my employee has hypochondria and is annoying all his coworkers

by Alison Green on July 10, 2017

A reader writes:

I have an employee who has hypochondria and health anxiety (Ronald). I have a question about balancing being sensitive to him and to his colleagues/my other employees. Some of the other people on my team have health issues or have family members with health issues. I realize Ronald sincerely believes he has health issues, but he doesn’t really have them.

To give an example: One of my team members has a heart condition and recently needed to have ablation surgery. She reminded me she would be having surgery and would not be able to attend a certain meeting. Not long after, Ronald, who sits next to her, collapsed at his desk saying he had chest pain. An ambulance was called and naturally everyone was concerned about him. It happened a second time a month later. After I asked Ronald how he was doing, he told me that extensive testing from a cardiologist and a second opinion found nothing wrong even though he is sure he had two heart attacks.

Another one of my employees had skin cancer removed last summer. She was fortunate because it had not spread to her lymph nodes so she didn’t need treatment beyond it being cut out. She did come in with a bandage over the wound while it healed. Ronald was telling people he had cancer and was going to see an oncologist. Again, later on he told me he tested negative for cancer by two separate doctors but was seeking a third opinion.

We have no HR department, but Ronald has given me letters from a physician and a therapist about his hypochondria diagnosis. Since he has worked here, he has used every day of alloted sick days and vacation days for doctors appointments and often requests unpaid days off.

His colleagues are fed up with hearing Ronald say he has health issues he doesn’t. My report who had melanoma complained to me about Ronald telling her and everyone else he had cancer when he didn’t, especially after she had surgery for cancer. Ronald told another colleague who has a parent with dementia that he thinks he had dementia too (Ronald is in his 20s with none of the symptoms) because he once forget about a meeting he was supposed to go to. Understandably, the colleague got very upset at Ronald’s behavior. Ronald has called out at the last minute more than once because he thought he was sick or dying and needed to go to the hospital.

I have not disclosed his hypochondria or health anxiety to anyone. But his colleagues all think he is faking to get attention or for other reasons. His general physician and his therapist all say he is not faking because he truly believes he has these illnesses. I understand why his colleagues are upset and I want to balance everything to be sensitive and fair to both them and Ronald, but I am having trouble accomplishing this. What should I be doing to make this happen?

Ronald doesn’t have any obligation to disclose his hypochondria to others, but this is a situation where he’d probably get better outcomes for himself if he chose to do that.

Right now, his coworkers are annoyed or offended because it seems like he’s trying to grab attention for himself and/or treating other people’s serious conditions lightly. They might not be entirely appeased by learning he has hypochondria, but it would be better than the way it looks right now.

Since Ronald disclosed the hypochondria to you, you might consider pointing out to him the way he’s currently being perceived by coworkers and asking if he’d be willing to share or let you share that he’s struggling with a disorder. I’m not a fan of defaulting to this, but I see this as similar to suggesting someone give their coworkers some context to explain any other behavior that causes negative consequences to others (like “I know I haven’t seemed fully attentive lately; I’m exhausted from chemo” or “it’s not your voice that makes me keep vomiting; I have morning sickness”).

But if he’s not up for that, then when his coworkers complain, you can try saying things like, “I don’t want us judging people’s choices about their medical care, even if they seem hard to understand.” If it gets to the point where people’s annoyance is interfering with their ability to work with Ronald, you’ve got to address that head-on by saying something like, “I understand you’re bothered by this and I’m not going to tell you how to feel about the situation, but I do need you to work with Ronald, regardless of your personal feelings about him.”

Also, this might ultimately fall in the category of “sometimes someone has a really bizarre-seeming trait, and that’s okay.” (To be clear, I don’t mean to call a medical condition bizarre. I’m talking about the way his colleagues are perceiving his behavior.) People can have (what seem like) quirks, eccentricities, and/or annoying habits and still do good work.

Of course, if Ronald’s work quality is suffering, that’s a different issue, and you’d need to address that like any other performance problem.

Updated to add: There’s a lot of advice in the comment section to tell Ronald to limit his medical talk at work. That’s absolutely a possibility, but the letter-writer needs to tread carefully here. If it turns out that Ronald’s condition is covered under the Americans with Disabilities Act, she may be legally required to accommodate some of his symptoms. If the letter-writer wants to go in that direction, he should consult with an employment lawyer to figure out how to navigate it legally.

Read updates to this letter here and here.

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  1. paul*

    The boss can say that sometimes people have quirks and it’s OK, but taken from outside perspective, the behavior is annoying and I can’t see how coworker’s aren’t going to be annoyed with him. I mean, they still need to be professional, but I can’t imagine it being pleasant to work in a place where everyone’s basically stuck on “icily polite” mode with you.

    1. Doe-Eyed*

      It’s not only annoying, it’s really insensitive even though he clearly doesn’t mean it to be. If he’d gone on in my office about having dementia while my father was in his slow dementia decline, I would have gone home crying almost every day.

      1. Hills to Die on*

        Yeah, that’s beyond upsetting. He needs to stop talking about it or it’s going to have an impact on the functioning of the office.

        Also, how do you balance the performance issues against a medically protected condition? It seems like they have made a lot of accommodations already, but at a certain point, the guy needs to be in the office working.

        1. fposte*

          That’s a policy call that is, ideally, independent of the nature of the illness. So if he’s not overdrawing on his sick days, I’d be uncomfortable with holding it against him; it’s not like most people know about their sick days in advance, after all.

          1. Jadelyn*

            It sounds like he is overdrawing his sick days, actually – OP said that he’s already used all his sick and vacation days and “often” requests unpaid days off.

            1. fposte*

              Whoops, you’re right; I missed that. I’d definitely consult with a lawyer, then, because it sounds like intermittent FMLA might be relevant here and maybe should have been in the mix already.

              1. Jadelyn*

                Yes, assuming the company is big enough to be covered under FMLA, I’d agree he should be set up to take intermittent leave. Between FMLA and ADA issues, this is a really tangled situation – my sympathies to the OP!

                1. fposte*

                  Yeah, a lawyer will help the workplace negotiate the most legally tenable thing, but it still might not necessarily be the happiest resolution.

            2. Bea*

              It entirely depends on his job. OP doesn’t say it’s effecting his work to be out, so unpaid days may just not matter in the scheme of things.

              We get 5 paid sick days because that’s a budget issue. But most people could be gone a day a week and things still get done just fine. It’s just annoying more than anything when someone isn’t reliable in some office settings. That’s how I’m reading this situation.

          2. Hills to Die on*

            It sounds like he had used them all and maybe some additional ones too, though. It just sounds like such a gray area to figure out where to draw the line and if you’re wrong, you could need an attorney.

        2. JessaB*

          I think that since he’s discussed the issue with OP, OP now needs to go into Reasonable Accommodation mode. If it’s a recognised disorder (hypochondria, Munchhausen’s) then there needs to be something.

          I am however at a legal loss (Princess CBH, I think you’re a lawyer,) is it legally bad if the accommodation starts from the boss asking something like “Okay you’ve got this, let’s talk about how we work this from here?” Or must the employee be the first one to say “accommodation,” even if they’ve already discussed their medical condition?

          1. Princess Consuela Banana Hammock*

            OMG, I’m so sorry I missed this, Jessa! Legally, it’s safe for the employer to initiate an accommodation conversation once the employee has disclosed their disability or if the disability is obvious (the latter can be tricky to navigate). The employee does not have to bring up accommodation, first, for the employer to raise the issue. The ADA really wants this process to be a back-and-forth conversation where both employer and employee come to the table to figure out a reasonable plan.

            So OP could initiate the conversation under the circumstances in this letter, although I think it would be safer to consult an attorney, first, just to get a handle on the process, proper language to use, and the range of specific kinds of accommodations.

      2. Jess*

        I was going to say the exact same thing. Without the context, his behavior and comments appear to be trivializing the actual serious health conditions (and what are probably fairly traumatic experiences) of his colleagues. As much as I’m a fan of trying to let people’s “quirks” roll off my back, if I was in the middle of dealing with actual cancer treatment or the actual dementia of a loved one or whatever it may be, I think I would have a pretty hard time putting up with Ronald’s comments everyday and not letting it affect my working relationship with him. Sharing the context of his hypochondria is what would take it from outright offensiveness to merely an annoying quirk.

        1. Manders*

          Agreed. I know people shouldn’t be forced to disclose their mental health conditions at work, but if I had to deal with this kind of behavior and I didn’t know why my colleague acted this way, it would be very hard to deal with. I’m currently dealing with a parent who has a scary and poorly understood terminal disease, and having to deal with someone self-diagnosing that disease and talking about the symptoms at work would be extremely upsetting.

          This is one of those weird situations where Ronald should absolutely have the right to privacy about his medical condition, but it’s also totally understandable that his colleagues who don’t know his diagnosis are frustrated and upset by his behavior. That’s a hard situation to have to manage.

        2. Pomona Sprout*

          “…if I was in the middle of dealing with actual cancer treatment or the actual dementia of a loved one or whatever it may be, I think I would have a pretty hard time putting up with Ronald’s comments everyday and not letting it affect my working relationship with him.”

          Agreed. To be honest, I’d have a hard time not blowing up at him, if I were dealing with something like that and he made the kind of comments mentioned in this post.

          Mental illness is not a free pass to be an @$$hole,

          1. oranges & lemons*

            I think the hard part about this situation is that it doesn’t really sound to me like Ronald is being an @$$hole though–it’s hard to know without being there, but it sounds like the only reason people are annoyed by his behaviour is because he doesn’t actually have the conditions he thinks he has. But in his mind, he does have them and he’s acting accordingly. It’s hard to appreciate that from the outside, and probably really tough on the coworkers, but I don’t think there is an easy solution.

            1. Snark*

              “I think the hard part about this situation is that it doesn’t really sound to me like Ronald is being an @$$hole though”

              I don’t think he intends to be an asshole, but he’s being one nonetheless, and I think the experience of everyone else involved needs to be honored as much as his. He may be, in his way, genuinely suffering, but that’s not a blank check for compassion – his coworkers, especially the coworkers he’s mirroring, are going to find it infuriating, particularly when it feels performative and takes away from their own authentic experiences with real health problems.

              1. oranges & lemons*

                I don’t want to be dismissive of how hard Ronald’s behaviour must be on his coworkers, but I don’t think that in itself is reason to see Ronald as behaving badly here. From the descriptions of his actions, it doesn’t sound like he’s doing anything that anyone would have a problem with if he really did have a heart condition, or cancer, or whatnot. I get that it seems performative from the outside, and I think that’s part of what people are responding to, but I think it would help to try to separate that from Ronald’s actual behaviour because from his perspective he is being sincere.

                1. SystemsLady*

                  “I think I had dementia once” sounds over the asshole line of stuff he can probably control for me, but the rest is all stuff he legitimately can’t control.

            2. Sunshine*

              Thing is, even if you genuinely thought you had dementia or skin cancer (as part of hypochondria or otherwise) why bother the person who’s going through the traumatic experience? That’s where it spills over into bad behaviour for me.

              Most people with a ragged mole wouldn’t run up to their colleague who is experiencing cancer and declare ‘samesies’. They’d quietly visit a GP.

              And with the ‘I forgot a meeting so I have dementia’ argument… at best that’s akin to the sort of people who declare they have depression when they’re a bit blue, or OCD because they like a clean house. At worst he sounds like he’s mocking his colleague and her situation.

    2. INTP*

      I agree, especially as it seems like in this case the condition is not at all under control and the coworkers are getting the full brunt of it. That’s a different, far more annoying situation than when someone is managing their condition well and working to minimize the impact on coworkers, but it still inevitably affects them sometimes. He knows he has hypochondria, and he is still telling people he has had heart attacks or cancer when doctors say he hasn’t. Maybe this is something that he can’t help doing, I don’t know. But to the coworkers it’s going to come across like “Ronald has this condition and it’s now your responsibility to deal with it instead of his to manage it” and I can’t imagine resentment not building.

      1. RVA Cat*

        This. If Ronald disclosed that he is an alcoholic, would you allow him to get drunk at the office? If he was a kleptomaniac, would you allow him to steal from his co-workers?

        1. SarahTheEntwife*

          That seems kind of extreme. Theft is illegal, as is possibly being drunk on the job depending on the job. This is just deeply frustrating.

          1. my two cents*

            Even still – one shouldn’t be cornering coworkers by rattling off their medical history, perceived or real. Ronald will continue to think he has whatever medical issue he believes he has. However, he doesn’t have to talk about it with everyone every time one crops back up.

            Ronald should be able to provide detail, either in discussion with OP or by way of written instruction from his Dr., how to help deescalate the behavior in the moment.

            1. Fish Microwaver*

              Yes, I am wondering what treatment options/de-escalation techniques Ronald and his physicians have available.

      2. Blue*

        ” He knows he has hypochondria, and he is still telling people he has had heart attacks or cancer when doctors say he hasn’t.”

        But that literally IS his condition. If he could believe he didn’t have it, he wouldn’t have hypochondria. Maybe he can avoid TELLING people he had a heart attack, but he can’t avoid believing he’s sick.

      3. SystemsLady*

        Yes, I think he needs to find a way to stop labeling his legitimate symptoms with sensitive labels like dementia well after he’s been checked out in response to somebody talking about their struggles. Not talking about it after the fact *at all* and would be an extra plus, but might be difficult with the health anxiety.

        Before having doctor’s appointments and his actual symptoms (even when they read as “drama”), however, that is where some understanding is needed.

    3. Sylvia*

      I strongly agree. I have anxiety that can sometimes focus on my health, so I am somewhat closer to this guy’s perspective. Lying about medical conditions, which is what he’s doing, although unintentionally, is more than a quirk.

      1. Sylvia*

        On second thought, I also have a diagnosed medical condition that is currently popular as a self-diagnosis. I might be oversensitive here. I’ll step back from judging Ronald.

  2. fposte*

    Ugh. Poor everybody. I could also see requesting that Ronald limit his health talk at work, if it’s really disproportionate in quantity; it’s not good for him either, so I don’t feel like I’m cutting off something he needs. I think as long as you stay away from judging the veracity of his anxiety foci, you’re free to ask him to change his office behavior.

    1. Mike C.*

      Yeah, I’m not sure why this isn’t the approach suggested. Essentially telling the coworkers to suck it up doesn’t feel like a good long term solution.

      1. CityMouse*

        It is one of those accommodations end at hurting other people things. Understanding and accommodating his condition is one thing, allowing him to upset other workers regularly is another.

        1. paul*

          Yeah. Even for stuff that’s relatively minor it’s annoying; but with the example Doe-Eye posted..yikes :/

        2. Wintermute*

          The law does not say that co-workers must not be inconvenienced or hurt by a “reasonable accommodation”, only that it’s not an “undue hardship” to the business… So upsetting them is not likely to be found unreasonable.

          So the law may well obligate an employer to make their co-workers jobs suck, at least somewhat, to protect an ADA employee– one reason I strongly disagree with the ADA accommodation provisions (I think the standard should be NO impact to co-workers and no hardship at all, not unreasonable hardship).

      2. SJ*

        Yeah… as someone who also suffers from health anxiety/hypochondria, I know you can’t tell an anxious person not to be anxious, but trying to figure out a way for Ronald to keep from expressing that anxiety at work seems like the best solution. I don’t know what the solution is, though. I’ve always just accepted that my health anxiety is something not to talk about at work, but I’ve been lucky to have parents who understand what I’m going through and will listen to my concerns (as unfounded as they are). I’ve called them up in the middle of the work day crying because I think I have breast cancer or a brain tumor something, but having that outlet has enabled me to keep it from interfering too much with my work life. Maybe Ronald doesn’t have anyone like that in his life, I don’t know.

        1. Allison*

          I too know it’s best to hide my health anxiety. I don’t need to needlessly exhaust people’s sympathy, or make it so that when I am sick no one takes me seriously because I cried wolf too many times. It came out at work once – just once – and only because I was legit worried I’d overdosed on an oral numbing gel and might have a seizure. Turns out, one of the engineering managers is also an EMT and he was able to check me out, but the whole thing was very embarrassing and it did not happen again.

          1. Wintermute*

            This isn’t entirely unreasonable, there’s no way as a civilian you could know that topical administration of amino-amide topical anesthetics won’t cause overdose in adults and older children (only babies) or what the threshold for clinically significant overdose IS.

            So your caution is entirely reasonable in that respect, you knew you took more than the recommended dose, you knew a seizure can occur with amino-amide overdose, you wanted to get checked out– reasonable in my opinion.

        2. Hills to Die on*

          You both have my sympathy.

          Out of genuine curiosity, how do temper your anxiety against the knowledge that your concern is likely unfounded? If you know it’s your anxiety / hypochondria and not an actual medical issue, are you able to push that aside or talk yourself down in any way?

          1. SJ*

            It can be really hard, especially when you actually have physical symptoms — and often it takes at least one trip to a trusted doctor to help me down off the ledge. Like last month, I had a 3-day migraine, which has never happened to me before, so naturally I jumped to all the worst conclusions about it. A brain tumor is one of my popular self-diagnoses, since my uncle died of a brain tumor. It did prompt me to finally schedule an appointment with my mother’s ENT, since the most likely explanation is that my wonky sinuses are causing problems. (My mother was a frequent migraine sufferer, had a septoplasty, and hasn’t had a single migraine since.)

            It’s been especially hard recently, since my brother, who’s never touched tobacco and rarely drinks, was diagnosed with oral cancer late last year and had to have surgery on his tongue and removal of a bunch of lymph nodes. He’s fine now, but having something like that hit so close to home kinda undermines the whole “oh what are the CHANCES you have something random like that??” argument.

            So for me, the anxiety is always there — it’s just about finding ways to be distracted from it, honestly. Keeping super busy at work so I don’t have time to stop and Google a bunch of symptoms, etc. etc. The book “It’s Not All in Your Head: How Worrying about Your Health Could Be Making You Sick–and What You Can Do about It” has helped too.

            2. Relly*

              As a fellow migraine sufferer with wonky sinuses: I take allergy meds (Allegra / Claritin) 24/7 to make my sinus issues less sucky to make the migraines less frequent. Might be worth looking into. (I hate the three-day ones, those just blow.)

          2. Manders*

            I’ve got an anxiety disorder that comes with a lot of psychosomatic symptoms, so there are times when I’ll be feeling real pain/vertigo/itchiness/whatever my brain has on the menu for the day. When it’s really bad, I just have to sit with those lousy feelings and remind myself that I’m not in immediate danger of dying until they go away. I’ll try to list the things that might be making me feel this way and fix them if I can (is my blood sugar too low? Did I have too much or too little caffeine today? Did I get enough sleep? Have I exercised lately? Is this pain a muscle twinge caused by lack of stretching?) If it’s really bad, I might message my partner and ask him to reassure me that I’m fine.

            There’s no easy fix, unfortunately, you just have to develop your own coping mechanisms (and you have to WANT to work hard on being functional).

            1. SJ*

              Yes — the point about anxiety causing symptoms is a good one. My heart rate/blood pressure are often out of wack, with things like chest pain, and it’s all due to anxiety.

          3. Rat in the Sugar*

            My paranoia and anxiety when they get bad focus more on mental health (I’ve been convinced that I am losing my memory or am somehow slowly getting dumber or something) or on social anxieties, but for me the knowledge that all of it was mental made absolutely zero difference. I explained to my friends like this: imagine walking in a little stretch of woods. It’s right by your neighborhood, you know it’s safe, but you get this crawling feeling on the back of your neck and have to fight to keep walking. No matter how much you tell yourself that it’s not real, there’s nothing there, don’t be silly–when a twig snaps, you take off running. Same thing here–I can tell myself it’s not real, but when that paranoia takes hold it’s like telling myself the chair I’m sitting in isn’t real and waiting to fall through to the floor. My brain just says, “Not gonna happen.”.

          4. oranges & lemons*

            As someone else with health anxiety/hypochondria, I think part of what makes me most nervous about health issues is that it can often seem very random and I don’t trust my own judgement about whether a symptom is serious. Also, as others have said, the anxiety can cause physical symptoms, which then just creates a feedback loop. And I also am very nervous about hospitals and doctors’ offices, so the idea of going to get checked out causes even more anxiety.

          5. Alton*

            For me, part of the problem is that you can never really prove that you’re not sick. You can always find examples of people who were told they were fine only to find out that their doctor missed something. Anxiety is good at creating confirmation bias where you find reasons not to trust reassurances and put more faith in the scarier possibilities.

            Another thing is that sometimes you really do have symptoms that need to be checked out, and it can be hard to strike a balance between reasonable, realistic concern and paranoia.

