how to successfully manage mental illness at work

It’s the Thursday “ask the readers” question. A reader writes:

This past month, I’ve been experiencing a flare up of chronic mental illnesses (predominantly PTSD/associated anxiety and an eating disorder). I’ve been managing relatively well, all things considered, but it would really help to hear from folks who have successfully managed mental illness at work. What conversations did they have, what resources did they use, did they take time off, etc.?

I know certain thought processes have been helpful for me (thinking of this like any other chronic condition, reminding myself health comes first), and of course the usual resources are in play (shout out to my therapists), but what other options are out there? It’s tough to have to ask yourself: am I too sick to work? Perhaps this will make those of us experiencing these things feel less alone.

Readers with experience managing mental illness at work, please share your thoughts in the comments!

{ 288 comments… read them below }

  1. Deliliah*

    When I first started taking anti-depressants, I let my immediate manager know in case anything was off with me for a few weeks. It turns out that I didn’t have any bad side effects, but I felt better letting him know.

    1. MarMar*

      Related, work from home was really helpful when I was trying new medications and adjusting dosages. Side effects like poor sleep, feeling hot, running to the restroom, etc are much more tolerable at home. So I could start a medication Thursday evening, work from home Friday, and be 4 days in by the time I had to be in the office again.

    2. reject187*

      Same. I never took antidepressants, but I let my immediate boss know that I was struggling with depression, I was seeing a counselor, and if my work was slipping badly to let me know. He made a well-meaning but ignorant comment about whether I was getting enough exercise, then sent me across the street to buy myself a coffee with his money.

      If you have a good relationship with your boss, tell them. No nitty gritty details, but let them know. It’s good to have everyone on the same page before there’s a major breakdown.

        1. smh RN*

          Sometimes comments aren’t helpful though…and if you’ve heard them 100 times it feels ignorant. When I was trying to get my autoimmune arthritis diagnosed it caused foot problems…and by the time the 38th person (who all meant well) asked if I’d just considered buying a good pair of shoes I was ready to scream.

        2. Julia*

          Maybe. But don’t you think most people with depression – or any health issue, actually – have not heard “have you tried exercising?” a bazillion times already, and often from people who have zero medical knowledge at all?

    3. ArtsNerd*

      I’ve frequently had to let colleagues know I’m seeing some side effects from medication adjustments (my mood stabilizers make my migraines significantly worse and it’s quite the balancing act, among other health adventures). It’s irrelevant which medicine I’m adjusting.

      A few years ago, I took a week off following a hypomanic episode that freaked me out. The next week, I had a major asthma episode that required a breathing treatment in urgent care, and some more time off. I almost a month off in sick leave.

      On my return, I disclosed my depression to my boss, who had no idea and has been happy to ‘trial’ (now permanently implemented) a weekly work from home day to better help me stay on top of basic chores like laundry, and attend my therapist appointments without having to drive all over the city. I can also work from home if I’m having a bad day where staring at a computer is fine but getting dressed isn’t. I’m also terrible at showing up to the office on time, but I do get my work done, sometimes by staying late, sometimes just because I’m very good at my job. It’s been surprisingly fine. The time flexibility is pretty unique to this office, though, and one I’m very grateful for.

      The hypomania was a manifestation of my PTSD that flares up every year — now that I’ve finally figured out that’s what’s going on, I’ve set a recurring calendar reminder so I can stop being surprised by it and get extra support in place beforehand.

      1. BookishMiss*

        I also have annual PTSD flares, but mine usually present as a major depression spiral. Being able to kind of predict it and recognize when it’s starting have been hugely helpful, and I make sure to build in time for me every day. Often that me time is just going to bed early, or being away from people entirely, which helps me.

        My work… I’m a trainer,so the fact that my depression tends to make me snappy is Not Okay Professionally, so I’ve learned to really closely monitor my reactions and breathe before saying literally anything. My retail customer service face comes in very handy as well. I’m also somewhat open with my boss, in that she knows I have a chronic health condition that flares.

    4. Pandora*

      I took anti-depressants for anxiety when I started old job too. Besides taking the daily dose, I also installed Calm app and went to the toilet with headphones for 3-5 min mindfulness meditation when I get anxious or nervous. For me, getting out of the office for mindful meditation or walk work out well.

    5. sadbutnotbad*

      I did the same, and she was really instrumental in helping me realize that one of them did make me a little bit off.

    6. Sympathetic Sally*


      I started taking antidepressants and quickly realized I was not feeling great. I was very irritable, foggy, and felt super antisocial. My boss noted I seemed more withdrawn than usual and asked me if I was okay. I let her know I was on some new meds that were making me feel funny, and she was totally understanding. Fortunately after a week or two I adjusted to the meds and now I feel 100% better.

    7. Curmudgeon in California*

      While I’m no longer on anti-depressants (they sapped my creativity and problem solving ability), my workplace’s two day a week WFH policy has made a ton of difference in dealing with the open plan office stress.

      What’s really weird is I’ve gone to 100% WFH while the Covid-19 conflagration is going on, so one the one hand my job related stress has dropped like a rock, but my health anxiety for myself and my household (all over 50) has skyrocketed.

  2. Crivens!*

    My major thing is: mental health days are valid and necessary (at least for me). And you do not have to label them as such. That counts as a sick day for me.

    1. merp*

      Yes, absolutely this. It was a hard thing for me to realize, what with my brain being a jerk along the lines of “but I’m physically FINE, why can’t I get out of bed, I must be so lazy, etc, etc, etc” – but that was 100% just unhelpful, negative self-talk coming from a place of depression and anxiety and not remotely true. If you need a day, or several, then you need them, and that is what sick days are for.

      (Now, we just need to get to a place where workers, in the US at least, consistently have paid sick days to take…. but that’s another beast entirely.)

    2. BRR*

      I’ve found it help to not even use the term mental health day in my head because it made me feel bad for calling out. I’ve transitioned to just thinking of it as a sick day and the subcategory is mental health.

      1. Not a Blossom*

        Oooh, I like that a lot. I need to start doing that. I have trouble allowing myself even a sick day (I know, I know), so I’m really tough on myself about mental health days.

      2. Valprehension*

        Yup. “Not well enough to go to work” describes brain illnesses as well as rest-of-body illnesses.

      3. J*

        Absolutely; I personally dislike the term “mental health day” because unfortunately in our current society, mental health care is seen as less “valid” than physical health care. So if I called in and said I was taking a “mental health day”, I would fear that my condition would be seen as less valid than if I had the flu or something.

        So, to me they’re sick days. If I wake up and feel like I need a mental health day for whatever reason, I call in sick and that’s the end of it.

        1. Friendly Comp Manager*

          Plus mental health day can sometimes still be a pseudonym for playing hookie, which is terrible.

          1. Friendly Comp Manager*

            Clarification: the term being tied to skipping work, is terrible, instead of its real meaning, which is to support mental health.

            1. allathian*

              Unfortunately there are still many people who think of mental health days as playing hookie… That’s an attitude that really needs to change.

              1. London Calling*

                And my company is one of them. Despite the message fom HR and senior management about the importance of managing our MH, one of my colleagues with depression and anxiety has been berated – by HR – for taking too many days. Now, if that was me I’d be asking what it is about my department that stresses someone to the extent that they need MH days, but my managers are’t that big on self’awareness.

      4. Oh No She Di'int*

        In my office we actually don’t have “sick time” at all. Everything is just under the umbrella of “Health Time”, which can be used in any way you want for mental, physical, or any other sort of health related issue. And the exact purpose doesn’t have to be disclosed.

        Because it’s called “health time” it’s wide open for all sorts of things: mental health day, doctor’s appointment, eye exam, massage, running a 5K, attending a community health demo, even preparing for a court case related to a health issue.

      5. Librarian of SHIELD*

        I like this framing. It’s similar to how I’ve tried to frame it in my own mind.

        I’ve always felt like taking one sick day right at the beginning of a cold can help prevent it from getting so bad I’d need to take several days off. And I’ve seen exactly the same thing in terms of my mental health (PTSD that tends to present as anxiety). If I notice early enough that I’m starting to feel more than usual stress, I can take a day for self-care and get my feet back under me. But if I don’t notice early, or I notice but guilt myself out of taking the day I need, it gets a whole lot worse.

        Also, my brain is inside my body. My brain being under stress means I’m sick, just like my lungs being under stress means I’m sick. Either way, I need to take the time I need and do the things I need to do to get back to a healthy level.

    3. Murphy*

      Agreeing heavily with this! Mental health days are health days and no one needs to know why you’re sick.

    4. irene adler*

      Who says sick days should be limited to physically ill? That’s stupid.

      And, taking periodic mental health days are also a good preventative measure.

      1. Veronica Mars*

        +1 on taking them proactively.

        I was bullied in grade school, and once a month my dad would surprise me by coming to get me out of school at noon and we’d go to the movies. Or we’d go to breakfast and he’d take me in late.
        Pretty sure its one of the main things that allowed me to survive that crappy experience in one piece.

        1. The Rat-Catcher*

          I make sure my daughter takes quarterly mental health days. I get side eye from school personnel but she’s well within their attendance policy and I will die on this hill.

        2. Curmudgeon in California*

          You have a great dad. I wish I could have done that when I was dealing with school bullies.

      2. SarahTheEntwife*

        This ship has long since sailed, but I really wish we’d change “mental health days” to “recharge days” or something like that, since that seems to be what most people mean whey they say they’re taking a mental health day. I’ve taken sick days when my anxiety or depression is really bad, but then I’ve also taken days off when I’m just generally feeling rundown and grumpy and it might be brain-weasels or it might be hormones or I might be coming down with something?

        1. Kiwi with laser beams*

          That would be the perfect solution to something that’s been bugging me for a while. Yes, recharge days are good, but they’re not the same thing as the time off I needed to go to therapy and then deal with the mental exhaustion I experienced after sessions.

    5. Quill*

      My mom used to call them “Sick *muttering*of all this shit*muttering* days.”

      Strategically using them to, say, make sure the house is habitable so your routine is less messed up the rest of the week, or to make sure you don’t drive on a day you got less than two hours of sleep, is also so helpful when I can get my hands on them.

      1. Rocky J Squirrel*

        I had a coworker who would say “I’m having vision problems- I just can’t see myself coming into work today!”

      2. the final brain cell*

        This! The last time I called in sick just because I woke up and was Not Feeling It, I was able to spend the day grocery shopping and doing all the tidying I’d put off all weekend, and I felt SO much better and more able to face the rest of my week after getting that stuff done.

        1. MayLou*

          I have had to take this kind of day off in the past, with a side of fatigue-flare-up can’t-walk-straight. Now I have decided to use my annual leave strategically through the year, so I’m going to take one day per month. I’m fortunate to be in the UK where we’re legally mandated 5.2 weeks’ paid time off.

          1. Director of Alpaca Exams*

            I do this too. I get four weeks of leave annually and try to space it out (usually one week each in April, July, November, and December). It’s pretty essential to my continued functioning.

    6. Duck Duck Goose*

      Yep, there are some days that I absolutely, /absolutely/ cannot face work and I count that as a sick day. I still feel guilty texting my manager that I’m “not feeling well” and won’t be in, but as soon as I do the relief is palpable

      1. CollegeSupervisor*

        I had a similar feeling on Thursday… I was having a depressive episode and just could not handle going in to work. But I didn’t feel like I could just say that and not be judged. So I may have made my dad’s trip to the ER the night before sound more serious than it was because that at least would have been an understandable reason (by my coworkers anyway) for being mentally unstable (as I clearly was on the phone when I called in because of course we were forced to change our passwords that day and I was locked out of my email account at the time).

    7. JG*

      Another +1 on this from me. I have bipolar disorder and recently went through some medication adjustments. Being able to take a few days off as sick days was critical to get over the initial side effects of the medication and just “reset” my anxiety and get some perspective before going back to work. I’m not “out” at my current office but in the past I’ve let certain trusted people know, which has certainly helped.

    8. Muriel Heslop*

      YES! I was struggling with my eating disorder recovery in my 20s plus I was in a high-stress job. A coworker mentioned that she was taking a mental health day and I thought: WE CAN DO THAT?! It changed my life.
      Sometimes just knowing that I *can* take a mental health day frees up some space in my head.

      Otherwise, setting good boundaries with and at work (no, I can’t work Saturday) was critical. Outside of work, I made it a priority to eat healthy, sleep when I could (insomnia) and exercise. For a year, it meant a three mile walk at 5 :30 am, but I needed it to stay healthy.

      Good luck, OP! I’m sending you good vibes from afar!

    9. Veronica Mars*

      This. I used to feel a lot of guilt around them. But then I realized how much more productive and nice to be around I was when I took a day to just not-adult once in a while.

      One thing that was hard for me was finding the balance between taking the time I needed, and allowing myself to use it as an avoidance strategy. So I put a few rules in place:
      1) In general, I try to procrastinate days off. If I feel like I need a break, I make myself go *that day* but allow myself to take the next day if I still don’t feel up to it.
      2) I give myself goals for number of days a month. Right now I’m doing good, and the goal is 1/month, which is actually kind of freeing, because its more than I need so I just get to walk around feeling good that its there if I need it.

      As far as actually taking the time off, I have gotten better at avoiding details whenever I ask for time off. Its either “I’m not feeling well” or “I’m going to an appointment” so its not weird when I’m vague about ‘mental health days’. But at my last job, my migraines provided a really useful cover because they explain leaving midday and not having the sniffles or whatever upon return.

    10. KR*

      Yes this. I always thought of mental health days as something I should take vacation for because I’m technically able to work. But when I started seeing a therapist who was like, “Yes you definitely have a mental illness, you are way more anxious than the normal person and it interrupts your life.” I was able to give myself permission to use sick days as mental health days once in a while.

      1. Joielle*

        Same! I didn’t start seeing a therapist until I was having a particularly rough time with some big life changes, and it was unbelievably eye-opening when she was like “Uh…. ok, aside from the immediate issue, this is not a normal level of background anxiety, you have a mental illness, let’s get you some medication for your brain.” I always just figured everyone felt like that. But the difference was unbelievable when I started meds and regular talk therapy! And it did force me to take my mental health more seriously, including taking days off when I need to.

      2. Eh-nonny-mouse*

        Oh, I feel this! I’m in my 30s and have had treatments and medication for years now, but still have a lot of difficulty accepting that I have a “real” mental illness. Every time I start with a new treatment provider, we have a conversation where we have to address my guilt about going to treatment because I feel guilty about taking time away from someone with a “real” mental illness. I’m still semi-in-recovery from a major episode that interfered with my work to the point that my boss was unwilling to work with me (in fairness, she was fed up with a lot of things at that job, not JUST me, and preemptively got a new job in a different city about a month after I went on leave, but not before co-authoring a somewhat nasty performance review about my lack of abilities and what would be needed for me to come back to the role). I moved away from that city with the help of family, cause there was no real treatment available for me there anyway, and am now struggling to go back to work and figure out what I can do and if I can be okay with a “regular” full time job, or if I will have to work at something lower key to avoid similar episodes. Knowing that a lot of people take mental health days from work helps. I grew up in a home where you went to work unless you were truly incapacitated (i.e., cannot physically crawl out the door).

    11. AnotherLibrarian*

      Yes. If I can, I try very hard to schedule them ahead of time by making sure I’m not leaving anyone in a bind. I have a public facing job. What I do is not tell anyone I’m planning one, but quietly assess my calendar to find a time that works for me and plan for that day. I find knowing I can call in with minimum disruption reduces my stress about needing a day to manage my mental illness.

    12. Mental in HR*

      I get the comment on “mental health days” and agree we ALL need “read books and make cookies” kind of days … but being diagnosed with mental illness is not “oops, take a self care day!” it is more “literally cannot get out of bed, not even to eat, drink or use the restroom, don’t care about anything or anyone, and the heaviness in your heart feels unescapable.” If I could read a book or make cookies on these days … I would rejoice.

      This “self care” train right now is common misconception that really makes it more difficult for those truly suffering with these diseases.

      1. Special K*

        I think it depends on how your mental illness manifests. There are people for whom reading a book or making cookies are things possible on a day they take off for mental health.

        I have depression and it doesn’t manifest consistently. Sometimes I am completely incapable of brain heavy tasks but do have the ability to physically move. Those are the days I generally use to try to tidy the apartment or do SOMETHING that I can see a physical result of my existence with. It’s a coping mechanism for me.

        1. Quill*

          Cleaning something with a podcast on tends to work for me with a specific mood.

          Last time I had a spurt of seasonal mania I did the Marie Kondo method in my closet, reorganized my crafting drawer and cleaned out my documents dating back to high school, but I was too anxious to speak to people at work or socialize at all… or drive…

        2. SarahTheEntwife*

          Same here. My particular flavor of depression and anxiety tends to present mostly as apathy and tiredness (not can’t-get-out-of-bed, just…tired), along with a decreased ability to *tell* how low-functioning I actually am, so me in a bad depression funk looks superficially much like me on a normal day. But on the inside I’m just going through the motions on a sort of autopilot and should definitely not be allowed to do things like run budget reports or cook.

          To be fair, many people have worse depression than I do. But saying I can’t take a day off because I’m still capable of getting out of bed and am not actively suicidal feels like saying I can’t take a day off for a bad cold because other people have pneumonia.

      2. Quill*

        Well, some days it’s a “I can’t contemplate leaving the house” or a “I cannot face being ‘on’ for eight hours, but I could probably read a book for an hour, wander off to slap a roll of tollhouse in the oven, brush my teeth because I’ve forgotten if I already did that, eat cookies, start reading again” sort of mental health days. It’s gonna depend entirely on which symptoms have shown up.

      3. k*

        I don’t disagree with you, but I also don’t think this misconception is entirely a bad thing. It functions as disguise and cover; it means taking a “mental health day” is not synonymous with telling your boss that you are having a severe crisis that, in the worst-case scenario, can result in work-related consequences or retaliation (the ADA is not great or well-defined for this kind of thing)

        1. Djuna*

          Yep, I feel the same way. I’m bipolar and (touches wood) pretty stable but if my stress levels start hitting the red zone and my sleep suffers, I know I’m going to need to take a day (at least) to reset myself and head off a possible swing in my mood. I get mixed-states when I’m manic, so I’m doing everyone a favor by keeping hulk-me from making an appearance.

          Other people taking mental health days (even to bake cookies) normalizes it to the extent that it’s easy for me to just take that time now. I don’t even think about it, which is great for someone like me who tends to overthink stuff like that.

      4. Veronica Mars*

        Honestly, I think this kind of viewpoint where only certain people with a certain level of non-function-ability deserve mental health days is hugely harmful.

        Guilt over feeding into this misconception was a huge barrier to me taking the mental health days at first. Because, I could physically get out of bed, so I should be grateful, and go to work, right? Except, forcing myself to get up and go to work and constantly lecturing myself to be grateful was actively harming my mental health.

        You deserve to take a sick day when you physically cannot get out of bed. But also, you deserve to take a sick day when you can get out of bed, but only for book reading and cookie baking. My need for mental health days does not in any way diminish or undermine your need for mental health days.
        To put this a different way, say I have cancer radiation scheduled and you “only” have the flu. Both of us deserve to take a sick day. The bar for “sick day” is “not feeling well enough to be productive at work” not “the worst possible version of an affliction.”

        Sure, self care has been translated to mean only bubble baths and wine, and really its so much more than that, and its annoying. But honestly, if bubble baths help your depression or anxiety (at whatever severity that’s currently manifesting) then I support that.

