expensive home repairs in a very compressed timeframe) and so I marked my non-work life section pretty low. My boss’s response during our discussion was “I mean, everybody has stuff to deal with.” So that’s going to be the last time I put that kind of thing out there. I’m all sunshine & roses from here on out with her.

    1. Thin Mints didn't make me thin*

      Ugh, that sucks. I’m sorry. If it’s supposed to be a helpful exercise, you should get offered actual help when you’re ready to admit you’re struggling.

    2. I'm just here for the cats!*

      It can be really nice to have management that actually cares about how you are doing. In theory your job is doing some really good stuff. I think that your boss just doesn’t know how to handle when someone rates their non work life low.
      I mean I can see that they can’t really help you but it would have been nice if she said something like, I couldn’t imagine what you’re going through. Let me know if there is anything work wise I can do to help. And maybe offer eap if your company has one.

      1. Lurking Tom*

        Yeha, and I should clarify that she’s great in all the work-related ways, I just don’t think this kind of thing is in her wheelhouse.

        1. Tiffany Aching's imaginary friend*

          Cats’ suggested response is exactly the kind of thing that should have come in whatever information your management is supposed to get about this program. Pfui on your boss.

    3. Lady_Lessa*

      Sorry you are going through that.

      I think that you are wise to be less than completely honest from now on out.

  5. De Minimis*

    I’m considering FMLA accommodation for mine, eventually, but I’m hesitant because my boss is not professional and even does things like sharing the information behind other people’s accommodations in staff meetings (not maliciously, but still not okay to do–basically said that his spouse had a medical condition similar to a coworker who has a permanent workplace accommodation due to their condition.] I think my boss doesn’t have to know the reason I would be requesting FMLA, but I’m not sure how it would go if he asks and I don’t want to tell him.

    2. Sea Anemone*

      FMLA has privacy protections in it. IANAL, so you definitely want to do this research on your own, and you then have to make sure you “remind” your boss of the privacy rules when you submit the paperwork. I put remind in quotes, bc really you are informing them, not reminding them. I had a boss blab my medical condition to people who had no need to know, and they went on to blab about it to others. Bosses should know better, but they don’t.

    3. Tiffany Aching*

      If your HR department is at all competent, they won’t share anything with your boss about your leave other than what’s relevant for scheduling and whatnot. For example, “De Minimis has been approved for intermittent FMLA leave and may need to be out up to X hours/days per week.”
      And then if your boss asks you, Alison has used great language before: “Oh it’s just a boring medical thing I need to deal with. So about that Work Thing…”

      1. Sea Anemone*

        I’m don’t know how different the request process is at different companies, but I needed my boss’s signature on the FMLA request forms. There was no option not to share with my boss.

        1. twocents*

          I checked my company and it’s an online form you fill out with HR. Tbh, it seems very odd to me that your manager would need to sign off… It’s a federal law that most managers aren’t equipped to decision if your scenario applies under it or not.

          1. Turtle*

            I always thought that was weird too as a manager, like…if you need it and it qualifies who am I allowed to stop you?

            The FMLA forms that go to HR are pretty detailed. Like full on diagnosis . I know they are HR and aren’t really caring about why you are out and arent suppossed to tell anyone, but when I went out for my second time I had a particular person in HR handle it that I felt comfortable with.

      2. Jen, from the library*

        Not all of us have HR to hide behind, which sucks. (LOL not that when I did have an HR dept they were any better than NO HR dept.) I work for fairly large local govt structure. I had thought about asking for leave in the past for mental health stuff; IDK what I’d ask my doctor to put down. Probably something intentionally vague. It sucks that with all of our efforts, this is still a taboo subject.

    4. De Minimis*

      Well, now apparently my boss is leaving in a few months and the person who would likely be my boss going forward is someone I don’t trust at all…..

    5. Tyche*

      My last boss was like that. For example, we had a young woman working at the office who ended up needing inpatient therapy for a couple of months. She was diagnosed with borderline personality disorder. I know this because my boss shared it with all of the managers. It included details of what that diagnosis means, her behaviors in her personal life, a lot of personal stuff I have to imagine she would be mortified to know was shared with anyone.

      I will probably never tell anyone I work with that I have ADHD because of how much stigma there is surrounding neurodivergence. It’s just not worth the risk to me.

    6. A Wolverine would be my preferred emotional support animal*

      I work in the public sector and I would not seek out accommodations for mine because I don’t trust the process or the personnel involved. Each division has a designated disability representative who oversees all ADA and FMLA requests and accommodations. At least in mine, it’s a HR person, not someone with training or background in handling sensitive issues like disabilities and mental health. I won’t be going to HR with very personal medical information and have to show more information that I feel comfortable with just to get some very basic accommodations. I don’t think it would be too much to ask that divisions with hundreds of permanent staff could have a disability and accommodations specialist to create a more welcoming climate for those who want to get some accommodations and to help mediate their requests with HR. At least in theory, it would be a position that might help people struggling with mental health concerns.

      As someone who works in higher ed at an institution, like many, that insists that campus has to return to normal, it’s been a long semester. Most requests for remote instruction and work were denied, even though there’s a campus wide mask mandate.

    7. npoqueen*

      I went on FMLA for depression and one of my coworkers was the most nosy person about it! I said it was for surgery, and she was mad because she didn’t think major surgery should get FMLA, since it wasn’t a “family” related thing. I ended up not returning, but HR was great with it. I don’t think my boss ever really knew why I was gone. I just packed up one day after she’d left and didn’t come back, so a good HR department will keep that secret for you. It’s really about how pushy you think your boss will be about figuring out why you were gone. I ended up taking a year off work and I’m in such a better place now. Still work to do, but way better than before.

  6. Colleen*

    I thought I could share that I suffered from depression with my boss. Then when I took a mental health day, she pried and asked if it was about work. I said I was feeling burnt out. She told me to take some time to myself, come in late or leave early.

    One day I worked from home for an hour and she chastised me for coming in late because I missed an impromptu meeting. I complained to our director that I was feeling burnout because of my manager’s style and suggested some ways we could all work together. The next day, I was fired.

    1. Bernice Clifton*

      Similar story here. It was a VERY bureaucratic place (for example, you needed approval from two people to place a business card order). As part of my job, I had seen PIPs and related docs for employees that had been terminated.

      I requested my personnel file because I wanted to see what they had documented in regards to me disclosing a medical issue to my boss and getting terminated the next day. The HR person didn’t reply to my email, but I received a FedEx envelope from the company’s corporate counsel’s office that contained a bunch of docs I already had; i.e. the results of background check when I was hired, performance reviews, pay rate docs.

      1. Sea Anemone*

        Here’s a trick when requesting files: request “all records related to employment stored in all places.” I actually learned that wording from my lawyer.

        1. Bernice Clifton*

          I know that I wrote “entire personnel file”. I would have pushed back but when they did not contest UI I assumed it was best to move on.

    2. Jen, from the library*

      When you take a MH day, do not say such. Even if your boss refers to them or other people do. Say sick day, not feeling well, etc.

  7. Smithy*

    I used to have a job where the boundaries around any kind of healthcare were wildly crossed and pushed (i.e. our CEO once asked to see my wound after minor surgery), where I am solidly on team “only disclose as a last resort.”

    That being said, as much as many people are generically sympathetic to mental health often being a nonlinear, lifelong care issue – if it feels necessary to disclose at work, I do encourage trying to find the ways to do so as much as to present any given issue as being as more timebound or episodic. Whether its increased stress around COVID, the recent passing of a loved one, or acknowledging that a change in medications might take a month or two to settle so having a later start time or flexibility in working hours would be supportive.