          6. Elizabeth West*

            I would like to extend sympathy as well. Oddly, except for worrying about accidents, health is one area where my anxiety is actually fairly well under control. I google symptoms but I’m fairly adept at putting my own mind at ease.

          7. LadyL*

            For me the issue is that my brain is pretty smart about manipulating me. I can convince myself of almost anything when I’m anxious, no matter how much the rational part of me tries to shout it down. W/r/t medical stuff the catch that gets me is usually the, “Well, SOMEBODY has to be that one in a million, right?” argument.

        3. Princess Carolyn*

          I understand anxiety disorders in general terms but didn’t realize this kind of health anxiety/hypochondria existed. I’m sure it’s terrifying to truly believe you have various life-threatening conditions, and the running theme with any mental illness is that it really sucks to feel like you can’t trust your own brain.

          Ronald has already disclosed his diagnosis with OP. He also seems relatively open about the conditions his hypochondria makes him think he has — probably more open than the people in this thread who also deal with hypochondria. That makes me wonder if Ronald is a very “no stigma, #talkingaboutit” kind of person — and that gives me hope that sharing his anxiety/hypochondria diagnosis with the rest of the office may be the right choice for him. It certainly would help his co-workers reframe his annoying/”insensitive” behavior.

          OP could also pair that with asking the other employees to avoid bringing up health issues around Ronald, since that seems to be kind of triggering. It’s a far more understandable request once they understand where Ronald is coming from. I hope things work out!

      3. MommyMD*

        No, I agree it won’t work long-term. It’s clearly impacting all his coworkers and Ronald is a grown adult with at least some control over his own behavior. And excessive absenteeism should have consequences. Including termination.

        1. Ask a Manager* Post author

          If Ronald ends up covered under the ADA, giving him extra unpaid days off may be a legally required accommodation. When there’s a medical condition in play, different rules apply.

          1. paul*

            Are you referencing FMLA or are you meaning above and beyond that? I have a hell of a time thinking more than 12 *weeks* extra off a year could be reasonable accommodation, yikes. The ADA confuses the hell out me

            1. Ask a Manager* Post author

              FMLA would almost certainly be in play, but yes, the ADA could require additional time, depending on the specifics of the situation. But it doesn’t sound like FMLA has been brought up yet, so they should start there.

              1. Questioning*

                This may be a question for a lawyer but wouldn’t it be Ronald’s responsibility to initiate any ADA or FMLA requests? Unless he is asking for accommodation, is it the employers responsibility to give him ADA accommodation?

                2. Retail HR Guy*

                  The law, however, interprets “asking for an accommodation” or “requesting FMLA” very, very loosely. The employer simply knowing (or suspecting) that a health condition is interfering with work duties or causing an absence is often enough to count.

                3. fposte*

                  @paul–and, in fact, for FMLA it’s on the employer to provide the forms, not on the employee to ask. The ADA is usually triggered by an accommodation request from the employee, but it can also be triggered by the employer’s recognition of the need for accommodation if the disability is already known to them. What you want to avoid is going “I bet you have a disability, person who’s never disclosed it! Let’s talk about that.”

                4. JessaB*

                  Especially since saying “I bet you have a disability,” pretty much instantly makes an ADA case of it, because ADA covers people presumed to have a disability as well as those who have. And if you’re seeing something you think qualifies, you’ve pretty much assured it.

            2. chocoholic*

              I’ve often gotten advice that additional time off may be a reasonable accommodation under the ADA. Not necessarily 12 weeks worth but what is reasonable from a business perspective. You’d want to work closely with an attorney when you are doing this.

            3. JessaB*

              If you have cancer, or need dialysis, there are plenty of conditions where 12 weeks isn’t all that long.

              Also FMLA covers family too, so if you’re caretaker for your Nan who has dementia, or your father has cancer, or your sibling has MD, you can be intermittently out a heckuva lot juggling medical appointments.

              1. Gadfly*

                Although you have to be careful about assuming who is covered. Sibling and Nan might be SOL depending on your state unless they meet very specific requirements beyond being what laypeople would consider to be family….

      4. To Carry On*

        I have a concern here that Ronald is causing much more distress and annoyance then the writer conveyed. All this leads to lost production, plain and simple. I concur with Mike C. laying this at the feet of the coworkers is not a short or long term solution. Ronald needs to suck it up, attend to his illness and attend to his work and let the rest of the staff do their work. There are many people who go to work, day in and day out, with much more distressing situations and they manage to get their work done without imposing on their coworkers.

        1. Ask a Manager* Post author

          Again, there are laws around this stuff, if in fact he ends up covered by the ADA. You can’t just tell people with covered conditions to suck it up and not have symptoms that annoy their coworkers.

          1. Alice*

            But I think the coworkers don’t need Ronald to stop _being_ a hypochondriac; they just need him to stop _talking_ about it. Or is part of hypochondria being compelled to share the perceived health conditions? I mean, we all know people who we refer to as hypochondriacs in common language, but I don’t know what the real definition is.
            I mean, Ronald cutting down on the health-related conversation wouldn’t solve the OP’s problem about Ronald calling out and needing more time off, but it would help with the primary problem in the letter.

            1. Ask a Manager* Post author

              I don’t know either! But this is an area where the OP shouldn’t assume; she needs a lawyer to advise her before she says what might be essentially “stop having your symptoms at work.”

              1. Observer*

                On the other hand, the ADA requires *reasonable* accommodations – and Ronald’s behavior is getting to a point of not being reasonable. So, he either needs to disclose his illness, as that does help, or stop talking about any illness that he does not have a diagnosis for.

                1. paul*

                  How reasonable it is is ultimately up to the courts though; Alison’s dead on right that “reasonable accommodations” can be weird and shocking (and it goes both ways). It’s not something an advice blog or us random internet commentators can say authoritatively. We can offer opinions but that’s about it.

                2. Ask a Manager* Post author

                  What Paul said :) It is really, really dangerous to assume that what courts consider reasonable is the same thing as what we as laypeople would consider reasonable. They are very often not the same thing, and it’s highly dangerous for an employer to assume they can decide on their own.

                3. Soon to be former fed*

                  Reasonable accommodations do not cause undue hardship to the employer (that’s the actual wording in the law). Undue hardship is a pretty high bar though, but an employer is not required to do anything and everything to accommodate a person who needs an accommodation to do their job.

                  I have several bona fide serious health conditions and likely would have told off Ronald by now. His behavior can cause good workers to leave if it is expected that they just suck up what to them is nonsense. Sorry, the mentally ill have an obligation to manage their illness well enough to not disrupt the workplace. Their rights shouldn’t be all encompassing. Remember the guy with a fear of birds who pushed a coworker into a car? There can be such a thing as too much accommodation wherein the other employees are making the accomodations, not the employer itself.

                4. Ask a Manager* Post author

                  Right, their rights aren’t all encompassing. But this particular situation — where the OP reports that he’s just really frustrating his coworkers — isn’t something I’d assume would be considered undue hardship under the law.

          2. This Daydreamer*

            But it sounds like his symptoms aren’t the problem so much as his constant talk about them, and I can see possible severe consequences to it. I’ve been diagnosed with depression, anxiety, and PTSD. If he started talking about having a pulmonary embolism, which very suddenly killed my sister, I’d be a wreck and might not be able to do my job. Hell, just thinking about it makes me cry and I lost her years ago.

            I’m covered by the ADA too.

            Even though he apparently hasn’t triggered anything that serious yet, he is having a very negative impact on the workplace. I would think it’s reasonable to require him to stop talking about the illnesses he is sure he has but doesn’t. Maybe suggest that he write everything down in a journal just to relieve the pressure. This isn’t just annoying his coworkers. It’s traumatizing them.

            1. Princess Consuela Banana Hammock*

              It may be that, in his case, talking about his perceived symptoms/illnesses is a symptom of his hypochondria. It may not be, but I don’t think OP can assume that “not talking about it” is a reasonable solution without more information.

              1. Soon to be former fed*

                But OP still must be cognizant of the impact on the workplace. Other people can’t be treated as though they don’t matter in the name of accommodation. That’s not right either.

        2. To Carry On*

          Before the big hue and cry that I am being insensitive let me clarify my position. Ronald does need help, there is no denying that. And I applaud the fact that he is getting help, at least that is implied that he is seeing a therapist. What I am addressing is that no workplace is a psychiatric ward, it is place of business where employees have certain tasks they are trying to accomplish. Ron’s behavior does not contribute to a positive work environment. This needs to be addressed, not his coworkers.

          1. Former Hoosier*

            And ADA specifically states that kleptomania is not a covered condition and hyperchrondria may not either. I agree that we can’t give legal advice but I also agree that while we may be surprised at what the courts feel are reasonable accomodations, ADA does not mean that you can impact the workplace so severely that others cannot get their work done.

            1. Princess Consuela Banana Hammock*

              We don’t know if that’s the case, though (that Ronald impacts the workplace so severely that others cannot get their work done). Ronald’s behavior is clearly annoying some coworkers and possibly distressing others. But we don’t know if he’s ADA-eligible or not, and it’s on OP’s employer to help figure that out as part of a conversation with Ronald.

          2. Soon to be former fed*

            Yes, yes, and yes. Well said. There is a limit to what can be accomodated in a workplace with other people in it. Unfettered symptoms of mental illness may not be able to be accomodated in the workplace.

    2. Government Worker*

      This was my thought, too. Especially if he’s been open with OP about his diagnosis and condition, OP should be able to say that his high amount of talk about his health is negatively affecting his coworkers. It will feel unfair in the moment (“Jane told everyone all about her skin cancer and I [sincerely believe that I] have the same thing so why can’t I talk about it”), but hopefully if he’s working with a therapist then he has enough perspective to see why this is a good idea.

      1. Tiffin*

        I think that if he does respond like that, the OP can note that most people don’t talk about their own health issues nearly as much, and the volume of talk is becoming a problem. At the very least, I could see asking him to only divulge the bare minimum and even then only when necessary. For example, if he needs someone to cover something while he is out at the doctor, he can say he has a doctor’s appointment. If he just generally thinks he has dementia, he can keep that to himself.

        1. MommyMD*

          Yes, Tiffin. It’s reasonable to have a discussion with him to cut way back on the health talk. Telling everyone around him they just have to tolerate it does nothing to help the situation and it is not helpful to Ronald as well. This is not how you act on the job and his next employer may have much less tolerance for this acting out behavior.

          1. Relly*

            “Acting out behavior” implies he is doing this deliberately, for selfish or malicious reasons.

    3. ZVA*

      Yes, this is what I came here to say! Asking him to limit health talk at work or even omit it entirely could help a lot (unless it’s work-related, like if he’s taking the afternoon off for a doctor’s appointment & needs to let his coworkers know. But even then he doesn’t need to tell them why he has the appointment, just that he has it). I think the fact that he’s disclosed his hypochondria to you makes this an even more valid option than it might be otherwise. You’re not asking him to stay silent about, say, having cancer; you’re asking him to stay silent about thinking he has cancer, which is a completely different thing.

    4. Clumsy Clara*

      I also thought it would make sense to try to ask Ronald to limit the health talk at work – wording would be tough though.

      1. AMPG*

        I think the OP could say something like, “I understand the inclination to talk about your health concerns with coworkers, especially since they’ve shared their own information with you. But due to the volume of these conversations on your end, I’d like to ask you to only bring up health issues that have been officially diagnosed by a medical professional. This will help keep everyone appropriately focused on work during the day.”

        1. Ask a Manager* Post author

          That’s great language.

          I didn’t originally go in that direction because I was concerned about whether the OP would be getting into areas where legally she might need to accommodate a certain amount of Ronald’s disorder.

          I don’t know enough about hyperchondria to say for sure, but it’s possible she’d run into ADA issues here and needs to navigate it somewhat carefully for that reason. It wouldn’t hurt for the OP to consult with an employment lawyer to make sure she’s not running afoul of ADA stuff, which is not always intuitive to interpret.

          1. Jadelyn*

            I guess the question then is, is “letting him talk about it to everyone” a necessary accommodation for that condition? Earnest question – I don’t know enough about the condition and its symptoms and treatment to know if being asked to keep it to oneself would be detrimental to management of the condition.

              1. Alli525*

                I just can’t imagine, after as many years as I’ve spent reading AAM, that “Please stop talking to your coworkers about X” would be illegal, where X=personal matters (not, say, wages or other workplace-related matters). One of the main issues here is that he’s regularly distracting and distressing his coworkers, so asking him talk waaaaay less about his health would–to me–be in the same vein as asking him to talk waaaaaay less about his basket-weaving or hedgehog farm.

                I wonder if allowing this to go on could open up the company to harassment charges from OP’s other employees.

                1. Ask a Manager* Post author

                  It’s really not implausible, which is why the OP needs to talk to an employment lawyer, not us. (And really, it’s my mistake for not saying that originally.)

                  It’s unlikely there would be harassment issues though.

            2. Observer*

              Well, the other question is whether the accommodation is reasonable, as well. As he’s causing some real problems for people, and it really is past the point of “this is just the job.”

              Of course, talking to an employment lawyer is a good idea, but I would think that asking him to dial it back would be reasonable.

              1. Ask a Manager* Post author

                I know I’m repeating this all over this post, but it’s really important for people to understand: What courts find reasonable is often not at all the same as what laypeople find reasonable. Employers cannot base their decisions on what feels like it should be reasonable; they need professional legal advice to determine that.

                1. Retail HR Guy*

                  For more complex ADA situations, or if your company is small enough to need a little HR guidance, absolutely go to a lawyer.

                  But on a day-to-day basis most employers of any size are perfectly capable of handling ADA requests on their own. ADA requests are routine, and it would be cost-prohibitive to run to the attorneys on every single one of them.

                2. Ask a Manager* Post author

                  You don’t need a lawyer for the routine stuff. But when you’re considering turning down an accommodation or navigating something like this where the lines aren’t clear, you talk to a lawyer.

                3. Green*

                  Most employers of decent size have lawyers on staff or have lawyers provide HR guidelines within which to make decisions. ADA stuff is routine, but…. this situation is not.

          2. Madeleine Matilda*

            My thought though is whether OP couldn’t say something about limiting medical talk around the office by everyone. It sounds as though Ronald is triggered by hearing about his coworkers’ conditions which then leads to his talking about conditions he doesn’t have which in turn is upsetting to those actually experiencing them. Perhaps encouraging everyone to limit such discussions would help ease the situation.

            1. BeautifulVoid*

              My reaction to the letter was that I think this is ultimately going to become a self-policing situation with or without OP. I’m almost willing to bet money that after what happened with coworkers already, people are already dialing back on what health issues of their own they’re willing to talk about in the office. I wouldn’t be surprised if the next person who needs extended time off due to a medical issue or procedure is intentionally vague about what they’re taking the time off for, as opposed to the woman who had her heart condition co-opted.

              And fair or not, Ronald’s going to become “that guy”. As in when someone’s showing around the latest new hire and introducing him/her to the rest of the office, the introduction to Ronald is going to come with a later whispered warning of “he’s nice enough, but whatever you do, do NOT mention any health problems around him!”

              1. BananaPants*

                Agreed. If I had a coworker like Ronald I’d absolutely self-censor around him so as to avoid him co-opting my genuine medical issue. That sort of thing is going to just annoy coworkers and cut him out of the group.

          3. Sigrid*

            Speaking as a doctor (although not a psychiatrist), the need to *talk* about illness is not part of the DSM-5 criteria for either Somatic Symptom Disorder or Illness Anxiety Disorder (the two formal conditions commonly referred to as hypochondria). SSD and IAD defined as the genuine belief that one has a serious illness despite repeated evidence to the contrary, extreme anxiety due to such beliefs, and the impairment of functioning as a result. (The primary difference between them is whether or not there are actual physical symptoms that are being misinterpreted to be more serious than they are — SSD — or no symptoms at all, just belief that you are ill — IAD.) The need to spread that anxiety far and wide by talking about it, although probably common, is not a defining symptom of either disorder.

            I can’t speak to what a lawyer would think would be reasonable accommodation. The ADA is its own beast and, as far as I can tell, ADA cases seem to be approached on a case-by-case basis, so talking to a lawyer who understands the ADA is definitely warranted. However, I wanted to point out that talking about his perceived illnesses is not a defined symptom of his condition and therefore may not be a reasonable accommodation.

            1. fposte*

              Thanks for the insight! It’s such a common component of anxiety that it’s really useful to have the differentiation.

              1. Sigrid*

                It’s a very frustrating condition for everyone involved. The patient is frustrated because they always feel like they aren’t being listened to, everyone in the patient’s life is frustrated because the patient is always “crying wolf”, and the patient’s physicians are frustrated because no matter what they say, the patient doesn’t believe them. It’s also extremely resistant to treatment. The first step is for a primary care doctor to recognize the condition and establish regular, frequent check ups so the patient believes they are being taken seriously and will be listened to, and doesn’t feel like they have to have a new symptom in order to be able to see the doctor. The second step is therapy, once the patient is at a point that they are willing to acknowledge that there might be a psychological component to their illness. Even getting to the second step is a challenge — many people with SSD or IAD are never able to consider that there is anything psychological going on. And then even if they do get into therapy, there’s not a very good success rate for “curing” the person. My understanding from talking to my psychiatrist colleagues is that the best that they hope for with SSD and IAD is that the patient learns coping mechanisms that reduces their anxiety and helps with their social interactions, and that they find an understanding primary care doctor who will treat them with compassion and continue to see them regularly for reassurance.

                I’m in emergency medicine, and I promise you that every ED has a set of SSD/IAD patients who are “frequent flyers” — someone who is always in and out of the ED for mostly non-medical reasons. Most frequent flyers are such for psychosocial reasons, usually homelessness combined with mental illness, but there’s always a few with SSD/IAD. It’s frustrating for us because even though you know it’s probably nothing, you can’t ignore whatever symptoms they have because it might actually be something this time around. You devote time and resources and it’s almost invariably nothing. And of course it’s frustrating for the patient because all the tests come back negative when they genuinely believe they have an illness so once again, they feel ignored and/or lied to. It’s just a bundle of frustration all around and no real solution.

                1. fposte*

                  Yeah, I have a couple of friends who suffer and I dived into a support forum for a while; some people knew, some people knew enough but would worry each new symptom was the exception, and some people really didn’t know. Anxiety is really cruel in its ability to hijack the body’s legitimate warning systems for its on purposes; it’s sort of the neurological equivalent of a virus that way.

              1. KatieBear*

                You are missing the point and hurting your credibility. No one can self-diagnose themselves or a family member. Please remember that before you speak, especially when you include your personal business website.

          4. Hope*

            From my own experience, I would think the ADA accommodation for someone with hypochondria would be more along the lines of “let them take time off to go see a doctor as needed to address their health concerns”, not enabling the condition by letting them talk about how they *think* they have something when it hasn’t been officially diagnosed. I say this as someone with anxiety and mild hypochondria (mine is fine as long as I have a doctor check me and confirm I’m fine; I’m thankfully not to the point of seeking out multiple doctors’ opinions because they won’t confirm my self-diagnosis).

            Because it *is* enabling to let someone with hypochondria consistently talk to everyone about how they *think* they have X condition. It’s actually harmful to them, and detrimental to their recovery to let them expound upon it over and over again, because it reinforces the idea that they are sick with something they haven’t been diagnosed for. Not that it’s not important to have an outlet for these feelings, but that outlet should NOT be the hypochondriac’s coworkers.

            It might also be in the coworkers’ best interests to not make their diagnoses public, or at least do what they can to not mention illnesses in front of Ronald. I personally hate hearing medical talk at work, because it inevitably makes my concerns flare up. That might be the best accommodation for Ronald, honestly.

            1. Princess Consuela Banana Hammock*

              Everything you said is right on. But this is where it’s helpful to talk to an employment lawyer. There are lots of accommodations that intuitively seem right/wrong to most people without a certain condition, but upon reexamination through a legal lens, are not considered a reasonable request from the employer. It’s also difficult because it should not be OP’s responsibility to manage Ronald’s treatment and care (i.e., trying to decide what is enabling or not enabling his condition)—that’s on Ronald and his physicians. But you and others are right that this can’t continue without OP at least getting the ball rolling on how to curtail the problem behavior while staying within the boundaries of the ADA.

          5. Soon to be former fed*

            Every possible ADA case does not need legal consultation. There is an abundance of implementation guidance, and any major employer had ADA protocol in place. I don’t think employers need to be afraid of making an ADA determination unless perhaps it is a smaller employer that is covered by the law with limited experience and expertise in this area.