        1. Extroverted Bean Counter*

          Personally, I also believe that even absent a mental illness/disorder diagnosis, everyone should have a vested interest in their own mental well-being. Avoiding burnout and recovering from stress is so important for people along the entire mental wellness spectrum.

          Planning to take a day off next week to attend a ball game and relax – that would be a good use of vacation time but I would consider a sort of “mental health day” rather than “vacation.” But having a bad week, whether it’s from work pressures or personal pressures, and waking up on Thursday thinking “I just want to… not…” to then take a sick day to relax – that in my opinion is a valid use of sick time, and also a type of “mental health day”.

          And certainly, having a bad depression day or noticing that you’ve been having increased anxiety attacks, though still “functioning”, are extremely good reasons to take a sick day.

          I know folk who need time off to manage mental illness (hi, I’m being treated for anxiety and know this well) sometimes feel affronted by the conflation of “I have a Real Mental Health Issue and spend my recovery days in bed/feeling poorly/not doing fun or relaxing things” with “I just need a break and a day to breathe and not think about work”, but I think that affront is misplaced.

        2. allathian*

          Thankfully things are changing at least here. Last year there was a really stressful period at work and I had to work very long days for months on end (think 12-hour days instead of 8). The project was poorly managed with last-minute priority changes coming in by email, so I couldn’t even close Outlook to avoid the distraction, as I usually do when I need to focus. I was honestly pretty close to burnout and when it was really bad I even burst into tears on the job once or twice, and got really short with my coworker who shares the same office (and the load, as he had to do most of the work I would have been doing if not for the big project as well as his usual work). Really unprofessional behavior, I’m just happy that my coworker was so understanding when it happened. I did apologize every time I snapped at him, but that of course doesn’t make it right. When the project was finally completed I had accrued enough comp time to take two weeks off just on that, as had my coworker, and my boss ended up outsourcing a lot of the work to cut our workload. Unfortunately there wasn’t enough money in our budget to hire a third coworker, even on a temporary basis.
          I’ve noticed that my stress tolerance still hasn’t recovered completely, so in future I’ll need to work harder at dealing with stress before it gets so bad.
          I did take advantage of our EAP-equivalent and got myself some much-needed therapy for stress management. It was literally an eye-opener when my therapist said that it’s OK to take time off work even when I’m not physically unwell and can enjoy exercising outdoors but don’t feel up to dealing with stress at work. I’m doing better with that but I don’t want to leave my coworker in the lurch, either.

      5. somethingchronic*

        Hey, could you not minimise other people’s experiences, please?

        Speaking as someone with bipolar 2, as well as assorted physical disabilities, it’s very important for me to keep myself balanced. It’s maintenance, and helps me avoid the debilitating highs and lows. It very much *is* ‘take a self-care day’ so I don’t end up in the place you describe, which I would call ‘acutely ill’.

    13. TardyTardis*

      I don’t how relevant this is, but I did tell my supervisor when I had to drop hormones (mammogram Looking Funny) and that I might have an adjustment period (like not having any sleep). Luckily enough, I went through it all right (evening primrose oil be my guide), but that wasn’t the way to bet.

  3. Jennifer*

    Everyone is different, but I can kind of feel a bad day coming and call in. I also pre-schedule mental health days throughout the year and try to take vacations when I can, even if I’m not traveling far away. For me, it’s more about taking care of myself outside of work so I can handle things at work, as opposed to asking for accommodation at work.

    1. Venus*

      A friend realized that their health problems were strongly linked to a specific time of year, so they made arrangements with their boss months ahead of time. At first they worked shorter weeks, but eventually they took leave for a couple weeks.

      1. Jennifer*

        That’s a great idea! It’s been raining here non-stop. I normally love the rain but I didn’t realize how much the lack of sun was affecting my mood. We haven’t had four consecutive days with no rain in months.

      2. Veronica Mars*

        One weird side benefit of being quarantined and WFH is that my home office is so much brighter and cozier than my gross work dungeon. It is helping SO MUCH with my seasonal depression and it just never would have occurred to me until now.
        It also has allowed me to take my lunch break to do a quick yoga session and eat a fresh healthy meal, maybe knock out an errand I was dreading. Which means that after work I feel much more “free” to relax.

        I’m thinking about negotiating some WFH day’s moving forward.

        1. Director of Alpaca Exams*

          The mental health benefits to my household of no one losing two hours a day to commuting are going to be immense. A colleague suggested using that time to take a walk before work-time and another one after, and I think that’s brilliant. More sun and fresh air for everyone!

        2. TardyTardis*

          Light bars and full spectrum bulbs may help. I had a friend who worked in a plant nursery who always faded badly in winter (I teased her that her chloroplasts were dying her) but when she went to a full spectrum bulb for her chair lamp, she had much better winters.

  4. Hawthorne*

    I actually told my boss I have PTSD and it becomes worse when men raise their voices, and that I was working on it. It never came to head as any sort of information that was useful to have, but it helped give me peace of mind.

    1. Jill of All Trades*

      I told my boss something similar – not PTSD but severe anxiety around sudden anger or frustration directed at me – and she basically just told me, “That’s how they are, just avoid them.”

      Good to know that other bosses might approach things differently.

  5. Lynn*

    I had episodic depression last year as a side effect to a new medication. I have a good relationship with my manager so I let her know that I was experiencing major and unexpected mood swings I struggled to control. She was super understanding (it helped that she had undergone something similar in the past) and helped connect me to resources at work I didn’t know about, and we worked out a system for me to notify her if I was suddenly experiencing symptoms and needed to go home.

    That was wonderful, but it really depends on your manager and your mental illness. This is something a primary mental health provider might be able to help brainstorm on.

    1. Desk-Nail-Clipperer*

      “it really depends on your manager and your mental illness.”

      So much this. My manager isn’t terrible, but she’s also not as supportive as she could be. I had some time off recently for major depression, and when I met with her to discuss my return to work I mentioned that being able to work from home – at least as a transitional phase until I felt well enough to return to the office full time. That was shot down immediately as she “doesn’t believe in remote working”. Despite the fact she does it fairly frequently.

      Anyway, to keep this positive, I think it’s important to advocate for what you want/need. The same way (for instance) a blind co-worker might need screen reading software to enable them to do their job, so can you ask for and advocate for the things that make you able to do your job. That could be flexibility in your hours, or being able to sequester yourself in an empty meeting room for a while, or whatever. I asked to be able to change my desktop background on my computer – by policy, we’re supposed to have a bland, corporate logo on the desktop but I asked to change mine to a sunset photograph of a local beauty spot. It’s a small pick-me-up whenever I WIN+D, but it really helps.

      1. Daydreaming Admin Assistant*

        Unrelated, but I didn’t know about the WIN+D hotkey until now — thanks!

  6. AGirlHasNoScreenName*

    Same boat, but different diagnoses. Honestly, I wish I had an answer that could apply to all situations. I’ve had jobs in the past where I had no issue telling my manager about my treatment-resistant major depression; jobs where I wouldn’t dare disclose and actively tried to hide it; and jobs where I knew I probably could disclose, and where flex time and PTO use was fairly lenient, but chose not to disclose my manager for whatever reason (this is where I am in my current job). So I guess the first step is figuring out your work environment and how illnesses in general are handled and go from there.

    But I’ll certainly be watching these comments with great interest for more actionable advice.

    1. AGirlHasNoScreenName*

      I feel I should also clarify my decisions to whether or not disclose aren’t based on shame, but on potential repercussions due to the widespread stigma against mental illness. Even if I knew for a fact my manager would be understanding, I just don’t want to risk her opinion of me and my abilities somehow changing, even if subconsciously.

      1. 404UsernameNotFound*

        This is super super important and my number one instincts. However, if you do feel comfortable disclosing, I’d do so early. I say that as someone who admittedly has fantastic management, but I’ll give you two opposing anecdotes. I have two main life-affecting mental disorders: ASD and CPTSD. I disclosed my ASD on my original application, and when I was hired, HR pulled me aside and asked if there were any accommodations they could make for me (funnily enough, there aren’t any so far). I never said anything about my CPTSD (barring a few offhand comments about the circumstances behind it to colleagues) until I’d already accidentally been put in a rotation that set me off. So, if and only if you feel comfortable disclosing, do so as soon as you know you can safely. Stay safe OP – mentally as well as physically :)

        1. Autistic AF*

          I disclosed early at a previous job and it was initially taken well, but things went downhill – this place was super inflexible on accommodations (headphones were summarily dismissed with no consideration of it being a legal requirement to assess), and as the resulting anxiety started to impact me I was even told that I wouldn’t be allowed to take sick leave for mental health problems. I realized that everyone I worked with had anxiety problems, and as someone who absorbs emotions I had to get out of there.

          I would prefer to be able to disclose, and have selectively in the much better job I have now – you don’t always know whether it’s safe until you’ve said something, though. Don’t go by corporate policies or public campaigns or having to take diversity training, but by how flexible they are: how do they handle sick time? Do they require everyone to participate in social activities? How do they handle suggestions to do things differently? How specific are they about the way things are done, and what are the reasons for such? That subconscious bias doesn’t exist in a vacuum.

  7. BRR*

    I’ve taken sick days as needed for mental illness flare up for the days where I just really don’t feel well enough to work. I think of it as the same thing as having a cold.

    I’ve found it helpful to have an outfit I can wear that’s comfier than my usual work clothes. I’m a cisman and usually do a button down and dress pants so having a sweater type top (that’s not as thick since my office is hot and I run hot) that is easier to throw in if I wake up and am having a day.

    1. Jadelyn*

      The clothes advice is really good – I don’t think of it consciously but now you mention it, I definitely have “mental health outfits” in a few different subcategories. There’s the “low-effort but I know I look pretty good”, the “this outfit reminds me of happy things [for whatever reason]”, and the “I need to feel like I look like I’m capable of straight-up murdering the next person who irritates me”. The ability to just grab and throw on something that suits my mood without having to plan or worry about things that go together or clash is really helpful for rough mornings.

      1. Curmudgeon in California*

        This. I’m enby, so dressing fem makes me super uncomfortable. My regular “work uniform” is a polo shirt and either jeans or cords. That said, I wear some purple when I’m feeling ok. I wear all purple when I want a mood boost. I wear nose to toes black when I’m really feeling grumpy, angry, stressed and/or unhappy and my mind wants to wallow in it for a while, ie “I need to feel like I look like I’m capable of straight-up murdering the next person who irritates me”. My wardrobe is mostly purple, because I usually go for the mood boost.

        1. Amethystmoon*

          There’s nothing wrong with purple. It’s also my favorite color, and I’m not going to wait until I’m an “old woman” to wear it, whatever that poem’s definition is.

      2. Julia*

        Yes! Putting on my favorite dress makes me feel better, it’s easy (no combination of top and bottom to think about) and I know I’ll at least look good. But then if I end up feeling worse during the day, I worry that it’ll be hard to take time off because “you looked okay!”…

    2. Sophie Hatter*

      I wear “cozy” work clothes when I’m not 100%, too! It’s a little thing to feel like I’m taking care of myself.

    3. Nea*

      Cis woman in a casual office. I have some black fleece drawstring pants with a straight leg – if you cover the top, nobody would know it was drawstring. Add on a fancy fair isle sweater, and I look really dressy while feeling like I’m wearing the most comfortable sweatsuit.

    4. Veronica Mars*

      This is great advice!

      Funny, I actually do the opposite sometimes too. I have a few special dresses that require 0 effort to throw on. I treat it as a kind of armor, like no one will notice my hair is in an unwashed bun and I have bags under my eyes and am not participating in small talk, because they’re too busy complimenting my outfit. Its become my go-to “Monday Armor” since I always sleep terribly Sunday night.

      1. sacados*

        I love that kind of thing so much. Dresses definitely suit well to that.
        I had a coworker compliment my outfit once, even asked if I was doing something special after work. And I’m standing there thinking– I’m wearing a loose, flowy tunic shirt; literally the STRETCHIEST pants I own; and a hat because I couldn’t be arsed to wash my hair. But …. thanks?

        1. Veronica Mars*

          Haha, exactly! I love it when coworkers are all “oh, do you have a presentation/date/event today?” best confidence boost ever when I’m feeling bad about myself. Meanwhile little did they know I rolled out of bed 10 minutes before I had to run out the door.

        2. SarahTheEntwife*

          Yes! I have several knit dresses that *look* really fancy and special, but structurally-speaking are basically especially well tailored nightgowns.

    5. Director of Alpaca Exams*

      Changing my wardrobe to only include clothes that don’t compress my body was absolutely life-changing for me. It’s harder in a masculine mode, but at the very least make sure you’re wearing the right size pants and not unnecessarily squeezing your waist. Being able to relax my abdomen turned out to significantly treat my anxiety.

    1. another CR*

      This is so excellent, thank you. I have a boss doing the same thing that happened to her. I am going through some tough times, and she is not making deadlines clear at ALL, despite me asking. It then looks like I am not accomplishing things and dropping the ball.

    2. lilaeden*

      Thank you! I thought of this immediately!

      This is a great place to start for how to get by and keep some amount of confidence/credibility intact even when things are ROUGH.

      For me, I AM a therapist, and I do struggle with my own mental health stuff, which is not to say it’s easier for me – if anything it’s a strange extra set of concerns. My genuine self-care and recovery are important always but it’s crucial for me to manage my stuff in a way that doesn’t cause people I am helping to worry for me SO I have an obligation to keep appearances up. This has helped me tons and also something I constantly give clients who are temporarily treading water.

  8. ThatGirl*

    Captain Awkward had a great post about this, link in reply. Some of her basic suggestions are to keep doing your routine as much as possible and try not to let hygiene or dress slide — the appearance of being put together can go a long way even if you don’t feel like you’re up to par.

      1. Tuckerman*

        Awesome article, thanks for sharing. I find so much advice on managing mental illness in the workplace is either too coddling or too stoic. This was a good, practical balance.

        1. ThatGirl*

          Captain Awkward is pretty awesome and great for practical life advice. She did a crossover with Alison a few weeks, month-ish ago?

    1. ThatGirl*

      I’m realizing now that her post is more about being depressed, and the LW’s question is more about anxiety and PTSD, but hopefully it’s still helpful.

      I agree with the other suggestions of taking a day off if you need it – that’s what sick time is for. And amp up your self-care. If you need to cut back on other things for a little while, no shame there.

      1. Quill*

        PTSD and anxiety can often drag in some depression along for the ride, so it should at least be mildly helpful if that comes up.

    2. RestroomTimeExtraordinaire*

      dress and hygiene 100% especially for those of use whose depression make it difficult to accomplish these daily routines… I call that faking it til I make it.

  9. Amber Rose*

    Anxiety/depression/BED sufferer here.

    When I need to, I take days off as if I caught a cold. But I don’t always take those days when my mental health is at it’s worst. Last week I took a day off when I was having a slightly better day, because the days prior had all been so awful that I’d got nothing done and if I wanted a hope in heck of keeping myself together, I needed time to do dishes, do laundry, and go out and get some groceries while I had the energy for it.

    At work, I make a lot of lists. Making the lists themselves is kind of a calming ritual, as is checking off items. I make the items as basic as possible. “Ask about Thing.” “File invoice.”

    I have no advice on the eating disorder front. I’m relatively newly dealing with it and quite frankly, every lunch meeting is a source of enormous stress and unhappiness for me. I’ll be checking in if anyone has any thoughts. Particularly since I have another one next week.

    I don’t really talk about this stuff at work. Sadly, this company is not really… mental health oriented. :/

    1. Dr. Cubicle Farm*

      Eating disorders at work (or anywhere) are tough! Food at work is extra-weird because everyone’s bringing their history with food and weird cultural baggage with them. I’m coming at this as someone with anxiety/depression/a decade of recovery from anorexia, and each person with an eating disorder is unique, but I really recommend working with a therapist to come up with strategies for dealing with food at work and people talking about food at work.

      For me, sometimes it’s bringing my own lunch because I know that choosing food in the moment when it’s a catered lunch will be too stressful, especially if people at work tend to moralize food choices and discuss them. I have to be really careful to make sure I pack a lunch that will feed me enough and not be restricting, but it removes one stressor at work that would make the day harder. (I also have good cover for this because I have some weird food allergies that can make catered lunches genuinely tricky, but I think that “Oh, I’m just trying to get in the habit of bringing my own lunch” can be fine cover any time.)

      I’ve also found it really helpful to have a work ally who can run food interference for me when I don’t have the energy to push back. This could be deputizing the person to shut down moralizing around food, food talk in general, or just being a dedicated subject-changer. With a decade of recovery under my belt, I often have the energy to do this myself, but I still have days/weeks when my brain isn’t cooperating and I need an ally.

      I hope other folks with experiences with eating disorders will add their thoughts because there’s woefully little out there about adults with eating disorders and eating disorders and workplaces. The cultural stigma and belief that only teenage girls get Eds really hurts us.

      1. Amber Rose*

        I bring my own lunch every day (or almost). The problem with BED is that if there’s food, my brain just goes FOOOOOODDD and then suddenly I’ve eaten my lunch, the lunch available to me, a couple servings of dessert, and the half a muffin my coworker didn’t want, and now I’m in all kinds of mental and physical anguish.

        Food talk I can shrug off. But being told to have some pizza, or having people bring me food, is an absolute disaster. I’m a lot better at saying no than I was. But god, some days it hits me at the same time as my depression and I spiral.

        1. Sarra*

          Mandatory working from home (I’m in Seattle – coronavirus!) has been a godsend for me and my food issues. there’s no candy bowl! there’s no group coffee runs! there’s no lunch meetings! There’s just what I have stocked in my house, none of which triggers my binge issues.

          1. Amber Rose*

            Husband just reported some of his coworkers are out with it and there’s a perverse part of my brain that’s hoping I might be able to spin it into a couple weeks working from home myself.

            Unfortunately, a lot of my job requires me to be at my desk.

            1. Sarra*

              Ugh, I’m sorry. The option of working from home is worth bringing up with your manager, especially if your husband will have to self-quarantine. Maybe your responsibilities can be distributed, and you could take on some different ones that could be done from home, or your desk phone could be forwarded to your cell, or something? (I don’t know what you do for work – I work in consulting and market research, so being 100% remote is totally possible for my office)

              Good luck. <3

        2. Curmudgeon in California*

          Oh, I feel you. I don’t have diagnosed BED, but I have a shitty relationship with food. Some days, literally.

          What helps me short circuit the desire to eat the leftover pizza, cookies or other snacky goodies is that I am allergic to soybean oil. My inner dialogue goes like “God that looks good. But I know they use cheap soy oil when they make it. The last I had one I nearly didn’t make it to the bathroom then spent an hour in there, and my butt ended up raw. Not worth it.” Yes, unless I know it was made with a safe oil, I now automatically assume it has soy oil in it, and that is starting to reliably send up a “nearly poisonous” reaction in my brain. It has helped me avoid the problem. YMMV, of course.

        3. ceiswyn*

          I’ve recently been diagnosed with BED, I’m in limbo because different clinics are arguing about which is the more appropriate one for my complex issues, and this is the major work thing I’m currently struggling with.

          I work at a place that has a box of fresh fruit constantly available. That all sounds good and healthy until you’re the one who’s just inhaled two pears and an apple and a couple of plums and is desperately trying to resist the bananas because THEY’RE RIGHT THERE.

          There is also free cake available every Wednesday. And people often bring in doughnuts or cookies Just Because. And what this means is that I spend all day with a portion of my brain entirely devoted to controlling the urge to binge – and at some point I run out of cope and start to go crazy. I’ve twice been unable to get to work on Thursday because Wednesday’s cake has started a binge that’s made me nauseated, run a high temperature overnight, and woken up with my bed soaked with sweat and feeling physically and mentally vile.