    The risk so often with disclosure is that there’s no point where people necessarily say they’re depression free or PTSD cured. Which is where that lingering fear of being labeled fragile comes into play. However, experiences like the loss of a loved one do have more social markers on when someone is “over it” (regardless of that reality). Therefore, when a manager potentially circles back to the issue, there’s the ability to flag accommodations still needed, or to put a marker on the crisis period being over. The medication has settled, new childcare was found which as reduced COVID stress levels, etc. It may not entirely be the whole issue, and longer term therapy may still be heavily in play, but in cases where disclosure is really needed – finding a way to mark a period of medical flux as having calmed down is really helpful.

    1. RebelwithMouseyHair*

      … a CEO asked to see your wound????? how could that ever be appropriate even if it’s a part of your body that he might see in the office?
      My boss was almost as intrusive, calling me to say I should have sent in a sick note once. I hadn’t sent the sick note because the doctor didn’t show up for the appointment. Luckily she rang the doorbell just as he was ranting, so I hung up.
      She agreed that I had the flu, so I just needed to rest for a few days, but she took my blood pressure and commented that I must be very stressed. I explained that I’d just had a stressful phone call with my boss, and she ripped up the sick note and wrote a new one giving me an extra week!

  8. Lobsterman*

    This article is 100% correct. Only disclose problems that require accommodation. Anything below or to the side of that is just asking to have them used against you.
    We live in a capitalist system. Some of us PMC have created comfortable places for ourselves administering that system, but temporary comfort should never be mistaken for shared class interests. Your boss, by and large, wants to pay you less for more work. And if not them, then their boss’s boss. You want to be paid more for less work. This divide can be dealt with through negotiation, but it is always fundamentally adversarial. If your boss determines that you’re more trouble than you’re worth, they’re going to fire you and hire someone else.
    US labor policy is to maintain “slackness” in the labor market to limit workers’ negotiating power. Until and unless that changes, always tread with extreme caution.

    1. Miami Beachbum*

      I don’t think the employment contract is adversarial. Sure, you are providing a service and they are paying you for it so its transactional, but I want to pay my people as much as possible – the good ones at least. I think you should pay people who really do a good job from a general “right thing to do” aspect, but also to keep them at the company and keep them happy. I also dont want them working too much. People need a work/life balance and I dont want them to burn out. If they have too much work, its my fault for not training properly or properly staffing.

      As an employee, of course I want to make more money, but I stay at a job making a lot less, because of other benefits I receive. I don’t necessarily need to work LESS, I have flexibility with my hours and have a ton of PTO. I stay due to some of my values which include time with my kids, ability to travel and do other things, so its worth it to me.

      1. Your Local Password Resetter*

        In theory, it should be cooperative. But businesses run on money, and employees cost money. So it’s all too easy for the people in power to see it as a zero sum game and try to get as much labour for as little money as possible.

        You can indeed mitigate that if your boss takes a more humane approach. But that depends entirely on the goodwill of your boss, and on nobody higher up the ladder overriding them. So you just have to kind of hope and gamble on the moral strength of your corporate executive. And that’s a very big risk indeed.

    2. Elizabeth (they/them)*

      To clarify if needed, PMC = professional managerial class and yes, different as the material trappings are an office worker has more in common with a barista than their boss, and it’s heartening as someone who has mostly done blue-collar work to see that class consciousness developing in real time. It’s interesting as I am, in my personal life, very open about all my stuff and tried to be the same way at work because it does suck that there’s a stigma, but what will ultimately move the needle on working conditions are collective labor action and state/federal policy shifts, not individuals risking their livelihoods in the hopes that their specific boss might realize that someone with X diagnosis isn’t automatically a liability. I’ll probably tap into FMLA as soon as I hit a year at my job and nobody will have a clue about it until I have all my documentation lined up.

  9. kevcat*

    Great article. Nicely done, Alison.

    I’m completely open about being bipolar — in person and on social media — in a very casual, matter-of-fact way, as if we’re discussing what we had for dinner. It’s important to me that I do what I can to decrease the stigma surrounding mental illness, so I tend to just drop it into conversation and take it from there. I’m also very capable of escalating the conversation if needed, and I understand that not everyone feels safe enough to do that, which is, as I said, one of the reasons that I do it.

    However, as the question is regarding work, I’m in a position in which that diagnosis — if it came up — would be a non-issue, and I recognize that not everyone has that privilege. And before anyone even thinks of bringing this up, because I’ve seen it here in the past, sharing a mental health diagnosis is absolutely appropriate at work, and suggesting that it isn’t just serves to feed that stigma. Silence = death, in more ways than some of you can imagine.

    1. Coenobita*

      Yeah, I think there is a difference between being open about a diagnosis as part of your daily life, vs. disclosing something because it’s causing a problem or you need accommodations. My immediate peer groups (both work and non-work) are pretty open and casual about mental health, which I think is great – for example, it’s not unusual for a coworker to mention a therapy appointment in passing or for a friend to vent about how the pharmacy messed up their SSRI prescription. I think that kind of thing can go a long way in reducing stigma so that there’s an overall better environment when a need for accommodations does arise. But I know that this is far from the norm!

    2. Waiting on the bus*

      Out of curiosity, what sort of response do you expect/want when you mention that your bipolar to a new coworker? I’m imagining what I would do as the coworker and I see myself awkwardly asking if that has an affect on their work because that’s the only reason I can think why a coworker would mention this to me at work. Or do you wait until you have a good rapport with the coworker before you mention it?

      But that makes it seem like I might think it does affect work, which I don’t . I’ve been struggling with depression for years and had some of my highest professional achievements while the depression was at its worst, so I’m well aware that mental health issues don’t have to impact work performance.

    3. miro*

      “And before anyone even thinks of bringing this up, because I’ve seen it here in the past, sharing a mental health diagnosis is absolutely appropriate at work, and suggesting that it isn’t just serves to feed that stigma. Silence = death, in more ways than some of you can imagine.”

      I’ve been thinking through this comment for a bit because it’s very different from how I tend to see things even though I think I see (and appreciate) what you’re saying. I guess I tend to fall on the side of really not wanting to know my colleague’s medical info and just not wanting medical info to be part of workplace conversations. I’m visibly, physically disabled and get sooooo many inappropriate questions about my condition (which I 100% do not share because it’s not their business) and I really wish medical information wasn’t a thing people discussed (especially at work). A couple of my colleagues have had medical leave lately and I’ve been really glad that people seem to have been respecting their privacy (and, frankly, glad that they haven’t really volunteered details) because I feel like medical talk begets medical talk which more often than not becomes uncomfortable (especially for disabled and chronically ill folks).

      But I don’t know, maybe this is a case where physical and mental health are really different? Like, if a colleague said they were out of work because they were depressed or had to leave a meeting because of a panic attack, I think I would be much more okay hearing that than if they talked about taking a sick day for explosive diarrhea or how they projectile vomited during a presentation.

      1. RebelwithMouseyHair*

        “if a colleague said they were out of work because they were depressed or had to leave a meeting because of a panic attack, I think I would be much more okay hearing that than if they talked about taking a sick day for explosive diarrhea or how they projectile vomited during a presentation”
        But if you were their manager rather than their peer, you’d rather it was diarrhoea or vomiting because food poisoning is quicker and easier to get over than mental health problems. Mental health problems can lead to the weirdest of behaviour and is much harder to diagnose and treat, and some problems are incurable and it’s difficult to say who’s going to be right as rain just as soon as lockdown is over and who’s going to need indefinite accommodations interspersed with meltdowns.

  10. Just a little stitious*

    Just a note that if your employer says you need a letter from your provider for accommodations or another reason, a therapist may not be able to provide one. This is generally because of licensing and the fact that many therapists aren’t technically doctors who can diagnose conditions, and it will vary depending on the type of mental health practitioner you see and where you live. If you’re used to self-referring for care (like if you have a PPO or are not going through insurance), that might be surprising, but usually your primary care provider would be willing to provide the documentation if you ask. This can also help if you don’t want to disclose what your condition is – if the letter comes from a therapist it may be obvious that it’s mental health-related, but if it comes from the PCP it could be anything.