            1. Princess Consuela Banana Hammock*

              Sure, in many of the most common ADA accommodation situations, employers likely do not need to consult an attorney about how accommodation works. And Alison isn’t recommending that people always obtain a legal opinion.

              She’s pointing out that this is a situation in which a condition is not well-understood by lay people, so the reasonableness of the accommodation may not fall within the scope of the guidances that already exist or a company’s prior experiences with ADA accommodation. I think that’s pretty reasonable advice in light of the unique issues regarding this particular employee. For all we know, he’s not even eligible for ADA accommodation, but the risks of fouling it up are significant enough that it makes sense to have some targeted legal guidance.

      2. Mike C.*

        Just take any standard speech about not discussing politics or religion at work and do a find/replace for medicinal issues instead.

      3. Infinity anon*

        I think bluntness might be needed. He provided documentation to the OP that he is a hypochondriac, so she is not making an assumption about that. Letting him know that talking so much about his perceived health issues is negatively impacting other’s view of him is something he needs to know. He is probably not aware that the volume of health talk from him is bad. Hearing that volume of health talk from someone is exhausting even if it is real. I say that as someone who has a lot of health issues. Unless it impacts my ability to do a task, my coworkers probably do not want to know. If I have a doctor’s appointment, I don’t say I’m going to my rheumatologist or cardiologist, I say I have a doctors appointment and should be back at X o’clock (or tomorrow).

    5. Artemesia*

      This. The OP knows he is a hypochondriac and should be able to discuss with him the need to not discuss his medical episodes at work. You can be sympathetic to the condition i.e. hypochondria without having to entertain his whining about each new condition. Why not “I understand that your hypochondria is upsetting to you and causes you to mirror other people’s medical conditions, but it is very disconcerting to your co-workers to have you appear to be one upping them when they have serious medical situations. I need to ask you to not discuss your medical conditions in the workplace except with me when you need to take time for appointments and such. You might want to share your hypochondria diagnosis with your colleagues, so that they understand why you seem to be mimicking their ailments but that is up to you. But I do need you to stop discussing your medical appointments and concerns with others while on the job. Can you do that?’

      1. Amber T*

        I think this is excellent wording! Shows sympathy to Ronald but still gets the point across on how it’s affecting his coworkers, and suggests the idea of sharing his diagnosis without it seeming like he’s being voluntold.

      2. Pomona Sprout*

        “…it is very disconcerting to your co-workers to have you appear to be one upping them when they have serious medical situations. ”

        THIS! His behavior really does have that quality, and imo, that’s the most problematic aspect of it. He seems to be taking every opportunity to respond to everyone else’s REAL medical problems by one upping them with an imaginary condition of his own, and that’s incredibly insensitive, even downright rude in some cases. Yes, work places have to provide reasonable accommodation for things like disabilities and mental illness, but is that supposed to include bending over backwards to accommodate someone’s need to be an obnoxious jerk? I sure as hell hope not.

        That said, onsulting with a lawyer as Alison suggests is undoubtedly the safest course of action, and I hope the O.P. does so and lets us know what they said

        1. Sylvia*

          +1. The aspect of it that reminds me of, for lack of a better word, appropriation can be grating.

        2. The Southern Gothic*

          + 1 Ronald seems more invested in the attention seeking than actual worry about imaginary illnesses. So when the next new co-worker says she has morning sickness or hot flashes, is Ronald going to try to Co-opt that too for attention?

      3. Merula*

        The problem I see with this is that “it is very disconcerting to your co-workers to have you appear to be one upping them when they have serious medical situations” seems to imply that Ronald doesn’t have a serious medical situation himself.

        What about just “it is very disconcerting to your co-workers to have you appear to be co-opting their medical situations”? That way it’s not a judgment about degree of seriousness and you’ve identified the issue clearly. (It’s not that Ronald talks about his feelings of having these medical conditions, it’s that people feel like he’s co-opting their situations for himself.)

        1. Relly*

          FWIW I took “serious” to mean life-threatening or requiring immediate and/or major intervention in some way. I didn’t think anyone was implying Ronald isn’t sick, just that sick can range from the flu to meningitis, and only one of those is a medical emergency. I imagine it’s particularly aggravating that the conditions he mirrors are on the more serious end of the spectrum.

    6. INTP*

      That would be ideal, and should probably be the first approach by the OP (maybe phrased as a question for disability discrimination reasons – “Are you able to limit the amount you talk about this?” rather than “You must limit your health talk.”) But I think it’s likely that he is not currently able (or maybe not willing, but it’s probably not productive to speculate about which) to do that. He has the hypochondria diagnosis, so he has probably been told that he needs to believe the doctors that tell him he doesn’t have conditions, and possibly counseled on how to handle the condition socially, but he is still proceeding like he genuinely believes he has all the health conditions. He may be too anxious to stop himself from talking about it or genuinely unable to tell the difference between his talk and other people when they mention their health issues in order to talk about health appropriately.

      1. Amber T*

        Also a good point. I don’t have hypochondria but I do suffer from anxiety, and when I’m panicking I have a tendency to word vomit about it to anyone around. It takes a lot of work to reign it in, because I know it’s inappropriate at work. I’ve gotten much better at limiting it so it’s not to everyone, but I still occasionally find myself blabbering on to closer coworkers (who have been nothing but kind and empathetic, even though this is NOT their job and I’m working on stopping that too.)

        1. Elizabeth West*

          Me too; it’s either that or have a panic attack. I HATE panic attacks. :(

          Sometimes opening a Notepad document and typing it all out helps. I don’t know if you’ve tried that–it doesn’t always work if I need to get up and go distract myself, but it does help.

    7. Another person*

      I don’t intend to sound heartless, but I think EVERYONE in this situation. should quit discussing their personal and family health problems at work if they are not relevant to work activities (missing meetings and such). What’s wrong with just saying “I have an appointment/procedure and will be out X amount of time”? If coworkers are triggering Ronald’s mental health condition to flare up by discussing all of this in great detail around him it would probably be better for everyone to just stop.

      1. Artemesia*

        The most obvious outcome of this will be the shunning of Ronald i.e. people will stop discussing their medical issues around him but will also avoid interacting with him at all. This is the kind of situation that gives the ADA a bad name when being really annoying gets to be a condition that needs to be accommodated by everyone else. I would think that having an annoying condition and inflicting it on everyone else would be separate issues and not doing the latter could be a condition of employment. The idea that you have to allow your employee to torment other workers with personal drama that mimics their medical issues seems ridiculous. (I know, I know IANAL)

        1. Another person*

          I don’t see any reason that they need to be told they shouldn’t openly go into medical details around the office because of Ronald. Some workplaces consider it professional to not talk about all your personal details openly at work.

          And frankly they are probably already trying to avoid him as much as possible already.

            1. Sam*

              Yeah, I agree, and I imagine some resentment popping up that they have to police their conversations in new ways because of the behavior he’s exhibiting. I think it would be very different if everyone was aware of his diagnosis and understood the context.

          2. Observer*

            Sane and functional workplaces do not ban any and all discussion of personal issues at work. Sure, all of the gory details and blow by blow accounts are one thing. But, “I’m sorry, I’m distracted because I’m waiting for work on whether my melanoma spread or not.” is fine. Certainly reminding your boss that you won’t be at a meeting because you’re having a scheduled treatment is considered acceptable!

            The idea that perfectly normal communications with co-workers and managers is somehow “unprofessional” is bizarre to me.

          3. Tuxedo Cat*

            I don’t know if people are going into medical details, but some conditions probably can’t be hidden that easily like losing your hair from chemo. Their current office seems to function that someone might share that they have cancer, which isn’t entirely unreasonable thing to share.

        2. paul*

          legalities aside (and as Alison has noted, we’re not qualified to judge those-even if we’re ADA attorneys we aren’t privy to all the facts of the case) I’d personally agree. I’m pretty big on the belief that accommodations *should* stop when you start hurting other people with them.

      2. Observer*

        That’s not really useful or realistic. People spend a huge amount of time at work. Asking to keep something like that under wraps is difficult. Also, often these things have ripple effects and when people understand what’s going on, it helps to deal with those. This is especially true when people need some accommodation.

        It doesn’t sound like people are discussing things in great gory detail. But they are mentioning their diagnosis or the ones of their loved ones.

        In any case, as long as Ronald doesn’t disclose his diagnosis, this is an impossible request.

        1. Hedgehog*

          I wonder if just counseling individuals who are complaining about Ronald to not talk about their/their loved ones’ medical issues around Ronald (as opposed than not talking about them at work at all) might be helpful to them and to Ronald, if they haven’t figured that out already. Obviously some things can’t be avoided, but some probably can. It needn’t involve disclosing his condition. I can think of any number of topics I avoid bringing up around certain people, lest they start being annoying.

      3. Amber T*

        I don’t think it’s heartless, but I think this is also a case where you’d be punishing everyone for one person’s actions, which isn’t fair.

      4. Sylvia*

        No, I don’t think Ronald’s behavior should control everyone else’s. There’s a point where you need to do something about the broken stair instead of stepping over it, you know?

        1. LBK*

          I think that analogy is meant for people who just have personality issues, though, not actual medical conditions/mental illnesses.

  3. Cambridge Comma*

    After reading the response, I think there’s still a question open and that’s the one that’s hardest to address: how about staff members who are genuinely upset and offended by Ronald’s comments (the colleague with cancer or with a family member with dementia). I don’t think that their upset is entirely taking the form of judging Ronald; someone with a medical issue might really find it hard to work with someone continually reminding them of it. Could Ronald be asked to completely avoid medical topics with coworkers? This wouldn’t stop him from using his sick days or from consulting medical professionals.

    1. designbot*

      Thank you for this perspective. I was left wondering after the letter how this is actually impacting the employees. It mostly sounds like they are just borrowing trouble to me–letting themselves become distressed about something that does not in fact impact them in any functional way. But if the actual impact is that they are constantly reminded about their own difficulties because Ronald is mimicking them, then yes that could be addressed by asking Ronald to keep the medical talk to what is functionally necessary, like informing you of absences.
      Another way to address it without disclosing Ronald’s diagnosis is to address the behavior that you’ve all witnessed, something like “I think we’ve all seen that Ronald tends to become very concerned about health issues when anything brings them to mind, so it doesn’t surprise me that he is concerned about his heart after what happened with you. I don’t believe he is being malicious in any way, so we have to try to not take it personally.”

      2. CityMouse*

        It’s not just the reminders, it can feel like he is mocking them by imitating them. It also takes someone who is in pain (physical or emtotional, I had a friend who had a melanoma and the recovery was painful according to her) and makes them afraid to disclose because it is going to be turned into a Ronald thing. I don’t think the coworkers are unreasonable for getting upset, what he is doing is upsetting.

        1. AJHall*

          There was someone at my college who (as we subsequently discovered) was in the process of going through a psychotic episode and one of his symptoms was compulsively imitating other people in college — not illnesses in this case, but personality quirks and characteristic campaigns in which they were involved. And it was unbelievably unsettling (it was a great relief when we realised there was a clear medical explanation) because it was so stalkerish.

      3. Natalie*

        “I think we’ve all seen that Ronald tends to become very concerned about health issues when anything brings them to mind, so it doesn’t surprise me that he is concerned about his heart after what happened with you. I don’t believe he is being malicious in any way, so we have to try to not take it personally.”

        It seems like it would be appropriate/helpful to also suggest co-workers not discuss health stuff with Ronald when possible. As you have here, no one has to disclose his condition to point out what the office has already observed.

      4. INTP*

        Besides constantly reminding them of their difficulties, he may be sabotaging their ability to get the emotional support that they feel that they need. Emotionally healthy people aren’t relying hugely on their coworkers for emotional support, but still may feel a need for it during especially vulnerable and difficult times, like when they disclose to the team that their parent has died of a heart attack or they’ll be out for cancer treatment. But if Ronald is there saying “Oh by the way, I also have cancer, look at this weird freckle!” the conversation can’t really go that way (at least not in any genuine way) because now everyone is gritting their teeth trying not to be hostile with Ronald for trying to steal the attention.

        Not to mention that gritting your teeth trying not to be hostile to someone IS emotional work, which limits the emotional energy resources those people have left to not get snippy with each other when they’re mildly annoyed, provide cheerful service to a difficult client or customer, be patient with their kids after work, and other tasks that are part of day-to-day life. An influence like this can make a normal day emotionally exhausting.

        Basically, there are many ways that the coworkers could genuinely be emotionally impacted by this behavior for reasons other than being judgy or borrowing trouble.

        1. designbot*

          ” Emotionally healthy people aren’t relying hugely on their coworkers for emotional support”

          This is the key. The whole idea that someone is one-upping someone else and competing for attention is a dynamic that doesn’t belong in the workplace in the first place. I think that can be a two-pronged conversation, one with Ronald to ask him to be more mindful of how he talks about his latest issues not to appear to be trying to one-up or me-too what other people have said. And the other with those coworkers who are complaining about him, to try and acknowledge what they’ve observed in Ronald to not be of malicious origin but rather a fixation of his that is not about his coworkers or competition in the least. They are likely already getting the signals that this is not the place to come for emotional comfort, but could be more proactive about that by choosing to have those sorts of conversations at lunches or after-work drinks with their particular friends rather than in the open office environment.

      5. Observer*

        Most people would find that quite offensive. He doesn’t just get “concerned” – he starts claiming that he has this, that or the other condition and acts on that conviction, including talking about it. This language really minimizes his behavior and it’s impact.

      6. BananaPants*

        Yeah, no. It’s not part of my job description to be endlessly patient with a colleague who constantly co-opts others health issues. At some point I’m not going to care if he’s not being malicious, I’m just not going to interact with him at all beyond work-related matters.

        1. designbot*

          I see absolutely nothing wrong with only engaging him on work-related matters. Dialing back on the amount of chatter might be in the interests of everyone in this situation.

    2. Temperance*

      Even knowing that he was dealing with a diagnosed mental health issue, I would find working with him difficult. A close friend’s father recently passed from pancreatic cancer, and if Ronald started claiming that he had it, it would be very difficult for me to deal with him in a polite or even professional way. Same thing if he claimed to have the infection/resulting muscle atrophy that I had last year. I would probably lose my shit on him and point out that he would have died if he had an infection for that long.

      1. Gazebo Slayer*

        Yes, and actually I think that’s how he should be dealt with. People need to tell him in no uncertain terms that his behavior is mocking, attention-seeiing, and offensive, and how and why. No sugarcoating, no holding back.

        1. Observer*

          Except that his behavior is NOT any of that, even though it feels like it. That’s the problem with hypochondria – the person who has it REALLY BELIEVES that they have this condition.

        2. Carla*

          It’s a mental illness, it’s not mocking or attention-seeking. This kind of rhetoric–suggesting that the symptoms of his anxiety disorder are malicious–just increases the stigma around mental illnesses. Yes, Ronald can be asked to talk about it less, but his issues are as real as any physical illness his coworkers have.

          1. AMPG*

            I actually think it might be harmful for Ronald to disclose his condition, for this reason. I think hypochondria isn’t well understood (I know I personally don’t understand it well), and having it be an open fact in the office could well open him up to the type of stigmatizing and discriminatory responses listed above.

            1. narratif*

              I was thinking about this as well. Most people probably don’t really get what hypochondria is, let alone the fact that, as another commenter posted above, it’s not an actual diagnostic term for the condition anymore. “Hypochondria” conjures up images of, say, Mrs. Bennet with her nerves, or Victorian-style invalids who are constantly coming down with something in an attempt to curry sympathy. Given that, and given that so many people don’t really understand why anxiety disorders (or any kind of psychiatric condition) are so hard to deal with–that you can’t just STOP being anxious/depressed/etc.–I honestly feel like Ronald’s disclosure wouldn’t go far. The OP would have to think hard about how her team is likely to react before making that suggestion.

              One other problem with asking Ronald to stop with the medical talk is that it isn’t all talk. For example, the LW’s description of his having a “heart attack” at his desk, necessitating a call to the paramedics. What do you do in that instance, or when Ronald has what he thinks is an asthma attack or tick paralysis after he hears a colleague talk about their kid’s asthma or about that tick paralysis video on Facebook? It’s not like OP can tell Ronald “no, you can’t manifest symptoms of a colleague’s/colleague’s family member’s condition that you heard them discussing.”

              1. my two cents*

                Ronald is already working with a professional, who had provided the workplace documentation. I’d imagine it’d also be reasonable (I’m not a lawyer nor ADA expert!) to ask Ronald to provide deescalation information specific to him, so that the workplace knows how to best-address the condition in the moment.

                Maybe pulling him aside in the moment is most helpful. Or maybe instituting twice-daily 10 min check-in’s would be more impactful and allow him ‘scheduled’ air time. Maybe it is recommended that they just go along with it, like in the case of the ‘heart attack’, and allow him to be wheeled off in an ambulance. *shrug*

                1. narratif*

                  I’m not sure how well that would go; this reminds me of the bird phobia letter from a while back, where there’s a fundamental conflict between one person’s disability and their coworkers’ right to work in a safe, or at least not actively censored and restricted, environment. Getting Ronald to provide OP with deescalation strategies, if such exist, would put OP in the place of having to be both a diagnostician and a therapist. Like,

                  Ronald: I’m totally having a seizure right now.
                  OP: Did anyone here, at any point today or in the recent past, talk about their seizure disorder or that of a friend or loved one?
                  Fergus: *raises hand*
                  OP: All right, Ronald, I’m going to need you to take a few deep breaths.

                  (Or, alternatively, OP has to make the decision to call 911 because they aren’t a medical professional and/or qualified to handle someone’s spiraling anxiety. And the thing with hypochondria is, sure Ronald might have low blood sugar or his neck hurts because he’s not sitting correctly, but in his mind he is *absolutely* having a seizure caused by possible panencephalitis so pulling him aside won’t do much good.)

                2. my two cents*

                  I’m saying after the ADA-related discussions/meetings/process, there should be some sort of triage the OP is made privy to for how to best-manage Ron in the moment. None of this would just come from Ronald and OP – this would be as a result of the ADA-accommodations convo. Maybe it’s recommended that OP just pull Ronald aside, and remove him from the general office space first, and then decide from there if he needs an ambulance…away from the coworkers. But maybe also having twice-daily check-ins would give him the venting air time needed for him to openly discuss medical stuff with *someone* as to whatever he thinks may be happening. I’d imagine this would be part of whatever discussion process is needed to determine ‘reasonable accommodations’.

                  I also think it would be fair to ask the entire office to work on reducing the amount of medical talk in open spaces – it’s not ‘banned’, but they should consider moving their conversations to a more-remote/quieter area as to not distract others.

          2. Sylvia*

            His behavior is still harmful to his coworkers, who also need some consideration and sympathy.

            I have mental and physical health issues, so I know I’m biased. But I did just want to step in and say that his coworkers deserve just as much care as Ronald does, whether they have disclosed mental health issues or not.

            1. Ask a Manager* Post author

              Well, and this is what is potentially so tricky about situations like this: The law actually says some people deserve more care than others when it comes to employment accommodations … in that it requires them for some situations and not for others, and it sometimes requires them even when it will be upsetting to other people — see for example, the situation with this letter:

              https://www.askamanager.org/2015/12/update-my-new-office-is-full-of-dogs-and-im-allergic.html

              https://www.askamanager.org/2015/07/my-new-office-is-full-of-dogs-and-im-allergic.html

              1. Sylvia*

                Yeah, you’re right, and I didn’t mean to comment on legality. I’m nowhere near well-informed enough to talk about the law.

          3. Temperance*

            I think it’s also really harmful to pretend that it’s not having a negative impact on his colleagues, though. Just because he has mental health issues does not immediately absolve him of responsibility. He’s hurting and upsetting people, and that needs to be dealt with.

            I think it’s stigmatizing to suggest that he has no agency or responsibility to others because he’s mentally ill.

        3. Temperance*

          I would find his behavior shocking, upsetting, and hurtful more than I would find it mocking (if I knew he had this disorder). I find that we sometimes make too many allowances for mental illness, like in the bird attack letter, but this seems to be veering into meanness.

          Which is not to say that I would react like a mature, understanding adult if Ronald worked with me and started on about pancreatic cancer after we just lost Bob.

          1. paul*

            The update from that letter made me think it was as much about how badly the company FUBAR’d reaching out to and interacting with the injured party as anything else.

          2. Gazebo Slayer*

            Thing is, I *have* anxiety that often expresses itself around health-related stuff – I’ve even been hospitalized for it. It did NOT involve going around one-upping anyone who had a legitimate illness, which is textbook attention-seeking behavior and just plain cruel. (It involves freaking out over contagious diseases and things like finding a breast lump, in my case.) The performative, competitive nature of Ronald’s behavior honestly makes me doubt the legitimacy of his diagnosis.