          I can’t tell my co-workers not to bring in food, that’s not fair. But I also can’t just ignore it, however much I wish I could :(

      2. Amethystmoon*

        I also bring in my own lunch due to having major issues with food. Also, while our cafeteria does have comfort food most of the time, I don’t feel like I’m allowed to eat most of it due to people being super judgey. But I’ve learned how to cook pretty well in the past few years.

    2. Sympathetic Sally*

      I just wanted to chime in as a fellow BED sufferer. I have been dealing with this for years and finally got into treatment this past fall. I see a team of healthcare professionals including a therapist, psychiatrist, nutritionist and internist. They have helped me immensely and I finally feel like maybe I can beat this (after 10+ years)!

      I resisted this for so long because I thought it would be too expensive, or that I would have to check into a facility. I had to do my research but found providers that are within my insurance network. My nutritionist is actually 100% covered which I couldn’t believe!

      I’m not sure if you are receiving any kind of treatment, but I just wanted to let you know about my experience in case it helps. You are not alone!

      1. Amber Rose*

        I wouldn’t even know where to start looking for treatment. It works differently here in Canada than in the US. I think I’d need a referral? I’m not sure. I do know that I have zero interest in talking to my GP about it.

        Being aware of what the problem is went 50% of the way to solving it tbh. I didn’t even know BED was a thing until about a year ago. When it comes to EDs you really don’t hear about much existing beyond bulimia/anorexia.

        1. Sarra*

          I know that a lot of people with BED go to Overeaters Anonymous. don’t know if that’s a thing in your area or not, or if you have strong opinions one way or another about 12-step programs, but it might be a place to start, and if it’s not for you, you may be able to get information from the facilitator / other participants about other resources available.

    3. pamela voorhees*

      Lists are immensely helpful because they lessen the guilt of calling out (“I have everything that needs to be done on a list on my desk”), or even stepping out if you need to manage a panic attack for a few hours. Personal notes added into the lists are also immensely helpful. Ex: “If presenting to Fergus, make sure to emphasize numbers. If presenting to Dahlia, be ready to answer questions about how it impacts her llama grooming (see page 3).” The small institutional knowledge builds a lot of goodwill when people are asked to cover, and can help you focus on what you need to do if you do end up taking on the whole list yourself.

  10. Not My Normal Account*

    Ugh, it’s me — anxiety is in a flare-up, exacerbated by work stress, and I’m already remote so covid is driving me mentally up a wall.

    Be kind to yourself, tell a few coworkers that you’re having some health issues, and be honest about how you’re feeling, even if you’re staying vague about the details, to coworkers. “It’s OK, I’m having a personal challenge that’s on my mind” is perfectly OK context.

  11. Horse Do-Overs*

    In my experience it really depends a lot on the manager. A less-than-great manager just calls for a different approach. I suffer from horrible PMDD if I’m not medicated, meaning I have bouts of debilitating depression as my hormones cycle around (the cycling is normal, of course, but my body’s reaction to it is extreme). Three managers ago, my manager was wonderful and I could be pretty honest with her about whether I was struggling that day or needed to leave or whatever. My next manager was a nice fellow but detached and clueless and I was not about to share such details with him, so I would just be “sick” if I needed to leave/take a day or “not feeling well” if I was visibly not-right while working. My current manager is sort of in between, but I lean more toward the “sick/not feeling well” with him.

  12. slayerofvampyres*

    Most jobs/bosses do not honor “mental health days”, and I worry about the trend of people being so vulnerable and honest with their bosses about this sort of thing. I also have PTSD, and if I need a day I call in sick, and I make sure I keep enough sick days in the bank to do this occasionally if needed. I don’t know all the rules/law about this, but I know at the very least it can be dicey for employers to question sick leave if employees are using it within the policy parameters, so you don’t owe them an explanation unless they have a policy requiring a doctor’s note or something like that. If I ever need extended time off, then I would do the FMLA thing and send the paperwork right to HR without giving my manager the details. Many people are understanding and knowledgeable about mental illness, but there’s still a ton of stigma and most people are expected to still “suck it up” and work like normal.

    1. Murphy*

      I’m really grateful my boss is so good about this, and I wish more were. She’s told us “I don’t need to know why you’re taking off. If you want to tell me, that’s fine, but you don’t need to give me any information.” So if we say we’re sick, we’re sick and it’s not questioned at all.

    2. Elly*

      I’ve actually done “intermittent FMLA” which means I take time off when I need it. I ran out of sick and vacation days, so this allowed me to take hours without pay (I’m salaried) and gave me peace of mind that I would be legally protected from losing my job due to my (mental) health status. This allowed me to come in late in the mornings (depression/anxiety flare ups usually happened in the morning for me). Or leave to go to psych/therapy appointments as needed. I had no idea you could use FMLA for mental health until I was all out of PTO and desperate enough to research my options.

      1. Jean*

        YES TO THIS! I’m surprised yours was the only comment I saw about FMLA. It does require some admin steps and documentation, but if you can meet the requirements and get it in place, it’s a godsend just for the peace of mind alone.

        Great strides have been made in awareness and acceptance of mental illness, but we still have a long way to go. Those of us who suffer need to take all the measures we can to make sure we’re protected in a still somewhat hostile environment.

      2. Funny In Other Ways*

        I second using FMLA if you are eligible for it. I have bipolar II, anxiety disorder, and ADHD. At my last job, I had a mentally abusive boss who constantly gaslighted me, lied to everyone about everything, and changed the rules on me when it suited him. There were days I’d have a panic attack while I was getting ready for work. Being able to use FMLA leave when I needed it helped me cope until I was able to find another job. Also, you can ask for accommodations, because mental disorders are covered under the ADA. (I’m assuming you are in the US)

      3. MissMeghan*

        I did a short term FMLA when I was really struggling with depression. I didn’t feel comfortable discussing my mental health with my higher up (he was very much an “old school” kind of guy who I felt would see this as me not being able to hang). Instead, I went to the doctor who recommended two weeks off for me, and I took that recommendation to HR. Our HR rep handled all the paperwork and all I had to say was that I’d be off for two weeks for a health issue. It was incredibly helpful for me, and my HR was supportive and fully understood why I needed the time off.

      4. Curmudgeon in California*

        I didn’t even know this was a thing… I thought it was all bulk, and only for major health issues.

        Thank you for telling me something I didn’t know.

    3. Name*

      I’ve taken a mental health day here an there at my current job, and I’ve couched it as “I’m under the weather today” or “not feeling well” for this reason.

    4. Lana Kane*

      Absolutely, it is worth going through the certification process to get FMLA. I counsel my employees to do this.

  13. IT But I Can't Fix Your Printer*

    It’s okay to take a sick day. It’s also okay to come to work but acknowledge that you won’t be at 100% – like if you had a bit of a cold and knew you would need to stop working often to make tea and blow your nose and that you should avoid anything very mentally complex. Some days I stay home because I Just Can’t, and other days I say Self, this is just going to be a quiet day where you catch up on easier stuff, hide in your cube and try to avoid coworkers, take breaks, and put that phone call off until tomorrow. No one is going to be 100% every day we go to the office and that’s fine!

    1. Amy Sly*

      Yeah, I try to keep one low priority and low mental energy project around, just so that if it’s a bad day, I can do something productive and within my mental means at work.

  14. BridgeNerdess*

    This is so hard, since every office reacts differently. I notified my manager when I started seeing a therapist regularly, but I didn’t specify. “I have an on-going medical issue, but it’s nothing to be concerned about. I just wanted to let you know I have reoccurring appointments coming up.” I tried to schedule them for least impact. If I needed medication, would have mentioned is, like one of the above commentators, but again without detail. “I’m starting a new medication that has some interesting potential side effects. If you notice something off about my behavior, please let me know so I can make sure it is addressed.”

    One thing I tell younger co-workers is you don’t need to justify sick time (in our office). “I have an appointment” is all people need to know. You don’t need to say dentist, eye doctor, specialist, etc. “I’m not feeling well” works for mental health days, food poisoning or diarrhea. You don’t need details to prove it, unless you’re using a lot of sick time.

    For mental health specific issues, make a list of your coping mechanisms you can use in the office. I had PTSD/anxiety and every day for a while and I would start with deep breathing exercises at my desk. Take a walk break if needed. Hide in a conference room. I wish I could say tell your manager and they will be supportive, but that’s not always the case. If you have someone at work you trust, start there. Hopefully your manager is supportive.

    It’s also more common than you think. I completely broke down in tears and found out my manager was supportive. But it got to “I need support because I can’t tolerate this any longer” level before I brought it up. You’re definitely not alone; that’s the mental health issues talking.

  15. barecca*

    If you have someone you trust, it can be useful to have one coworker who knows what you’re going through. They can be your confidante, and also a barometer for your work performance.

    1. Knotty Ferret*

      This is especially helpful if you don’t know if the general office culture or your boss are going to be understanding. Someone more familiar with the office, sympathetic, and with an outside perspective of your behavior can help you figure out if/when/how to discuss with your manager.

  16. I'm just here for the cats*

    It sounds like you have a therapist so that’s good but I would check to see if your work has an employee assistance program (eap). In fact that’s a good place to start for anyone who does not have a therapist. Often you can get a free or a number of free sessions.

    1. NeonFireworks*

      This. I had struggled with OCD for many, many years. About a decade ago I discovered that my workplace allowed for 12 sessions of cognitive behavioral therapy, which I cashed in one summer. Landed with an incredible CBT therapist and little by little went from ‘no days without symptoms’ to ‘okay 99% of the time’. I could still cry with relief.

  17. Rebecca*

    I have chronic depression and anxiety. I live and work in France, so the legal stuff is different – getting a week of paid medical leave was pretty easy, getting therapy will never be covered by my insurance. I work with children, so I have never disclosed to my employers that I have this. All I need is for one parent to start to question my ability, and … well, even if they could have no practical effect on me, that would make me feel worse and cause me to spiral, etc. And there is a good chance they could have practical effects and make my life harder, even if they are not legally allowed to fire me.

    I have found that if I sort of let it slip that I have a different kind of chronic illness that’s more socially acceptable – “I’m a little tired today because of that stomach thing that’s been bugging me” – I can cope a little better without needing to disclose. I also have the freedom to sometimes change my own schedule around. I can’t change when I have a class, but I can move the super energetic science experiment to Friday and give the kids a quiet writing work day today. If you have any kind of flexibility around how you can structure your days and your work, you might find it’s useful to figure out what you can mange on your ‘bad’ days so that you don’t have to always take time off. I also really learned how to look at my work and judge it in the long term – if I look at a single day, sometimes I will go home thinking I am terrible at my job, and then I spiral. Instead, I taught myself to look at my success in the long term – have I been effective over all? And that has really helped my peace of mind.

  18. Plant Lady*

    When I was diagnosed with anxiety I was in the middle of a pretty bad episode. My relationship with my superviser was good enough that I felt comfortable with letting him know my diagnosis and giving him just a general heads up that I may seem a little off for a bit. Whenever I’m having a flare I make sure to take time to walk outside at some point during the day and that helps immensely. Look at your employee handbook to see what kind of breaks are outlined by your employer. Most companies I’ve worked for have had 2 15 minute paid breaks (often called smoke breaks by colleagues) that do not include your lunch. I use these breaks to do a lap around the building, or a quick walk outside whenever I’m feeling anxious.

    1. Joielle*

      I was also in the middle of a bad episode when I was diagnosed with anxiety, and I didn’t say anything to anyone at work, but looking back, I probably should have at least done a general heads up. I was a disaster. I was basically never getting more than a couple hours of sleep so was useless at work, and was taking long (LONG) breaks to hide somewhere and hyperventilate and cry. Mercifully, it was a slow period at work, so my output of important stuff didn’t suffer that much and I thought I was pulling it off, but I’m sure people noticed. Woof.

  19. INTP99*

    This is interesting and timely – I have just started a new job at a large, well organized employer and contacted the Diversity and Wellness office. I came from being a grad student, where you go to the accoms office to put in notice when you have an episodic ongoing illness / disability. I want to do the same here. I am fine now, but it might flare up, however I was directed to the Accoms office / process. But I don’t need an accom now and mightn’t ever. I just want to cover my ass in case things get cray-cray (it is a mental illness). I am curious if the OP when through any kind of quasi-formalizing in the first place / considered it and if they opted not to then why not.

  20. CastIrony*

    Ugh, I’m sorry, OP.

    It took me lashing out and yelling at a cook dramatically to realize that I needed to start taking anti-depressants again after a summer of depression and burnout from working two jobs and having one day off every two weeks or so.
    The pills help me adjust, and everyone likes me again.

    So to succeed at working with mental illness, I just take one pill and deal with the fact that my outbursts will never let me get a full-time job at my company.

    And no, I don’t feel that I can tell Boss and Grandboss that I have mental issues.

  21. AVP*

    In the long-term, please consider if there’s a particular type of job or lifestyle that is better for your conditions and day-to-day experiences, even if it’s not the type of career you expected to have. You might be totally fine with your current set-up and that is great!

    For me, I have a mix of anxiety, depression and ADHD, and one of my big things is that I am just absolutely shit at mornings and generally managing a normal energy flow throughout the day and week. I switched to a fully remote job when I can sleep a little later and am not running to get into the shower and onto a train first thing in the day, and it’s worked wonders. It’s not that I don’t have the same “everything is doomed how can i possibly move right now” feelings a lot of the mornings, but I have way more time if I’m not commuting and no one notices if I am crap at 9am because they can’t see me. So, think about particular lifestyle triggers and figure out if there’s a work schedule/location/type of job that might be more accommodating to your needs and allow you to do your best.

    1. OP Here!*

      Hey, OP here, and that has been one of my major realizations. I think I need to consider professions that are more naturally introverted and analytical, because I’m currently on the extroverted/managing cross-functional teams end, and while it has its moments of glory, I think I am going to burn out.

  22. Sleepio*

    I battled PSTD/depression and anxiety related insomnia for 2 years hard. There were days I showed up to work without having really slept for 2 days or more. I told my managers that I occasionally have insomnia and I am working though it as much as possible. I kept the conversations with them upbeat and optismistic so they would feel like I am actively working through it and they could still count on me. When I have good days I try to work as best as possible so I have as much capital on my down days which I knew would come. What got me through it was buying a CBT-I app called Sleepio to work on my insomnia. That way I can work through my issues and still not miss much work due to not sleeping. It was the best solution for me as I could not see a therapist at the time but if I could that would have been my first choice. If you could use a remote tool such as a virtual therapist/doctor or app I would recommend it so you can save your sick time for when you really need it. I would encourage anyone to stay positive as you can. That way you keep your managers from worrying about you too much but know you are trying to be the best employee you can be.

  23. Quill*

    For impostor syndrome, I have accidentally stumbled on a good coping mechanism: replace negative thoughts about your qualifications / ability to cope / mental stability with bees.

    What I mean is not physical bees, (Obviously) but to find something you care about but that is obviously ludicrous in the context of work. Instead of “What will I do if people at work find out I have PTSD? Will that ruin my chances at getting a long term job?” its “What will I do if people at work discover I’m Secretly A Swarm Of Bees in a cardigan?” Because I am obviously, physically not a swarm of bees in a cardigan (emotionally may be a different story, depending on the level of buzzing feeling due to anxiety on any given day) it helps reduce some of the paranoia surrounding “will people treat me poorly if they discover any facet of my weird cocktail of neurodivergence and mental illness?”

    For best results, pick something that you’d also treat kindly / think is cute. It may take a bit of repetition (I got there by making a joke on a forum and five years later if I still mentioned being stressed about work with that commentariat I still get ‘can’t you just sting your work problems?’) but I did eventually retrain my brain to go with bees instead of paranoia.

    It also helps because I’m more likely to think someone who, for a personal work example, yells at a swarm of bees who’s never been trained to ship products internationally for not knowing the right customs code, is a complete duckwad, than I am to remember that I cannot be expected to magically intuit all solutions.

    1. AndersonDarling*

      This is a lovely suggestion. I’m personally thinking about Chicken Boo, “What if they find out I’m actually a giant chicken.”

      1. Ms. Green Jeans*

        I love this! My first thought was a giant, hairy llama, and it made me smile. It already works.

      2. Yarrow*

        If people can’t figure out that Chicken Boo is a huge nonverbal chicken, people probably won’t notice my neuro stuff. I love this.

        1. Quill*

          I’m slowly accumulating bee themed jewelry (and owl themed for other reasons) and I have discovered that there is an ocean of things that grown adults who aren’t constantly looking for any lack of conformity because they’d rather be doing their actual jobs just don’t notice.

    2. ToodleOodleWhordleOrdle*

      I have a similar thing that I shamelessly stole from a friend– referring to depressed/insecure thoughts as Brain Weasels. They may squiggle around saying mean things, but ultimately they’re a lot smaller than me, and kind of fuzzy. It definitely makes them less threatening.

      And on the manic side of things, since long before I heard about Brain Weasels, I’ve visualized those feelings of panic at not being Getting Things Done every single second as a hamster running on a hamster wheel. He started out as the Homework Hamster when I was a kid, then later became the more general Productivity Hamster. I remind myself that Productivity Hamster’s tiny hamster brain just can’t comprehend that I actually *shouldn’t* do the next thing until I hear back from other people etc., so if he wants to keep running on the wheel he can suit himself but I’m going to bed.

  24. beagle mama*

    I don’t know if it counts as successful, but in my experience I’ve let people know that I trust. Last week I knew I was entering into a deep depression (I’m bi-polar 2) and just couldn’t “people” but had to be in the office. I let a colleague know that I was struggling and they helped me cover. I’ve also found just getting up and getting away for a few minutes helps – even if it’s for a short walk to remove myself from a situation and reset. Finally, agree with the above comments that mental health days are essential and vital.

    1. Union rep*

      Agreed with the option of telling someone you trust.

      I am known as a union rep who wants to advocate for people with health issues, and I have had some people talk with me about their mental health problems that they wouldn’t want to share with management. I offer them resources, and if there is a conflict due to their health then I will offer to work with them and management. We have a good sick leave program, so people can take time off without worry. We aren’t a very strong unionized group, so I’m pretty sure that some employees get similar support from a friendly coworker and not specifically the union. And not all unions are helpful, so I’m not suggesting that this would work for everyone.

      Sadly, I have learned that stigma problems aren’t just related to mental health, as bad managers will be critical of all types of illnesses. It is worse with mental health, but definitely not exclusive. As a result, I tell my coworkers to avoid mentioning any details about their illness to managers, and to only say that they are too sick to work.

  25. LinesInTheSand*

    The one thing I generally need that my office really doesn’t provide at all is privacy. We don’t even have cubes, just open plan desks. So I’ve taken to throwing in some noise cancelling headphones and taking a walk. I don’t play music. I pretend I’m on a conference call. Then I can say whatever I need to to myself to get me back on track and no one blinks. The headphones dampen a lot of the ambient din (I work in a city) and give me a little mobile privacy booth.

    It’s not perfect, but it’s better than nothing.

  26. inoffensive nickname*

    Hi there…chiming in with Anxiety and Seasonal Depression! I explained to my boss that I have MH issues that are generally not bothersome, but I get seasonal depression pretty bad, so during those months (which pretty much turns out to be whenever I have to go home in the dark), I burn through quite a bit of my vacation time with a day here or there, or a long weekend away. I’ve found I cope a lot better with a few pre-emptive MH days, than with not having anything to look forward to. It’s nice to get out when there are no crowds, even if it’s to run errands, because everyone else is at work.