    1. Miami Beachbum*

      Although my therapist (a PsyD) filled out my FMLA paperwork, I needed a medical doctor to do the actual short term disability and things. Also could not return without being cleared by a medical doctor (or PA or NP) and not my therapist eventhough it was completely mental health.

    2. stornry*

      As an HR person, I remind employees that I don’t need or want a diagnosis. All I need, from a professional provider, is how whatever condition you have interferes with your ability to do the work and, from that, what we might be able to do to accommodate — the purpose of which is to get the work done.

  11. Justin*

    I had to do the performance disclosure thing but you’re right that what made it work was the fact that I said I had resumed treatment. In a much better place at work now, and in life. Though I still want a different job…

  12. Your friendly neighborhood Zen Buddhist*

    I was let go the day I requested FMLA leave (based on the suggestion of my care team) from the small company I worked for. I didn’t say it was for mental health issues but I’m pretty sure they could tell. Or not — I’m not sure which is ethically worse. Being let go like that in the middle of a personal and global (pandemic!) crisis has made me wary of ever even asking for accommodations, but the place I work now seems much more open and actually encouraging of people taking care of their health, both physical and mental. Taking time-off is encouraged and I’ve seen multiple co-workers do so without any gossip or complaints.

    My best suggestion is just be kind.

    1. fposte*

      Yikes; sorry that happened to you. Did you file a DOL complaint or just figure moving on is the best plan?

      1. Your friendly neighborhood Zen Buddhist*

        It was a tiny non-profit and they weren’t technically covered by FMLA (although it was spelled out as a benefit in the employee handbook). Honestly, this was part of a pattern of suck at that place and I’m just happy I got out with unemployment and a good recommendation.

  13. Here we go again*

    What about using fmla to care for family with mental health issues? I’m next of kin for someone with some mental health issues.

    1. fposte*

      That definitely can come under FMLA–it’s recommended that you get something from the treating doctor certifying that the patient has a serious medical condition and that your presence is necessary for their care and treatment.

    2. DANGER: Gumption Ahead*

      I think you could just make it a general health/medical issue rather than naming the diagnosis. This is especially true if it is a child (people can be crazy judgey of parents) or a spouse (last think you need is prying about livign with someone with the MH issue)

        1. AcademiaNut*

          FMLA does have very definite limits about what sort of family member is covered (spouse, parent, child), so if they’re not one of those, you’re out of luck. I had a coworker who wasn’t able to use it to care for an ill sister, who was single, with no parents or child.

  14. Eldritch Office Worker*

    I’m personally very open. I don’t overshare at work in general but if it comes up I’m just as open as my medication or mental health state or diagnoses as I am about my weekend plans. I think it’s important, I want to destigmatize or be someone that seems approachable regarding mental health issues, I’m generally high performing and I don’t want to have to do a big reveal if that slips, and it’s much easier for me to ask for small day-to-day accommodations that way.

    I screen for pro mental health jobs in interviews to the extent I can, and I have been successful with this approach so far. However it will not work for everyone, and I would never pressure anyone to do the same. But I do want to share my experience against the current of “never bring it up” because I think the idea of hiding mental health conditions at work can be very stressful for some people. Just know there are different approaches.

    1. You get a pen and you get a pen*

      Would you be willing to share how you screen for pro mental health jobs? As a person that suffers from depression and anxiety and also job seeking – I would love some tips on how to suss out if companies will accommodate me/my mental health state.

      1. Eldritch Office Worker*

        Yeah! Well first, I always check the “do you consider yourself a person with a disability” box. I don’t want to deal with anyone who screens that.

        One of my standard questions is “how do you help your employees manage their mental health?” which, if pressed I’ll specify as stress, burnout, work-life balance – but I ask about it as mental health to see how people react and respond. For instance my current job was very honest that it’s something they’re actively working on and could do better, but that employee wellbeing was important to them and I was able to chat and ask followup questions. This also allows me to screen “weekly mood board” places that are very proud of their terrible ideas.

        If I have multiple interviews I’ll find ways to get that question in front of multiple people too. How’s your stress level? Oh, high, are you ever able to take a mental health day? The pandemic has been making that a lot easier because there’s a baseline understanding that everyone has had a hard time lately.

        If asked about my strengths or work philosophies I try to talk about valuing staff and being a manager who really tries to get to know my employees strengths and weaknesses so I can support them, and push employee wellbeing as a personal value. Whole pitch about employees who are treated well doing better work, and that I don’t like seeing my staff not use their vacation time or work through lunch more than occasionally. That’s another one where the followup conversation tells a lot.

        I also screen for different types of diversity (gender, race, weight, age) because I find that places that embrace differences handle mental health issues better. I don’t know that there are studies about the correlation but I’ve found it to be true. Places with higher rates of women in leadership and under-40s in positions of authority also trend more mental health positive in my personal experience but take that with a grain of salt.

        I am also privileged in that I’ve more or less been in a position to walk away from opportunities I don’t match well with, and that I have a resume that often gets interviews, so again your mileage will vary and everyone should do what’s best for their situation but I’ve chosen to take this approach and make it a priority and it’s worked os far.

        1. Nethwen*

          You commented, Eldritch, while I was typing my comment below.

          I usually end interview invitation e-mails and first-day logistic e-mails with some version of “let me know if there’s anything else we can do to make this a positive experience for you.” I’ve never had anyone take me up on it, but I’m hoping that this signals that if florescent lights give them headaches or they can’t focus when facing a window or mobility issues mean that chairs with wheels are difficult for them or whatever it is, that they’ll feel better about asking. I also do things during the interview like say, “We’re going to break for five minutes while I clean up these papers, otherwise I won’t be able to focus.” The intent is to communicate, “We all have things that need accommodation. It’s fine.”

          For you, if you feel like commenting, would these things land the way I intend?

            1. Eldritch Office Worker*

              I think people who know they need accommodations or know they aren’t “ideally suited” to office work for whatever reason pick up on those small clues very loudly. We’re looking for cues. What you’re doing certainly won’t hurt and maybe be very helpful.

              I will say that sometimes when I say something like “sorry my adhd makes this hard” even in an established setting, sometimes people think I’m using it colloquially and THAT can be offputting if you don’t know I have ADHD. You didn’t say that you were saying anything like “Oh my OCD won’t let me focus until these papers are put away” and I would assume you’re not, but since you asked for feedback I’d just put that as the line in the sand to avoid. Anything on the mild and conversational side of that line is good.

          2. Splendid Colors*

            I am Autistic, and I would not know how to interpret “anything else we can do to make this a positive experience.” I would not realize it was an offer of disability accommodations, even though I would LOVE to be able to specify “scent-free environment” and “minimize distractions.” (I’ve visited way too many disability-related offices with air fresheners that give me migraines, and they won’t even agree to move the meeting somewhere else.)

            1. Nethwen*

              Splendid Colors, what phrasing would let you know that I won’t hold it against someone if they ask for accommodations?

              I don’t want to say “If you need an accommodation, let me know” because that sounds like I’m asking them to disclose something they may want to keep private. Also, if they tell me about a disability and I don’t hire them, they may think it is because they told me about their disability.

              I want to do what I can to accommodate disabilities. I also want to do what I can to accommodate people. A person doesn’t need a named disability to get headaches from florescent lights or feel unsteady in a chair with castors or any other number of things that are simple to accommodate.

              1. Susie*

                Taking things literally is a hallmark of autism. Which means that if you don’t say, “If you need an accommodation, let me know,” then I am not going to understand what you want me to do.

                So say, “If you need an accommodation, let me know.” And then list examples of things that you can accomodate: “Perhaps florescent lights give you headaches, or you can’t focus when facing a window, or chairs with wheels are difficult for you to use.”