            1. Ask a Manager* Post author

              “Person A has issues in this area and didn’t have these symptoms so therefore person B is faking it” isn’t a super reliable way to navigate this stuff.

              1. veggiewolf*

                This. There’s a reason for the saying that meeting three people with X in common means…you’ve met three people.

    3. Callalily*

      The thing is that he is apparently physically mimicking these conditions as well (from collapsing at his desk from chest pains). So even though he isn’t talking about it or making comments to coworkers, they still have to deal with those kinds of medical outbursts not knowing if they are a legitimate issue or if his condition has caused him to essentially put on a show.

      For me it is so concerning because of the trauma he could cause to his coworkers. My dad is dying of a heart condition that cannot be treated… he could literally just die while watching television. If I had a coworker collapsing at his desk from chest pains and needing to be rushed to the hospital multiple times, it would likely cause me a great deal of trauma and even trigger a panic attack.

      It is such a fine line because he presumably isn’t doing any of this intentionally (even though it is possible in some cases he could do certain things intentionally for attention but hide behind his diagnosis). You wouldn’t get mad at someone with the legitimate medical condition for collapsing at their desk, but there is so much grey area to deal with when you know the episode was a result from another medical condition.

      I think the best that everyone could do would just be to not be adding up ALL of the medical episodes he has had in his life and view each individually. OP need not reveal his medical condition to them but remind them that even if he appears to be faking it or lying that someday he could have a real medical emergency. You wouldn’t want everyone rolling their eyes at their desk while he may have an actual heart attack at his desk someday.

      It would probably help too for the manager to ask him to keep the details of his medical conditions private. They can at least have a candid conversation referencing the hypochondria and explaining that it can make some coworkers feel uncomfortable when he is bringing it up around them. It could even be easier to have a ‘no medical conversations’ rule for all employees so that they shouldn’t be sharing the details that could trigger him. Because really, if he doesn’t know he can’t really mimic anything.

      1. DCGirl*

        Anxiety can cause chest pains that can seem as real as a heart attack (before I was diagnosed with anxiety, I genuinely thought I was dying during panic attacks). It can also become hard to breath. He may not be “mimicking” his coworkers but experiencing real chest pains.

        1. fposte*

          Yes, I was thinking that’s a verb that can be misleading; it’s not just heart attacks, either, since in general the body’s quite capable of producing symptoms it “thinks” it’s supposed to have.

        2. Wannabe Disney Princess*

          I was actually thinking that might have been anxiety. A few weeks ago, I had a panic attack. The chest pains were so bad I was *almost* concerned it was something else. Luckily, I’ve had enough that I’m very familiar with the other sensations. Had I not known? I definitely would have called 911.

          1. many bells down*

            I have a heart condition, so when something set off a panic attack (which isn’t something I’m prone to), I really did think I was finally having a heart attack. One of the symptoms I’ve heard is “an overwhelming feeling of impending doom” which could certainly describe a panic attack as well.

        3. JoAnna*

          I went to the ER for chest pains once and it turned it to be an anxiety attack. (I’d suffered a miscarriage the week before, so that was likely the trigger.) I honesty did think it was a heart issue – the pain was very real.

          1. Elizabeth West*

            I’ve had esophageal spasms that could definitely be mistaken for a heart attack. The key–I discovered randomly that a drink of cold water makes them stop immediately. If they didn’t, of course, I would call for help. But since I know my blood pressure is good and I don’t have any other symptoms of heart trouble, a heart attack would not be my first go-to.

            1. Free Meerkats (formerly Gene)*

              I’ll have to try the cold water cure! Being in the prime heart attack demographic (overweight males over 50), I had to do everything except catheterization to rule out an actual heart attack. I enjoyed the nuclear stress test; get injected with zoomies, do a scan, treadmill until your heart rate gets to a certain level, get another injection of zoomies, get a scan. Then go out for a fatty meal, they told me ideal is a big bacon cheeseburger and fries with a shake or malt, wait 90 minutes and repeat the tests.

              All day off work, a couple of treadmill sessions, and a great lunch! Final diagnosis, esophageal spasm.

        4. INTP*

          This is true, but at some point he needs to have the self-awareness to handle his condition – a managed condition that affects coworkers sometimes is experienced much differently by coworkers than an uncontrolled condition where they feel like they are shouldering the entire burden (I know they aren’t, but they may feel that way). Leaving with heart pains caused by an anxiety attack is one thing, coming back to work and telling everyone he has definitely had a heart attack even though doctors say he hasn’t while coworkers that have real heart conditions are told that they need to just smile and nod because he has anxiety is another. I know he may not be able to control his perception or even his talk about it right now, but it may not be a tenable situation if he’s not at least in therapy to progress towards that.

          1. Rusty Shackelford*

            Leaving with heart pains caused by an anxiety attack is one thing, coming back to work and telling everyone he has definitely had a heart attack even though doctors say he hasn’t while coworkers that have real heart conditions are told that they need to just smile and nod because he has anxiety is another.

            This. You can give Ronald all the time off he needs, but you cannot tell me that he *also* gets to pretend he’s as ill as me or my loved one (because if I’m not aware of his hypochondria, that’s what it feels like) and I’m just supposed to (a) go along with it, or (b) ignore it and pretend it’s not happening, and expect me to be really excited about working with him. :-/

          2. DCGirl*

            I was addressing “physically mimicking” and “put on a show” in the post, not the way he’s treating his coworkers or the way in which he’s learning to manage his attacks with his doctor.

        5. Sylvia*

          That’s true, and that’s how some people get diagnosed with anxiety disorders. You can definitely think you’re having a heart attack or dying during a panic attack. (Actually, maybe getting off-track at this point, a “sense of impending doom” or feeling like you’re dying is one of the symptoms.)

          But after the fact, when doctors have given you the okay, you don’t keep telling people you had heart attacks.

          1. Zara*

            It wouldn’t be hypochondria if a doctor saying “it wasn’t a heart attack” was enough.

  4. Important Moi*

    I have a co-worker who self-diagnosed herself to with an allergy to the sun. No doctor’s visits or formal diagnosis from a doctor. She gets light headed, dizzy and dehydrated from sun exposure. It takes her “2 days” to cover from an hour of exposure. My boss attempted to reprimand me for making my co-worker stay in the sun. Fortunately, I was able to provide evidence I was willing to make concessions for my co-worker.

    I’m curious to see what the other commenters will say. I’ll just say as a co-worker this is bothersome.

    1. designbot*

      Why would you be in a position to make her stay in the sun? Is this some form of punishment, or an actual function of the job? If it’s the latter, then it’s up to her to ask for accommodations and HR to determine what reasonable accommodations are. If it’s not completely necessary to be in the sun for your job, I’m curious how or why you “make her” do so.

      1. Important Moi*

        We were returning from a mandatory daytime work event. 3 hour drive. I was driving, my co-worker was also in the car. I offered to drive her all the way home so she wouldn’t have to be in the car any longer than necessary. My co-worker said no. She opted to be dropped off elsewhere and make her own way home.

        Bonus information – in the car, was the first I’d heard of her allergy.

        Upon returning to work, she told my boss I didn’t take her home and she was feeling ill. In other words, by not taking her home, my co-worker was in the sun longer than necessary and I caused her to be ill.

        My boss spoke to me, i.e. attempted reprimand. I was able to tell my boss honestly, I offered to take co-worker home, but SHE DECLINED.

        1. designbot*

          That story makes me think the allergy issue is a red herring and just say that your coworker is manipulating you, your boss, or both. She asked for one thing, when you complied she blamed you for not doing another. I don’t even care if the allergy is real after reading that, coworker is bananas.

    2. Beth*

      I think it’s best to always treat people’s stated medical issues as legitimate regardless of what it looks like to you.

      I had a colleague who was constantly calling out because she had a million sinus infections. Also, if anyone came to work with a cough or other sign of potential illness she would leave for the day saying it would make her sick. She used more sick days than we typically get, which really annoyed people. She seemed totally healthy and fine and her actions seemed melodramatic to me. I admit, I got annoyed after having to cover for her unexpected absences so often.

      Until she confided in me that she has a serious auto-immune disease, AND that she had worked out a deal with my boss to get more sick days in exchange for lower pay. In light of that her actions seemed completely, 100% fine.

      Maybe your colleague has a sun allergy (which is a real albeit very rare thing), maybe they have a different medical issue like anxiety or hypochondria, maybe or maybe they don’t, but deciding you know more about their health than they do doesn’t get you anything. If it impacts your ability to do your job, then you can address whatever that impact is with your boss or coworker, but otherwise I try to tell myself these things are not my business.

      1. INTP*

        “I think it’s best to always treat people’s stated medical issues as legitimate regardless of what it looks like to you.”

        Agree x 1,000,000,000.

        Besides the fact that someone might have a condition they haven’t disclosed, there are also many, many conditions (especially autoimmune) where the average time from onset to diagnosis is YEARS because the symptoms are nonspecific and easily dismissed by doctors, or doctors are not educated about the condition (i.e. the nurse practitioner that declared me too fat to be tested for celiac disease despite a clear reaction to gluten and a family history of autoimmune disorders). And that is for average cases where people have typical symptoms, people with atypical presentation may take much longer. These people’s symptoms are just as real and severe before diagnosis as after, maybe even more so because they’re receiving no treatment. The lack of a diagnosis often just means that someone hasn’t been lucky enough to have seen an open-minded, thorough doctor, not that someone’s illness is psychosomatic or made up.

        1. caryatis*

          Let me add here–mental illness is real illness. Psychosomatic illness is real illness. People truly suffer from these symptoms; it’s not a lie or something that is just “made up.”

          So, you don’t know whether someone’s symptoms are physical or psychosomatic–but it doesn’t matter. Either way, the person is suffering and deserves compassion.

          1. Snark*

            I agree that they’re suffering subjectively, and that they deserve a measure of compassion, but….especially when someone else is suffering from a real physical illness or injury that is not delusional, there’s really only so far compassion goes. I’m not going to treat the guy who fakes every illness he sees with the same concern as the people who actually are having the heart attacks and melanoma and so on.

            1. caryatis*

              You’re confusing faking, i.e. intentionally lying, with health anxiety and psychosomatic symptoms. Mental illness is not something anyone voluntarily chooses. And, depending on the illness, someone may suffer more from psychosomatic symptoms than from physical ones.

              1. Free Meerkats (formerly Gene)*

                Mental illness is not something anyone voluntarily chooses.

                I disagree. I have a cousin who has diagnosed schizophrenia which is well controlled with meds. Every 3 or 4 years he lets family know that he’s going off his meds because he likes himself better that way. He freely admits that he knows he shouldn’t, but he does it anyway. Eventually he ends up on a 72 hour hold, gets properly medicated, and we wait for the next time. He’s in his 60s; sooner or later the hold isn’t going to happen in time.

                1. MegaMoose, Esq.*

                  I don’t think that’s quite the point, though. Your cousin is deciding that they like themselves better when they are un-medicated, but that does not mean they choose to be ill in the first place. Maybe they would even say that they would choose to have it if given the option, but that still doesn’t mean their mental illness is voluntary.

                2. JessaB*

                  Doing the “I feel better, so now I don’t need meds,” is a very typical thing in psychiatric disorders. It’s not a rational thing either, they really, truly believe they are fine, and no amount of trying to tell them they need to keep taking their meds will work. It’s almost the reverse of hypocondria. I’m well now. Meds are for sick people.

                3. Gadfly*

                  Well, and sometimes deciding if it is worse to have the unmedicated illness versus the side effects of the meds can have you voting illness.

                  I’m lucky with my pituitary tumor in that I am doing well on the meds, relatively. And I am hating some of the side effects enough to have debated at times just giving up. People who have bad reactions often do because it can be worse feeling than the day to day effects of the tumor.

                  It is true for all sorts of conditions, and mental health ones in particular.

    3. boop the first*

      Do you sneak nuts and shellfish into your coworkers’ lunches regularly to see if they die?

      3. Observer*

        That’s a really unnecessary crack. While I agree that Moi shouldn’t blow off the allergy – just because it hasn’t formally been diagnosed, it doesn’t mean it’s not real – but she DID try to accommodate the issue, even though it was sprung on her unexpectedly. And, having the co-worker then claim that that Moi “forced” her to be in the sun would be extra upsetting.

        1. Laura*

          I’m allergic to nuts and this is not remotely a good comparison! (Frankly I find it very cheap, too.) Moi did her best and then the co-worker lied. God knows why you’re dragging nut allergies into this.

    4. JB (not in Houston)*

      Are you saying that there’s no way your coworker could be seriously affected by the sun unless a doctor has confirmed it? There are a number of illnesses that can cause a person to have real health consequences from sun exposure, and you don’t necessarily need a diagnosis to connect the dots. I know that I can tell when I’ve developed a new food allergy before I get a test to confirm it, because when I eat it I have an allergic reaction to it.

      I’m just confused because you seem to be acknowledging that your coworker gets dizzy from sun exposure, but then you say that your coworker is bothersome, so I’m not clear whether you doubt her experience or not. And regardless, I am not clear how your problems with your coworker relate to the OP. Are you thinking that the OP’s employees might be upset that they are having to cover for Ronald? Because I’m not sure from the letter that they are. The OP says he’s using all of his sick time, but I’m not clear that his coworkers are having to cover for him. If they are, I can see how his coworkers, who don’t know his diagnosis, would feel irritated.

      1. Fictional Butt*

        Yeah, I was very confused by this. People can get very sick very quickly from sun exposure, even if they don’t have a “condition.” I am extremely sensitive to sun and heat (yes I have talked to my doctor, no I don’t have a diagnosis because there is nothing to diagnose). Ordinarily I just make sure to keep myself fed and hydrated and covered up and everything is fine. But if I felt the need to explain my sensitivity to someone–say, a cruel coworker who thought I was being “bothersome”–I might come up with a fake diagnosis like “sun allergy.”

        1. Fictional Butt*

          And by “very sick,” I mean fainting and vomiting all day. That’s not something you can just “deal with.”

        2. Dr. Johnny Fever*

          I know someone who has had heatstroke 3-4 times. It reduced his ability to deal with heat to the point where he can have issues on a bright beautiful sunny day when temperatures are no where near as dangerous as they are to others. He had to give up golf.

      2. Snark*

        “Are you saying that there’s no way your coworker could be seriously affected by the sun unless a doctor has confirmed it?”

        Honestly? I wouldn’t and don’t dispute “I ate this thing and it made me sick” or something, but “sun allergy” is not a thing. It’s just not. Claiming such a thing is not going to be taken seriously, because it’s not a serious allegation nor a real health issue; it’s the kind of thing you hear reading the “NaturalNews” Facebook comments.

        “Sun and heat really affect me, and I can’t stay out long,” on the other hand, is utterly legit and should – and would – be taken seriously by anyone so told.

        1. Observer*

          You actually are wrong. It is a thing. So, by the way is allergy to the cold. Yeah, it’s weird as can be, but it really does exist. The formal medical name may not be “sun allergy”, just as allergy to cold has a different medical name, but that’s pretty much what it is.

          The idea that something should not be taken seriously because someone is using a term in a way that’s not standard is pretty silly. People use “allergy” a lot, even though most things that are seen as allergies are actually “sensitivity” or a “histamine reaction”. Medically, they are different things. In practice? For non-medical professionals? That just comes off as looking for an excuse to not accommodate an issue.

          1. Snark*

            “You actually are wrong. It is a thing. So, by the way is allergy to the cold. Yeah, it’s weird as can be, but it really does exist. The formal medical name may not be “sun allergy”, just as allergy to cold has a different medical name, but that’s pretty much what it is.”

            No, I’m not actually wrong. Sun and cold allergies are not a thing. I recognize that some folks have histamine reactions from sun exposure, but that is quite a different thing.

            “The idea that something should not be taken seriously because someone is using a term in a way that’s not standard is pretty silly.”

            Hard, hard disagree. I’m a scientist. Scientific terms have meaning and dimension and need to be used with precision and understanding; just look at how warped the discussion around, say, vaccines and global warming have become, in large part because terms started being misused and concepts misrepresented. “Sun allergy” might get at the subjective experience, but in a world where science is a target for conspiracy theories, someone suffering from that really owes it to themselves to call it photosensitivity, say, or PMLE, or solar urticaria, or whatever they’ve actually been diagnosed with.

            “People use “allergy” a lot, even though most things that are seen as allergies are actually “sensitivity” or a “histamine reaction”. Medically, they are different things. In practice? For non-medical professionals? That just comes off as looking for an excuse to not accommodate an issue.”

            If it’s a real issue, use the technical term and discuss it plainly. “My skin is photosensitive and I get a bad rash called PMLE when I’m exposed to the sun” sounds like you went to a doctor, and “I have a sun allergy” sounds like the product of a late night reading fake health news, and one is going to be accomodated and taken more seriously than the other. Is that necessarily fair? No, but that’s the terrain we’re walking on here.

            2. Observer*

              I’m not going to get into a discussion about this, per Allisons’s request. But according to my doctor it actually IS an allergy.

              1. Laura*

                Oh damn, that was responding to the scientist. I have a serious allergy and am so sick of that word being incorrectly used.

    5. SJ*

      I don’t have a formal diagnosis, but I’m very susceptible to side effects from sun exposure. I’ve had all the symptoms your coworker mentioned, plus rosacea flare-ups. I’m prone to fainting — I fainted just a few weeks ago despite drinking lots of water, and yes, it did take me a day to recover from it. I’d be incredibly annoyed if a co-worker thought she knew better than me about this.

    6. Katie the Fed*

      Yeah, this is something better left to the plot of Better Call Saul. Why would you risk a coworker’s health just because you don’t believe her?

    7. AW*

      Even if she’s wrong about it being an allergy, there are medical conditions that directly and indirectly make sun exposure a problem.

      If your only issue is that there isn’t a formal diagnosis, you should let this go. Not (yet) being diagnosed doesn’t mean she’s lying about how the sun affects her.

      1. Beth*

        Yeah, requiring someone has a formal diagnosis to take their medical conditions seriously is not okay. Doctors can be expensive, and it’s not always so simple as just going to one visit and getting a diagnosis. I have a medical diagnosis that is very real but wasn’t properly diagnosed until I had been going to doctors for 13 YEARS. The cumulative costs of all the tests and specialists visits is thousands of dollars at this point, and that’s with good insurance.

        This person knows that sun exposure causes them to feel ill and limiting sun exposure makes them feel better. That’s all you should need to know to not want to “make” someone go out in the sun.

        2. Snark*

          Not telling people that you have an illness, telling Important Moi to drop you off instead of drive you home, and then exposing them to potential professional consequences by telling the boss that they didn’t drive you home and you had to take 2 days off to recover is even more seriously Not Okay.

      2. LavaLamp*

        I think this is probably a case of a coworker who may or may not have an legit medical issue using it to get out of work they don’t want to (or can’t) do.

        I highly doubt Important Moi held chained the coworker to a post in the Sahara, more likely they actually expected coworker to do their job and pointed out to the management that if there’s no formal accommodations in place then coworker needs to do their job.

      3. Cassandra*

        Some medications can also complicate sun exposure. I can’t say much more than that — I’m not a pharmacist — but I did have to get extra-careful about sunscreen for a while because of a med I was temporarily on.

        1. Fiennes*

          I’ve had this happen too. Normally the sun requires me only to use sunblock, but on that medication, I had to hide from the light like Gollum or be sick as a dog.

    8. Lora*

      Four hours in sunlight triggers migraines for me. And when I say migraine, I don’t mean a nasty headache, I mean “oh god where is my emergency imitrex and Zofran NOW NOW NOW” on the bathroom floor vomiting and crying with a damp cold washcloth on my head and praying for death to take me swiftly.

      I’m also ghostly pale and wear a lot of sunblock, but if it’s midafternoon and the sunblock has worn off, I will turn brick red and blister in under one hour.

      My ancestors were cavemen, what can I say.

      1. strawberries and raspberries*

        From my bed, where my pale ass is taking a sick day because I spent four hours too long in the sun on Saturday WITH SUNSCREEN and not only burnt significantly but also felt lightheaded and nauseated for the rest of the weekend, I say, “+1.” (And truthfully, a big part of the reason I stayed home is because I’m feeling too lousy to take any ribbing from my coworkers about being burnt. It’s not just ugly, it’s wholly painful.)