    Otherwise, if you have them, use your sick days if you’re having a MH down day or even if you feel triggered or are in a position where not being your best can be dangerous or cause you to make unwise choices or preventable mistakes. Sick leave is there for when you don’t feel well, and all of us with MH challenges realize that there can be physical symptoms, as well, so use it when you can. Unless your employer requires a doctor’s note, it’s perfectly ok to call and say you’re under the weather. I would say the one caveat to all of that is that you have to make sure you’re doing your best work when you are feeling well, because it gives you more leverage and credibility to take those occasional sick days.

  27. semi-anonforthisbulie*

    I am taking a mental health day right now, as a matter of fact. Except it turns out I’m working after all, at home, because the moment the stress of trying to decide what to do was gone, I no longer felt like hiding and now I am even kind of enjoying my work. (My boss doesn’t count sick days, or else I’d still be stressing out over whether to call it or not. Or I’d rush to produce some deliverable to prove that I really did end up working today.)

    I’m in the middle of a mixed hypomanic episode, which is the emotional equivalent of feeling ants walk all over my naked body. Being able to work in a relaxed way, at home, where I can use the TV and a rock tumbler to drown out the voices of 15 looping, overlapping earworms caused by lack of sleep because who needs sleep??? I do, desperately. Maybe tonight will be the night.

    I am fortunate to have a good boss. Actually, most bosses have been pretty cool about not wanting to know the details once I tell them what I’m dealing with. Other bosses can be real assholes. Those bosses are probably not going to change.

  28. Lexin*

    I have bipolar affective disorder and I’m very lucky that my employer has processes to deal with it, up to and including “Mental Health First Aiders”, who are colleagues trained to listen and accept.

    I have also told my boss that some days are hard for me, for no real reason that I’ve been able to work out. She’s been excellent.

    The other thing that I’ve done is that I’ve made use of the UK’s rules on being able to ask for flexible working, and work only four days a week. That extra day at home totally helps keep me on an even keel.

  29. A First Rated Mess*

    Not my usual name, because I’m only partially out at work.

    A few years ago, I was diagnosed with comorbid ADHD and Bipolar Disorder (NOS (Not Otherwise Specified)). I’m out about the ADHD, as it’s pretty common in my industry (tech). I’m not out with the bipolar, due to the general stigma about mental illness and misunderstandings about bipolar in particular.

    I have regular appointments for therapy. My therapist only offers appointments during normal business hours, so I do my best to minimize schedule disruptions and make up the time.

    I was vague when I told my manager about the appointments, and took advantage of the fact that my company is very reasonable about doctor’s appointments. My script was something like this: “Ever since I hurt my shoulder last fall, I’ve realized I need to be more proactive about my health. The upshot is that I’m going to have regular doctor’s appointments to monitor an ongoing condition. It’s nothing serious, but it is chronic.” My boss was fine with that level of detail.

    I’ve taken mental health days, but never identified them as such at work. I am fortunate in that I can get away with vague statements like “under the weather” when calling in.

    1. Sal*

      This is a great script for people who want to stay comparatively undercover. Thank you for sharing.

  30. Keyboard Cowboy*

    How are folks phrasing their mental sick days to their teams/bosses around the current illness scare? I mean, how do I say “No, I can’t work today, no, it’s not contagious, no, not like Bob who has a cough but says he’s pretty sure he’s not contagious” without saying “My ADHD is preventing me from seeing any topic through to completion including making a cup of coffee from start to finish”?

    1. Valentine Wiggin*

      That’s exactly how I phrase it. “I can’t come in, I started a new antidepressant and I need to get over the initial side effects at home.” “I’m having a flare up with my mental illness.” Blunt honesty has been my friend, but it doesn’t work for all cases.

      1. Keyboard Cowboy*

        Unfortunately, while I disclosed my newfound ADHD to my boss, I don’t quite feel comfortable discussing it with the whole team (and there’s a culture of letting everyone on the team know when you’ll be out). I like my team but I’m still somewhat new, and I’m the only female-presenting person for at least two managers up the chain :(

        1. Keyboard Cowboy*

          Er, what I mean by that was, “I’m a little afraid to show ‘weakness’ by disclosing a mental illness to my team.”

          1. Megabeth*

            *Nods* I understand what you mean by showing ‘weakness’, that is a thought I struggle with as well. Something that has helped in my case is trying to reframe how I think about mental illness: I just subtract the word ‘mental’. I have an illness – whether it is mental or physical is irrelevant. It helps me to think about that when I feel the urge to ‘justify’ a sick day when I’m physically ok.

        2. Valentine Wiggin*

          I totally understand that. It took me a lot of years in therapy to get to a point that I could be open. It’s just not for everyone. I hope you find a way that works for you. :)

    2. semi-anonforthisbulie*

      Believe it or not, I just tell my boss “I won’t be in today. Not feeling well.” I don’t have to say anything else. He’s made it clear he doesn’t want to know.

      I’d still tell him, if it were something he needed to know, like, “I licked all the doorknobs in the office last night but I just found out I have coronavirus!” but that doesn’t happen very often. I’d never tell him “I can’t hear anything over the sound of the Van Scoy the Diamond King radio jingle from my childhood that’s playing over and over and over in my head.” It’d sound like I was joking.

      I’ve worked for this guy for years and have earned his trust. I don’t know if he’s similarly easy on everyone else.

      1. MayLou*

        I’m pretty sure that if you tell your boss you licked all the doorknobs in the office, they are going to wonder whether you might be unwell…

    3. Arctic*

      I just say I’m unwell and won’t be in.

      When I get back and people ask how I’m feeling I say “better, thanks!”

    4. Count Boochie Flagrante*

      Sick day, not contagious. I usually cite insomnia — that’s my most common symptom that warrants calling out anyway, and I’ve found managers aren’t minded to argue when I say something like “I’m not fit to drive so I’m pretty sure I’m not fit to handle anyone’s money either.” Citing my ability to drive to work also tends, I think, to pull in the idea of safety issues as well as my ability to perform.

      1. Curmudgeon in California*

        I have both migraines and chronic insomnia. I will stay home if I don’t feel safe to drive, and either be sick (in bed, NOS), or WFH. Most of my mental health stuff is aggravated by the insomnia, so I just lump it under that. “Insomnia is playing up. I don’t feel safe to drive, and I need to try to sleep.”

    5. Teacher's wife*

      When I took a MH day last week, I phrased it that I’m feeling a little under the weather, and in light of the coronavirus and flu, I thought it was best to stay home and rest and let my body fight this without potentially sharing any germs with anyone. That worked with my boss – his response was that I was smart to not come in. I kinda knew it was going to happen, though, so I made sure when I left I didn’t leave any open projects hanging that would push on someone else’s deadlines.

    6. synecdoche*

      I really feel you on this because I also want to be clear I’m not contagious while also not telling the whole team what’s actually up—personally I’ve used “migraine” as an excuse a lot if I want to be specific. I do get migraines sometimes but typically people understand that they can make working impossible but they’re not contagious, people tend not to ask a ton of followup questions about migraines, and migraines can technically last a half day (if you only want to take a half day off) to days at a time.

      1. ToodleOodleWhordleOrdle*

        +1 to this. I’m usually a huge advocate of “I’m not feeling well and that’s all you need to know”, but in the current climate if you need to get more specific but don’t feel safe disclosing your mental illness, “migraine” and “ate something that disagreed with me” are both excellent non-threatening conversation stoppers.

        1. Curmudgeon in California*

          Plus, stress of various sorts is often a migraine trigger. I have taken a mental health day and literally ended up with a migraine in the middle of it.

      2. allathian*

        Or weeks. Although in that case they’re rarely incapacitating, at least not for all of that time. A very good friend I’ve known since middle school has migraines that can last up to three weeks. She can work through some of them, luckily.

  31. Cap*

    Oof. I disclosed my depression flare-up to my manager last week after things had been getting worse for a few months trying different treatment approaches, felt very raw afterwards and am still not sure if it was a good idea. He said many supportive things like “it’s courageous to ask for help” and then suggested a bunch of resources through our insurance provider, but the meeting also discussed a bunch of stuff like my readiness for a promotion and gender at our workplace and it all feels jumbled together .. also I can’t seem to figure out these resources and feel pretty wretched about it. Have a dr appt next week, hoping she can help advise, but how do you know who you trust/ what treatment approach to go with, especially from the bottom of a pit?

    1. GS*

      I’m having a struggle with figuring out my therapy coverage options in this new job too, and I’m nervous about asking anyone since I don’t know how folks regard mental health issues here. I feel ya.

    2. J.B.*

      I’m sorry. If you have a very close friend or family member, who will go to an appointment with you, that can sometimes be a help to remember the options and to give some accountability for treatment steps. Of course that person should not be one who pushes you towards a particular decision, but one who listens to you.

    3. Director of Alpaca Exams*

      It’s okay to ask your doctor—any kind of doctor as long as it’s someone you trust and have a good rapport with—to help you go through your options and make a plan. That’s not a waste of their time or yours.

  32. Valentine Wiggin*

    What has worked for me is just being very open about it. I talk about my mental health the way I talk about physical health. “Sorry I seem under the weather, I have a cold.” vs “Sorry I seem out of it, my doctor is adjusting my medication.” / “Don’t mind me, I’ll be taking an hour to close up my office because my OCD is flaring up.” I’m very matter-of-fact about it. I’ve found that while a handful of my colleagues have registered surprise the first time it’s brought up, they seem to take my cue and not really address it. I have an anxiety disorder and OCD. Flare ups are hard to deal with at work. But not feeling like I have to hide everything with my mental health has been a game changer for me. I recognize that this doesn’t / can’t work for everyone, just sharing my experience.

  33. Ms. Chanandalar Bong*

    So I suffer from anxiety and BED, which are relatively well managed with therapy and medication. But when I lost my grandfather, I spun out hard. I was having major panic attacks every day and I used to lay on my office floor and sob.

    Three things that helped:
    1. I shared a broad overview with my boss: as a chronic overachiever, I was seriously concerned about the quantity and quality of my work. I didn’t give a lot of detail, I just shared that I was struggling, and while I was getting additional support, I was worried about my work in the interim.
    2. Meditation. I’m fortunate enough to have an office, so I was able to comfortably use the Headspace app to do a guided exercise when I started feeling overwhelmed.
    3. I make notes of things that are going well (in this case, specifically at work). I just started doing this on the advice of my therapist – I save nice emails, I pull up my performance reviews or I make notes of something nice that someone says in conversation.

    I’m doing a lot better now, but it’s still an everyday process. Know that you’re not alone!

  34. Atgo*

    Not sure if you know that FMLA is available for mental health (if you’re in the US). Hopefully you have a good care provider that would do the paperwork for you if needed. I took leave last year for anxiety and depression that was correlated to burnout and it was very very helpful. You do have to have an MD, not a therapist, submit the paperwork for disability pay in my state, so if you think this is a route you may way to take you should be talking to your primary care or a psychiatrist now.

  35. Alton Brown's Evil Twin*

    Oh boy, this is tough.

    I’ve dealt with depression on and off, and work can help or hurt my condition, depending on what’s going on that day.

    If I have mostly repetitive things to do, or am under direct supervision by a boss or coworkers, then I can just zen out and go through the day. And that’s a good thing, because after my 8 hours I can look back and say “Yep, I got stuff done.”

    But if I’m working independently, or on things that require long-term , then it’s far too easily to spiral into procrastination and time-wasting.

    So the only technique I have when I’m in the throes of depression is to find (or ask for) situation #1.

    1. SarahTheEntwife*

      I’m the same way! I moved from circulation to cataloging last summer and now there is no end to the weird metadata errors I can fix when I need something repetitive.

  36. Geneva*

    I’m right there with you. I’ve dealt with anxiety/depression/PTSD for my entire professional career. Here are my tips: 1. As tempting as it is, don’t eat a bunch of crap. It messes with your blood sugar levels, which will make your physical mental health symptoms worse. 2. Sleep! I know it can be hard, but even if you just lay in a dark room while listening to music, it’ll help your body recharge. 3. Make a to-do list and keep it short. Think about what you have to accomplish each day and just focus on getting that done. 4. Stop and take a few deep breaths between each task you complete. 5. Accept your feelings and FEEL them. At work this looks like, acknowledging to yourself that you feel [blank], you’re allowed to feel [blank], you’re not weak/lazy/terrible/wrong/etc. for feeling [blank] and it will pass. 6. Take time off. If you know ahead of time that a certain week will be demanding, plan to take a day off the next week, or leave early on Friday, if possible. Or if you’re having a really bad day, go home sick. Sick is sick and you don’t have to explain exactly how you’re sick to anyone.

  37. prismo*

    I’m sorry you’re dealing with this, OP! I (unfortunately) have a lot of experience managing mental illness in an office. An important thing for me is identifying a spot where I can work privately when needed. Sometimes when my anxiety is acting up, I have symptoms like crying, getting flushed, etc., that don’t actually prevent me from working but are for obvious reasons embarrassing and distracting to have visible to others. So being able to hide somewhere and cry while I work is really useful and helps in not throwing off my entire day. (Thankfully that happens much less frequently now!)

    I also find it really useful to generally be more open at least with select people about my anxiety/depression. That way, when it’s flaring up, I have people to talk to, and it also doesn’t feel like a big deal in the moment. (Kind of like how people are advised to talk about safe sex in a neutral moment, not right before you’re about to have sex.) Once my colleagues were used to hearing me talk about anxiety, it didn’t feel like a big deal to say, “Sorry I’m acting off today, my anxiety is giving me a hard time.” Plus, it helped me identify other people who were going through the same or similar issues!

    I still haven’t been able to convince myself that it’s okay for me to take a day off for mental health, but I’m working on it. (To be clear, I think it’s great for other people, but I still have a hard time believing it’s okay for ME, which is part of the anxiety.)

  38. Detective Amy Santiago*

    I have a panic disorder/generalized anxiety/depression.

    When my panic disorder was at its worst, I was very open and honest about it with my colleagues. For me, it was helpful to identify one or two people in particular that I knew I was comfortable with and could let know when I was having a panic attack. Those folks knew how to talk me down. I was very lucky that I had colleagues who understood and were willing to provide that support.

  39. Quickbeam*

    I have an anxiety disorder from being sexually assaulted when I was in college. I am very sensitive to people coming up behind me; I react badly, shake, yell out. Of course my office has an in facing seating plan for cubes that cannot be altered.

    –I got a deer hunting mirror for my cube which is like a car rear view mirror on a pole.
    –I told my manager I need this to not get startled.
    –When people accidentally startle me, I explain the need to say my name first.
    –When someone questioned my need for the mirror, I had my therapist write a reasonable accommodation letter.

    I still think making people sit face in is just stupid. But I did what I needed to do in order to be productive.

    1. Ariana Grande's Ponytail*

      I am also a survivor, I hope you are doing okay. I really identify with this and want to share that I originally had a desk that faced away from the door of my shared office, right in front of the entry. One day about a month or two after I started my job, I decided that there was no reason for me to be startled day in and day out, and I just moved the desk around (a 90-degree turn) myself. It took a big chunk of an afternoon, but now being able to see the entry and into the hallway has significantly improved my quality of life. For anyone that can shift their desk, I strongly encourage and empower you to advocate for yourself and do it!

    2. Alli525*

      I don’t mean to question you on this, but wouldn’t your workplace have a duty to make accommodations for your work space because of your disability (aka your diagnosed anxiety disorder)? I love that you used a deer-hunting mirror, though – I’ve never even heard of such an item and usually just tape a purse-size mirror (the mirror part of a compact, not a mirror the size of my purse!) to a section of my cube.

      I don’t have any specific trauma or a reaction quite as strong as yours, but I also despise being “snuck up on” and have been known to startle rather violently (pens flying in the air, etc.) in such circumstances, so now I try to position my computer so I at least can see people walking by in my periphery. My current cubicle has me facing parallel to the main office hallway, and that works really well unless I have headphones in and am concentrating hard on something.

      1. Autistic AF*

        Having a duty to accommodate and actually doing so are different things. Ambient noise, especially other people talking, can really distract me, and wearing lightweight (i.e. not noise-cancelling) headphones is usually enough. I interviewed for a job and said as much, everything went well and I got an offer… I asked if I could wear headphones my first day and was immediately told “no, we collaborate and talk to each other.” I was fine with talking when I needed to be part of the conversation, I just wanted to be able to focus on my work otherwise.

        They absolutely had a duty to accommodate me, especially since my solution was free, but I don’t think they even considered it as an accommodation… which further burdens me to put up with anxiety-inducing noise all day, every day, and to use limited sick time seeing a doctor needlessly.

  40. DepressoEspresso*

    Hi! Someone with severe depression, panic disorder, and CPTSD. I think the hardest part about mood disorders/mental illness in the workplace is executive functioning. Like, literally your memory, your ability to concentrate, to synthesize information, even auditory processing (“I know that was English, but I didn’t understand it…) is impacted. Obviously, you do what you can to manage it as far as medication, therapy, exercise, mindfulness, etc. Sometimes, it’s not enough.

    For me, I think disclosing is really important. I would disclose to HR. You don’t want to get to a point where you are behind on work, or on a PIP, to let your employer know that you technically have a disability under ADA. It will not protect you then.

    If you disclose now, should you have these problems, you will be protected. And, people don’t realize that there are some pretty easy accommodations that can help tons. is a great resource to both direct your employer to and to get ideas about what could be done to help you and your specific problems.

    It’s super scary to disclose. What I’ve found is people follow your lead, for the most part, when responding to your disclosure. If you present it like a matter-of-fact chronic condition, which you smartly manage and understand, then people often respond well. When I have disclosed, I also help my employer out by not just naming my conditions, but by saying something along the lines of : “I have diagnoses x, y, and z. I manage it in the following ways [insert here]. However, sometimes, it can effect my work [in the following ways]. I would like to request [accommodation] that would really help me.” Point them to, and be prepared to have someone on your mental health team answer yout employer’s questions, as they are allowed to ask for (some) medical proof when the disability is not visible.

    Good luck!

  41. Not So Super-visor*

    I would love some tips as a manager on how to help/support an employee struggling with mental health. I currently have one who has been open about it, but to be honest, I struggle with managing him. I encouraged him to take FMLA for bad mental health days, but it seems like any time that I have to give him feedback that is less than positive, he calls in the next day. To be honest, I’ve at times had to hold back feedback on his work because I know that the next day that we’ll already be hard-up on staffing, and I can’t afford for him to be out. I can’t “compliment sandwich” feedback either because then he only hears the positive and doesn’t improve the actual problem with his work. He’s not meeting minimum requirements for his work because he says that he’s struggling mentally, so I lowered his goals, but now he’s not even hitting the reduced goals.
    Thoughts from someone who is going through it?

    1. INTP99*

      How bad is his work? Is there need for a PIP? Even if he has a mental illness, there’s room for a more formalized response on the nature of his work. Ie. I had a job where my mental illness was all kinds of all over the place. It was a contract and by the end of it both the employer and I were thinking, “Let it just be over.” But I really, really could have used a more formal intervention – I did terribly “meh” work there, which led to me not using it as a reference, which was not great in my job search following. If they’d formalized that “meh” wasn’t good enough, I’d have had a chance to (and awareness even of the need to) turn it around.

      1. Pommette!*

        I have had situations like that before. With worry and shame taking up most of my time while employed, then a non-renewal, and valuable experience left of my CV because there is no way that I would ask that person for a reference. Even when the news is hard to deal with, knowing is better than wondering!