                This way you aren’t making the focus on having a named disability, but you are making it clear that anyone applying can approach you with accomodations that may help them.

                One thing I don’t like about the above list specifically is that it doesn’t include non-physical accommodations. You should also list some of those, if they would work for your workplace.

                The big one that I use all of the time is flexibility in my schedule. I have ADHD and ASD and when they are not playing nice it’s nearly impossible for me to get to work on time. So I have a buffer. Usually I get to work within 15 minutes of my start time. The odd time it’s within 30 minutes. I was always staying 15-30 minutes late finishing up whatever task that I was in the middle of anyway, so this helps on both ends.

          1. Eldritch Office Worker*

            I’m glad it’s helpful! Oh one more small one – places that have pronouns in their email signatures or zoom names. That’s not a guarantee on its own that places will be good, but it’s a positive sign that they’re at least paying attention and are open to adapting to new norms (and I think mental health positivity is trending towards being a norm, in a lot of industries).

    2. DANGER: Gumption Ahead*

      I am very much like you, up to and including organizing events and whatnot for mental health awareness month. I do it because I am 100% not perceived as the “type” of person who anyone would guess has depression with suicidal ideation (people describe me as “bubbly”, “easy going”, “positive”) and I have a 20+ year track record of high performance. I would never expect anyone else to do the same, but for me, it helps be deal with my own guilt/shame/issues around my own diagnosis.

    3. Nethwen*

      Seconding the request for how you screen for pro-mental health jobs. I would love to be proactive about signaling that we think employees are humans who have mental and emotional lives and sometimes those lives need special attention, just like physical lives do.

      I’ve started being explicit in interviews about the potential mental and emotional challenges of working here and in the profession in general, especially highlighting the things people often don’t realize until they start working in the profession. It makes the interviews a bit of shock and doom and gloom, but I want people to enter the profession with their eyes open, as much as is possible.

      That doesn’t say much about how open we are to accommodating mental health needs, but my hope is that it helps people to self-select out if they realize that the profession, at least in the capacity they are applying for, isn’t what it seems from the outside. (I hire a lot of recent grads and career-switchers.)

  15. KHB*

    The one time I did this, it’s because a medication I was taking was causing some sudden and scary changes to my mental health. I told my boss right away, because I just wanted him to know that if he noticed anything “off” about my demeanor or my performance, that I wasn’t just slacking off or flaking out for no reason. But he ended up being awesome about it – without my asking, he offered to take everything off my plate that wasn’t time-sensitive or specific to me (we postponed a big project I was working on, and he took over a couple of my smaller duties himself).

    Eventually I got off the medication (which it turned out I didn’t need to be on in the first place) and back to my usual self, but it was a rough few months getting there. My boss’s goodwill and understanding helped a lot.

  16. BuckeyeIT*

    I disclosed my depression diagnosis to a former boss, because due to our attendance point system I was close to a write-up from tardies related to my mental illness ( didn’t know at the time it was more likely due to my then-undiagnosed ADHD). She seemed really understanding, but I couldn’t put anything in place to flex my start time because grand boss was against it, for *reasons*. I managed to pull it together enough that even if I was tardy, I was within their grace period for clocking in for the rest of the year.

    Fast forward eight months later and I’m filling in an open position. I’m the only one who has been trained to do this by the predecessor and the only one out of the five applicants who has all the truly necessary qualifications. I don’t get the job- and end up having to train the person who does completely from square one.

    I asked my boss what I could done to improve my chances in case the spot opens again. She fully admitted that I didn’t get the spot because she was worried that I would have another depressive episode or that my mental health would make me be ‘grumpy’ in front of new hires, which I would be in more contact with in the role. “But since I can’t put that officially, I just said it was due to the tardies at the beginning of the year”.

    I have not disclosed my depression (or ADHD) since- even though my psychiatrist said I could have requested a formal accommodation through HR. Lesson learned the hard way.

    2. WomEngineer*

      Have you found other ways to manage it at work? I’ve considered getting tested for ADHD, but I feel like either way I’d be left to deal with it by myself.

      1. Emily*

        I was diagnosed with ADHD in my 30s and medication has been life-changing. Now I can (usually) actually follow through on various productivity tricks like the Pomodoro Method, or scheduling my tasks, or the recommendations in the very helpful book, The Adult ADHD Toolkit. If you’re curious, get tested. Go from there.

      2. BuckeyeIT*

        Sorry Wom, I kinda forgot I commented here! (par for the course with my ADHD).
        Honestly, the biggest help was moving into a salaried position where I WAS allowed to flex my schedule. It literally saved my job. I can work the hours where I feel most productive once the medication kicks in & take a break as often as I need to, as long as the work gets done and meets deadlines.

        I also utilize a couple of whiteboards in my office. I use them to loosely map out my tasks for the day & keep it visible to stay on track.
        I was allowed to request everyone send issues to me via email, because it’s easier to remember & follow up on instead of remembering details from a phone call. I just worded the request in a way that didn’t flag as it being so I don’t forget, but more so that there’s always a paper trail.

        So far- that’s kept me from having to request formal accommodations and having to disclose.

      3. Rebecca Stewart*

        It helps to have the diagnosis.
        There’s a lot of help out there to manage focus and get better routines, and a lot of that is very helpful, and then for me medication is the keystone that makes the whole thing stand up and work for me.

  18. Ali*

    I love that I’ve been reading AAM for so many years that I approached my standing therapy appointment in exactly the way she recommended! As a person who struggles to take time off or request what I need, I just told him I had a standing medical appointment and when he probed to make sure I was ok just said that it was nothing to worry about but something I needed to take care of. I love how easily that rolled off too! Best thing I’ve ever done.

  19. Chc34*

    My previous boss was very open about the fact that he came in late one day a week because he had therapy in the morning, and it made me comfortable enough to ask to leave early one day a week for therapy as well, which he was totally fine with.

  20. Not Mad Just Disappointed Scientist*

    This is a very timely article. I just received a diagnosis that may explain my behavior at work and have been wondering if it would be worth disclosing just so everyone’s aware that I’m working on a solution. However, given my boss’s response to my complaints of burnout in the past (i.e., get over it, “you can’t have a bad day in this job [death care]”), I’ve decided against it. I don’t think there are specific accommodations to request anyway. What I did do was tell a trusted shift supervisor who has a strong record of advocating for me to upper management. I’m hoping that’ll do until I’m able to find another job in my field…

    1. Julia*

      I’ve had good luck with saying something like “I’ve been working on my issues with X and I’ve found a great method of treating/improving/resolving that. It’s already improving how I respond to X.”

      When I was dealing with excessive startling due to PTSD I basically said “Yeah I get startled easily. I moved my desk so it’s easier to see people walking over.” “When I’m concentrating on work I get so engrossed I don’t notice things around me. Next time could you say hello when you’re coming into my cube? Thanks!”

      I’ve also done “I’ve had some problems with deadlines lately. I’ve implemented a new system to address this. I’ve already noticed improvement.” I’ve also mentioned vague “So weird, it’s medical related! I’ve been working with a doctor to resolve/improve it.”

  21. idio-idio-idio-syncrasy*

    Count me in on the chorus saying “don’t do it.”

    In my case, I didn’t disclose and ask for accommodation, but when I resigned from my current job, my manager grilled me until I confessed it was for mental health reasons, then proceeded to weapon my desire to be a good teammate and not leave my coworkers in the lurch to persuade me to stay on three more months to finish up an important project, and now that the end of those three months is coming up, is making noises about ‘needing me’ to stay on another couple of months. They absolutely would not have pulled this bs if I had given notice because I found a new job… all that noble language they trot out in town halls about putting employee first and caring about our mental health? So much performance art.