        1. JessaB*

          I decompensate very quickly when I get overheated, I start to slur my words and mumble weirdness. We have a new word in our house – whooze whooze. Because I saw a fan and wanted my husband to turn it on and point it at me, now dammit, and couldn’t think of any word that described that thing that went around and made air come, but waving my hand in a circle and making a fan noise.

          Sun makes me blister up like crazy, but HEAT will down me every time.

          But telling a coworker you have problems with the sun and then getting them in trouble because they offered to drive you and you said no, is so far out of the normal bounds of civility, I’d (if I were the boss) take a very careful look at anyone else she complained about and wonder if she was being rational about it.

    9. Jesmlet*

      A doctor’s job isn’t to tell you how you feel. Their job is to listen to how you feel and assist in providing a name to describe that (and run tests, and treat, and so on…) Whether or not she has an allergy to the sun really doesn’t matter. If she reacts poorly to being in the sun, who are you to make her expose herself? If she legitimately can’t do her job then that’s something else but fair treatment rarely means making two individuals do the exact same thing so if she has to stay in the shade, that really shouldn’t be considered a huge deal.

    10. Liane*

      Would it be less “bothersome” to be let go because Boss, Grandboss, &/or HR decides that it is “bothersome” to continue employing someone who possibly opens them up to complaints of ADA violations?

      1. Anna*

        Important Moi did say she wasn’t diagnosed by a doctor. An ADA accommodation requires there to be a diagnosis. You can’t just decide you need an ADA acc0mmodation and then it happens.

        1. fposte*

          To be clear, an ADA accommodation doesn’t require there to be a diagnosis; it just allows an employer to made medical inquiries of the relevant health care professionals. According to AskJAN, some states may forbid explicitly asking for a diagnosis, in fact. I suspect a lot of accommodations don’t even involve medical inquiries.

          If someone declared that the sun would make them unwell, I wouldn’t make them work in it, though, and it doesn’t sound like Important Moi did either.

    11. Tammy*

      Some years ago, I was out in the sun for a group activity on a way-too-hot day with way too much sun and way too little water, and I gave myself a case of heatstroke. I was not diagnosed by a doctor, though a member of my group who was an EMT recognized what happened and got me out of the sun/hydrating before it got really bad – but I still had a 2-day long headache, vomiting, dizziness, sweating, etc.

      One thing about heatstroke is that you have to really be careful about heat/sun exposure, because once you’ve had it once you’re much more susceptible to getting it again. So I try really hard to avoid multi-hour sun exposure without making sure I have a hat, access to shade and cold water, and so forth. I’ve never been diagnosed with anything by a doctor, but I know what I experience when I have lots of sun exposure. If I was your coworker, I would have no formal diagnosis but I would be pretty determined about avoiding the sun.

    12. Relly*

      There are conditions which cause residual aftereffects. If your coworker received radiation therapy for cancer, she may have sensitivity to sun exposure. I had a friend (childhood cancer survivor) who needed to be covered up whenever she was outdoors.

  5. Whippers.*

    Oh god, I know this isn’t funny to anyone involved but the way the OP has described this has tickled me a bit.

    2. Rachel 2: Electric Boogaloo*

      I just kept picturing a male version of Penelope from Saturday Night Live.

      1. Allison*

        Ha, me too! God that character was funny – obnoxious, but funny. I’m also picturing some little sister from a kid’s show in her “me too” phase, going “oh, I wanna [do/have the thing] too!” “I wanna go to the hospital too!” “I wanna have cancer too!”

    3. Poohbear McGriddles*

      I could totally see Fergus trolling him with tales of explosive diarrhea and erectile dysfunction.

      1. Hills to Die on*

        I am glad I’m not the only one who thought this. It’s not nice and I wouldn’t do it, but the thought did occur to me.

        1. Hillsto Die on*

          Or tell him you’re a workaholic and you have severe anxiety and panic attacks if you aren’t on the office working.

    4. BeautifulVoid*

      I thought of the old movie My Girl, where the main character doesn’t deal well with death despite living in a funeral home, and after her father had a client who had died of prostate cancer, SHE (yes, she) was rolling around on the floor during dinner claiming problems with her prostate.

      So yeah, it’s not funny at all, but I can’t help but think what Ronald’s going to do if someone comes in with morning sickness or ovarian cancer.

  6. Yalla*

    I definitely would not share Ronald’s medical information with his coworkers myself, even with his go-ahead. If he wants people to know (and maybe here he should) he would have to tell his coworkers himself.

    For the reason even the most delicate conversation about this still might reveal more than Ronald wanted, or frame it slightly differently than he had imagined, and once that bell is rung it cannot be unrung. Let him talk, so he can say exactly what he wants about it. I just don’t think it is possible to be sensitive enough when discussing mental health issues to do it on behalf of staff, because of the privacy concerns.

    1. LavaLamp*

      I would be wary of sharing it because it could cause coworkers to not take him seriously thinking it’s an episode, when he really is having a heart attack or something.

      1. INTP*

        I get your point, but I think that’s going to happen regardless. I’m sure they’ve already picked up on the fact that he says he has conditions he doesn’t actually have and will assume he’s crying wolf, whether they think he’s intentionally lying for attention or just experiencing hypochondriac symptoms.

  7. Bolt*

    I live with a hypochondriac and even KNOWING doesn’t help.

    It can be enraging to be dealing with a medical condition (or one of a close relative) and have someone else really putting on a show that they have the same (or worse) condition. Even knowing that my husband is technically ill in his own way and cannot help it, it is still the most insensitive things I have ever had to deal with.

    If you have anything you basically have to give a big disclaimer that it is in no way contagious so he can’t catch it… or he’ll actually start mimicking the symptoms or end up in the emergency room claiming he has it. Once I had stomach cramps from my period and was laying in bed… I got a call from the hospital saying my husband needed to be picked up because he claimed he had caught a parasite from me and he was having the same severe stomach pains (despite medical tests showing nothing, he later claimed he ‘passed’ all the parasites in one big dump without needing any treatment to kill them).

    I think something like this should really get addressed with the staff should Ronald be willing… it could certainly change their perception slightly that he isn’t TRYING to do this kind of stuff but that it is unavoidable. It could make it a tad easier for them to just let the comments/episodes roll off of their backs.

    1. MechanicalPencil*

      An inlaw is a hypochondriac, so I can sympathize with you a bit. I sometimes wonder if we’ll ever know if there’s a serious medical issue (like appendix rupture) or something because of how many false alarms we’ve seen.

    2. Lora*

      That must be nerve-wracking. I would be terrified of him actually being sick and getting eyerolls from the ER staff, “that guy comes in here all the time, give him a saline IV and send him home” or whatever. And on top of that, I imagine you feel pressure yourself to hide your own symptoms – what if you get really sick and need support during treatment, and all you’ve got is more stress from his behaviors?

      My ex used to choose the moments when I was really sick or under a ton of pressure at work, working two jobs etc. to have some sort of totally avoidable personal crisis, basically because I didn’t have any time or energy to spare for him while I was getting, you know, surgery and stuff. It was infuriating.

      1. the_scientist*

        I have a family member who has hypochondria and I can attest that it is incredibly difficult to deal with and that we also worry a lot about compassion fatigue/crying wolf syndrome- like when there is a serious medical issue, the people that need to spring into action (us included) will assume it’s another episode of anxiety and not an emergent issue.
        Beyond that it is extraordinarily difficult and extremely frustrating to deal with. I have a lot of sympathy for everyone in this situation. Ronald, because it must be truly debilitating to live every day in fear for your life, and for the coworkers who are dealing with their own issues and likely running out of goodwill.

        1. JessaB*

          You put it perfectly “compassion fatigue.” It does get harder and harder, especially since he’s also interacting with people with an actual diagnosis, who have to care for themselves as well.

    3. Jesmlet*

      At the very least, I think knowing would help their feelings go from extreme annoyance to mild annoyance plus pity. It must be very debilitating always believing there’s something wrong with you and I think sympathy would overrule any irritation I’d previously felt.

    4. (another) b*

      Kudos to you, Bolt – I don’t think I could be married to someone like that. I would probably flip out on him lol.

      A question – is it a medical thing or could therapy help?

      1. fposte*

        Both. But as with many anxieties about things you can’t avoid, it can be really hard to manage.

    5. ShowerTheHorse*

      I’m so sorry, I had an ex significant other with the same issues and it’s exhausting and anxiety inducing for all involved. I hope you get to take time for self care as well.

  8. Allison*

    Seems like Ronald is set off by people talking about their health issues. It’s like seeing a bug and suddenly having this weird sensation that there’s a bug on you even if there’s nothing there, especially if it’s the sort of bug you’re scared of. Similarly, if you hear of a health condition, you may start feeling psychosomatic symptoms, especially if you’re in the same risk group as the person who has it. Would it help to ask people not to discuss their health problems where Ronald could overhear them? Or be really vague if it has to come up?

    1. Temperance*

      I’m not sure that would work in practice, though. If my colleague Susan came back from heart surgery, I’m going to ask how she is doing and offer to help, because that’s how I prefer to treat people.

      1. AW*

        Sure, but do you have to have that conversation in front of everyone? Why does Ronald have to know the specifics about Susan’s absence?

        1. Temperance*

          Yes. Because that’s normal. If I haven’t seen Susan since she got back from her surgery, I’m going to a.) tell her how happy I am to see her, and b.) ask how she’s doing. If we’re in the coffee station, and Ronald is nearby, the onus should be on him to leave the area/avoid Susan if he knows that she just got back from medical leave. This is especially true because I, the colleague, have no clue that Ronald has these mental health issues.

          I was on medical leave last year, and when I returned, my colleagues asked how I was doing. I thought it very kind, especially since it wasn’t a secret that I missed a month of work.

          1. Hedgehog*

            Yes, that is normal. But if you and your colleague both know you have a colleague in earshot who is going to react in a completely atypical and possibly very bothersome way, you could probably find a way to carry on that conversation somewhere else, right? If Jane has just gotten back from her wedding and honeymoon and you are in the room with Wakeen who is going through a painful divorce or just lost his wife (or with Susan who has strong opinion should about marriage or big weddings that she is going to rant about) you might hold off in asking how the wedding was. Why not do that here?

            1. Temperance*

              I’m picturing the kitchen on my floor, which is the social gathering space. I’m getting coffee with Susan, and we are chatting. Are we obligated to look around to make sure Ronald isn’t behind us? Shouldn’t the onus be on him to avoid social gathering spaces that might trigger his issue?

        2. Observer*

          If it’s an open plan office, there is not much choice. Also, there are a lot of situations where multiple people need to know about something – eg letting people know that they are going to miss a meeting and could someone take notes for them. And sometimes where you see someone is in a more public space. It’s just not realistic to never have any mention of people’s medical conditions come up around a specific person, in most work places.

    2. Trout 'Waver*

      I suppose you could, but it’s come across as insensitive to the people with serious medical issues (not excluding hypochondria) or are going through grief due to medical issues with loved ones.

      1. WPH*

        It’s an accomodation that seems needlessly cruel to everyone else, especially if they don’t know why.

        1. AW*

          How could they not know why? They’ve already complained to the OP about Ronald’s behavior. They might not know about his condition but they do know that he’s going to think he has whatever medical problem they discuss in front of him.

          If anything, I’m surprised they haven’t started doing this on their own.

          1. WPH*

            But there is a huge difference between thinking someone is an insenstive jerk and drama queen who likes to mock other people’s illnesses (one possible interpretation) and knowing that someone has diagnosed condition and reason for their behavior.

            1. Toph*

              Yes, but if your personal experience is limited to “Ronald seems to think he has whatever medical thing he most recently heard coworkers talking about” and I am frustrated by that, regardless of whether I think he’s mocking or has his own diagnosed condition, my first impulse is going to be “avoid talking about anything medical in front of him so he doesn’t do ThingHeAlwaysSeemsToDo” regardless of his reason for doing so. If I thought he were mocking, I’d be avoiding giving him ammo for insensitive behaviour. If I suspected he were a hypochondriac, I’d be avoiding setting off his condition.

              1. Observer*

                Yes, and the fact that things still get said in front of him, even though it’s in people’s self interest speaks to how impractical the suggestion is.

                1. Toph*

                  I’m not suggesting it as a course of action. I’m saying that would be my instinctive response and I’m surprised it didn’t happen naturally already. That or maybe it has happened to some extent and there’s so much illness in this office that even with some people naturally shying away, it’s still getting talked about frequently anyway from the proportion who didn’t have such an inclination.

                2. Observer*

                  Or maybe it’s happening, but even at normal levels of illness, it’s not practical to keep everything under wraps.

    3. Anon today...and tomorrow*

      I can see that helping a bit, but honestly health issues come up in even a regular conversation. This morning I asked a co-worker how her vacation was and she told me that it was good, that she got to visit with her mom who’s very old and is starting to really suffer from her arthritic pain. It was, at most, a passing comment, but it did come up.

      I’ve worked with two women who had behaviors similar to Ronald and I can attest that it was frustrating. One women would suddenly announce she’d been pregnant and that she’d miscarried the day after someone announced they were pregnant. I worked in a call center with over 100 people. One month she “miscarried” four times. A co-worker who had recently announced she was pregnant after actually having several miscarriages while trying to get pregnant was so upset about this she actually quit her job because the managers didn’t make any attempt to curtail the false announcers behavior. I really do believe the woman had a mental health condition and couldn’t help it, but it came across as awful and insensitive. She would literally come by the pregnant person’s desk and say (in the most morose tone possible) “I heard you were pregnant. Congratulations. I was pregnant too, but miscarried yesterday. Hope your baby is safe.”

      1. George Willard*

        “I heard you were pregnant. Congratulations. I was pregnant too, but miscarried yesterday. Hope your baby is safe.”

        This is one of the most upsetting things I’ve ever read on this website. Good lord.

      2. Questioning*

        I can’t imagine a reasonable person or court would believe that her saying this to coworkers would be covered under the ADA for any diagnosis. Your managers suck at their job.

        1. Laura*

          I have to hope you’re right, Questioning. I would have made the biggest scene if I were the pregnant woman.

  9. many bells down*

    My daughter’s a hypochondriac as well, but she only thinks she has things that match “symptoms” she has. Not that other people have! Like, she’ll have a headache and she comes up with some rare condition that might cause a bad headache. She doesn’t decide she has heart trouble because I do.

    This sounds way more frustrating. And really difficult for the co-workers. Like he’s trying to one-up their medical problems every time.

    1. ThatGirl*

      My husband is not a diagnosed hypochondriac, but he definitely tends to default toward “oh I have a terrible headache so it’s probably a brain tumor” or “this slightly funny-looking mole is definitely melanoma, right?” thankfully I can usually logic him out of it.

      1. many bells down*

        The thing is, she was actually right about a weird rare condition on two occasions. So while we’re glad to have an actual diagnosis for an actual problem, it also feeds the anxiety. Because she really DID have that thing, so maybe she’s right about THIS thing, too!

        1. Gadfly*

          I recently was diagnosed with a pituitary tumor basically out of mostly luck (I was getting labs for a new dr who included prolactin as sonething to check.) And it makes it very hard to trust doctors when I have had matching symptoms for years. So I get that. I was right for years, maybe I am right about every other stray thought?

      1. Merci Dee*

        My deceased grandmother had a classic case of medical one-upsmanship. My dad mentioned once that he’d recently had an appointment with his doctor to have his prostate checked . . . and my grandmother mentioned that she’d had surgery the previous year to have her prostate removed.

        Ummmmm . . . . .

        3. many bells down*

          I mean, I suppose it’s theoretically *possible* – I don’t know of any cases where an intersex person had a prostate and a uterus, but I’m sure it’s happened. But … not very *likely* if your grandmother had kids and all.

          1. Hedgehog*

            Or she never did have a uterus and it’s one hell of a unique to finally tell your child he was adopted. :)

    3. Kate 2*

      Interesting. I have a relative who hasn’t been diagnosed, but clearly has mild hypochondria. The health issues are diet related. So, they’ll decide they have a deadly gluten allergy, says it will kill them if they eat anything with gluten, and that their naturopath agrees.

      But then they’ll decide they want a pizza and eat the entire chock full of gluten pizza by themselves and not have any issues afterwards, not even an upset stomach. And the tests the real doctors have done, the scientific tests, show they don’t have any gluten allergies whatsoever.

      Basically, whatever the hot new diet fad is, or whatever they don’t feel like eating they immediately develop a deadly allergy to. One so strong it crosses the bounds of what is scientifically possible! Like having an allergic reaction to a cold beverage when across the room from the person drinking it.

    4. oranges & lemons*

      My health anxiety sounds more like your daughter’s but I don’t think it’s uncommon for the anxiety to be triggered by exposure to health conditions that other people have. I’ve found that the anxiety tends to be worse with conditions that I know more about, and sometimes I start to imagine that I have the corresponding symptoms once I know what they are, so it doesn’t surprise me that some people would have extreme reactions to learning about other people’s medical issues.

      1. many bells down*

        That post upthread about the two different types of hypochondria was really helpful. My kid is definitely an SSD person. Woke up with a stiff neck? It must be meningitis!

        1. oranges & lemons*

          Yep, sounds pretty familiar! I had a sore back a couple of weeks ago and I managed to narrow it down to shingles or lymphoma.

  10. Lady Russell's Turban*

    Why not tell Ronald to not talk about his health, real or perceived, to his coworkers? How he spends his PTO is up to him. Granting unpaid time off is between you and Ronald. But his behavior–talking about his real or imaginary illnesses–is impacting the team.

    I have a sister with hypochondria, much milder than Ronald’s but still annoying as all get out. I shut down any health-related talk immediately. Since it consumes her thoughts it is hard for her, but years of my saying, “I won’t talk about health with you. Let’s change the subject” has helped.

    A funny note: as kids, before I understood what hypochonria is, there were a couple of times when my sister complained of illness so my mom took her to the doctor. She returned with a clean bill of health. Shortly after I developed the same symptoms but didn’t say anything, thinking it must be nothing. Finally things got so bad that even my distracted mother noticed. My stoicism resulted in a hospital stay one time and a week in bed the other. My mother was chastised for waiting so long to bring me in.

  11. Snarkus Aurelius*

    The best piece of advice you can give your staff is to redirect hurtful conversations with Ronald back to work. There’s no point in getting into a debate on whether or not he has cancer or dementia, and there’s really no point in talking about it with him. Redirecting the topic back to work is the easiest, most professional way to diffuse the conversation and bring it back to neutral territory.

    I work with someone who has mental health issues and tries to insert those problems into meetings and work-related conversations. Whenever she does this, I ignore the personal stuff and respond to only work-related stuff.

  12. league*

    I’m a huge fan and think you’re right 99% of the time, but I think you missed the mark here, Alison. As far as his interpersonal relationships go, Ronald’s hypochondria isn’t the issue; it’s his behavior. The OP should tell him to stop discussing his health in the office.

    1. Ask a Manager* Post author

      I don’t know enough about hyperchondria to say for sure, but it’s possible she’d run into ADA issues here and needs to navigate it somewhat carefully for that reason. An employment lawyer could tell her for sure, but I’m not comfortable telling her to tell someone essentially, “stop doing this thing that your condition makes you do” when we have the ADA potentially in play.

      1. Katie the Fed*

        I cannot see a reasonable accommodation being that Ronald is allowed to talk about his health as much as he wants with coworkers though. But I don’t know much.

        1. Ask a Manager* Post author

          Eh, there are loads of accommodations employers end up required to make that laypeople don’t find reasonable. “Undue hardship” tends to be about financial cost (although not always). So I really, really think she should talk to a lawyer because ADA stuff is not an area where what feels reasonable always lines up with what’s legally required.

          1. Katie the Fed*

            But the hardship is one that’s borne by the employer. The coworkers should be under no obligation by the ADA to suffer a hardship.

            Regardless, I agree that a chat with a lawyer is in order.

            1. Ask a Manager* Post author

              Sometimes the hardship does fall on coworkers too, depending on the situation (for example, covering for someone who needs a religious holiday off — a very different kind of thing, but an example of how coworkers are indeed bearing the brunt of the accommodation).

              1. Argh!*

                Perhaps the accommodation could be that nobody discuss illnesses at work. It would be a strange workplace, though. It would help him stay on task and keep him from annoying coworkers.

      2. league*

        I am not a lawyer nor a doctor, and I realize accommodations can take all kinds of unusual forms. Still, I don’t think that *talking about* his perceived health conditions is necessarily a part of hypochondria. Fixating on them is one thing, but talking about them at work is another.