    2. Pommette!*

      I’ve found it helpful when supervisors set clear, well-defined expectations and provide clear information about what accommodations are available, and what the terms are for availing myself of them.

      Working in a situation where I have the opportunity to “slip” (e.g. to not meet any of my work goals, to avoid awkward situations) makes it harder for me to maintain healthy behaviours, and tends to prolong the worst part of my illness. I find it helpful to have well-defined hard minimums that I must meet at work. (At least in theory; in practice, it’s complicated, because not meeting those could mean – has meant – unemployment. Things may be better for your employee if FMLA is an option).

      In any case, being clear about expectations means that whatever happens, you can keep performance discussions about performance. It’s not about what you think of him as a human being, about blame, shame, praise, or hope. It’s just about simple goals being met or not, and about what the next steps are in either case.

      (Others’ experience may differ!!!!)

    3. Autistic AF*

      The website Job Accommodation Network is a great resource, even if you’re not US-based like it is. This isn’t intended as armchair diagnosis, but if there’s a neurodiverse condition such as ASD or ADHD underlying these issues, dealing with them becomes much more complex and medical supports – including a diagnosis in itself – are often non-existent.

    4. Director of Alpaca Exams*

      Your employee needs you to provide clarity, consistency, and structure.

      Don’t think in terms of lowering goals, but instead of lifting him up toward them. Ask what support he needs in order to do what he needs to do. He does have to do his job! That’s a really important part of having a job. And showing that you trust him to do his job and want to work with him to empower him can be very supportive and encouraging.

      Make sure his workspace is conducive to working the way that’s best for him. Does he need a keyboard that clicks, or that doesn’t? Does he need to be assigned to a less customer-facing role?

      Which parts of his work are most enjoyable or satisfying for him? Can he do more of those? Enjoyment can be extremely motivating when one is feeling anxious or depressed.

      People with mental health challenges vary widely, but almost all of us do better with some degree of set routines, even if improvisation is needed within that routine. Work with him to develop a day-to-day or week-to-week schedule with clear tasks and objectives. Also, be consistent in your interactions with him. Keep your commitments around things like 1-on-1 meetings. Don’t change goals or plans, even to make them easier, unless they’re really untenable.

      Be clear and informative in your communications, and take a moment to think about how an anxious or depressed person might see them. The most stressful boss I ever had would send me emails that just said “Come see me” and I would panic every time, even though it was usually that she wanted to go over the latest llama grooming numbers or chat with me about a proposed change to TPS report formatting. Be clear and unambiguous with your feedback, too.

      And if nothing works and nothing helps, it’s okay to tell this employee that he needs to be doing his job, and if he can’t, you can’t keep him on. Mental illness isn’t a get-out-of-being-fired-free card.

  42. NothingToBeAshamedOf*

    I have become quite outspoken at work about my depression and anxiety. When I first mention it, I always get the “Oh, you don’t seem like someone who’s depressed” bit. I generally come across as a happy, positive, humorous, and optimistic person. But depression can really take the wind out of my sails on days when it’s bad, and thankfully I’ve been able to regulate it with medication and therapy so my “bad times” are much more infrequent than a decade ago. I take mental health days when I need to, and call them such. Also, I’ve just started managing, and I want my direct reports to know that it’s OK to need time away from work even when it’s not a physical illness.

    That being said, not everyone feels comfortable being outspoken about their mental health. It’s perfectly legitimate to take a sick or personal day, and to just call it that. But the point remains – you need to take care of you.

  43. sunshinesounds*

    I serve in a church in a lay position so my experiences could possibly be different (my denomination is very aware of burnout and tries to provide as much support as possible).

    I started the position with bipolar II disorder-but had been symptom free for many years. During the nearly 5 years I have been here, I have begun transitioning from my long term medication to a similar medication, and received a PTSD diagnosis.

    I am very close with my coworkers and have notified them regarding both (especially as they ultimately spend more time with me than most people and would be able to tell me if something really seemed off!); I also gave a heads up to our church version of HR that I live with these conditions and they have been very supportive.

    I am very fortunate in that I have a very supportive workplace, my own office, and flexible hours if needed. We also have a number of retired nurses in our congregation. I have been encouraged to take lieu time/sick days when needed but so far that has not been an issue (I actually do better with a ongoing schedule so try to keep with that as much as possible).

    I don’t typically talk about my diagnosis publicly to congregants, etc because I want to focus more on supporting them (rather than focusing on my story), but have been more open in recent years and I believe it has helped some folks feel more comfortable accessing assistance. I have also brought in workshops to our community specifically to discuss mental health and those have been quite well received by our community.

    Relating to what was mentioned earlier-I was *very* intentional in the type of career I went into because I wanted to best accommodate my health (no overnight shifts or loud noises, for example). I know this is not always an economically viable option but if it is I can’t say enough about this strategy.

    Best wishes to you, OP!

  44. Alex*

    I deal with all of the above as well! It helps that I have great benefits and PTO, and my supervisor is really great. I do what I can, which sometimes means trying to shrug it off when there is an office-wide invitation to a Weight Watchers seminar or fitness boot camp. Other days I just tell my supervisor I’m not quite at my best but will do what I can, maybe just a bit more slowly. It gets hard sometimes, but I’m getting more comfortable being open with my supervisor to an extent about what is stressing me out. We do weekly check-ins company-wide, and I am honest there about my stress since I’m not always comfortable saying it out loud.

  45. Grbtw*

    So, I have diagnosed PTSD with anxiety and depression, therapy gave me the tools to manage.

    I’m a little different in how I approach work, this advice might sound judgmental, but this is not how I feel most people should manage, it helps me tremendously. I hope I’m being clear, this is not how I think most people should approach it, and nobody should try unless their therapist agrees.

    I come from a bootstraps mentality, I do this because it helps me to keep boundaries on myself, I’ve also worked mostly at workplaces where mental health issues are treated with scorn. I do not share my mental issues with anyone but my work friends who have been in those shoes. I always shower and do my hair and wear clean clothes as a routine I never let slip, if I do nothing else all week, its laundry, daily showers, and hair. When I’m having a mental health day, I focus hard-core on my work tasks, and meditate at lunch in my car. I have a few breathing techniques I use on the fly, and every management tool I’ve learned in therapy. I actively forgive myself when I start feeling guilty and have noticed when I push through and continue working, my symptoms lessen because I’m not focused on them. I don’t take mental days at all, I work through them and enjoy my vacations.

    This works for me because I find it too easy to fall into self-pity, which always makes things worse for me. My therapist was a bit old school, but always encouraged me to face challenges, because they will always come back. I find our society sometimes goes too far in allowing unhealthy behavior, like cutting out loved ones because they’re toxic. Your mom may be difficult, but once you cut her out, another difficult person shows up and you can’t keep cutting people out, they keep showing up again, sometimes they’re your boss, or your next door neighbor. Face it, unless of course, they are violent, get away from them. But don’t avoid things, get a therapist to help you navigate, it’s worth it.

    1. 'Tis Me*

      I would say there is a massive difference between a difficult parent and a toxic one.

      My mum’s difficult – I know she loves me and wants what’s best for me, but she doesn’t have a mental filter, jumps to conclusions, can be really cutting without realising it, etc. It means that I revert to teenager more than I would like and end up snapping/yelling at her because she unintentionally presses my buttons. But I’m also happy for my parents to have my young children for overnight stays without me etc, talk to her on the phone regularly, love her and generally have a reasonable relationship with her.

      I have a friend whose biological parents were unfit to care for her and whose adoptive parents were emotionally, verbally, physically and sexually abusive. She has no contact with either set. As an example of emotional/verbal abuse – as a young girl she was taken to visit her adoptive grandmother, who made a fuss of her, telling her she’s loved, special etc. When her “mother” got her home again, the vile creature told her that this was all untrue – that she’s worthless, unlovable etc. She was the family scapegoat. They would assume if something went wrong (from something breaking to the washing machine putting knicks in clothing) that she had done it. If she tried to protest her innocence, her room and things would get smashed up until she “admitted” to whatever it was. Then she’d get beaten twice as hard for lying. And I’m not talking being spanked once – I mean being beaten, including being belted. She came to school more than once with a split lip courtesy of the pathetic excuse for a person who was on paper her father. Her “mother” also pushed her down the stairs more than once as “punishment” …

      Becoming legally estranged from them at 15 was an act of self-preservation. These are not people she would feel safe having in her life in any way, shape or form. They’re toxic, damaging, awful people and she still has the scars, physical and mental, even though she hasn’t seen or spoken to them for well over half her lifetime.

      I know other people who have needed to go non-contact with their parents, or change their expectations from “unconditional love on both sides” to “civil at family gatherings” because constant rejection and insults/put-downs become too much at some point.

      1. Grbtw*

        Going no-contact is something that needs to be approached with a trained professional. There are instances where it must be done, and I stated that in my original post. But it’s not something people should ever recommend over the internet, I wasn’t very clear on that, sorry, not enough coffee early in the morning. I can tell you that my PTSD is directly related to my upbringing, things were very bad, and my sibling is in bad shape too. I approached my therapist about going no-contact, but as an adult I was no longer in physical danger, so he strongly recommended against it. I thank God every day I listened. My family has made a giant effort to respect my boundaries(relative to my family), something I never thought I’d see in my life. Keep in mind, this took place over 15 years.

        I think I have an especially difficult time with how quick I see people recommend no-contact online, that’s what cults do to separate people, and the ADA would legit take people’s licenses over it, not sure if that’s still happening.

        1. 'Tis Me*

          Aah, sorry, I misunderstood and thought you were dismissing how damaging non-violent abusive families can be!

          I’m glad your therapist is a good one and your family has actually changed.

          And yeah, going non-contact is a big deal and shouldn’t be undertaken or recommended/suggested lightly. But at the same time if an adult mentions they’ve made that decision and it’s the right thing for them and their offspring, I’m going to assume that they were in a situation that warranted it.

          (The site is telling me this has posted but won’t show me the response so not sure if it has or not…)

  46. DecorativeCacti*

    If you are in the US and eligible, FMLA is going to be your friend. I told a past boss that I was struggling with depression because my work was sliding and she was trying to address that. I regretted that and will never disclose at work again because she continually held it over my head for years. If I ever did something that wasn’t to her standards (not even making a mistake, but something like using the “wrong” font) she would spit, “Is this because you’re depressed?” at me.

    I now have intermittent FMLA and use it for those days that I just can’t leave the house. If I’m trying to figure out if it’s a standard I-don’t-want-to-get-up day versus a I-really-can’t-do-this day, I make myself at least get out of bed and go through the motions of getting ready. Sometimes I find that just starting is the hardest and I’m fine once I’m out of bed. Sometimes I end up crying in the shower and crawling back into bed (and emailing my boss “I’m taking an FMLA day. See you tomorrow”).

  47. Charmander*

    I have BPD, which is mostly under control nowadays. During the trial period of my current job, I choose to alert my team lead and senior. I wanted to be sure that the company would support mental health sick days and luckily they do! They are also really lenient with working from home and in general really great in how they deal with this kind of stuff.

    I’ve noticed, that for me, it really helps knowing that my company has my back. I haven’t had to take any days off because of my bpd.

    Oh, I am not US-based, maybe that helps.

  48. Pommette!*

    I have two chronic mental illnesses (OCD and depression) that, when they flare up, can be intellectually disabling and can leave me disconnected with reality. When I go through bad episodes, it takes me a loooong time to get better. As a result, even if I can take some sick leave when I most direly need it, I end up having to work while sick.

    I’m pushing forty and still figuring things out, but here’s what I learned.

    1- When finding work, I should look for jobs that can accommodate my illness at its worse. So: jobs where responsibilities are shared and/or where workload is flexible. It’s meant passing up great opportunities. It’s sad. But having done the “doing a spectacular job until I flame out and fail spectacularly” carousel a few too many times, I have learned to prize sustainability. (Yes, my family wonders why I’m not “living up to my potential”… but I’m alive and employed. Those things weren’t guaranteed, and they are worth celebrating).

    2- I do try to make up for the bad times by doing a great job during good times, to accumulate goodwill. And I try to be upfront about not being at my best when I’m not.

    3- When things get bad, I try to define realistic minimum standards for myself, and hold myself to them. Minimum includes basics like: showing up! wearing clean clothes! working on pre-defined and agreed-upon tasks rather than on the things that seem important to me (when it’s clear that my judgement is temporarily out of commission)! Answering emails every day! Setting realistic deadlines and meeting them!… And then I try to take pride in having done the minimum, because that means that I did what I HAD to do. It means that I could be depended on and trusted. I try not to focus on all of the things I am not doing and I try not to take on any extras until I’m feeling better.

    4- For me, having healthy habits really helps. I’ve learned to stick to those even when they don’t feel necessary. It feels weird and sad to avoid spending late-nights on exciting projects when I have the energy and drive for it, but I’ve learned that sleeping a full night every night helps keep flareups rarer and less intense, so I do it.

    So… that’s my story. I’m still looking for a job that will better match my needs/abilities, and will provide me with the kind of routine I apparently need in order to stay healthy. And I’m still trying to figure out what exactly that routine looks like!

    So… Good luck. You are definitely not alone!

  49. remizidae*

    Every part of life, including mental illness, gets easier when you live close to work. It’s lovely to be able to go home and take a nap over lunch. Or just a brief walk can help.

  50. Claudia Kinkaid*

    Ugh. This is hard. I find that it helps me on a personal level, any time I feel weird about taking time off, to reframe it mentally as “I have a chronic condition that flares up from time to time.” I know I personally wouldn’t feel as bad if it was a physical condition, so I have to remind myself that it is *also* a chronic illness, one that just affects a different organ (the brain).

    Personally, I am a bit skittish about sharing this kind of information with colleagues and supervisors due to some bad past experiences. However, in the event that you do end up talking about it with them, it might also be helpful to think of it in terms of the strengths it gives you as a neurodiverse person. I’m obviously not saying, “These conditions are great!”, but I know that my particular conditions mean that I tend to be more creative, flexible, and resourceful, as a result of both my weird brain and my experiences dealing with it. Perhaps your health experiences have given you more strength and resilience in the face of challenges? (For example.)

    Good luck. <3

  51. Bipolars wife*

    My husband is bipolar with pretty severe depression. My husband is learning how to deal with this now. For him knowing his limits helps. He had to leave his job with a lot of downtime for one that has little to no downtime. When he switched to his previous job he was surprised to find out how important I was to keeping him balanced. Be honest with yourself about your needs. My husband often downplayed what he needed from me and others around him. He didnt want to be needy or put anyone out. So be honest with yourself and your partner, friends, and family about your needs.

  52. UnabashedVixen*

    I have lifelong, chronic severe depression and moderate anxiety. These are the things I’ve learned in 20 years of trying to manage that while working:

    1. Absolutely take time off if you need it. You don’t have to say why you are taking sick time if you don’t want.
    2. If you feel you can trust your boss, do loop them in on what’s happening. I have lost jobs because I was honest with my boss, and I have succeeded at jobs because I was honest with my boss. It just depends on the boss. If you have a good rapport, good HR systems, etc., I recommend letting your boss know what’s going on and asking for what you need (an adjusted schedule, working from home, an extended amount of time off, etc.)
    3. Be honest with yourself about whether you need time off. So many times I’ve tried to “tough it out” at work, all the while my health was suffering and so was my work. I would get to the point of crisis where I would have to take time off, but my work was in disarray because I was so ill, and knowing I was failing at work made everything so much worse.
    4. Be gentle with yourself. You are sick, just like if you had the flu or pneumonia or something. Take care of yourself, do nice things for yourself, whatever that looks like for you (when I can afford it, retail therapy is something I enjoy. If not, I take nice hot baths, snuggle my dog, and stay away from social media. Whatever works for you).
    5. Double down on therapy, exercise, good food, medication, whatever you need. Sometimes when we’re struggling it’s hard to do the things that will help us feel better – mental illness is tough that way.
    6. Know that you’ll get through this.

  53. PTSD Professional*

    Hello, fellow PTSD Pro!

    I’ve never been open about my diagnosis, so a lot of my experience is centered around keeping my sh!t together and my life as on track as possible during a flare-up. So first and foremost, I want you to know I think you’re brave and amazing for reaching out for help. It’s hard to do and I respect the hell out of anyone who does.

    Second, thirding Captain Awkward’s excellent blog post about tightening up your work game when your brain is behaving badly. She’s been there, she understands, and she is awesome.

    Third: automate, plan, and make life as frictionless as possible. Developing some locked in-habits around work, email, sleep, exercise, meals, chores, finances (autopay is a LIFE SAVER), and basically any and all aspects of my personal and professional life where it’s possible has made my PTSD about a million more times manageable when I’m having a flare-up. If I’m on autopilot and stick to my routine then I can at least know the basics are getting done and I won’t have to clean up a horrible mess when I’m doing a bit better.

    Planning is essential for managing my symptoms. Knowing what my deadlines are, what needs to get done, and who needs to be involved helps me feel calmer and more in control. And then building out and sticking to a manageable, small-steps plan with a generous cushion for emergencies and surprises can has, over time, made my flare-ups way less impactful on my work and personal life. And made it easier to get back on track once things have settled down.

    One of my therapists explained that people without PTSD have an empty cup at the beginning of every day, and throughout the day they pour their irritations, frustrations, and other negative emotions into the cup. A rare “bad day” for a person without PTSD is when their cup overflows, and they themselves overflow and start externalizing their feelings. A person with PTSD starts with their cup half or three-fourths or already totally full, depending on where they are in treatment and management. We fill up faster, and that’s why it’s easy for little things to be what finally causes us to totally overflow.

    Keeping that in mind, I go out of my way to make my life as “frictionless” as possible when I’m having a bad spell. Do I need to take an Uber to work instead of the train? Done. Do I need to have my meals or groceries delivered instead of dealing with the store? Done. Can I lay out all of my clothes a week ahead of time so I don’t have to think about what I’m wearing that week? Hell, I do that anyway. But removing as many potential irritations and triggers from the equation as possible means that I have more mental and emotional space to deal with whatever issues are happening at work.

    I call that last part my “Emergency Protocol”. I figure out what my pain points are when I’m having a flare-up, I figure out strategies to mitigate them when I’m doing better, and I give myself permission to do it when I need to. For some people that might include taking a day or two off, or having a code word with a friend.

    One size does not fit all, but I hope some of this helps. Good luck!

    1. Grbtw*

      Okay, this is the best advice I’ve seen ever! I’m going to implement a few of these into my routine, thank you for sharing.

    2. deesse877*

      Yeah, a life-changing piece of chronic-illness advice for me was “it’s OK to use paper plates when you feel bad.” Seriously! Doing the dishes had been a life-long guilt-and-shame dealio, and just hearing a stranger say it made me see what I already knew, to wit, that (a) I’m not lazy and (b) consumer choices do not save the planet and (c) cutting yourself a break is good medicine.

      1. A First Rated Mess*

        My equivalent of “paper plates” is part of a list that lives permanently on the whiteboard on my fridge. It’s a list of things I must remember to do each night when my husband is out of town. Mostly it’s around pet care things that he usually does before I get home. Those things aren’t the paper plates.

        The paper plate is smack in the middle of the list: “EAT DINNER”, because if it’s not on the list there’s easily a 50% chance I will either forget or decide I’m too tired to bother, and that way lies badness.

        I’m getting better at replacing the embarrassment of needing to put such an apparently basic thing on my list with being pleased I figured out a way to solve this problem.