  22. Me*

    I have a chronic medical condition which requires regular doctors appointments and also thanks to COVID have discovered working from home at least part time is majorly beneficial.

    My boss knows that the chronic medical condition is bipolar 2. And he knows because I’m lucky enough and have known him long enough to know he is a decent human being who’s wife is a psychiatric nurse. And he’s been great in giving me the accommodations I need without having to formerly request them. I offered and he said nope we’ll keep it between us because of the stigma.

    I’m fully aware not everyone is that lucky. Despite my experience, my suggestion to anyone else would be to leave it at chronic medical condition that is being managed, or flaring and requiring some time/grace/whatever you need while addressing it.

    The stigma around mental health has improved, but still has a long way to go. It’s pretty evident in the comments here whenever there’s a letter writer struggling and wondering how to handle it.

    1. Jill of All Trades*

      I’m really glad to hear that you have had a good experience with navigating your workplace with bipolar. I also have bipolar 2, and to be honest, I’m kind of terrified to re-enter the workplace. I know to be cautious and likely will leave it at “chronic medical condition” myself, but it’s still very nice to hear a positive story once in a while.

    2. A First Rated Mess*

      I use the phrase “chronic, but not serious as long as I keep on top of it” when describing my mental health issues (Bipolar NOS* and ADHD). It’s not uncommon for me to deliberately structure these conversations so I mention a physical injury shortly before using this phrase. So if people assume it’s not a mental health issue, well, that’s on purpose. My therapy sessions are always “an appointment” with no details other than the time. (They’re during the workday – I make up the time during the week.)

      I will admit to the ADHD in different conversations, but that tends to come with a lot less stigma than the bipolar. Sometimes it’s even a minor superpower (software development – hyperfocus can be really useful if you can direct it properly).

      *NOS – Not Otherwise Specified. In my case, it’s similar to bipolar II, but my upswings aren’t hypomania. It’s some sort of high energy state, it definitely cycles, but doesn’t quite match the criteria for hypomania.

  23. Oh well….*

    Unfortunately, what I have found over the years is that many companies talk a lot about mental health, but don’t offer the necessary benefits for their employees to prioritize it. For example, where I work there are regular webinars and workshops that discuss mental health related issues (everything from work/life balance to how to access mental health support if you need it), but there is no paid time off beyond typical PTO for any sort of extended period. And, I work for an employer who is generally very good.

    But, what many people need is protected paid time off. For example, if you have a loved one who is dying, most people can’t afford to take weeks or longer of paid time off. And, things like short-term disability doesn’t cover that sort of leave. So many employees work through major life stressors which often lead to worsening existing mental health issues or leads to mental health disorders, when if they had just been given the protected and paid time off early on it could have been avoided.

  24. Bucky Barnes*

    20 years ago, I was very open about having anxiety in grad school, so I (naively) thought it would it be the same at my first job. I casually mentioned it, though I’m not sure when exactly. Cut to implementing a new system and being stressed. I commented on being stressed about implementing the system and she said “Maybe you need to take some of your meds.” Less than six months later, I was employed with my present company. I never again breathed a word of it to anyone…

    …until last fall when my anxiety, coupled with working in-office during the pandemic, was getting rough. I’ve known my boss for a long time and trusted him, plus he had worked with me a long time so he knew my work ethic. I met, told him about my previous experience and explained what was going on. He didn’t even bat an eye. I’m still here a year later, and he doesn’t treat me any different. So I’ve had a bad and a good (so far) experience with it.

  25. learnedthehardway*

    I wouldn’t disclose anything health-wise (mental health or anything else) that wasn’t absolutely necessary. In retrospect, although my company at the time treated me well during my pregnancy, my manager’s SURPRISE that I was back up to speed as soon as I got back to work (we have year of maternity/parental leave) was kind of off-putting to me. I mean, I had had a baby, not a traumatic brain injury.

    1. allathian*

      Yeah, well. I had 2 years of maternity leave (not in the US), and when my son started in daycare, he was sick a lot. For as long as he was home, he never needed a doctor’s appointment other than scheduled checkups with the pediatrician, but when he started, the first 8 or 9 months I was out a few days every other week on average. I was also on part-time at first, so I took most of the days off, especially as my husband traveled a lot on business as well. I’m grateful that I had practically unlimited paid sick leave at the time.

      My son was around 4 years old when things stabilized and I felt like I was pulling my full weight at work again.

  26. Elizabeth West*

    Reading the part about accommodations makes me realize how poorly my last job handled my ADA request. My new boss refused to provide the information I needed to request appropriate
    accommodations for my dyscalculia. They gave me an advocate, but there was no way we could structure them without even knowing what tasks I was supposed to be doing.

    It turned out that I couldn’t do what she wanted even with accommodation. In hindsight, I should have started looking for another job as soon as they announced the department merger. Being cagey about the changes was a sign of major dysfunction. Instead, I tried to deal with it, and the lack of communication made me incredibly anxious. I will never make that mistake again.

  28. Echo*

    Fellow managers – what are some things you do to demonstrate that you are a safe person to disclose to and that you believe in destigmatizing mental health?

    None of this feels exactly specific to mental health, but I’m generally very flexible around hours, working styles, etc. I encourage my direct reports to use their paid time off, including unplanned time off if they let me know they’re dealing with something challenging (anything from “my pet is sick” to “I’m moving on Sunday” to “I have outpatient surgery today” or even just “there’s a lot going on at home and it’s been a tough week”, I’ll usually say something like “just let me know if you need some time off tomorrow and we can move XYZ meeting”). I also tell new team members upfront to let me know if they have recurring commitments we should schedule around and I specify they don’t need to tell me what it’s for.

    I think the signs so far have shown I’m doing something right but I’m always looking for more ideas.

    1. Eldritch Office Worker*

      I think that’s all very good. I’m also very, very careful not to push or be nosy and to let people set their own boundaries around sharing. I think being open can be scary and one of the best things you can do to show you’re safe is to give people as much room as they need to take care of themselves, but never make them feel pushed to disclose more than they’re comfortable (while still addressing performance issues and what not as professionally and matter of fact as possible). I think when you’re trying to be a safe person there’s sometimes a drive to share a lot or get people to talk to you but in my experience what people really need in these situations is control over their own situations.

    2. Nessun*

      My office reached out to a mental health advocacy group in our province, and asked about MH training. The organization we reached out to was a national one, and they had training they could provide in-office – so we made the training mandatory for all managers and above. It was two full days, with ample breaks for downtime and contemplation (as the content could be very challenging or triggering) and we learned a lot. There was also a chance to share if we were comfortable, in a completely non-judgemental environment. Several c-suite level employees who knew of the training specifics in advance chose to give personal stories about their struggles and successes in mental health care for themselves and their families, to encourage people to know who understood the issues from a personal perspective. There was no pressure to say anything at all if you didn’t want to.

      After the training, the entire office was told what levels of staff participated, so they were aware of what we’d learned, and that we should have some training in how to assist them and how to provide links to our EAP or other programs in the community (with info provided by the MH org that presented). It was very well received, and I appreciated learning how to approach conversations with my direct reports and how to listen and help effectively if someone – anyone – approached me.

  29. SassyAccountant*

    Anyone have advice on how to navigate drug testing when applying for jobs? I’m newly diagnosed with ADHD and when I had some blood work done recently it really dawned on my that drug screenings are going to show “amphetamines” without any qualifying explanation that it’s my very legal and necessary medication. I also don’t really want to tell a potential employer upfront about it because although it may be illegal to discriminate we all know employers do it anyway. So what should I do?

    1. Bernice Clifton*

      A lot fewer places were drug testing when I last job searched than they did in the past. Also, I have a friend who takes a medication that shows up as opiates as she’s been able to get a note from her doctor.