        1. Fiennes*

          To me this sounds analogous to the coworker who had anxiety issues where the whole office had to avoid wearing patterns and non-symmetrical jewelry, plus line up male/female at the bus stop. In other words, allowing this guy to talk about his imaginary health woes nonstop isn’t accommodating his condition, but enabling it.

  13. HisGirlFriday*

    Actually, asking Ronald not to talk about his health issues is only going to solve half the problem — the other half is having other people talk about theirs where he can hear it, because that’s what sets off his hypochondria.

    The ideal solution would be no one talks about medical issues at all, but that’s not possible. And I think you run the risk of going too far the other way in terms of being accommodating. (I’m thinking of the letter from a while back where the LW’s managers were making people dress certain ways to accommodate another employee’s OCD.)

    I agree that Ronald disclosing this is the best solution, but you can’t force him to and you can’t do it on his behalf. I admittedly don’t love Alison’s language because I think it asks people to make concessions for something that they don’t fully understand, but which seems (to them) like being an attention-seeker. And yes, it would be great if we were all more understanding of mental health issues than we are in America, but we’re not.

    I think you have to try re-framing it. How would you handle this situation if it weren’t a mental health/medical issue? Say you had an employee who had a personality quirk that meant he or she always tried to ‘one-up’ people in story telling? I’d frame it to Ronald by saying, ‘When you do X, people see Y,’ and see if that helps.

    1. JulieBulie*

      But the difference here is that Ronald doesn’t have cancer or dementia. He has hypochondria. If he limited his health-related remarks to that, people might find it less upsetting. He could say “I’m worried about symptoms again” instead of saying “hey everybody I have sarcoidosis just like Jane!”

    2. Trout 'Waver*

      I agree. I’m not a big fan of Alison’s language either. The behavior the OP describes would be distressing to experience from the OP’s employees’ points of view. I imagine telling people you can’t explain, but they’re going to have to keep working with Ronald would lead to increased turnover.

      I have absolutely no suggestions on what to say or do instead, though. This one is tough on everyone.

    3. Natalie*

      I think you have to try re-framing it. How would you handle this situation if it weren’t a mental health/medical issue? Say you had an employee who had a personality quirk that meant he or she always tried to ‘one-up’ people in story telling? I’d frame it to Ronald by saying, ‘When you do X, people see Y,’ and see if that helps.

      The risk here is that, because it is a health issue and potentially a disability, Ronald may have legal protections that your run-of-the-mill story topper doesn’t have.

      1. LBK*

        Yeah, you can’t just disregard the fact that it’s a medical condition. That works in some cases (eg if constant absences are affecting someone’s ability to do their job) but it’s relevant here because to an extent this might be an uncontrollable behavior, so you might not be able to tell him to just cut it out while he’s being treated for it (assuming he is getting treated).

        1. fposte*

          Yup. And even the fact that his symptoms have deleterious effects on other people isn’t automatically enough to count against him; nor does it automatically means he gets a free pass for them. A lawyer will help guide the OP’s company through that web.

      2. Stellaaaaa*

        Well yeah. With at-will employment, you can absolutely fire someone who continually offends people and makes other people want to quit. Without disability protections, I’d advocate for thinking about letting Ronald go for not being a good culture fit.

    4. Observer*

      If there were not a medical condition involved here? I’d shut him down so hard, he’d have a sore bottom. Seriously. The only reason to be gentle here is because he has a genuine problem which really does make him suffer. But if this were garden variety attention seeking? No way.

  14. Jenn*

    I’m totally using “it’s not your voice that makes me keep vomiting; I have morning sickness” if I get pregnant.

    1. JulieBulie*

      Also look for a chance to say, “I have morning sickness, but it’s your voice that makes me keep vomiting.”

  15. Ophelia Bumblesmoop*

    Is hypochondria considered a medical issue or a mental health issue? Can Ronald be referred to the EAP?

    This is such a difficult position because it isn’t fair to tell people they can’t talk about their health just because of Ronald and it also isn’t fair to force Ronald to “out” his hypochondria. Not that fairness really has anything to do with life. But for the coworker who had cancer, she likely needs support and feels insulted by Ronald’s actions.

    1. JulieBulie*

      Mental health issues ARE medical issues. And Ronald already has a hypochondria diagnosis from a doctor, so the EAP would be redundant.

      1. Judy (since 2010)*

        But the EAPs that I’m familiar with cover a certain number (6-8) of therapy appointments per year outside of the company’s health plan with its deductables. Of course if the company is so small they don’t have HR, they probably don’t have an EAP either.

        1. Turquoise Cow*

          He’s already seeing a therapist. The best an EAP might do is recommend he keep doing that? Unless there are hypochondria specific resources, although I imagine his therapist would recommend something like that already.

  16. Katie the Fed*

    In addition to the comments above, I’m concerned about the amount of time Ronald is missing away from work. Has he actually requested reasonable accommodation or invoked FMLA? Because I would think OP is within her rights to tell him that he’s missing too much time from work, especially since he’s exhausted all his paid leave. That can’t be fun for the other coworkers.

    1. Ask a Manager* Post author

      Again we potentially get into ADA stuff, though, because additional unpaid time off is often considered a reasonable accommodation. The more I think about it, the more I think the OP needs a lawyer advising her.

  17. autumnwood*

    I’ve spent many years working in disability advocacy and inclusion. If this is a documented mental health condition (and you’re in the US) it could fall under the ADA. In any case, the Job Accommodation Network is an excellent resource for helpful information about working with individuals with disabilities. https://askjan.org/index.html

    Having a disability does not exempt a person from meeting the essential requirements of any job, or allow them to be a disruptive presence, any more than their disability has to keep them from being able to meet the requirements with reasonable accommodation. It works both ways. Some situations are definitely more challenging than others! Good luck to you.

  18. Jake*

    He needs to let his coworkers know about his condition. Three years ago my wife was diagnosed with a cancer that presents in women over 30 years older than her over 95% of the time. For the first month after that, I was extremely short tempered when people were insensitive about cancer, both online and in person.

    If I didn’t know this guy had a diagnosed medical condition causing him to think he has cancer, I would have absolutely unloaded on him when he kept saying he had cancer after being cleared. I’m not saying my reaction would have been right, or even okay, but that’s just the truth on how that would have unfolded.

    1. Treecat*

      Yeah I had cancer in my 20s. If I’d had to deal with a Ronald at that point, I don’t know what I would have done, but I would have been very, very angry.

  19. Magenta Sky*

    Given the serious legal issues involved, and that one should be sympathetic to someone with a serious medical issue, I’m wondering what your advice would be when one (or more) of Ronald’s coworkers gives notice, and makes it very clear that it is because Ronald’s behavior is intolerable?

    1. Ask a Manager* Post author

      That’s why the OP needs to talk to a lawyer. Really, I’m realizing that I should have replaced my entire answer with “talk to a lawyer” because ultimately that’s going be the thing that has to drive everything else. “People are quitting because they don’t like this accommodation” is not in itself legal reason not to make the accommodation. To make this more intuitive: If you quit because you were annoyed that you kept having to work on Saturdays because your Jewish coworker couldn’t, your annoyance and your quitting wouldn’t exempt the employer from having to make that accommodation.

      1. Bassoon Wielding Chemist*

        I think the difference is that in your example working all the Saturdays is simply annoying – been there, done that. As someone who actually had to go through cancer treatment and the rehabilitation afterwards (I am well now!), having a coworker seemingly mimicking my illness would have been traumatizing enough for me to have quit. The OP absolutely needs legal advice because they are potentially on a collision course of conflicting accommodations.

        1. Rusty Shackelford*

          Well, working Saturdays can be a hardship for many people (especially those who need childcare) so I don’t think your statement that it’s “simply annoying” is universally true. And many people would find Ronald’s behavior “simply annoying.”

          1. Bassoon Wielding Chemist*

            Indeed, being expected to work unanticipated shifts is difficult and can be highly stressful regardless of the day (or time of day/night). I still don’t think is rises to the level of Roland potentially seeming to mock a person with a life-threatening illness.

          2. Observer*

            Well, if a significant percentage of staff are really going to be seriously negatively affected by the accommodation, then you are almost certainly not going to have to accommodate it. I think that in every case that I’ve seen on the matter, the issue was whether is really was realistic to have others cover or not.

            1. LBK*

              My understanding is that the bar for absences/schedule changes to be considered a hardship is pretty high (ie more than just “I don’t like having to always work the Saturday closing shift to cover Fergus’s doctor’s appointment”) although I think we’re mixing ADA and EEOC now so I’m not sure if the standard is the same for both.

              1. Observer*

                The standards are different. But the point is that religious accommodation definitely has limits, and serious negative effects on co-workers is seen differently that annoyance.

                1. LBK*

                  It does have limits, but Alison’s point is just that people quitting because they don’t like accommodating their coworker’s schedule change doesn’t inherently indicate that the accommodation is causing an undue hardship; employee turnover isn’t a defined measure of whether an accommodation is unreasonable, in either the ADA or EEOC.

      2. Trout 'Waver*

        This is a very interesting and well-mannered discussion, and that’s based on your comments and advice. I hope the moderation hasn’t been too intensive on this one.

  20. Kate 2*

    I agree the OP should tread carefully, but all the ADA requires are “reasonable accommodations”. I should think that letting Ronald keep taking tons of time off for his doctor’s appointments is enough. I can’t imagine that the ADA would require OP to allow Ronald to keep talking at work about his medical issues to everyone and upsetting them.

    Hypochondria, as I understand, just means that you think you have every illness under the sun. It doesn’t mean that you have to talk about them to every single one of your coworkers. Regardless of his condition Ronald is being rude and giving TMI.

    1. fposte*

      Talking about the object of your anxiety is a really common symptom of anxiety, though. Whether it’s legally considered something you can depends, I suspect, on how manageable the symptom of talking to people about his symptoms is considered to be.

    2. Ask a Manager* Post author

      There are loads of employers who found out the hard way that deciding on their own what the ADA “should” require is how you lose lawsuits. Seriously, it is not intuitive, no matter how reasonable/unreasonable you think something sounds. It’s genuinely surprising what accommodations have been deemed reasonable by courts.

      1. Shadow*

        It’s simple enough to find out though without a lawyer. Why can’t they just ask him how he needs to be accommodated and provide some medical documentation to back it up? Employers don’t have to guess they can simply say “how do you need to be accommodated?”. And “your talking about your medical concerns is becoming disruptive. Is this something you can stop?”

        1. Temperance*

          I vehemently disagree with this advice. This is an issue for a lawyer.

          The second statement you offer as a suggestion is potentially actionable. His issues are related to his mental health. It’s not as simple as correcting an annoying behavior from someone typical.

            1. Temperance*

              Ask/telling him to stop what he’s doing, asking what he needs to be accommodated without advice from a lawyer … all of it, actually. I’m actually an attorney and my understanding of employment is somewhat limited, but I know enough to recognize bad advice.

              1. Shadow*

                Sure legal advice is always the safest, but not necessary if you do some homework. The accommodation process recommended by the EEOC is not so complicated on purpose.

        2. LBK*

          I think asking him if it’s something he can stop is on kind of sketchy ground, and if his answer to how he needs to be accommodated is “I’m just going to continue to do exactly what I’m doing,” then what?

          1. Shadow*

            Whats sketchy about asking? The Ada actually calls for this type of back and forth to clarify what’s needed and how to accommodate it

            1. LBK*

              If bringing it up is an intrinsic part of his disorder, I don’t think you can ask him if it’s possible for him to just cut it out anymore than you can ask someone with a broken leg if they can just stop using their crutches because others are finding the noise disruptive.

              1. Shadow*

                But you don’t know if it’s part of his disorder and you’re no medical expert and aren’t required to diagnose. It’s up to him to clarify what needs to be accommodated.

        3. Ask a Manager* Post author

          It’s really not simple.

          I think there are a lot of people in this thread without legal training or experience dealing with this stuff stating their opinions as fact, and I’d ask people to be aware of that and rein it in. Following this advice would be dangerous.

          1. Shadow*

            unknowns don’t need to be accommodated. And unless it’s obvious (which this isn’t) it’s up to the employee to inform the company of the need for an accommodation

              1. Shadow*

                True, and if he says it’s related then I’d take his word for it, tell him how it’s impacting work and ask if there’s a way to minimize the disruption. The point is you don’t have to guess what’s related to his disability, you can and should ask.

                1. LBK*

                  But I think you need to start with that open-ended question and ask things like “Can you stop doing that at work?” before you know, which is what you suggested above.

  21. A4this*

    This is one of those situations where I don’t know how to deal with people with mental illnesses that manifest in really annoying behaviors. On one hand, I want to be sensitive to the fact they have a mental illness, but their behaviors can be psychotic. I have an uncle with hypochondria and his behavior is annoying for the reasons Ronald’s are – it got to the point where he even forced his KIDS on meds that had seriously negative effects.

      1. fposte*

        I don’t think it’s that uncommon for pediatricians to rely on parental reports in determining treatment for kids.

        1. BananaPants*

          In my experience the pediatrician will rely on parental reports mainly to determine if and when the kid needs to be seen. They’ll also call in refills for meds for a known/diagnosed condition. That said, there are very few instances where our peds will call in prescriptions for a new medical complaint without actually seeing the patient and diagnosing the condition (head lice is the only one I can think of).

          1. doreen*

            I don’t think fposte is talking about the doctor calling in prescriptions without seeing the patient. But if I tell the doctor my kid has exhibiting some symptom ( say he’s been been vomiting for three days) , the doctor is typically going to take my word for it and base the treatment on what I report

          1. fposte*

            I’m not meaning instead of seeing the patient, but parental reports can weigh pretty heavily, especially when you’re talking something more behavioral than lab-testable, when it comes to deciding how to treat a kid.

            1. Observer*

              Yes, but when you are talking about medication with potentially serious side effects you do enough examination to make sure that it’s warranted. You do NOT prescribe purely on parental reports. And the term “force” makes me think that the kids were actually able to protest and were over-riden.

  22. AW*

    I personally don’t think disclosing the hypochondria would help much.

    It’s one of those conditions where 1) everyone thinks they understand because the term gets used casually and 2) many people don’t think is a “real” or “serious” condition anyway, for the same reason. The co-workers are just as, if not more, likely to hear he has hypochondria and get more annoyed at him. “If he knows he has hypochondria, then shouldn’t he know he doesn’t have all these other conditions?” “Why can’t he just stop?”

    What could be helpful, if it doesn’t violate ADA, is for the OP to ask Ronald what he needs from the office in order to limit how often it happens. People have suggested just having him not discuss his medical issues at all or people avoiding discussing medical issues around him but maybe there are other things that could help. He’s seeing a therapist so even if he doesn’t know yet himself, presumably he can find out.

    1. fposte*

      I think the term “health anxiety” (which I believe is UK standard now) is a lot more useful; a lot of people are familiar with anxiety, and it has a clinical ring whereas hypochondria sounds like a casual characteristic.

    2. LBK*

      Yeah, I agree – I don’t know that that will really garner much sympathy, since “hypochondriac” is often used as a diminutive term rather than a diagnostic one.

      1. fposte*

        I just looked it up, and Mayo reports that the new DSM uses two terms: “Illness anxiety disorder, especially if there are no physical symptoms or they’re mild; Somatic symptom disorder, especially if there are multiple or major physical symptoms.” Their section is called “illness anxiety disorder.” (TBH, I don’t love that for everyday usage because its unfamiliarity makes it sound a little made up, but I think it’s better than “hypochondria.”)

    3. Leenie*

      I agree with this. Hypochondria is used so often in the colloquial way that I think the reaction is less likely to be, “Oh – I had no idea he had a diagnosed condition, I’ll be more patient with him.” And more likely to be, “No duh, he’s a hypochondriac.”

  23. Kate*

    I know so very little about ADA, so I don’t know if this is hazy territory, but would it be acceptable for the OP to talk to Ronald about how this is impacting his coworkers so that he might be able to discuss better coping mechanisms with his therapist? This situations really just sucks for everyone involved. If I was one of the employees making a complaint about Ronald and was told not to judge his medical choices or some people just have quirks, I’d feel really ignored, so I can see this as a major morale killer. If the OP is able to talk to Ronald about it, she could at least tell the other employees she has spoken to him about the problem (without disclosing any details), so maybe they’ll feel a little heard.

    1. Ask a Manager* Post author

      I would think yes — but the OP should talk to a lawyer first, because that conversation could go in a bunch of different directions where it would be good for the OP to understand the boundaries of what she can/can’t say. If the lawyer says it’s okay for her to say “I need you to do X,” then it would be great to know that before sitting down with him (and vice versa).

      2. Soon to be former fed*

        Actually, Ronald’s doctors should be making accomodation recommendations, which are not legal matters. The employer then evaluates them for undue hardship, and can accept, reject, or counterpropose accomodations. The employer should also look at the Job Accommodation Network and other resources. It’s not a cut and dried process especially when mental issues are involved.

    2. ZenJen*

      THIS. it sounds like Ronald has mental health issues (anxiety disorder, maybe) causing the hypochondria and the excessive absences from work. maybe OP, with lawyer and HR’s consent, also needs to gently mention that there are resources in case this is a mental health issue plaguing Ronald? clearly Ronald’s behavior is disruptive to the office and it needs to change

  24. Menacia*

    Seems like the discussions about the illnesses of his coworkers or their family members is a trigger for him. Could your employees perhaps limit their discussions (to you only, or to their coworkers other than Ronald), or keep the discussions very general (don’t talk specifically about the type of illness?). Keep all discussions work-related or very general in nature around him.

    1. Game of Scones*

      I think this is one half (and a really important half) of a fair agreement. Employees on both sides of the argument should be more discreet about health related conversation.

      1. Fiennes*

        Honestly, I’d be surprised if coworkers aren’t doing this to some extent already, purely out of annoyance.

        1. fposte*

          I’d be okay with that; another possibility that I’m afraid might happen is people consciously baiting Ronald with talk of illnesses, and that I would be not okay with.

          1. Soon to be former fed*

            I’m not okay with that. It’s asking too much of coworkers to police their normal banter. The co-workers would be making the accommodation, not the employer. I wouldn’t want to work in such an environment. Its an office, not a psychiatric ward.

    2. Carla*

      I agree. Considering that his discussions cause them pain and their discussions are a trigger for him, the first step should be to ask everyone to limit their health discussions, and that should help with both issues.

      1. Soon to be former fed*

        I don’t think so. Normal conversation should not have to be monitored, that would create an artificial and stilted environment.

  25. SL #2*

    OP, I know you want to do right by Ronald and your staff, so I think talking to an employment lawyer about the ADA and what’s possible here is best. A lawyer will be able to guide you through what’s a reasonable accommodation for Ronald. Is it limiting health talk in the office? Is it letting him react to his anxieties and asking the rest of the staff to live with it? Is it something else entirely? We don’t know (I guess an employment lawyer in the commentariat would know), but please, please sit down with a lawyer before doing anything, including using Alison’s script.

  26. CappaCity*

    Is it possible to coach Ronald a bit on establishing some boundaries for himself with his co-workers? It must be exhausting and upsetting for him to be managing that kind of anxiety as a result of his interactions with his co-workers. Can you help him develop a script or something?

    As in – “I’m so sorry that you’re not feeling well, Co-Worker, but I have to ask you not to give me any medical details beyond the dates I should expect to cover for you. I’m not able to listen to any discussions about your illness beyond that. Please email me whatever tasks I need to be responsible for. I’m happy to help.” Then empower him to hold that boundary for himself.

    Maybe equipping him to opt out of conversations with his co-workers that he knows will be problematic for his anxiety would be helpful for him and cut down on the rest of the staff’s feeling that he’s trying to upstage/usurp their own health issues.

    1. Cookienay*

      I agree. Also empowering co-workers to politely shut down/redirect any medical conversations. This has proven to be effective in many situations for me. An example “I am not engaging in a conversation about any medical conditions. Did you find the report on teapot sale projections to your satisfaction?” Said in a neutral manner, this can be effective but many people are afraid to sound rude or insensitive so I understand it’s difficult to do. Good luck to the OP, this is a tough one.

      1. Cookienay*

        Sorry for my incomplete sentence above. It should read “…redirect any medical conversation can be beneficial.”

  27. Tina*

    I agree a lawyer probably needs to be consulted but “getting along with your coworkers” is a requirement of basically any job and it doesn’t seem like this is happening with Ronald. And I don’t agree with Alison’s advice because it is placing the burden of getting along with Ronald on the coworkers instead of on Ronald, and that is not at all fair to them. There are situations like him collapsing from chest pains that you can’t really do anything about in case he actually is having a heart attack (and even if it’s just a panic attack, medical attention could be needed) and it’s fair to not get on his case about that, but as others have already pointed out, it can be extremely upsetting to hear somebody claim to have a medical issue that they or a loved one suffers from. A couple of years ago I lost two family members in the course of six months (one to heart disease, one to leukemia) while two other family members (including my infant nephew) were dealing with serious health issues involving multiple hospitalizations and if Ronald had been working with me it would have added to the already considerable stress and emotional distress I was dealing with at the time.