  54. Ms. Minn*

    I have anxiety and depression, which gets much worse in the winter. When I’m going through down spots, I try to do at least the basic tasks and put more ambitious projects on the back burner if I can. Also, I take advantage of any productive spurts that I can to get things done to balance out the unproductive times. I give myself things to look forward to, like a good lunch or a treat. On mornings where it’s hard to get out of bed, I tell myself that I can go home early, but I have to go in (and once I’m there, I can usually make it through the day). And some days, I just can’t get out of bed and stay home…and I try not to beat myself up too much about needing that time to myself.
    When I was going through a really bad spot a few years ago, I did end up sending an email to my manager, manager’s manager and HR that I have a chronic illness, I was going through a bad period but working with my doctor to help get it under control, but wanted to call it out because I thought it was noticeably affecting my work. I said that I may need some time off for appointments or to work from home, but didn’t mention what I had and said I don’t like to talk about my illness. For the most part, they were understanding and supportive without prying. The reason I didn’t want to name my illness is that I work for a small family company with some people who don’t understand mental illness. It’s sad that I can’t be open about it to everyone, but I also don’t want my co-workers and bosses to treat me differently or keep me from opportunities. But the email was a way to protect myself and my career during a time when I couldn’t hide my illness like I typically can.

  55. Red Reader the Adulting Fairy*

    I don’t have mental illness issues myself, but the number of times my husband has texted me from work to thank me for making him keep a dose of his daily meds in a little pill safe on his keychain in case he forgets to take them before he leaves for work is STAGGERING. So that would be my suggestion, along with a reminder of some sort to swap out the dose every few weeks if it doesn’t get used.

    He forgets his about once a month, so he takes the ones in his keychain pill safe, then when he gets home and puts his keys down next to his weekly pillbox, he moves the ones he forgot to take that morning from the pillbox to the pill safe. But he also has a monthly reminder set in his phone to swap them out so he doesn’t end up with year-old meds in an emergency.

  56. hanners*

    I’ve been dealing with anxiety and worry related depression for most of my life, so a few years ago when I started a new management role and had to deal with a loved one needing some major emergency surgery and after care I hit a depression wall that I just couldn’t overcome with my normal coping methods.
    My performance started to drop at work and I realized that I was spiraling into a pretty bad depression. The first thing I did was set up a meeting with my immediate supervisor to let him know that there was a reason (but not an excuse) that things were slipping. I was really nervous going into the meeting, but he was incredibly supportive and treated it like any other chronic/flared up health issue. He was forward with asking me what I would need (days off, appointments, more support, etc) and was really happy that I had let him know before he had even noticed the slip start.
    Since then I’ve tried to be fairly up front with managers about my mental health and needs and trying to normalize it like any other chronic illness. I happen to work for a company that prioritizes holistic well-being, so the discussion has been pretty easy, but I’ve also found that when I’m upfront with people about problems I may have they tend to become more comfortable with talking about mental health. I’ve also found that since moving into a team leadership role it’s been helpful for me to be up front to let me employees know that mental health struggles are valid and not something to be ashamed of.

    1. ThatGirl*

      I knew that post was gonna get a lot of mileage :) (I think four people have posted the link now?)

        1. ThatGirl*

          No worries! I just think it’s funny how many Captain Awkward aficionados there are here :)

  57. QuinleyThorne*

    (For background: Major Depression, Generalized Anxiety Disorder, and Panic Disorder).

    Hi OP!

    Firstly, sending you strength during this difficult time. Generally, my illness is managed through regular therapy and adherence to a medication regimen. I went through a really bad episode around this time last year, where I was having panic attacks with seemingly no trigger at all. I managed to keep it together at work for a week, by keeping busy and focusing on tasks at hand, but the tipping point came when I had a panic attack while driving to work. At that point, I knew that I was a danger to not only myself, but others on the road. I also knew that should I get pulled over during an attack, there’s a chance that I could compromise my driver’s license. So for me, it wasn’t just a mental health issue, it became a safety issue, which was the wake-up call I needed to file for FMLA to give myself adequate time to devote to addressing the issue.

    Speaking more broadly, I’m thankfully in a place where my good days outnumber my bad ones. I can usually feel a “bad” day coming, so one of the things I do if I’m still in the office is make it a point to get as much off my plate as possible. If I decide to take off, I won’t get behind, and if I decide to push through it, it gives me some wiggle room to adjust my pace and work through my feelings a bit if I need to. The times that I decide to stay home are days when I feel bad enough that I know my focus would be shot, and I wouldn’t be able to get anything done, or done correctly; so it’s better to get some rest and recharge.

    I guess overall, I would say take it one day at a time, be kind to yourself, and push through it only when absolutely necessary. Feelings are fleeting, but only when you take time to process them. Good luck OP!

  58. NW Mossy*

    While I can’t comment from the condition-having side of things, as a manager, I just want to say a hearty thank you for opening up this question. All of you sharing your experiences and concerns is directly helping me be a more inclusive and supportive leader, which is one of my goals for both my work this year and for life generally.

    This isn’t the kind of stuff managers get training on (although goodness knows we should!) and it’s entirely not appropriate to ask one’s own staff, so these discussions give me a level of insight that would be otherwise inaccessible. My job is about creating an environment where people can thrive, and y’all have really helped me get a clearer vision of the kinds of words and behaviors that do that for people with mental health concerns. It’s also taught me about the importance of being a good advocate for these issues with other leaders and to do my part to spread better practices to my real-life peers.

  59. Small Biz Escapee*

    I’d love any feedback on managing an employee with an eating disorder. I just began managing one. I now understand what I thought was a strange request when we hired her–that attending company lunches or happy hours was not mandatory. (It’s not.) I am sensitive enough myself about body image that I would never comment on her size or her appearance at all, or what she eats. But she can be incredibly self-abnegating with work-related things–she is a perfectionist with no patience for herself as she learns. It is so devastating. I would love to support her but giving her feedback about her work is part of the job (she’s a writer/I am an editor.) It’s so challenging. Would love any advice.

    1. Count Boochie Flagrante*

      Maybe it’s just the way you phrased this question, but I would separate the eating disorder from her work-related challenges. While they may indeed be related, that’s not something for you to dig into; that’s a therapist’s job. For you, focus on the work. Alison has some good posts about employees who take feedback way too hard.

      1. Small Biz Escapee*

        I would never say to her, “I know your eating disorder is related to your perfectionism.” I don’t want to “dig into” that. I want to figure out how to compassionately coach her without triggering her.

  60. Lentils*

    OCD/ADHD/PTSD, brain injury, and previously PPD, plus a few episodic bouts of major depression that has since stabilized. I also manage someone with anxiety.

    As an employee, I believe it depends on what your workplace support system looks like, as well as what your social support system looks like. I have a partner with depression and anxiety, and when I was suffering from PPD I had a boss who was Not Sympathetic. I handled it by putting my nose to the grindstone at work (headphones in, hammering away at busy work, not giving myself ANY space to think), and finding a therapist who accepted my insurance. That’s not necessarily my recommendation, but if we’re talking survival mode until you can get to a better place, it worked short-term.

    I now have a much better boss. Measures include setting my workspace up in a way that allows for me to physically move around and work from different areas, arranging to work from home if I Just Can’t (usually phrased as “feeling under the weather but up to working remotely”), and being kind to myself if I can’t be productive (when my OCD takes over, I am a 120 lb paperweight). I will also bring small crafting projects to work- if I am too twitchy, I’ll step away from my work and knit a row or two or promise myself that I can knit at lunch if I finish [X]. I understand the optics are iffy on that so you have to know your workplace. And I make lists. So, so, so many color-coded lists. All the lists. Healthy rituals give you control and predictability. Small things to look forward to give you hope.

    As a manager, I follow my employee’s lead. They’ve been very up front about their anxiety, and it’s very obvious as to how it manifests in the workplace. I listen when they need (especially now that COVID-19 is in our community). I encourage days off and let them know that all they need to do is tell me they’re going to take some time. I also run interference when they ask, but do draw a firm line about remaining collegial.

    1. anon24*

      I haven’t read the comments yet, so maybe someone already said this, but I wanted to share because it’s been actually life changing for me.

      A few years back I was discussing my depression with my doctor. I do not take anti-depressants and she knows that I would prefer to hold off on going that route as long as possible. I was telling her that every so often I sometimes have a day where I just don’t really get out of bed, but spend the day reading, gaming, drinking tea, and watching Netflix. I talked about how I always felt recharged and ready to face the world the next day but that was overshadowed by the overwhelming guilt I experienced by being such a lazy failure for spending the day in bed for no reason. I said I wished I didn’t need to take those days but sometimes I just couldn’t face the world.

      My doctor told me to spend the day in bed. I was astonished. Why would she do that? Doesn’t she understand I am a failure? But then she pointed out that it’s not very often, I feel recharged afterwards, and I wouldn’t feel guilty spending the day in bed recovering from a physical illness would I? She said “if this is working for you, keep doing it, and if these days become more frequent come back and see me and we’ll get you referred to someone for better care and medication but for now it seems like you’ve got this under control.”

      Oh my god the guilt all went away. I now do not feel bad if I need to take a day to myself. I try to schedule time off from work in advance maybe 2 or 3 times a year, (I actually have a “mental health day” scheduled in 2 weeks that I requested time off for several weeks ago) but if I am feeling short tempered and frayed I will call out sick for the day. This is not something I do often, I think once in the last 2 years, but I’ve told my boss I would rather call out than come in and be short tempered and snap and people because I’m barely holding myself together.

      1. Lentils*

        Yes! My partner’s therapist calls this “filling your cup.” Whatever combination of talk therapy, pharmaceutical intervention, activities, rituals, and other repeatable behaviors not only gets you through the day, but gets you through the day and looking forward to the next. We can’t exist on survival mode, though so many of us default to that because we’re fearful of affecting those around us.

        Self-care, which is still so radical, can come with a lot of privilege and I would deeply love for it to become part of typical life. I didn’t have access to it until I had paid leave, health insurance, and a steady income. How do we make this accessible to those who don’t?

  61. Anonynonymouse*

    I haven’t read the other comments yet, but I wanted to get my suggestions out here.

    If you haven’t yet, get with your HR (assuming competence – it’s out there!) about ADA accommodations. If nothing else, this puts your “disability” on record.

    Part of the accommodation, if you meet the eligibility requirements, could be Intermittent FMLA leave. Depending on what you discuss with your healthcare provider (your therapist in this case), it could cover the occasional full day or 2 off, or just an allowance to come in late or leave early due to symptoms or for your appointments.

    Past that, hopefully you have a supervisor you can talk to. I’m in a lot of denial about my own mental health because I’m having to fight my daughter’s demons (and have the intermittent FMLA in place for all her appointments and when we have a hard time getting out in the morning), but my boss is AH-MAY-ZING and supportive. We do a lot of check-ins, and she helps me keep all my work prioritized; she’ll also move some to my teammates temporarily to help keep the load manageable.

    That open communication is really key at keeping me on an even level (as much as possible) at work, and being successful at work helps my overall well-being.

    And yes, sometimes there is a call-out because a mental health day, to veg at home and reset, is needed. Along with scheduled vacation time, that I have the support and encouragement to use.

  62. aliascelli*

    I have an emergency plan that I developed for extreme anxiety/panic attacks/PTSD flareups while in an Intensive Outpatient Program (which I highly recommend, btw, if you can make insurance and leave work in your favor for that):

    * name three things I can see (this is a grounding exercise, to bring me back to the present)
    * name the thing I’m feeling
    * name one thing I’m grateful for
    * reach out to someone – call or text a friend, usually

    I’m also a big fan of breathing exercises.

    So that’s my in the moment thing. My big picture was: admitting when I needed more help, not being afraid to take FMLA and go to the IOP, and in my case, looking for a new job that doesn’t push my anxiety buttons in the same way this one does. Obviously your mileage will vary, but it’s really helped me.

  63. Rachel*

    I found it helpful to work through what’s appropriate to disclose (items that need accommodation/protected status requests), apologize for (task-specific screw-ups that require proactive changes), and things I could just do and not disclose or apologize for (‘healthy/normal’ requests that I struggled with, like leaving on time or not checking work email in the evening). I kept a running a list, in consultation with my therapist and resources like this blog. The latter category I would prioritize 1 or 2 a week, put into practice and notice any changes. They were almost always positive and it helped to keep a record of ‘progress,’ even when they were pretty minor/normal adult things that overtime had a big impact on my mental health.

  64. Queen_of_Comms*

    Everyone is different. For me, it helps to view my wellness as pie wedges:

    Pie Wedge #1: Physical health. My big three are regular cardio, eating plenty of veggies, and getting adequate sleep. The last item is toughest for me.
    Pie Wedge #2: Brain health. For me, this means achieving a balance of intellectually stimulating activities (i.e. reading high-quality literature) and “offline” time (i.e. watching crappy television for an hour at night).
    Pie Wedge #3: Social health. When I’m depressed, I cut myself off from my family and friends. It results in loneliness and feelings of worthlessness. I try to achieve a balance of seeing friends and family frequently, while still making room for “introvert time”. Sometimes this means sending my husband out of the house for an evening so I can eat macaroni and cheese and watch Hoarders in my fuzzy pants.
    Pie Wedge #4: Spiritual health. Taking care of your spiritual health is not a religious practice, although it can be if you’re into that sort of thing. For others, it means meditation, reading uplifting news stories to counter negative media talk, or just being in nature.

    Understanding your pie wedges is the first step to identifying effective self-care. Self-care looks different for everyone and is not necessarily “bubble bath with a glass of wine” (although that sounds hella good right now). Understanding what actions put your pie wedges back into circuitous sync is the first step of combating mental health issues, especially before they take over you and your work life.

    I’ve been depressed most of my life and have come to terms with the fact that I will always battle it. However, this does not mean I have no control over my mental health – it means that I have to pay attention to it more than others. When my brain is especially sick, it’s usually a sign that one of these aspects is “out of whack” in my life. I can usually narrow it down fairly quickly and course correct before it gets out of control.

    Best of luck and love on your journey.

    1. 'Tis Me*

      I love the framing of this – that it means it’s harder but not out of your control :-)

      It won’t always be the case for everybody but definitely for slower slides downwards, with attributable and fixable external causes (or ones that you know will be temporary and can count down the time until they won’t be issues any more), this seems like such an empowering approach to take :-)

  65. Sleepytime Tea*

    A lot of this comes down to a personal choice of what you feel comfortable sharing. I have bipolar disorder, which comes with certain stigmas (I won’t get into whether or not these are “worse” than the stigmas associated with other mental illnesses, how different people react varies widely, so that’s all there is to it). Personally, I’m not comfortable sharing my diagnosis with the vast majority of people, professional or personal. I am also fortunate in that I have been in a pretty stable place for awhile and that means that it hasn’t impacted me professionally in a long time. But that doesn’t mean it isn’t also a serious struggle at times.

    I have had jobs, including my current one, where I’ve never told anyone and I haven’t had to ask for any accommodations. The flexibility currently offered meets my needs, but I also know that if that were to change, as it did in a previous job, I have the option of filing for FMLA accommodations. Working with psychiatrists and therapists, I know what I need to be successful (WFH, mental health sick days, and flexibility to go to appointments). If I need to apply for FMLA to ensure I’m getting those things I can, and have, done so.

    I think one of the most important things is to find the right job. If you know you’re triggered by a high stress environment and that’s where you’re working, finding another job is the right choice for your health and you have to make that choice the same way someone working with a severe mold allergy working in an old mildewy building may need to ultimately find another job. Could you spend your energy fighting for accommodations? Yes. Will that really be the best for your health during the fight and perhaps having a rough relationship with your manager/whoever at your job in the long run? Probably not.

    Also, a lot of people with chronic mental health illnesses do consider trying to get social security disability because working is such a hardship. I tell people to really make sure they research this. If you are currently working and have been working successfully, the presumption is that you are able to and therefore are able to continue doing so, and it may be very difficult to get approved. Not to mention that your income will not be nearly the same. I am not saying that’s fair, only that it’s the way it is. You may very well have to quit your job and be without income for a long indeterminate period of time before being approved (or maybe never approved) and realistically most of us can’t absorb that cost. If you can identify the right working environment and accommodations to be successful at work, it is your best bet.

  66. Yarrow*

    I’m starting to get overwhelmed (I’ve got ASD, ADHD, depression, anxiety, and insomnia), my executive functioning (memory, staying on task, noticing things, being on time) gets worse and while I can muddle through, it it really starts affecting my mood and work. I’ve learning to recognize when those things are getting worse so I can take time off before I have a meltdown or stop sleeping. When I’m in a funk, my perspective is totally skewed to the point where I can’t immediately tell what I need, so I have some things written down. For example: bad sleep for 3 out of 7 nights or increased sensory weirdness means I need to consider at least a half day. I schedule days off in advance knowing I’ll need them but not want to take them. That lets some of the pressure off. I’ve let me boss know that I’m having some issues with sleep and focus and asked coworkers to check my work for errors when I’ve known I was feeling off.

  67. Alycess*

    I took a leave from work, and I found it helped me to get things straight and go back refreshed. I started a new medication treatment without worrying about it impacting my work, I went to more frequent therapy sessions, I got regular massages and exercised, and took good care of me. When I did come back to work, I only came back 4 days a week for a while, and then I regularly scheduled a day off every 2 weeks until I felt better. I also called in sick on days that were really hard.

    Note, I had the FULL support of my management and that made it even easier. We are very focused on being a healthy place to work (and study), so I think that helped. Our basic statement is everyone has mental health as well as physical health, and we simply treat it the same. Flu or depression, you do what is right for you.

    My grand-boss encouraged me to take days off for my mental health, my manager and coworkers stepped up and covered for me, and there was absolutely no judgment or “backlash” from this end. That really helped. In fact, when I took the leave they just emailed me and said “Thank you for letting us know. I’m glad you are taking care of yourself. We look forward to having you back when you feel ready.”

    Since I have come back, I’ve also been very open about my leave and why I was out. I still take sick time for therapy appointments, and have worked wellness breaks into my day. It is still hard at times, but the more I normalize my actions and feelings about treating it like physical illness, the easier I find it is to take care of me!

  68. AnotherLibrarian*

    I have anxiety- especially social anxiety. One of the ways I manage it, and this might sounds kinda weird, is that I uniform dress. I am a woman and I wear the same outfit everyday to work, except Fridays when I wear jeans and a logo top. My uniform is a little more formal than a lot of coworkers (think colorful jacket, black dress pants, cream or white shell), but I like it because I can unexpectedly end up speaking to higher ups and I never feel under dressed. Because I never feel like I am wearing the “wrong thing” I find I can manage my anxiety better.

    Also, as a lot of people have said, sick days can be used for mental illness. It’s okay!

  69. You're Not My Supervisor!*

    I feel pretty lucky to have a great manager who encourages everyone on the team to take care of their physical AND mental heath, and I am personally pretty open about what I’m going through and what I need. So my boss is well aware of my mental illnesses (eating disorder, anxiety, and most recently postpartum depression) and is always encouraging me to take days off when I need them and I can be honest about why. That said, I am also free to simply say “I’m sick today, not coming in” or “gonna be late, I have an appointment” and that’s perfectly acceptable, I don’t need to be specific if I don’t want to and sometimes when I’m in a major spiral the most I can do is text “sick, home today” and follow up later if/when I’m in a better space.