      1. SassyAccountant*

        Unfortunately I’m in a particular field where its not going by the wayside anytime soon and I’m gearing up to start looking for a new job. My question is what do I do with the note from my doctor? Give it to my potential boss that discloses or heavily hints at my issue since it will coming from a psychiatrist? That’s what I’m trying to avoid. I was told by one friend that if you bring that information to the place doing the testing (like LabCorp etc) they will omit those results. But I don’t how true or reliable that is

        1. Beth*

          Maybe you can get a note from your pharmacist instead? That should be just as clear a confirmation that this is a prescribed medication, while avoiding any particular evidence of what it’s for.

        2. SassyAccountant*

          Thank you everyone! I appreciate the insight and I think when the time comes I will contact the lab ahead of time and inquire how it all works and hopefully a list from my pharmacist will ensure that my medication/diagnosis is kept on the lowdown. It’s one thing to be open about it AFTER you have a job but as you’re trying to get one? Right now, I work as an accountant in the educational realm so thankfully the people I interact with at my job are of course all very knowledgeable about ADHD and many have children who are ADHD themselves. It’s just I know in the future as I navigate back into government/contracting roles the drug testing will continue and I didn’t want this to be a problem.

    2. hbc*

      I haven’t seen the whole procedure for a while, but there is always a chance before or after the test to show that you’ve been legally prescribed anything for which you test positive. At least some places will make sure that the employer doesn’t see the positive result and will only see that your test was negative for illegal drugs. So it may be in your interest to withhold that info entirely from the employer.

      If you don’t want to rely on that, your other options are to call the testing place to find out how they handle positive results (and figure out if you want to give the heads up to the employer) or just be vague and tell the employer that you’ve got a prescription that contains “one of the drugs in the test.”

    3. PT*

      I once asked a drug testing company if they needed a list of prescriptions, and they said, “Oh no, it’s not that sort of test.” But I wasn’t hinting at asking about ADHD drugs so I don’t know if that’s relevant.

    4. Meghan*

      I’m late here and it was several years ago but I had a drug screen and I think I mentioned it at the testing place so they told me to get a printout from the pharmacist that had information on it (like maybe an identifying number?) So when the lab people called I had my list printed out and let them know whatever they wanted to prove it was a legit script.

    5. relationships in buckets*

      Do not tell the employer. Take your rx bottles to the drug testing facility. They omit them from the results. This is not a problem. I’ve been on stimulants for decades.

  30. Orora*

    I don’t know. I’m on the fence about disclosure. On one hand, yes to the normalization of people seeking help for mental illness! On the other hand, disclosing your mental illness can get you labeled as “fragile” or “sensitive” which can hold you back.

    I had a very bad depressive episode earlier this year — living alone during the lock-down really messed with me and. I probably should have taken some FMLA to get more intensive help, but at that point, most everything was virtual; most of the issue was that I wasn’t having human contact, which wouldn’t be helped by virtual mental health programs. Work was the only thing that felt normal. If I had to complete TPS reports, I had to get out of bed. My work got done (pretty well, in fact), but my “attitude” suffered. I was sharp with people and reacted in some ways that were not professional. I recognized that I was not myself and sought TMS treatment which helped a great deal. My boss was aware I was having difficulty, but I didn’t tell her the extent. At my review in June (when I was doing much better), I was chastised for my “attitude” and mistakes; there was no mention of improvement. I was given a COLA when others received raises and bonuses. The mistakes mentioned in my review were never presented to me as a problem at the time they occurred. As for my attitude, no quarter was given due to COVID. Despite all the talk of “being understanding”, there was no understanding of how isolation destroys your spirit. (There’s a reason solitary confinement is punishment.) I responded to my review with a note from my psychiatrist, and a detailed list of all the duties I took on during COVID. I wanted a record that I was having a medical emergency at the time my performance was “slipping”.

    Do I think my manager would have been more understanding if I’d told her what was happening at the time? No. It’s clear to me now that my manager only has interest in my mental health to the extent that my work is getting done the way she wants it and that I don’t make her life harder. Now, if I have work problems, I send her very professional formal emails detailing what the issue is and formally asking for a response. I have disinvested in caring about my work.

    A little understanding would’ve helped me maintain concern for my workplace and my job. Now I just do enough so as not to get in trouble.

  31. hbc*

    I would be very hesitant to share more than is mandatory to get accommodations unless I’d actually seen management deal with similar situations. I’ve met a fair number of people who have handled these situations gracefully, and I know *tons* of people who 100% believe they’re professional and supportive and aren’t even close. It’s so hard because it’s not like they’re lying–their intentions are often good, even when they’re being pretty objectively harmful.

  32. Gerry Keay*

    I’m relatively open about the fact that I have “mental health issues” but other than that I keep it extremely vague. I’ll occasionally mention therapy, and have talked to my boss about sick days due to interruptions to my medication — though I’ve always kept it intentionally vague what the medication is or is for. I’m bipolar and deal with a history of eating disorders, and I’ve found there’s *much* less sympathy and understanding for those mental illnesses than for depression and anxiety, which have been destigmatized to at least some extent over the past decade. Bipolar and EDs just make people treat you with kid gloves, and I hate it. Basically, I keep mental health info on a need-to-know basis and leave the advocacy work to the professionals.

  33. Pobody’s Nerfect*

    Regarding asking for an ADA accommodation, where Alison said “They might ask you to put the request in writing or have your doctor complete paperwork, but neither you nor your doctor should need to disclose your specific diagnosis in doing this.” In our company, they absolutely do ask that the health care professional/doctor cite the specific diagnosis on the ADA paperwork. Then they go further and want to know how the details of that specific diagnosis affect the ability of the employee to do their job functions. It feels not right somehow, but that’s what they do and we’re all subject to their rules.

    1. Ursula*

      I think they’re not allowed to ask your diagnosis, just the the second part about what’s affected. Best to check, but if that’s correct you could tell them their policy violates the ADA.

  34. Aggretsuko*

    Ah, yes, this reminds me of me having to keep my camera off all 2020 because I would get in trouble if people found out I was spontaneously bursting into tears off and on all day, every day. I very tentatively admitted I was having issues after I finally dried up, but I am sure I would have been penalized for my nervous breakdown if I’d been open about it.

  35. I Always Listen to The Boss*

    I’m job searching and I have mental health issues. I also have Non Hodgkins Lymphoma, for which I currently don’t need treatment but could need to go into cancer treatment again at any time. Here in the US, most job applications ask you to complete that separate government required form asking if you have a disability. Cancer is considered a disability, and my combination of mental health issues could be one as well. Is it a good or bad idea for me to check that “Yes, I have a disability” box? They always say those forms are separate from applications, but I have my doubts about that.

    1. Eldritch Office Worker*

      I think in your situation if places do select you out because of that it might be best they didn’t waste your time, so even thinking cynically I’d recommend checking the box.

    2. Why did I go to library school?*

      I always click the box. As others have said, it might exclude me from consideration at some places, but that’s a bullet dodged.

      Also, if there’s one thing asking for disability accommodations in college/grad school and the professional world has taught me, it’s that PREPARATION IS EVERYTHING. I see that little box as part of that. If I have huge depressive episode and need accommodations, I can say something like, “As I indicated when I applied for this position, I have a disability. It’s usually well-managed, but right now I’m going through a flareup. As such–” etc etc etc.

  36. iglwif*

    I’m extremely lucky in that disclosing my mental health diagnosis (I have anxiety) has gone well for me in my current job, where my manager, grandiose, and colleagues are supportive and non-judgemental and genuinely value good work-life balance.

    I would have NEVER disclosed to my previous boss in ExJob (although in fairness he was not the kind of person to whom anyone disclosed anything personal ever, and vice versa). He was adversarial enough about extremely reasonable things like “can this person who has a long commute work from home one day a week” that rather than seeking any kind of accommodation or understanding from him, I just straight-up quit.