  28. mreasy*

    One thing I haven’t seen mentioned yet: while there is a lot of language around “fair” and “unfair” re Ronald’s annoying behavior, I haven’t seen much compassion toward Ronald himself. Perhaps most of us can only relate his behavior to some “drama llama” we know IRL who likes to one-up others, or a garden-variety overcomplainer, and accommodating those folks seems unjust. But Ronald, with his mental illness that is clearly not yet well-managed, is himself thoroughly miserable. While that doesn’t give him the “right” to antagonize his coworkers, it seems good in these discussions to remember that anxiety and fear like he is experiencing are exhausting and are preventing him from living a full life. It’s reasonable to do something like limiting health talk in public areas, in order to help diminish the opportunities for panic and fear for one’s coworker. “Fair” just doesn’t apply.

    1. Temperance*

      He hasn’t disclosed his illness to his colleagues, so he’s just the PITA that they work with. I know many people prone to dramatics, so frankly, I would assume that Ronald is doing the same.

      There’s no way to really put these rules in place without disclosing, at least in a way that I can see.

    2. paul*

      Bluntly: What would us tutt-tutting over how hard he has it actually *do* to help the letter writer, his coworkers, or Ronald? It doesn’t sound the letter writer’s being a hard case in dealing with the guy, or isn’t somewhat empathetic to Ronald’s own diagnoses. A lack of empathy on OP’s part doesn’t seem to be the problem.

      And as far as it being reasonable to limit health talk in public areas…leaving aside legal definitions (since none of us are qualified to judge this case) I think it’s absurd to expect people not to casually mention any health topics in any common areas. Casually mentioning you have a cold or that you’re a little stressed due to XYZ thing your spouse is going through is a pretty normal part of minor social interactions.

      1. Dr. Johnny Fever*

        I’m with you. I have a mental illness and I have empathy. But giving Ronald a pass intimates that anyone with a mental disorder gets a pass for being a PITA.

        I can be a PITA on a bad day, but I am 100% responsible for how I behave, regardless of how I feel. Same holds for Ronald. He may be miserable in his illness, but he is 100% responsible for the situation as it stands.

        1. mreasy*

          I have severe mental illness also, and it’s certainly not an excuse to be a jerk. I guess I take issue with the language of “fair” and “unfair.” But point taken that the issue is that to coworkers, he’s just an annoying one-upper, because OP is the only one who knows the truth. Re compassion, I was referring to commenters here, not Ronald’s colleagues.

          1. paul*

            I’m just not seeing it. I think I’ve seen one or two comments that were a bit harsh, but it isn’t like we’re under an obligation to start any discussion of the topic with a paragraph disclaiming how hard he has it and how much we empathize with him. I haven’t seen a lot of people rip into him; I *have* seen a lot of people mention that his actions–regardless of cause–can be and probably will be legitimately difficult for a lot of his colleagues, and annoying for probably all of them.

            If the OP seemed like they were being incredibly unemphatic it’d be one thing, but they didn’t come across that way.

    3. Another person*

      You have a good point. I once worked in a dysfunctional office where people (especially the boss) would go into great detail openly about every illness and ailment and I swear it sounded like they were all trying to one up each other. I’d come in after being out sick or after a medical procedure and they’d look at me like “and…?” and act disappointed I didn’t go into detail. It was exhausting to deal with all their health drama and I don’t even have hypochondria. I can’t imagine how awful it would be to have a condition like that and have to hear every little thing out in the open.

    4. Observer*

      I disagree with you. Most people seem to be fairly sympathetic. The problem is that despite the sympathy, people recognize just how difficult it is for everyone around him, especially since they have no idea what’s going on here.

      It also doesn’t sound like there is a huge amount of detail going on here. The examples that the OP gave are fairly typical of normal interactions between people who work together and get along reasonably well.

  29. Lady Phoenix*

    Maybe she can tell him to limit the medical talk around affected individuals? Like, “Susie is upset because someone in her family is sick. Please respect her by not discussing medical issues while she is present.” If your company has a therapist, perhaps you should direct him there.

  30. ZSD*

    Well, I definitely learned something from this post. I had no idea that hypochondria was a diagnosable condition. I just thought it was a character trait.

    1. Bea*

      It’s a mental health issue so many are cloaked as personality traits it seems. It goes deep into our past as humans because before we brushed it into a “weird things people do and say” file.

      Many wouldn’t know about agoraphobia either, they just think the person is a hermit and likes to be alone all the time :( or you’re seen as eccentric when you have certain OCD tendencies kind of stuff.

      2. Tammy*

        Exactly. I was recently – at the age of forty three – diagnosed with both ADHD and Autism Spectrum Disorder. These are classed as mental health disorders, and they’ve had a profound impact on my life that I’m only now starting to understand. (Cue 20,000 “oh, so THAT’S why doing that thing/behaving that way/managing that challenge has been such a struggle for my whole life!” epiphanies.)

        Luckily, the combination of medication, therapy, adaptive skills (both new and those I’ve learned from decades of trial and error) are helping enough that I’m a senior manager at CurrentCompany and I haven’t had to ask for ADA accommodations. But before I knew these were the reasons for my struggles, I’m sure people looked at my behaviors and thought I was just an odd duck.

    2. Sylvia*

      It’s one of those things that’s on a spectrum that runs from “mild quirk” to “diagnosable mental illness,” and unfortunately the word “hypochondria” has been used to describe that whole range.

      1. Fiennes*

        Yes, the “spectrum” elements is important to realize – both for those who only deal with quirks/traits (to understand it can be severe to the point of being debilitating) and for those who suffer from mental illness (to get why others react as they do.)

  31. Cheryl*

    I would hate this too. And like others have said, if I were the one suffering with a loved one’s dementia, or my own cancer, or whatever, I would be a mess too. But here’s the thing: he really is sick! He just doesn’t have the diseases he imagines himself to have. But his severe, diagnosed hypochondria is a real disease. Even though his symptoms of other diseases aren’t real, they are very real to him! I am at a loss as to how the workplace can accommodate his disease, while minimizing pain to others.

    1. Temperance*

      I think at least part of the issue is that his colleagues don’t *know*. They aren’t being nasty to a sick person, they’re acting annoyed and upset with a person who is making light of their family’s medical issues. It’s different.

  32. Happy Temp*

    I’m curious about the ADA accomodations. Is presenting letters from a physician and therapist (as OP said the employee did) the same thing as asking for accomdation? Or once an employee has presented proof that a condition exists does it mean it’s on the employer to sit down with the employee and discuss accomdations? (Obviously in this situation, since there is no HR department, consulting an employment lawyer is the next step.) Who has to raise the issue of accomdation, I guess I’m asking?

    2. fposte*

      AskJAN says, “Any time an employee indicates that he/she is having a problem and the problem is related to a medical condition, the employer should consider whether the employee is making a request for accommodation under the ADA.” So it’s possible, yes.

    3. Observer*

      Once the employer is on notice, they have an obligation to have a dialog with the employee. Which is why I agree with all the suggestions to talk to a lawyer. This is not just an issue of sensitivity, although it is that, too. But it’s also a significant legal issue.

    4. Argh!*

      In a bigger workplace, the doctor & HR would figure out the accommodation then instruct the supervisor and the supervisor may never even know what the diagnosis is. The employee doesn’t get to order the employer around just because there’s a letter from a doctor. The doctor merely making a diagnosis isn’t the same as a letter requesting an accommodation. People with the same diagnosis could have different needs.

  33. Anita*

    Ugh, I can so relate to this. In my workplace, it’s normal for employees to send all-staff emails with detailed reasons about WHY they are calling in sick that day. I have received emails about hernia-related mesh implants and urinary tract infections from both my direct supervisor and our CEO. The pressure to self-disclose is unreal and I wish that there were any recourse to stop this kind of almost-compulsory sharing.

    1. Another person*

      I know! People do get sick and need help sometimes, but whatever happened to being discreet and private?

      In my case it was really all on management for understaffing and then creating a culture where sharing the kinds of details I preferred to keep between me and my doctor was the only way to not end up overworked (I suffered silently and then I left).

      I really hope that’s not the case at the OP’s workplace though.

    2. Ellen N.*

      I’ve worked in several places where you had to “prove” that you were really too sick to work by describing the symptoms in detail. I would have vastly preferred to just say that I was taking a sick day, but it wasn’t permitted. In one of these workplaces, the owner of the company would call periodically throughout the day to make sure that I still sounded sick.

    3. Bea*

      My boss is really good about telling people to watch how much info they give and to whom. They’d put details on the company calendar sometimes “Bobby out, pap smear!” kind of stuff was popping up I’m told.

      He’s a firm believer that privacy laws are beyond your doctor’s office and will shut down chat about other people’s health issues. It’s amazing since I come from a “prove you’re sick” background.

  34. barracuda*

    Being a hypochondriac is one thing; talking about your imaginary illnesses in the workplace is another. I am not sure that the diagnosis covers his incessant discussion about his medical problems, even if the diagnosis itself is ADA protected.

    1. LBK*

      But as others have said, I don’t think that’s a judgment call the OP should make. Seems like a question for a lawyer.

  35. Shadow*

    isnt it called illness anxiety disorder now? Are his co workers upset because it impacts their work? That’s actionable. If they’re upset because he’s being “dramatic” then that’s something they need to get over themselves. By the way, you don’t have to allow him to take unpaid days off if you don’t allow others to.

      1. Shadow*

        true but it’s usually not hard to show that excessive absences are an undue hardship

        1. Ask a Manager* Post author

          That’s actually not true! It’s a very, very common required accommodation.

          And what you’re saying is really against the spirit of the law as well, which is to genuinely try to find a way to accommodate people with disabilities, not to look for a way to get rid of them.

          1. Shadow*

            That’s no true what I’m saying. What I’m saying is most companies literally cannot afford to have someone absent excessively

            1. Ask a Manager* Post author

              An employer’s definition of excessive is often different from a court’s. Allowing unpaid time off is a very common legally required accommodation.

    2. Bea*

      The letter has no mention that his unpaid time off is an issue. I’ve seen plenty of companies that are small be able to absorb the issue

      OP isn’t asking how to get rid of him anyways, I’m not sure why everyone thinks a dude who is just insensitive should be fired. There are a lot of people who are annoying in every office, they just need to all get along and that’s what the letter is asking about

      1. Shadow*

        Maybe it is maybe it isn’t. I put it out there because managers typically fall into two extremes- dismissive or overly cautious to the point that they feel like they must approve every request.

  36. Kimberly R*

    I wonder if the OP and Ronald can let everyone know he has a chronic health issue that requires absences for treatment (his hypochondria) without telling everyone what it is. Although it wouldn’t necessarily stop people from feeling hurt when he has a “heart attack” right after someone else does, they would at least know that he has some sort of health issue that is causing his behavior. I think telling people about his hypochondria isn’t necessarily the best idea since it is a misunderstood diagnosis. We all know people who refer to themselves or others as “hypochondriacs” but they aren’t truly-just like OCD, these are terms people throw around without thinking. A hypochondria diagnosis could come across as petty and silly, whereas a private medical issue could conceivably cause a variety of issues. Ronald would have to agree, of course, but maybe it would help his reputation slightly.

    I agree with Alison though-no matter what else the OP does, she should consider consulting an attorney about how to handle this from beginning to end.

    1. mreasy*

      Great point about sharing the diagnosis – “hypochondriac” is a culturally belittled condition and seems almost cartoonish, whereas in reality it’s a serious medical issue.

  37. oranges & lemons*

    As someone with health anxiety myself, I really feel for Ronald. It sounds like his hypochondria is quite severe and it can be pretty awful to live with. I realize that it must be really hard on the coworkers as well, though. For anyone in this position it might be helpful to reframe Ronald’s anxiety as being something like trauma from previous experiences with illness–just to emphasize that he is genuinely suffering, not trying to draw attention to himself.

    1. Observer*

      I think that if he discloses, this is a good way of framing it. It doesn’t matter if he actually has an official trauma, but it’s a term people understand as being a real thing.

    2. Stellaaaaa*

      I haven’t seen it addressed that it may be complicated by the fact that the people he’s insulting and hurting have also been diagnosed with very serious conditions. I doubt that full-on accommodations would come into play for the coworkers, but a conscientious employer would want to avoid triggering and re-traumatizing employees who are also coming to bat with their own diagnoses. Someone who was in therapy after losing a loved one could easily have her therapist write a note explaining that the Ronald situation was harmful and requesting that it be dealt with. I’m really not comfortable with the idea that someone with an unmanaged mental illness should be able to do and say whatever he wants and that his coworkers – who are dealing with real trauma in their private lives – just have to let him trample all over their feelings.

      1. oranges & lemons*

        I agree, that’s what makes this situation so difficult all around–maybe I didn’t explain myself very well in my original comment. I don’t know if there is a good solution here that can address both Ronald’s needs and those of his coworkers. But I am trying to push back against the idea that Ronald’s behaviour is “trampling over the feelings” of his coworkers or that he’s intentionally mimicking them or dismissing their illnesses. I think people are finding it easier to empathize with the coworkers and are reading his behaviour pretty uncharitably as a result.

        1. Temperance*

          The issue is that his actions are reading as mimicry and dismissive, though, and even if unintentional, he is “trampling over the feelings” of his coworkers. If I was dealing with a parent with dementia, and then my young colleague starting nattering on about how he must have dementia, too, I would be deeply upset. This is even moreso a problem if Ronald’s anxiety manifests itself in such a way that he repeats his statements over and over.

          This is one of those difficult situations where no one can really “win”. Just because Ronald’s issues are coming from mental illness does not mean that it’s okay for him to be upsetting people, nor does it mean that his colleagues should put their hurt feelings aside. They don’t know that he has a dx, and honestly, even if they did, it’s still not totally reasonable to expect people to be able to just deal. Mentally ill people can hurt others and should be held accountable in a way that doesn’t run afoul of the ADA.

      2. Laura*

        So much this. It could very easily become a therapy competition and his co-workers would naturally win. Which they should. “Trample all over their feelings” is very well said.

  38. Anon for this because it makes me look bad :-)*

    Once I recognized the pattern of, “When Sue talked about her sister having X, Ronald suddenly had X,” I would search out the most obscure, probably genetic pediatric disease I could find and make sure Ronald heard me talking about how Y relative has it. Just to see how far he would run with it and see how long it took him to research the symptoms. I wouldn’t do this if I had the knowledge that he is suffering from hypochondria, because I do have some compassion; just if I thought he was being an annoying git who has to one-up everyone around him.

    And unfortunately, I would tend to ignore his episodes at work due to the Boy Who Cried Wolf effect.

    1. Snark*

      It does bear some mention that we really have no idea if he has hypochondria. I pretended food poisoning and dizzy spells a few times in high school because I was an annoying git who wanted attention. I knew damn well I wasn’t sick. This site’s commentariat is extraordinarily sensitive to mental health issues and I think that’s generally a very fine and respectable thing, but let’s all keep in mind: Ronald has not been diagnosed, to our knowledge, with anything. We don’t need to necessarily proceed under the assumption that he has.

      1. LBK*

        From the letter:

        We have no HR department, but Ronald has given me letters from a physician and a therapist about his hypochondria diagnosis.

        1. Snark*

          Yes, I just reread the letter and saw that, too late. That said, I’m still a little skeptical that this is a diagnosed mental health issue, because those came from a physician and a therapist, neither of whom is qualified to diagnose, not a psychologist who’s actually qualified, and because hypochondria is not in the DSM. It’d be diagnosed as somatic symptom disorder or illness anxiety disorder – hypochondria is a term years out of date.

          1. LBK*

            I would think that a psychologist could refer to a therapist who could in turn write a note as the person treating the employee. I imagine the OP is also using the term “hypochondria” colloquially because she’s not a doctor, so she’s writing it a way that will be easy for the general audience to understand, and FWIW she does use the term “health anxiety” multiple times.

            Moreover, I would be suuuuuuuuper skeptical of trying to question the veracity of someone’s diagnosis, which the ADA doesn’t even officially require before requesting accommodation. This situation is fraught with nuances and just working from the mental premise that he might be totally lying and/or wrong even without explicitly saying so feels like steering yourself right into a lawsuit.

            1. Snark*

              Yeah, you’re very right. Ultimately, what Alison keeps saying is correct: hie thee to an employment lawyer, OP.

            2. Dr. Johnny Fever*

              Most therapists cannot write doctor notes or scripts. Some cannot diagnose. Medical information about one’s mental health is required from the psychiatrist, at least per my dealings with FMLA. Maybe a manager would accept a note, but it’s not a diagnosis. I doubt it would be enough for ADA.

              From my personal experiences and taking the OP at her word, no ways were those notes official in terms of a diagnosis. I’d be highly suspect. Again, IME, my doctor would not do that. I’ve never asked my therapist – he doesn’t diagnose or prescribe. My psychiatrist handles all records release per written request.

              Man, I really hate that I doubt Ronald so much and find little empathy, but this is someone for whom his therapy is not working and the chatter is a huge warning sign in his healing. You have the problem of dealing with that in the office, but Ronald needs some sort of wakeup that he needs help based on his behavior and possibly deeper therapy. I doubt his doctor and therapist have any idea how much this is affecting him at work.

              1. LBK*

                But is a doctor going to provide a note that says something completely false? Are you suggesting Ronald falsified the letters?

                1. Dr. Johnny Fever*

                  Anything is within the realm of possibility. I find two notes fishy though when neither one is from someone qualified to diagnose the disorder. Could Ronald have falsified them? Sure. A simple doctor note would be pretty easy to forge to a layman’s eye.

                  It’s possible the notes are real and inform of a psychiatrist’s diagnosis. Yet I would think a psychiatrist is going to use the latest DSM wording (SSD/IAD), not an outdated term.

                  It’s most likely everything is on the up and up. I’m just puzzling over what to do in the situation because it’s not the coworkers’ fault here. Ronald is sick but still responsible for his actions. I’m not as sympathetic because I’ve had illness and grief in my family (And PTSD related to some of it) and I think I would have a hard time not tearing Ronald a new one whether I knew he was sick or not.

                2. paul*

                  It’s also entirely possible the letterwriter mildly mixed up with their terminology; I can’t tell you how many times I’ve seen laypeople say things like “My therapist prescribed…” and I’m like…that isn’t how it works. It was hilarious when they were seeing the same therapist I was because I knew damn well she didn’t prescribe jack, she couldn’t (joys of a small city–when some of your clients and you have the same shrink).

                3. LBK*

                  I guess I don’t see what benefit tearing him a new one is going to have aside from maybe temporarily making you feel better about getting your frustration off your chest. It’s not going to make him stop.

                4. The Southern Gothic*

                  It would be easy enough to verify by calling the doctors on the letterhead and asking them to confirm they wrote the letters, as well as the content of the letters.

              2. Chomps*

                Psychologists and Licensed Clinical Social Workers are people who provide therapy, are often referred to as therapists, and can diagnose mental disorders. Being unable to write prescriptions is completely irrelevant.

          2. Natalie*

            In my experience, people tend to use the term “therapist” pretty broadly, up to and including psychologists and psychiatrists. So I wouldn’t assume that the therapist isn’t a medical doctor.

          4. Chomps*

            Ummm… therapist is often a term used for psychologists. Also, Licensed Clinical Social Workers provide therapy and are licensed to diagnose. They are also often referred to as therapists. You’re being unnecessarily nitpicky here.

    2. Mb13*

      I was thinking the exact same thing. Or more importantly say the Ronald were to disclose his condition employees who don’t like him might use that to bully him. Such as saying “oh I read this article today about how this illness is really common in the area” just to watch him spiral.

  39. Snark*

    I fully realize the standing rule against diagnosis-at-a-distance on this site, but the letter’s details were striking – this may not be simple hypochondria. There may be some delusional and compulsive elements to this, at LW would be well-advised to consider that and tread carefully. There are a family of syndromes, Munchausen being the most famous, that may be at work, which involve the delusional mirroring or adoption of symptoms and injuries. I’ve known hypochondriacs, and it’s more of a continual compulsive worry that they may have a disease, not really so much the delusion that they’re suffering symptoms. I’m not saying that this is in play, just a possibility, and if it is, OP is going to get a lot of pushback from Ronald.