    For me, I know that I’m too sick for work when I’ve been at work at least a couple of hours and I haven’t gotten anything done, because I’m too scared to work on projects (anxiety so high I feel like no matter what my approach, I’ll fail or make a mistake), or because I’m so down on myself I feel useless (thoughts like “why did they even hire me, I’m terrible at this job” or “I’m such a failure, they should fire me” or “what am I even doing here, I don’t belong here”), or because I’m isolating myself to avoid all social interactions. Basically when the thoughts and/or behaviors are so bad no work is getting done, it’s time to go home. At work we jokingly call this “not being spiritually fit”, in part because we work for a non-profit connected to a very liberal church. So I might tell my manager “I think I need to go home, I’m not spiritually fit today.” It’s actually a good way to make something heavy like mental illness feel a bit lighter, if only for a moment.

  70. A Teacher*

    Anxiety/Depression diagnosis here and I have fibromyalgia which can flare up depending on the levels of stress I’m under. I think everyone is different but for me: weighted blanket to sleep at night; essential oils (Lavender and frankincense along with geranium); calm app when I can use it at work; alter my level of lighting; exercise helps too. I am also big on a physical planner so I can write stuff down and I keep checklists as needed near my desk for things to accomplish. I’m not open with my boss about most of it because when I had to disclose my migraines he told me I should “always use a sick day and not come in if I didn’t feel well.” That’s not realistic. I do believe in mental health days if you need them too.

  71. Jessica*

    Person with clinical depression here. In addition to all the advice given above, I will add that being 100% honest with myself with what will actually help in regards to work has been helpful. Some days I really do need to stay home sick, because I am sick, just mentally. But other days, even when it seems insurmountable to do so, I know full well that the act of getting myself together—putting on the clothes and makeup, having to talk with people even as I will try to minimize unnecessary chatter on these days—is part of what will get me through the day.

  72. willow for now*

    I am going to protect myself and my job by getting ADA and FMLA in place. I have some managers who raise a stink when they can’t reach me immediately, and some days (luckily few) I can’t get out of bed.

  73. Hyacinth Bucket (Pronounced Bouquet!)*

    In California, a lawyer’s physical, mental, and emotional health is part of determining whether they’re competent to practice law. As such, I have to be a little guarded about my PTSD and depression so it’s not used as a tool against me. I think it’s fucked up that I have to do that and am part of a movement to improve mental health awareness in the legal field.

    But since I do have to be cautious, here’s my strategy:
    I request official accommodations with HR. I start on my first day of work and explain I have an on-going, chronic health condition that is recognized by the ADA and that I will need the following accommodations: a flexible work schedule for doctor appointments, the ability to work from home during a flare up, a slightly modified desk set up (I only ask for this if my office has my back to the door), and HR’s support in addressing this with my supervising attorneys. I ask that after we chat, they send out a blast to my direct supervisor and mentor chain of command notifying of what my accommodations are, and then I address it individually with any additional attorneys I work as it comes up.

    I also check in with the supervisors and mentors to say, “HR sent you an email, this is how I normally handle a flare-up, does this cause any concern for you?” I assure them that my flare ups are few and far between, and that it impacts me the way cold and flu season impacts most other employees – I’m typically able to work from home, but may have the occasional day that requires going offline. I find that putting it in the context of a well-known situation really helps.

    I don’t disclose my condition, and if asked by HR or a supervisor, I tell explain that I’m not in the habit of sharing my exact diagnosis but I can get a doctor’s note if needed. I actually also have some urinary issues, so if I’m pressed on the matter that’s the condition I disclose, with the comment that of course they can understand why I’m not in the practice of sharing this information and I trust I have their utmost discretion now that they know. (For anyone curious about how I make my desk arrangement an accommodation for urinary issues, it affords me more privacy if I need to use a heating pad or other therapeutic aid while working.) My urologist and psychologist both know this and are cool with it, and either is happy to provide documentation if necessary. If people I don’t know well ask I deflect and say it’s boring or gross, depending on the audience, then immediately change the subject.

    I am out with some coworkers I trust more, and I do discuss mental health in the office as appropriate. I just personally don’t want it tied to my accommodations at this time to protect myself from being denied more challenging work or a promotion down the line because of concerns about whether I can handle the pressures. Law is still a conservative industry, and I am doing my best to change minds from the inside.

  74. FutureLibrarianNoMore*

    So my workplace is pretty laid back, but still professional.

    I’ve chosen to just always be open and honest. People know I have OCD, they know my triggers. I joke about it and so do they, but they also are the first people to have my back when things get ugly.

  75. Suni*

    Never skip work or go incommunicado. Its always, always better to at the very least shoot off an email saying, “Hey, I’m not feeling well and won’t be in today.” even if you don’t have any sick days left.

    For those of us with mental illness, especially depression, it’s very tempting to just ignore the alarm and sleep through the whole day without letting anyone know what’s going on. Don’t do this. Send the email first, then go back to sleep.

    Obviously this is a short-term strategy. In the long run, I have found a lot of success sitting down with my manager and sharing that I have a recurring medical appointment once a week (aka therapy), and sometimes I might need to take an unexpected day off. Bringing this up ahead of time instead if surprising them the day-of gives you a LOT more flexibility and leeway. My manager has been great with sharing FMLA resources and EAP with me once I told him (in vague terms) about this.

    Even if your manager is less understanding than mine, they will always be more willing to work with you if you communicate with them, rather than leaving them guessing where you are and assuming the worst.

  76. Public Facing Librarian*

    Mental illness: Anxiety and Depression
    When: About twenty years ago.
    What happened:
    I made it a year by reminding myself taking it one day at a time. Seeing professional help. As I got better I was able to see clearly that it was the actual job that was not sustainable and I needed to take what is often termed “a recovery job” One without high pressure deadlines, extreme attention to detail, unreasonable overtime. I did that job for a year for less pay, way less stress and continued my mental health recovery with medication and therapy and support groups.
    I still have bad days but they are few and far between. I recognize them and do what helps me.

    I do not disclose at work but as a now supervisor, I am empathetic to reports who need to step back a little or need a mental health day. No one needs to disclose. If you call in sick- that is it. Let me know if I will see you tomorrow.

  77. Sympathetic Sally*

    Hi OP, I am dealing with some similar mental health issues myself right now. I am currently in treatment for anxiety, depression and an eating disorder, and some of these illnesses have been exacerbated by a stressful work environment.

    Without going into specifics, I was candid with my boss and told her I was going through a difficult time healthwise. She was very understanding and asked what I needed from her. We talked about it and I work remote on days when coming into the office seems unbearable. My boss is also very flexible about doctor appointments, which is helpful considering I sometimes have 2-3 per week.

    The best advice I can give is to be kind to yourself and try to prioritize self care. In addition to routine therapy and ongoing medical care, I am making an effort to eat well, sleep well, exercise and schedule plenty of “me’ time.

    I really sympathize with your situation and hope you start feeling better soon.

  78. Oaktree*

    I’m lucky in that my workplace a) has a generous policy around mental health coverage (up to $2175 a year) and b) that my actual supervisor is very lenient about lateness and attendance. (It’s taken me over a year to really believe that she’s ok with me being 10-15 minutes late due to something out of my control and that it doesn’t “count against me”.) She’s also fine with my calling in sick, or leaving due to illness- these are things that should go without saying, but we all know that they don’t. I was conditioned by years of strict classroom attendance policies and then shift jobs at fast food restaurants to feel like if I called in sick even once that was a mark against me for future firing. So I’m leery of calling in sick at all, and especially for mental health reasons (though I deal with severe anxiety and depression). Thank god for my partner, who has told me it’s ok to call in sick when I can’t get out of bed for crying at 7 am.

  79. Absurda*

    I’ve struggled with depression and anxiety most of my adult life, this isn’t something I’ve disclosed to anyone in the office. I’ve used most of the strategies others have mentioned (sick days when needed, taking breaks, etc) with the addition of this:

    I had a very long, honest conversation with myself about how my job was helping/hurting my well being. I was in a very high-stress, high-emotion role (managing compensation) where no matter how hard I worked, no matter what I did, the resolution to most of the issues was completely out of my hands, but I took the brunt of people’s displeasure about it. I had no control over anything and no authority to fix anything. I had a major feeling of helplessness and this was not good for my anxiety; it got to the point where just hearing the phone ring made me feel a sense of panic. I had to come to the conclusion that, for my own personal well-being, I needed to get out of that role.

    Luckily for me, I’ve been with the same company for 15 years (most of them with the same grand boss) and had already established a good reputation so my grand boss was willing to work with me to switch me to a new team and a new role. It took a while and I had to hint (to my potential new manager) that I was looking outside the company but I did get a transfer to a role better suited to me.

    The hardest part for me was in NOT seeing this as a failure on my part or that I couldn’t “handle” the job. Depression does not help with this sort of thinking, but I have been able to reframe it to just moving to a role that better suited my needs and skillset. It’s perfectly okay to say “this job just isn’t for me.” People do that all the time and it’s not a failure for them so it’s not a failure for me, either.

  80. Down with the sickness*

    Unfortunately, I’ve only had bad experiences when dealing with management, co-workers, etc when dealing with my mental health (PTSD, Anxiety, and so on).

    Be careful which coworkers you tell or they could use it against you. I made the mistake of telling a work friend, who than told everyone. It gave everyone who didn’t like me an excuse to run to HR saying they didn’t feel “safe” working with me (because what if I go postal?) or they accused me of being a drug addict and so on.

    My manager acted like I was “faking” a mental health issue to get out of work, working unpaid overtime, and would guilt trip me into not going to much needed appointments. She would tell me to “grow up” or roll her eyes when I requested days off for appointments.

    I hope you’re workplace is more accommodating…

  81. M*

    I’ve been dealing with an eating disorder since I was a teen and while I had it “managed” for a while, the last few years have been really tough. I’ve relapsed a few times, lost a lot of weight.. gained it all back.. etc. I realized that work wasn’t helping me deal any better since we tended to have a lot of available free treats for staff. I found myself walking into the breakroom and freaking out if I saw food back there. It was getting to the point where I couldn’t even walk in the back room and started skipping eating lunch all together.

    In the end, the best thing I did was tell my boss. I didn’t tell her everything, but I told her enough to explain that I’m having a hard time with my eating disorder and I might need to figure out better ways of dealing with food in the back. I ended up writing a list of things (with the help of my therapist) that were triggering while at work. I went over the list with my boss and we talked about the things that we can help over the things that we can’t. For example, a staff member would often bring around donuts or other treats in the morning to each person at their desk. It was a nice gesture but it was having a really negative effect on me. My boss sent out a memo about not doing it, not singling me out but just saying to leave them in the back and don’t worry about passing them around.

    She also requested a cut down on bringing treats in, instead suggesting staff stick to “events” a few times a month instead of just overloading the breakroom with endless treats that usually just sit around waiting to be eaten.

    There were other smaller things that we did in order to lessen the triggering and while a lot of it was more on my end, I found myself getting back on track. While it’s still really difficult to handle things sometimes, talking to my boss and being able to provide her with the exact problems I was having, really helped. It also helped but in context a lot of issues I was having and things that might have come across negatively or odd.

    Good luck LW, I hope you can find a good balance. <3

  82. Adam*

    I focus a lot on self care and self introspection. As a result, I can tend to feel my anxiety peaking and take steps to curb it.

    (At work for example I’ll step into the restroom and practice deep breathing, or excuse myself for a quick break and pop outside to let the cool air wash over me.)

    I also try to refocus what I’m hearing. Specifically when it’s job related. I always take things personally, and I’ve learned over the years that it is caused by my overall anxieties. It’s just feedback and it’s there to help me do a better job!

    I also took up going to the gym. For me it’s o e of the few times I’m burning enough energy physically to calm my anxiety. And I feel much more calm after.

    1. Breathing*

      I was in the restroom doing my deep breathing because I was about to go into a potentially triggering situation. The automatic lights went off. I realized I had no idea where the sensor was and that if someone else came in it would be really weird that I was in a bathroom stall in the dark. Thankfully the toilet flushing turned the lights back on.

      But to the question at hand. My boss has a general idea of my health issues. More importantly I have a trusted colleague who knows and occasionally checks in on me.

  83. SallyForth*

    I had to be somewhat upfront about it when I was hired because I needed one morning a week to go to my therapist. I just termed it as an appointment. I worked late that day to make up for it.
    When the “Bell Let’s Talk” initiative started in Canada, I was honest about how my appointment was actually treatment for depression, how my doctor was working with me to scale back my dosage in the spring, and how sometimes a dosage change gave me bad headaches. Most of my coworkers knew anyway, so it wasn’t an issue.
    My immediate supervisor was great, as was our Executive Director. However, one day, when I was quite upset over a plan that didn’t make any sense operationally, my ED told me my anxiety was taking over (I don’t really have anxiety issues) and to dial it back. I realized she was writing off my concerns as being mental illness and not listening to what I was saying. I tried to reword it but it just didn’t take.
    I didn’t last long after that. The workplace was already heading toward chaos and I just wasn’t comfortable there any more.

  84. RestroomTimeExtraordinaire*

    remember, mental illness, even episodic, is considered a protected disability under the ADA if it impairs major life function. In some instances, you can and should request accommodations. My ptsd is triggered by sudden movement or noise – when I requested being moved from a ‘in the middle of all traffic cubicle to one against a wall with no ‘through-traffic’, I was told those were for people with more seniority, and i didn’t qualify. However, upon notification of my need for accommodation under the ADA, I was able to obtain support for both better more secure placement (for my health) and also that my cubicle be reconfigured so i wouldn’t be sitting with my back to the entrance… seems silly that such EASY fixes required going through an HR process, but oh well.

  85. Kathlynn (Canada)*

    The only good advice I can think of at the moment is that if you are in a location where you are always visible to others, when you aren’t (like in the bathroom), take a deep breath and relax your shoulders and/or back. I think of it as “peacing out”.
    Knowing your symptoms, and watching for others you might not realize you have is also important. I get more emotional PMS style before my period. And just plain more frustrated/angrier when not properly medicated. So, I have to watch for that, and check my reaction and the level I react at.

  86. deesse877*

    Very belated, but here is one thing I have not seen mentioned. Being ill myself (depression, anxiety, mild PTSD) makes it easier to clock other people with mental illnesses (at least some people, some of the time), and I’ve noticed that I have to be careful not to take on their problems along with my own. It can feel like a failure of compassion to note “Josh hasn’t made eye contact in weeks and he’s walking so slow–prolly depressed” and do nothing, but outside of life-threatening situations people have to save themselves. Moreover concern can come off as gossip or nosiness, or actually injure someone’s standing in the org, so best to leave it alone, or look for solidarity if you are friendly. No fixing people.

  87. OP Here!*

    Hey everyone – OP here! This thread is a true delight and I can’t wait to read the entire thing when I get home.

    It’s been a while since I wrote in this letter, and I am happy to share that I’m officially out of the thicket of relapse and into the usual relatively harmless weeds. I took a lot of the same strategies that folks mention here, but in case this helps, I did the following:
    – Took JUDICIOUS time off (all of Thanksgiving week, all of holiday break, random days off, WFH random days)
    – “Leaned out” at work – i.e., performing at my same high level, but not necessarily jumping in to volunteer for new efforts or overextend myself – being up front with my management about my limitations/bandwidth (I got a promotion last year and started a new role and finished my Masters. the same year I was diagnosed with PTSD! woof.)
    – Met up regularly with my therapist, who was a true delight in dark times
    – Selectively shared what I was dealing with with my mentor – it really helped that someone at work had a sense of what was going on
    – Was as candid as possible with my friends outside of work – I work in a very corporate environment, and I can’t be as transparent here as I would like, so being open in the rest of my life helped balance things out
    – ED specific: I made it a self-care habit to take myself out for a nice grocery shop every Sunday before the work week started, so I could make sure I have things that I love eating in the fridge and a lovely little breakfast/lunch to look forward to during the workday. It really helped!
    – More ED specific: never skip lunch. Seriously. My current role has me in 15-25+ meetings a week, some which run through lunch, so I plan ahead when I need to eat each day to stay healthy. And I cancel/reschedule direct lunch conflicts whenever I can, with very little remorse. (So many people don’t eat at all during the workday. It is awful.)
    – Honestly? I went to hide in empty conference rooms whenever I needed to just *have a moment.* Highly recommend finding a secret spot/area in your building for this purpose, if you can.

    Now that I’m out of that really rough stretch, I’ve had time to reflect as well on my current role and how it plays on the fact that I have been accustomed to high stress levels throughout my life (think project management work – tight deadlines, lots of politics, big personalities). I think, more than I realized at the time, my job was contributing to my stress levels in a way that I still need to evaluate. I am thinking about what I want to do next and hoping to keep that motivation going. Kudos to everyone out there facing similar big decisions! I am rooting for you!

  88. Random Thought*

    A few things have helped me manage anxiety recently:
    1. I got a small water fountain for my office. I turn it off when I am “in the zone” and I turn it on when my anxiety starts to build. It can be a little distracting, but it also really helps instill a sense of calm. (It was a gift from a coworker who said it would help my feng shui, if that’s your thing!)

    2. I told my boss in vague terms what I was experiencing. It was a long the lines of “I’m going through a difficult time right now. It’s not something I’m comfortable discussing, but it’s having X and Y impacts on my work. It’s very helpful for me to talk about Literally Anything Else. However, I wanted to let you know so that if I seem distracted, upset, or more stressed and usual, you would have some context.” She has been wonderful about checking in with me, and her response has actually encouraged me to be more open about what I’m dealing with.

    3. I’ve been working from home more frequently. I am less productive at home, but I’m letting myself be less productive, in the name of self care. There will ALWAYS be more work. I am still working on learning to take a 20minute walk during the day to clear my head without feeling overwhelmed.

  89. Robin Ellacott*

    In case it is helpful… from the perspective of someone managing an employee who needs to take days off due to anxiety/depression: I made an arrangement with him that if he realizes overnight (sleep is an issue) that he may not be able to come in he texts me something along the lines of “not feeling great” and is encouraged to take a day if he needs one. I don’t care what he does that day, though I hope it’s something that makes him feel better.

    It took me months to convince him that he is not letting me or us down. I had a cast on my arm and had to give a small speech, like “I’m hurt right now, so I can’t do some things and others are way harder. But I don’t think anyone blames me for it, and we don’t blame you either.” I meant it. So if your manager says it’s fine, please try to believe them as far as the brain weasels allow! And if they don’t consider it a health issue, I’m sorry, and they’re being a jerk.

  90. Anon85*

    I’ve considered being more open about my (severe) depression at work, but I keep getting hung up on how awkward it will get. I feel like there’s such an expectation to soften it somehow, like “I have X but I’m getting treatment” or “I’ll have regular appointments but it’s nothing to worry about”. I’m already worried that someone will notice that I had an appointment and say “nothing serious, I hope?” (as I would!)

    Any suggestions on how to respond to that (without being dishonest), and more in general, how to navigate this?

    It *is* serious, and I’m not feeling particularly hopeful. I do find that working tends to help – should I use that as a softener then?

    1. 'Tis Me*

      “Serious enough to need a standing appointment, but for the most part while I’m here I’m able to focus on work which helps me cope – thanks for asking. [Work-related question, e.g. Did I miss anything important in the morning meeting?]”? Doesn’t dismiss it or downplay it but should help close the topic and make it clear that you’re in “work mode” rather than in need of a sympathetic ear?

  91. Retail not Retail*

    I see tips a lot but they seem geared towards indoors/office work.

    When I have a bad day at work I feel a pressure building that makes me want to scream or hide in a tight place. I am too tightly wound to do so but I do pace.