  37. Mimmy*

    Thank you for writing this piece.

    I have significant anxiety (among a couple other disabilities) and have been pretty open about it to my supervisor and some coworkers. My supervisor has informally accommodated me as best she can and I really appreciate her support. What I’m nervous about is when I start doing my internship (still looking) and begin looking for full-time work after I finish my grad degree. I am pretty knowledgeable about the ADA but because of the stigma of mental health disabilities, navigating those accommodations are going to be tricky.

  38. Miami Beachbum*

    I’ve always been super open about my depression and anxiety because I feel like that is so common and doesn’t come with as much stigma, but I also have an eating disorder, and probably the more “embarassing” one – bulimia (just because of the purging I say that.) I would not want anyone at work to know. Our head of HR knows because I told her while I was crying in her office about how I was afraid to lose my job if I went back to treatment, and also I ended up telling my boss.

    So the telling has worked out for me, but honestly, I would not recommend it. My boss is not warm and fuzzy and while we have a good relationship, I would not say we are close. I do not always think she is a great manager. However, when I had to go out on leave for the 4th (yes the 4th) time in 8 years, I did tell her what was going on and she was very supportive and actually told me about her own issues with alcoholism. She never brings is up. I dont know if she has told anyone – it wouldnt surprise me if she did, but its not something I am aware of.

  39. Moi*

    Several years ago, I had an employee who was having a pattern of (uncharacteristic) unprofessional behavior. Think things like snapping at people, refusing to answer (work-related) questions, etc. I had a conversation with him, referred him to the EAP, etc., and he apologized for the behavior, said the cause was medical, and that he was addressing it. I was fine with that as an explanation, and the behavior stopped pretty soon thereafter.

    As for myself, NO WAY IN HELL would I disclose any of that. Even my family doesn’t know – my husband knows and that’s it. No one’s business whatsoever. I’ve seen/heard the way people talk about those with mental health issues, and I’m not signing up for that.

  40. Ms. Hagrid Frizzle*

    I disclosed my PTSD to my (current) boss after I changed departments – I thought I could trust him, my previous manager had found out through a very fraught and toxic situation and so was likely to hint towards my diagnosis, and he asked in what seemed like a really supportive and caring fashion as he asked about my assistance canine and what led to me getting her so he could understand what accommodations I might need. . .
    I was very matter-of-fact, explained I was in treatment and my condition was well-managed, but then extensive or prolonged overnight travel was not something I could do regurlarly (this was all work-relevant). I thought it went well until a few months later when we were discussing my workload and our lack of support staff and he commented that he “wouldn’t want to trigger [my] ~AnXiETy~” – complete with jazz hands.
    Now I get to dread having to ask for very necessary physical accommodations for a different/new ADA-protected condition. And I’ve learned not to trust my boss for anything.

  41. Aj Crowley*

    I’m a licensed mental health provider and I very much appreciate this article. I plan to share it with clients whose mental health is impacting them at work. My advice in the past has been similar to what Alison recommends (give the fewest details possible, if you need documentation we have a long discussion about possible pros and cons and viable alternatives) but that always feels like a conflict of interest and providing guidance outside my field. This article allows me to provide that guidance from someone with expertise in management and business.

    I’m all for reducing stigma. Half my career has been spent in mental health education with that express goal. However there are ways to do that without risking one’s job (or comfort and privacy at one’s job). In an ideal world we could speak about mental health as easily as we speak about a common cold but until we reach that time, protecting oneself through wise decisions about disclosure is paramount.

    FWIW most places I’ve worked (as a therapist, supervised and managed by other therapists) have been absolute nightmares around granting accommodation (for physical and emotional needs) and then retaliating for requesting accommodations. These same places that paid me to educate the public about mental health stigma… so don’t confuse workplaces that put mental health front and center of their mission as actually caring about the well-being of those doing the work.

  42. itsobvious*

    I work in a small law office where 2 out of the 5 paralegals have passed away in the last year (both cancer related, not Covid thankfully). It left a huge hole and we are very short-staffed because of it. I requested 2 full weeks off in January (our slow period) for burn-out and mental health, since I’ve been working my butt off. While one of my partners was perfectly fine with it, the other gave me a list of things I’ll have to do to “earn” it (my words, not hers). I have more than enough vacation time in the bank. So frustrating that I have to do extra things like train new staff, etc. to “earn” my extended vacation :( Don’t I already earn it by working EXTREMELY hard?

  43. Bookworm*

    I wouldn’t. Earlier this year I had a minor version of this and convo with the HR-type person about things I wasn’t supposedly doing work-wise. It was a culmination of the pandemic, election (worked at a place where it really does matter how the election went), a worsening of multiple problems that were existence prior to the pandemic that had been previously manageable if annoying, etc. It was to the point where I couldn’t do aspects of my job because of both work and staffing changes.

    I was told that I had to suck it up. That this is how the organization was being run now, and I had to find ways to cope–oh, and I needed to be doing X, Y and Z better. I spent a couple of days and then about a few weeks mulling things over. There was no follow-up (they said they would).

    Not as severe or anything as others, but it did tell me I had to go, or else things would become worse for me. Quit with no offer in hand, and landed some place that isn’t going to work out for me, either. But even now, as tired as I am, I don’t regret leaving. Mentally I was starting to deteriorate and there was nothing I could do to change it. They don’t care about me and I finally understood it was time to stop caring about them.

    I do hope this changes the conversations about mental health and wellness but until then I’m not too hopeful.

  44. What Comes Next May Shock You*

    My boss, soon to be former boss, was anything but understanding. He joined the company late summer 2020. After listening to me outline my struggles, the steps I’ve taken to mitigate them, the things I could use help with so that I can do my best work, and my suggestion for how to keep on top of all of this, he said, “I need what I need.”

    That didn’t leave me any room to argue. We’re a small company (<20 in the office), my department is one person (me), and even if I could mask my mental illness enough to force my way into the role he wants me to fill, without his support I'd fail anyway. To be honest, I think any reasonable person would, it's just that the next person he hires is going to start from a fresh and optimistic slate versus the whole getting to know one another during a pandemic situation we've had.

    So it just became clear that the two of us just do not have compatible working styles, my mental illness is an added detriment to my ability to adapt to his approach, and it's time for *me* to go somewhere else.

    There's plenty of normal work reason for me to leave, but the tipping point was the "I need what I need" conversation. It didn't leave any room for accommodation.

  45. Cat Toys*

    I think I may be on the autism spectrum. I need to go get diagnosed first, but if I fit at all into that category, how do I push back on when something on a job description is going to be a real problem?

    Like if they want to reassign me to an area with a lot of noise, and that’s an area I have issues with?

    If HR is asking “why didn’t you have a problem with this before”? What’s the response if ” I did” work conditions changed and now this is problem now?

    1. Beth*

      You can always say “I didn’t tell you about this before because it wasn’t relevant to my work. Now it’s becoming relevant, though, so I’m bringing it up in response to that change.”

  46. Keymaster of Gozer (she/her)*

    I’m not telling work about my schizophrenia. Not after the time I did and people started ‘worrying that you’ll snap and hurt someone else’.

  47. Sensitive Topic Pseudonym*

    When reading about disclosures, I always think back to being in law school at a conference on disability law. There was a conference talk from one of the nationwide mental health advocacy groups, talking about ADA suits and de-stigmatization and how people with serious mental illness should be an open part of our society. If I’m remembering correctly, there were some bright predictions about how people coming forward about their conditions is advancing society by leaps and bounds, comparing this discussion to the history of being gay in the workplace with bright optimism. The talk focused on the firm’s clients, with the attitude that people sometimes faced discrimination, but that the law was building this bright future and people are more open than ever with great results. Freedom to disclose for all! Open self-advocacy groups! Here’s our legal tools to chase out discrimination wherever it shows up!