    1. Snark*

      And the other thing is, as I noted above: Ronald has not been diagnosed, to our knowledge, with anything. The diagnosis rule cuts both ways. Whether he’s delusional or faking it or somewhere in between is entirely a matter of speculation.

    2. fposte*

      I think you’re falling afoul of the colloquial usage there–it is an official anxiety disorder of its own already.

      1. Snark*

        I found the terms I was groping for and forgot – it’s somatic symptom disorder, as distinct from illness anxiety disorder. If that’s what he’s suffering, he’s actually experiencing chest pain and whatever, which makes it harder to tell him to keep a lid on the health talk. “I’m worried I have a tumor” can be saved for later, but “I feel like I’m having an actual heart attack right now” sort of demands to be announced, psychosomatic or not.

        1. fposte*

          Right, you don’t stand in the way of his going to the ER. But I think actionable statements for your workplace can be pretty easily differentiated.

  40. Alton*

    One of the problems I have with the idea of asking Ronald not to talk about his health concerns at work is that it’s not really clear to me from the question how disruptive Ronald is being when it comes to the frequency with which he brings this stuff up. Now obviously, saying you have cancer or that you had heart attacks is disruptive in the sense that it’s going to elicit a lot of concern. It’s not like mentioning you had a cold over the weekend. But it sounds like a lot of the problem is that Ronald’s co-workers don’t take him seriously, not necessarily that he’s talking about it excessively. If he’s sincere in his belief that he has these conditions and his level of talk about it would been seen as acceptable coming from someone who’s trusted more, then I think it’s tricky and a little risky to essentially hold Ronald to a different standard. “Don’t talk about health issues excessively or graphically because it makes people uncomfortable” is a different rule than “Don’t talk about *your* health, even in passing, because it makes people uncomfortable.”

    1. Stellaaaaa*

      The problem is that health stuff comes up more than you might realize, and there are situations that might ding Ronald’s radar when you weren’t even aware that you were talking about health stuff. What if a coworker asked about my weekend and I said that I visited my friend, who’s been having a hard time since her dad’s stroke? What if I mentioned in passing that my elbow hurts because it’s about to rain, an annoying quirk I acquired when a childhood broken arm didn’t heal right? What if I hurt my foot in the office or talk about having a headache in that moment and Ronald just happens to be in the room? Can you really mandate that Jane can’t tell Amy that tuna salad upsets her stomach?

    2. Observer*

      Well, it’s more that “it makes people uncomfortable”. And, the ask is not to talk about his health but about the conditions that have not been diagnosed by a doctor because it’s clear that he does not have those conditions.

      Yes, it’s true that doctors sometime mis-diagnose or miss real issues. But, when someone starts freaking out about something that he CLEARLY doesn’t have, you know that something is up.

        1. Temperance*

          Well, Ronald is the only one speculating that he might have dementia when he clearly doesn’t, so ….

        2. Stellaaaaa*

          This is a bit of a straw man question. Very few people routinely suck the air out of the room by claiming, with aplomb, to definitely have illnesses that they most certainly do not have but that other people in the vicinity have been diagnosed with. Very few people hear about someone else’s major surgery and say, “OMG me too!”

            1. Shadow*

              Optics matter if he ever says “and I was the only one barred from talking about medical conditions”

              1. Argh!*

                Yes, the rule would have to be that nobody talks about medical conditions. This would be the most helpful, because he seems triggered by it. He’d have fewer days off and there would be less time spent talking about his problems.

                1. Soon to be former fed*

                  Nope. The natural flow of social intercourse betwern co-workers would be seriously disrupted. The accomodation co-workers would be expected to make here is not reasonable.

                2. Observer*

                  Nope. Because the rule is there for a specific reason – he has repeatedly claimed to have conditions that he clearly does not have. Since he is the only one with that pattern, he is the only one to whom the rule applies.

                  As Soon to be former fed says, reasons matter.

  41. Gabriela*

    The questions regarding mental health on this blog are always the most interesting to me, because this commenting community is both compassionate towards mental illness and in possession of a firm belief in personal responsibility. As a mental health practitioner, I almost default towards taking the side of the person who is struggling with mental illness, just because there is so much misunderstanding around mental illness (especially somatization disorders or anything that is discussed in a colloquial fashion). But, the truth is, one can both be struggling acutely from mental anguish and be callous to those around them. Understanding one’s anguish can sometimes lessen the stress of being around them, but in this case the coworkers don’t have access to that understanding.

    TL;DR OP, you seem like a very compassionate manager and I wish you luck in figuring this one out.

  42. Barney Stinson*

    I’m astounded that his coworkers haven’t taken him out at the knees over this one. I realize that if someone says they have dementia we’re not supposed to question it, etc but I have worked with enough non-PC people who would have, at that statement, whipped around and said, “Ohferpetessake, Ronald, cut it out.”

    I’m not a big fan of letting the crowd control fellow employees. I’m just amazed someone hasn’t yelled at him outright by now.

  43. Former Employee*

    After reading the letter and some of the comments, I’m already tired of this guy. I see no reason why his co-workers should be constrained from discussing their or their family member’s illnesses in the office. That might be the only place for them to get consistent moral support. However, there should be some way for them to do so when Ronald is not around.

  44. K*

    This is similar to Alton’s thought above, but my concern is that even if Ronald cuts out excessive extended health talk (if that is in fact happening here), his issues will likely still be apparent at work sometimes (for example, calling an ambulance if he feels that he’s having a medical emergency), and I hope that wouldn’t still be aggravating to coworkers that are already burnt out on Ronald drama. I guess this is the point where advising the other employees to just ignore Ronald would come into play, and I also think that letting it be known that it’s part of a serious anxiety disorder would also probably be useful if that is something that would be possible. (I would literally say something like “serious anxiety disorder” because “hypochondria” alone may not be fully understood, as we can see even from some of the comments here.)

    I have had some health/anxiety issues of my own (though not nearly as serious), and I feel sorry for Ronald. It’s very hard to ignore impulsive thoughts that something may be wrong with you, especially if it’s a potentially hugely serious problem and the cost of reassuring yourself (going to the doctor to get it checked) feels comparatively small. I hope he can get some help with this soon.

  45. Kelli*

    I worked for many years with someone who turned every sniffle into triple pneumonia and every rash into a rare tropical disease (that she couldn’t possibly have). DON’T FEED THE BEAST. Say you are sorry, suggest they go home or to the doctor and walk away.

    1. Argh!*

      I worked with someone like this too. I considered him a friend but his medical delusions were annoying. I basically treated them the way I would treat talk about Area 51 or other unusual topics — uh huh… well okay…. and in other news today…

  46. Argh!*

    re: update

    I don’t see how it could be necessary to accommodate his health talk with coworkers. Sure, a reasonable accommodation But annoying coworkers isn’t reasonable, at least for the reason that allowing a worker to waste other people’s time isn’t reasonable. If he had depression or a gambling obsession, would the employer be obligated to allow the employee to talk about his crying jags or gambling losses ad nauseum? I would think a more reasonable accommodation would be allowing him to talk to his therapist on the phone occasionally from work in order to get back to work and be effective. ADA law isn’t excuse-making law. It’s supposed to help employers help employees do their jobs.

        1. LBK*

          Really unlikely that would rise to the legal bar for an undue hardship. You have to be able to show a financial impact to the business, and vague “lost productivity” isn’t going to cut it.

      2. Soon to be former fed*

        But creating an unproductive work environment might be.

        I don’t understand the minimization of of the impact of Ronald’s behavior on others. Another poster said it best, an office is not a psychiatric facility. To expect untrained workers to twist themselves around the disordered behavior of a coworker is not fair or reasonable.

  47. ..Kat..*

    Sadly, accommodating Ronald may drive away OP’s productive employees. Depending on how small the company is, this could put the company out of business.

  48. ZucchiniBikini*

    I haven’t read all the comments, so please forgive me if I am repeating anything. I’m Australian, and here, the Disability Discrimination Act would absolutely and explicitly cover discrimination on the basis of any diagnosed mental health issue, including any of the histrionic personality disorders (of which hypochondriasis is one) or health anxiety. Here, as in the US, however, accommodations do not have to be infinite. I have no idea what a court would find reasonable in this sort of case.

    In terms of my own experience, I have Generalised Anxiety Disorder (GAD) and this sometimes manifests as health anxiety, although not consistently. In my case, it is more a matter of assuming the most catastrophic possible health outcome from any existing health problem (eg I have a heart arrhythmia, which is real, diagnosed and monitored, but when my anxiety is spiking, I start thinking I am having / about to have an atrial fibrillation blood clot event and will shortly expire, which is a possible but not likely scenario).

    When I am having anxiety about my health, it is a burden that sits heavily on me all the time. I become extremely disinclined to talk about it – or anything else – to anyone, even my doctor (I have an avoidant form of health anxiety, which is different from reassurance-seeking forms). In such a state, even hearing anyone else talk about their own health problems is very uncomfortable for me, but I hope I mask this reasonably well. Working with a R0n would be actively painful for me and would send my anxiety off the charts.

    I am not suggesting that it would come down to “duelling accommodations at dawn”, but in a case like Ron’s, it does beg a question about how his condition may be detrimentally affecting others and how that can be reconciled. I don’t have any good answers and I am very sympathetic to how Ron must be feeling – is truly sucks. I guess I am just wondering at what point it’s reasonable to say, the needs of everyone else have to be weighed too. (And those needs can include not having their own anxieties and traumas triggered by compulsive behaviours by a coworker).

  49. Soon to be former fed*

    I couldn’t work with Ronald, it would drive me to distraction. I would be angry, especially not knowing anything about a diagnosed condition. Everybody has their issues. Its not my coworkers responsibility to carry mine.

  50. Soon to be former fed*

    Whenever these situations come up, it becomes apparent that the USA ADA is sorely misunderstood.

    I wonder if Ronald gets pregnancy symptoms or other female only issues too and yes I would be tempted to try him and see.

  51. Observer*

    OP, in thinking about this, I think you have to things to consider when dealing with Ronald. One is what is reasonable from a compassion standpoint, and the other is what is reasonable from the legal standpoint.

    In terms of compassion, making Ronald cut down the talk about un-diagnosed illnesses is reasonable, I think. Also, if he agrees to let people know that he has a serious mental health disorder which is the reason for his behavior. (I agree to avoid the term hypochondria as it’s so misunderstood.) This cuts down the exposure that people have to his very upsetting behavior. And if they understand that he’s ill rather than malicious it helps the part where people feel like their issues are being minimized. And it would make it much easier to tell people that they need to be professional around him.

    For the legal stuff – get yourself to a lawyer. Find out whether you are covered by the ADA, given your size, or any other state analogs, and if so is what you want to do legally acceptable. I’d be willing to bet that you would be on thin ice to disclose his issue without his permission.

    Lots of luck with this.

  52. nonegiven*

    You can’t tell people he has hypochondria without his permission.

    You need to offer accommodation, extra time off for doctor visits, FMLA, etc. Can you require him to stop saying he has “disease of the week” and if he has to say something he needs to limit it to “I have a medical condition.”

    Does he need a new therapist, is he showing any improvement, at all?

  53. Susan McIntyre*

    Hello,

    I was called a hypochondriac when I had this potentially fatal infection. It also happens to cause all the symptoms of mass “psychogenic” illness, Morgellon’s, and Gulf War Syndrome.

    I’d like to share information I learned during my workplace’s outbreak of an airborne infectious disease that can cause malignancies, precancerous conditions, rheumatological diseases, connective tissue diseases, heart disease, autoimmune symptoms, inflammation in any organ/tissue, “mimics” inflammatory bowel disease, causes seizures, migraines, mood swings, hallucinations, etc. and is often undiagnosed/misdiagnosed in immunocompetent people. 80-90+% of people in some areas have been infected, and it can lay dormant for up to 40 years in the lungs and/or adrenals.
     
    My coworkers and I, all immunocompetent, got Disseminated Histoplasmosis in Dallas-Fort Worth from roosting bats, the most numerous non-human mammal in the U.S., that shed the fungus in their feces. The doctors said we couldn’t possibly have it, since we all had intact immune systems. The doctors were wrong. Healthy people can get it, too, with widely varying symptoms. And we did not develop immunity over time, we’d get better and then progressively worse, relapsing periodically and concurrently every year.
     
    More than 100 outbreaks have occurred in the U.S. since 1938, and those are just the ones that were figured out, since people go to different doctors. One outbreak was over 100,000 victims in Indianapolis.

    It’s known to cause hematological malignancies, and some doctors claim their leukemia patients go into remission when given antifungal. My friend in another state who died from lupus lived across the street from a bat colony. An acquaintance with alopecia universalis and whose mother had degenerative brain disorder has bat houses on their property.

    There’s too much smoke for there not to be at least a little fire.

    Researchers claim the subacute type is more common than believed. It’s known to at least “mimic” autoimmune diseases and cancer and known to give false-positives in PET scans. But no one diagnosed with an autoimmune disease or cancer is screened for it. In fact, at least one NIH paper states explicitly that all patients diagnosed with sarcoidosis be tested for it, but most, if not all, are not. Other doctors are claiming sarcoidosis IS disseminated histoplasmosis.

    What if this infection, that made me and my coworkers so ill, isn’t rare in immunocompetent people? What if just the diagnosis is rare, since most doctors apparently ignore it? Especially since online documents erroneously state it’s not zoonotic.

    Older documents state people exposed to bats are known to get Disseminated histoplasmosis, but at some point this information appears to have been lost, for the most part. And now bat conservation groups encourage people to leave bats in place in public buildings and homes, since they claim they’re harmless and even beneficial. What a horrible mistake they’ve made.

    This pathogen parasitizes the reticuloendothelial system/invades macrophages, can infect and affect the lymphatic system and all tissues/organs, causes inflammation, granulomas, and idiopathic (unknown cause) diseases and conditions, including hematological malignancies, autoimmune symptoms, myelitis, myositis, vasculitis, panniculitis, dysplasia, hyperplasia, etc. It causes hypervascularization, calcifications, sclerosis, fibrosis, necrosis, eosinophilia, leukopenia, anemia, neutrophilia, pancytopenia, thrombocytopenia, hypoglycemia, cysts, abscesses, polyps, stenosis, perforations, GI problems, hepatitis, focal neurologic deficits, etc.

    Many diseases it might cause are comorbid with other diseases it might cause, for example depression/anxiety/MS linked to Crohn’s.

    The fungus is an Oxygenale and therefore consumes collagen. It’s known to cause connective tissue diseases (Myxomatous degeneration?), rheumatological conditions, seizures, and mental illness. Fungal hyphae carry an electrical charge and align under a current. It causes RNA/DNA damage. It’s known to cause delusions, wild mood swings (pseudobulbar affect?), and hallucinations. It’s most potent in female lactating bats, because the fungus likes sugar (lactose) and nitrogen (amino acids, protein, neurotransmitters?). What about female lactating humans…postpartum psychosis (and don’t some of these poor women also have trouble swallowing)? The bats give birth late spring/summer, and I noticed suicide rates spike in late spring/early summer. It’s known to cause retinal detachment, and retinal detachments are known to peak around June-July/in hot weather. A map of mental distress and some diseases appear to almost perfectly overlay a map of Histoplasmosis. Johns Hopkins linked autism to an immune response in the womb. Alzheimer’s was linked to hypoglycemia, which can be caused by chronic CNS histoplasmosis. The bats eat moths, which are attracted to blue and white city lights that simulate the moon the moths use to navigate. Bats feed up to 500 feet in the air and six miles away in any direction from their roost, but not when it’s raining or when the temperature is less than approximately 56° F. Although the fungus grows in bird feces, birds cannot carry the fungus like mammals can, because their body temperature is too high, killing the fungus.
     
    I believe the “side effects” of Haldol (leukopenia and MS symptoms) might not always be side effects but just more symptoms of Disseminated Histoplasmosis, since it causes leukopenia and MS symptoms. What about the unknown reason why beta receptor blockers cause tardive dyskinesia? The tinnitus, photophobia, psychosis “caused” by Cipro? Hypersexuality and leukemia “caused” by Abilify? Humira linked to lymphoma, leukemia and melanoma in children? Disseminated Histoplasmosis is known to cause enteropathy, so could some people thought to have nonsteroidal anti-inflammatory drug enteropathy have it and taking NSAIDs for the pain/inflammation it causes, and the NSAIDs aren’t the actual culprit?
     
    From my experience, I learned that NO doctor, at least in DFW, will suspect subacute and/or progressive disseminated histoplasmosis in immunocompetent people. Some doctors, at least the ones I went to, will actually REFUSE to test for it, even when told someone and their coworkers have all the symptoms and spend a lot of time in a building with bats in the ceiling. Victims will be accused of hypochondriasis. In fact, the first doctor to diagnose me was a pulmonologist, and the only reason he examined me was to try to prove that I didn’t have it, when I really did. No doctor I went to realized bats carry the fungus. And NO doctor I went to in DFW, even infectious disease “experts,” understand the DISSEMINATED form, just the pulmonary form, and the only test that will be done by many doctors before they diagnose people as NOT having it is an X-ray, even though at least 40-70% of victims will have NO sign of it on a lung X-ray. It OFTEN gives false-negatives in lab tests (some people are correctly diagnosed only during an autopsy after obtaining negative test results) and cultures may not show growth until after 12 weeks of incubation (but some labs report results after 2 weeks).
     
    One disease of unknown cause that could be caused by Disseminated Histoplasmosis: I suspect, based on my and my coworker’s symptoms (during our “rare” infectious disease outbreak) and my research, that interstitial cystitis and its comorbid conditions can be caused by disseminated histoplasmosis, which causes inflammation throughout the body, causes “autoimmune” symptoms, and is not as rare as believed. I read that “interstitial cystitis (IC) is a chronic inflammatory condition of the submucosal and muscular layers of the bladder, and the cause is currently unknown. Some people with IC have been diagnosed with other conditions such as irritable bowel syndrome (IBS), fibromyalgia, chronic fatigue syndrome, allergies, and Sjogren’s syndrome, which raises the possibility that interstitial cystitis may be caused by mechanisms that cause these other conditions. In addition, men with IC are frequently diagnosed as having chronic nonbacterial prostatitis, and there is an extensive overlap of symptoms and treatment between the two conditions, leading researchers to posit that the conditions may share the same etiology and pathology.” Sounds like Disseminated Histoplasmosis, doesn’t it?
     
    My coworkers and I were always most ill around April/May/June, presumably since the Mexican Free-tail bats gave birth in Texas during May, and fall/Thanksgiving to December, for some unknown reason (maybe migrating bats from the north?). We had GI problems, liver problems, weird rashes (erythema nodosum, erythema multiforme, erythema annulare, etc.), plantar fasciitis, etc., and I had swollen lymph nodes, hives, lesions, abdominal aura, and started getting migraines and plantar fasciitis in the building, and I haven’t had them since I left. It gave me temporary fecal incontinence, seizures, dark blood from my intestines, tinnitus, nystagmus, benign paroxysmal positional vertigo, what felt like burning skin, various aches and pains (some felt like pin pricks and pinches), tingling, tremors, “explosions” like fireworks in my head while sleeping, temporary blindness, and chronic spontaneous “orgasms”/convulsions. Suddenly I was allergic to pears (latex fruit allergy?). I had insomnia (presumably from the fungus acidifying the blood, releasing adrenaline) and parasomnias. I suddenly had symptoms of several inflammatory/autoimmune diseases, including Fibromyalgia, Sarcoidosis, ALS, MS, Sjogren’s syndrome, etc. that have disappeared since leaving the area and taking nothing but Itraconazole antifungal.
     
    No one, including doctors (we all went to different ones), could figure out what was wrong with us, and I was being killed by my doctor, who mistakenly refused to believe I had it and gave me progressively higher and higher doses of Prednisone (at least 2 years after I already had Disseminated Histoplasmosis) after a positive ANA titer, until I miraculously remembered that a visiting man once told my elementary school class that bats CARRY histoplasmosis….so much of it that they evolved to deal with the photophobia and tinnitus it causes by hunting at night by echolocation. There’s a lot more. I wrote a book about my experience with Disseminated Histoplasmosis called “Batsh#t Crazy,” because bats shed the fungus in their feces and it causes delusions and hallucinations, I suspect by the sclerotia it can form emitting hallucinogens (like psilocybin and dimethyltryptamine) along with inflammation in the CNS. (Schizophrenics have 2X of a chemical associated with yeast, part of the fungal life cycle.)
     
    Thank you for your time,
     
    Susan McIntyre

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