    It’s worse in the greenhouse so if it’s not storming I’ll just pace the greenhouse grounds.

    I’m depressed and anxious and possibly have adhd and ptsd so i have no idea what to do. I super flaked out of my first remotely sedentary job and get squirrelly when work becomes stationary (which it always is at the greenhouse).

    I found myself exhausted at the greenhouse but tips to stay awake are like “go outside” “get out of your chair!” “move around!”

    That is my job… so what are the steps to take?

    1. Retail not Retail*

      Also I literally climbed the wall one day in the greenhouse – justified it by saying this crouch felt good on my hip. This is nonsense.

      It was supposed to rain all day today and i was so tempted to call in because my boss said greenhouse all day!! Thankfully, no rain.

      Also I want to hoard my PTO for the moment bc who knows

    2. foxinabox*

      could you possibly get a standing desk or a ball chair so that movement is more built into your day?

      1. Retail not Retail*

        My day is usually nothing but outdoor movement. It’s the days that aren’t (stand at your broken topiary and weave in strands of ivy as it pours outside and in because this greenhouse is broken) that are really hard.

        Take today – cleaned the parking lot, cleaned the new exhibit (no watering since it won’t stop raining when we’re off), rake various spots in the parking lots, then “supervise” two guys mowing and blowing the clippings off the road. All mobile and outdoors. Only sitting at lunch and when zipping around in the golf cart.

        A greenhouse day is stare at that dang topiary. Maybe get away with weeding but topiaries go out in a month and they’re literally impossible to finish.

  92. Holly*

    I am a grad student currently taking medical leave from this term (and possibly/likely all summer). I ended up quitting both of my jobs as a research assistant and as a student intern at the library in order to cope with my mental illnesses (severe depression, anxiety, and I suspect undiagnosed ptsd). But last term I chose to muscle through as best I could, because my symptoms weren’t as severe. I was lucky in that both of my bosses were extremely understanding and kind to me about this, and I know that’s not the case for everyone. But I was honest with them about what was going on and they made accomodations for me. I haven’t read all the comments but I’ll mention it just in case it hasn’t been mentioned – sometimes employers, especially bigger ones, like at my university, can offer additional accomodations for people with chronic illnesses, disabilities etc. This can be very flexible according to your individual situation, and include things like working fewer days, working some days from home, etc. I believe (I’m in Canada so might be different where you are) that they have an obligation to make these accomodations if you have a chronic illness/disability. I didn’t take advantage of this because I saw that things were going so quickly downhill but I know of others who have, and it’s definitely helpful. If you’re in an environment where you feel you can be at least semi-open with your company, then this is definitely something to look into. Imagine having every Wednesday off, that’s like one long garbage week turned into two mini-weeks that seem, at least to me, much more manageable.

    As for taking sick days for mental health reasons… I mean… I dunno, I think I have a lot less loyalty to my jobs than many people. But like, you are your number one priority! Take advantage of what’s been offered to you to the best of your ability. I understand feeling guilty about taking sick days for something that is not validated as a “real” sickness, I have often felt that way too, but that is a socially conditioned response to something that is a very real and legitimate chronic illness. It’s kind of a side topic but something that might be helpful in changing the way you/people reading this think about mental illness is to do some reading on how mental illness affects our bodies and brains. There is a book I’m reading right now (only 1/3 of the way through so can’t totally vouch for it, but) called The Body Keeps the Score, which is about how the body holds on to trauma in very VERY physical ways. How trauma literally rewires your brain and parts of your nervous system. Mental illnesses are invisible but they are not “in your head” – they are very real and this kind of book has really underscored that for me.

    In solidarity – you can do it! <3

    1. Julia*

      Thank you for reminding me of that book!

      Grad school and mental health are so complicated. I quit my master’s after the first semester and then went back a few years later after feeling better and changing some things in my life. When I first left, it felt like the end of my life, but now I think it was a great decision.

  93. char*

    Personally, I have a mental list of work tasks categorized in rough order of how much focus and mental energy I need for them. When I’m not feeling good, I give myself permission to put the more difficult tasks on hold and only focus on easier stuff – even if the easier tasks are less important. Conversely, when I do have the energy, I make a point of focusing on the more difficult tasks. And if I end up in a low period when I’m barely having any “good” days at all, my manager helps strategize how to take things of my plate.

    It’s also useful to see if you can find any patterns in when you’re feeling better or worse. For example, I tend to have the most energy in the mornings, so I usually schedule more complicated tasks for the morning and simpler tasks for the afternoon. And I know that I’m likely to have spikes of anxiety after doing certain things, so I try to do those right before lunch so I can take a quiet lunch break afterward to calm down.

  94. DJ*

    I was going through some really bad months with OCD and depression a few years back. I had a good relationship with my boss and was able to tell her, “Hey, I am dealing with these illnesses, which gives me these symptoms. I am trying to do good work, but I need help with XYZ.” I used my lunch breaks to go to therapy, but my boss would have been fine if I used sick time, too. (The company didn’t offer much sick time, so even taking an hour a week for therapy would wipe out my sick time pretty quickly.)
    To cope with my symptoms at work, having structure helped. Not just, “get in at 8, eat at 12, leave at 5,” but having my to-do lists and priorities written out in my notebook helped a lot. Like, “My thoughts are everywhere right now and they’re unpleasant, but look, here is a list of things I can do.” I would break the to-do lists down into really bite-size pieces. Instead of “Paint teapot,” it would be, “Pick teapot. Pick paint color. Find paint brushes. Paint coat 1. Wait. Paint coat 2.” That made things seem manageable when things felt very unmanageable.
    I’m in a different job now. (And I’m doing better!) Sometimes I’ll tell managers/coworkers that I’m dealing with a chronic illness if I don’t feel like getting into the specifics. On the flip side, if someone tells me, “Oh, I’m really OCD about my browser tabs,” I’ll explain, “That sounds more like having a preference instead of having a disorder.” A lot people use a lot of mental illnesses as synonyms for things that, you know, are not illnesses. (OCD doesn’t mean you’re a neat freak, bipolar doesn’t mean you have mood swings, etc.) I don’t know that calling things out like that changes opinions or affects the company culture, but it at least makes me feel like I’m validating my very real illness, and if I need a day off or to step away from my desk, then I have a history of validating myself and my needs.

  95. Anon For This*

    I don’t have good advice for the OP yet. I’m in a similar boat. This has actually been really helpful for me to read. A couple of years ago my brain…came apart. Nothing too public or dramatic, but it was still very obvious that I was suddenly Not Okay. Turns I was having a full-blown mixed episode and I’d been been walking around with bipolar II for about a decade. (Fun Fact: ADHD masks hypomania really, really well.) In hindsight, I’m amazed I was functioning at all.

    The way things went down meant I didn’t get a choice about disclosing. My boss was understanding and supportive, made it clear that I should take the time I needed, and that letting low priority stuff slide was fine as long as I kept them in the loop. Anywhere else likely would have let me go, and I’m thankful they let me stay on. But as my treatment dragged out, I could feel their frustration building. Things were said that made me really wish they didn’t know or that I could afford to leave. The stigma is real, even when people want to help.

    My doctor did finally find the right meds for me. I’m regaining function, catching up on loose ends, and somehow my annual review was fine (?!). But I can’t put the toothpaste back into the tube.

    75% of the drive and energy that made this role a good fit were unhealthy mood cycles. It’s going to be really hard for me to keep up, even once I catch up. That person doesn’t exist anymore, but I’m still doing her job. Plus, there’s no workaround for the erratic weekly schedule that keeps destabilizing me; that’s just part of the position.

    This isn’t sustainable, so I’m going to have to find something else eventually. It’s going to suck. (I’ve been in this niche industry forever.) At least I think I can take my time.

    1. 'Tis Me*

      My husband has BPII. He loved running his own business – 98% of the time. But that 2% of the time when things were spiraling and he just couldn’t made it a bad fit overall.

      He’s been working in healthcare for the past 4 years – even if he’s having a less than stellar day, he knows he’s making a real difference to people’s lives, and he finds that helps.

  96. Usagi*

    I have PTSD from being fired in a really weird way from a previous job. I was a good employee: I worked closely with people at the top of the company, and had no reason to think I was going to be let go, and yet it happened.

    I found a job I like better, but I still get all kinds of anxiety when my manager calls me into her office, the COO walks around and stops by my desk, etc. I (again) have no reason to think I’d get in trouble for anything, but I can’t help it.

    What makes it worse (and what’s keeping me from talking to my manager about it) is that I feel like my PTSD isn’t “real.” Like when you think of PTSD you think of veterans who have been to war, victims of violent crimes, survivors of accidents… I just got fired from a job that honestly I didn’t even like that much. My therapist is working with me on it, and generally I’m able to logic my way through it (reminding myself that I’ve done nothing wrong, I have a good relationship with the people above me, not to mention they’re good managers and would make it clear if there was something wrong, etc.) but sometimes I just have to walk away and take a walk around the block or something to get away from it.

    Just a couple weeks ago, I was in my department meeting when the COO came in with one of the guys from IT. The COO was looking in my general direction, and did the “come here” motion. My heart started pounding in my ears, I felt all the blood leave my face, I had difficulty breathing, and I got tunnel vision. Turns out, she wanted to talk to the person sitting next to me about getting her a computer, and they needed her to log in so they could move her files. The person sitting on the other side of me noticed that something was wrong and asked about it, but I just feel so silly suffering from something like PTSD for such a (comparatively) silly little thing, and told her that I just randomly felt dizzy and needed a drink of water.

    Ughhhhhhh. I want to tell my manager? But what the heck kind of accommodations would I even need, let alone what kind of accommodations would my employer provide?

  97. QWR*

    I have OCD, and some related anxiety/depression. I am not out at work, because there are so many misconceptions about OCD that I don’t want to deal with on a daily basis. I figure that I would not share the details of a physical illness if I did not want to, and the same should be true of mental illnesses.

    However, I am completely unapologetic about my symptoms. If anyone asks, I just say somthing like “I know it’s a little quirky, but doing this helps me focus” with a big smile and a shrug. People usually don’t make a fuss about it if I don’t—everyone has some quirks, right? But there have been a few people who have pressed, and I always respond with “What a thing to say!” Or “What a thing to ask about!” When I say that with a smile, no one knows how to respond! Works like a charm.

  98. Zsa*

    First time commenter, long time lurker.. but I got some stuff to say around this.

    So, I was diagnosed with some severe mental illness stuff at 11 years old (I am 36 now), so I feel like at this time of my life, I have a lot of experience around this.

    I feel like when it comes to social acceptance of mental health, there is a hierarchy of what’s okay and what’s not. Anxiety and depression, generally don’t freak people out. Borderline Personality, Schizophrenia, dissociative disorders do. I think the more severe illnesses freaks people out because they might not know much about the disorder and, as a result, default to stereotypes and/or the media who highlight extreme cases of people with the illness who don’t keep it in check. Regardless of the level of social acceptance, I recommend to test the waters first while at work. Make an off comment about stress or something about a 3rd party or anything non-relevant, such as “did you see (enter random person here) they look really stressed, I wonder if its anxiety.” People who have strong negative reactions will show their views on mental health fast and without hesitation. Those are the folks to avoid. If you have a lot of those folks at work, keep quiet or it gets weird fast. My experience is that they quickly treat you as overreacting, weak, dumb, etc.. basically beneath them. It makes the work environment not so good and, for me, made me leave fast. I have quit jobs over this without a second thought.

    If you have coworkers who do not react negatively then you are good to go. Talk about it, normalize it like any other normal medical condition and they will follow suit. It’s liberating! At my current office I tell folks I had a rough day and need to run the anxiety off or I am feeling an onset and need to take a mental health day off. I don’t know about others but I can feel/know the signs days before the actual onset occurs (kind of like how my body gives indicators that I am getting a cold). I just schedule time off ahead to compensate. I also don’t let this be an excuse for my work! When I can operate at 100, I do. When I can’t I let people know but I still give it a try. Don’t make excuses or over exaggerate about it.. just treat/talk about it as nonchalantly as you would with a cold.

    Also, if anything.. don’t overthink it. You are you and people can take it or leave it. You’ll figure out what works for you.

  99. Data Analyst*

    I have bipolar II disorder and ocd (obsessive thoughts type). My experience is: like any illness, it can sometimes get so bad you can’t work, but that doesn’t mean you never can again. A couple years ago, after the birth of my second kid, I was having terrible post Partum anxiety. I went back to work but couldn’t get much done, I was agitated to the point of total distraction and I started to worry that I might suddenly stand up and start screaming, or kiss my boss or do something else really inappropriate for no reason (not because I wanted to – this is the obsessive thoughts part). My psychiatrist tried to change up my meds and was approaching it with the “let’s do whatever we can to get you over the hump so you can keep working” lens. She said at one point “let me know if you have thoughts of hurting yourself or others and we can think of some more intensive solutions” and I realized I was thinking “I’m tempted to just say I want to kill myself so we can jump to whatever that next level is.” So I let her know and she recommended a local behavioral health treatment center. I called for an intake assessment and I qualified to go there. I was signed up for short term disability (note: if your job offers that, everyone just sign up for it. You never know. I had only signed up for it because I knew I planned to have a kid and that’s how you pay for that leave…so glad I was on it since I did end up needing it for this other thing!) so I was able to be out a couple months and collect 2/3 of my pay. The treatment was exposure therapy to get used to the bad feelings from my anxiety triggers. So like, send an email with a deliberate spelling mistake. Tell someone an incorrect fact. (I was terrified of making mistakes or being wrong)
    This therapy helped me so so much. I had been very used to a mindset of “I need to everything I can you minimize my discomfort” when instead I needed to learn to tolerate discomfort.
    There have been backslides since then, but if I get too worked up I break out some of my tools from treatment, like my exposure workbook, and treat work as an exposure.
    I also told my boss what was up with me. Which was a mixed bag – he was kind an empathetic but also did not get it at all (think telling me “you shouldn’t be anxious about X!”)
    Anyway; that specific kind of treatment isn’t for everyone but I wanted to bring it up because often I feel like the advice of “get help” or “you should talk to someone” means like start weekly talk therapy and/or medications, but for people who have been doing those things for ages it can feel scary when that’s no longer enough. But that’s not the only game in town.

  100. Random IT person*

    Be open – not in detail.

    My office / manager knows about my sons autism diagnosis – as this results in more meetings at school etc.
    When I need to have some extra hours off – i can note ‘time off / sons name’ and it`s accepted. (of course, in IT making up these hours is easy).
    During the path to discover what this ‘autism’ is, and how it impacts people – we found out i shared a LOT of characteristics and mannerisms with my son – up to the point that we (my wife and me) are 99.9% certain I am on the spectrum too. (Formal diagnosis I do not dare, as that could result in me losing my driving license – and as sole provider that`s a risk i am not willing to take) .

    As I said, i`m in IT – so some of the ‘weird’ things one might see with an autistic person, has been attributed to ‘well, IT people are weird anyway’ . Plus it helps that I have my own office/workspace here – so i can effectively ‘hide’ if there is a need. (Sitting tapping on the keyboard with headphones on is seen as ‘oh, he`s busy, i`ll be back later’)

    What helps me is being open (yes, we found out i`m autistic too) – but don`t go into many details.
    What helps is if you have an environment that is understanding (Work, which i have – Family, less so – Friends, lost a few, kept a good one) – and have your own way of coping / destressing and somewhere you can do this safe.
    (If you need to let of steam by singing ‘Bohemian Rhapsody’ at the top of your volume – best not do that in an open plan office – but if you have a room (isolated) where you can spend 10 minutes – and it`s okay to do so (Server room for me!) – then make sure you can)

    I believe it helps that more people are ‘coming out’ on mental health issues too. Acceptance is slowly increasing.
    So, be open, be clear – and make sure you have support somewhere.

  101. foxinabox*

    I have managed a major mental illness at work both well and VERY badly. Here’s what I can tell you from my experience, which may or may not apply to you depending on your illness and resources:

    1) Be in open communication…with your mental health providers. Check in as honestly and often as you can and be willing to make adjustments in behavior and treatment.

    2) Focus on skill building and healthy coping skills that apply to you rather than specifically to work, because when you strengthen those areas in general, managing your job will become significantly easier. Rather than hyperfocusing on one thing you struggle with on the job, look at your overall thought processes and behaviors that hurt you, and work on those.

    3) Identify your workplace (culture and management) in terms of safety vs. stigma. Do not disclose anything more specific than you need to in order to get any accommodations you need–event a lot of nice bosses will keep your diagnosis in the back of their head, and that does matter.

    4) Research your workplace’s resources, including PTO, paid medical and disability leave, WFH, and other in-house accommodations. Teach yourself that it’s acceptable and sometimes necessary to make use of them.

    5) Be willing to evaluate yourself honestly for what you can force yourself to work through and what is making you feel worse. Do your best to shift your workload and tasks accordingly and be honest about the need to take a leave or seek more acute care.

    6) Being paid is very important, but being alive is even more important. If you can successfully do without one in order to secure the other, don’t cut yourself off from that option. Do make as graceful an exit as possible.

    7) Treat yourself well outside work.

    I know it can be rough, so good luck, and know you’re not alone!

  102. Ashley K*

    As someone who struggles with depression, anxiety, and a past eating disorder, as well as works in the ED treatment field, here are some things that help me/others in the same boat:
    -Having a fidget of some sort at the desk (ie. silly putty, stress ball, rock garden, …)
    -Emailing your therapist whenever something is up at work. Even if they don’t respond in depth, you can ask them to acknowledge they received it and you can talk with them about each instance at your next session. This has helped a lot of people I know to feel heard and get out of their head, especially if work is unsupportive. This can also help identify stress patterns and new triggers.
    -Pack pre-planned snacks/meals and eat them at scheduled times (if you are not doing so already). If you are seeing a dietitian they can help plan with you. If you need accountability and don’t feel comfortable disclosing at the workplace you can send a text to a friend/SO/dietitian whenever you complete your meal/snack and for challenging days schedule phone dates for lunch.
    -Wind down at the end of the workday with self-care. I know this is hard when you have mental illness, but doing some sort of self-care really helps. A friendly reminder that self-care is not all books and bubble baths, but is also taking a shower, doing laundry, budgeting, cooking, grocery shopping

    And lastly, you are loved, it is hard and I have faith that you can do this.

  103. GrumpyGnome*

    I am bi-polar type 2 and also have PTSD/associated anxiety. Last year was very bad for my mental health, it was the culmination of a few years of dealing with a toxic, overwhelming work environment and a horrible supervisor. I went on a modified schedule (work from home in the mornings, go into the office in the afternoons), and finally ended up taking off 3 months from work. I utilized FMLA for both of these actions. While off work, I attend 2 intensive outpatient programs back to back and was able to return to work much more like how I had been before everything got to be too much. For me, that time off was absolutely worth it and if that’s what you feel you need to do to ‘reset’ for your mental health, I would say do it! And make sure that if you are eligible, you look at FMLA. Good luck, OP!

  104. Rockin Takin*

    About a year and a half ago my depression/anxiety flared up and I realized I needed help because my coping mechanisms were not enough. I used my company’s benefits and got an appt through the emergency therapy program. The counselor was able to help me find a psychiatrist and therapist that would see me within 48 hours and I was able to start a new therapy and medication plan.
    When I spoke to my manager, I was vague and told him I have a chronic health issue that required regular check ups. He never asked for documentation, but I had it at the ready if he ever required it.
    Some days I just take a sick day because I cannot get out of bed or think straight or I cannot stop crying. It takes a lot to remind myself that mental health care is as important as physical health.

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