    During the audience Q&A, someone asked about the best path forward for law students and attorneys with mental illnesses; something like 30% of attorneys have a diagnosable mental illness over the course of their lives, and it’s a hot button topic especially for law students, who risk Character and Fitness exams keeping them out of the profession altogether if they have a documented treatment history. The attitude of the presenter changed immediately. It was one thing to talk a big game about how the ADA is doing better work than it ever has when talking about clients– especially poor clients who were meant to be very ‘other’ from the professionals in the conference room. During the main talk, the tone wasn’t at all one of ‘man, sometimes it’s hell to be the martyr for civil rights’, to the point where I’d guess he never thought about his clients’ lives that way. But when it came to lawyers with mental illnesses, all he could muster was, essentially, don’t disclose because it would make you permanently unemployable. Don’t tell friends, don’t tell work, don’t tell HR. Someone with a decade of strong work experience may be able to survive the career hit of admitting they had panic attacks (in the past) or were suicidal (in the past) but he wasn’t optimistic about someone’s career prospects even at that point. No advice on how to weather the storm if you can’t keep your illness a secret.

    I didn’t come into the room with any rosy glasses about how good it was to be mentally ill in our society. I have a mental illness, and also live in society, and I’ve definitely experienced discrimination. But the memory sticks in my mind, because disclosure was a boon to society and fighting the good fight for everyone else, but Mr. Sunshine couldn’t even imagine a future where someone with a mental illness would be his equal. Hour long session on how it’s the civil rights issue of our age, and he couldn’t pull together a basic ‘yeah, I hope this helps our profession open up as well and I have a lot of respect for people fighting the good fight on that even when it’s hard for them’. That says more to me than any number of sunny seminars about mindfulness and self care from the university or the bar association could. I’ll hold a candle in my heart for when things are better, but I’ll hold that candle while quietly kicking my illness under the couch where no one from work will find it. Pun unintended but the state of affairs is, frankly, depressing. Hope like hell other people have a better time of it than I have.

  48. Beth*

    I don’t disclose any medical conditions at work, as a rule. I wouldn’t do so unless I needed to put in a formal request for accommodations. Short of that, if I need time off for an appointment or to take sick time, I just stick to a vague “for medical reasons” or “due to a health condition.”

    This is extra true for mental health, but I also generally don’t want to talk about physical health conditions with colleagues. Our society has a lot of preconceptions about health, and people can get really judgmental about it, sometimes without even realizing what they’re doing. Plus, if you have a general habit of being private about health, no one will be surprised if you don’t want to tell them what tomorrow’s appointment (which happens to be therapy) is for.

  49. Becky C*

    I honestly couldn’t have survived the last 18 months without the open and honest culture towards mental health of my teams. I work in a role with NHS England and since Covid hit in the U.K. I’ve been working on projects from increasing ventilators and oxygen capacity to the current vaccine rollout programme. It has been exhausting and challenging with at times incredibly long hours.

    The tone was set from the start when the leads of the team pulling our covid cell together asked me to come up with a plan so that our team could cover a 7 day rota. They themselves (both men) have been very honest about their own struggles with mental health and resilience during this time and it really helped our team do the same.

    The project team I’m working on now has just had a very open conversation where people shared the struggles they’ve had, including panic attacks and one person having to take time off after a particularly challenging issue. We’ve advocated for more resource into our team and our senior leadership has listened and we’re interviewing people next week.

    I’d say it has to come from the top of your team. If the leaders I’ve worked with hadn’t been open and honest with me first and I wouldn’t have felt so able to be open in return.

  50. Big Ol' Meanie*

    Don’t. I once had a problem with burnout due to some struggles with depression and anxiety. I talked to my boss about it, and he seemed to be quite supportive. But it turned out to be career suicide. Since then I have been treated like some fragile little flower, and any even slightly challenging tasks automatically go to other people. I only get the soft and fluffy jobs, which means nothing to me and my career.

    No. Find ways to deal with whatever problems you have, and hope your boss doesn’t find out.

  51. Katiemouse61*

    It’s all to do with how bad management is. I WAS clear about mental health issues at interview (internal) and they wanted me for the jab (ATM). But when a large IT project affecting the whole department came up it was mine on top of my job and then in the same month my boss went sick I was doing her job too. FOR 8 months…asking for help support anything fell on mostly deaf ears- they didn’t want to hear it. In the end breakdown was followed by early retirement. Even that wasn’t done properly. I now have a brain made of oatmeal and couldn’t focus long enough to apply for a job let alone do one. And this was a supposedly responsible branch of Local Govt.

  52. They Called Me....Skeletor*

    I disclosed my anxiety and depression once, and had an accommodation “forced” on me (a demotion because the company felt I couldn’t handle the stress….). I’ll never disclose my mental health issues again to an employer again.

  53. Nina*

    I have always disclosed and felt that it was for the best in most cases. However, my direct manager keeps dismissing, saying things like “I don’t think you are autistic” (well my psychiatrist does, along with several psychologists), and the other day told me “You are so dramatic” while I was having a panic attack at work. Then she says she is hurt because my actions “show that I don’t trust her”. I wonder why…

  54. Jill*

    ABSOLUTELY NOT. I was fired for sharing with my boss that I was having suicidal thoughts and intended to, on my own time, seek help for them. She felt an obligation to let HR know. The way HR saw it, if my friends and family knew that my employer knew that I was suicidal, and they failed to act, and I hurt myself, then my friends and family could potentially accuse my employer of not intervening even though I knew I was unwell. So I went about my day, clocked out, and I was pulling in the driveway I got the call form HR letting me know the Employee Assistance Program would be happy to help me, for free! Followed less than five minutes later by the call letting me know I was fired. I told them that I didn’t think they could fire me due to a mental health situation, pretty sure that’s discrimination. They told me they had already compiled every mistake I had made in the last five years, pick one, that’s the reason I was fired. I’m in Texas, and this is a mulimillion (at least) dollar company, so I would have stood no chance if I tried to pursue anything. NO, DO NOT tell your employer you are suffering from a mental health related issue.

  55. Lucy Skywalker*

    Just wanted to add: if you are admitted to a psychiatric hospital and have to miss work, but aren’t comfortable telling your boss the reason why, say that you have the flu. That’s what I did.

  56. Mid*

    I’m very much in the minority, in that my direct supervisor knows a lot of details about my mental health issues. However, she also deals with many of the same things, and I trust her. The rest of the office doesn’t know much, if anything, about my medical issues, though they’ve likely seen me take my prescription meds in passing.

    In general, I’m also on team “only disclose what needs to be disclosed for accommodations” because even if people try to be supportive, it can go poorly. (Like the LW a while back who had a condescending welcome back party and had a bunch of “accommodations” made that weren’t necessary or wanted.)

    The general script I go by is “I have a medical issue and I need ____.” (Time off, flexible schedule to accommodate appointments, etc.)

  57. PJ*

    I just had a refreshing conversation with a colleague in the same field, different office. She has a parent and spouse both fighting cancer. Her boss checks in weekly and encourages her to take mental health time, as in “What does your week look like, could you take a couple afternoons off” or “It’s been awhile since you’ve had a day off, how are you doing?” It’s pretty awesome, no pressure to take the time but the acknowledgement that being the caregiver for two loved ones is not easy.

  58. OyHiOh*

    I have therapy twice a week for a constellation of behaviors and thought patterns that fall under the general heading of “failure to mentally thrive” (my choice of phrases, not my therapist, though they like the phrase), rather than any specific diagnosis. My boss roughly knows my appointments schedule because occasionally I need to flex my hours and I have to remind him of my standing appointments. Like “hey, yes I can come in Friday to finish Thing, but I won’t be here until after X time, because of therapy.” It’s fine and life moves on, but I have a very human-centered boss and that makes a big difference.

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