After graduating from college, Abby, a 22-year-old from Nebraska, accepted a dream job as an editorial assistant at a book publishing company in New York City. She had been attending weekly therapy sessions and taking antidepressant medication for the three years, and felt ready for the big move. At first, things at work were great—both of her supervisors were pleased with her performance. So initially she didn’t want to disclose that she was still receiving treatment for depression. “I scheduled appointments during my lunch hour, so I didn't feel the need to request a disability accommodation,” she says. “I didn’t really know how to anyway.”
But even though things looked like they were going well, Abby started self-harming. Five months after starting her job, she attempted suicide. In the aftermath, she missed three days of work without an explanation. It was time to tell her boss about her mental health struggles.
Abby’s case is extreme, but odds are there is someone in your office or workplace who is dealing with mental health issues. Mental illness affects nearly a quarter of women in the U.S. each year; 28 percent of women in a Glamour survey reported that their mental health struggles have impacted their career.
Liat had that experience. A 47-year-old licensed clinical social worker at a local government agency, she struggled with depression. About a year into her role in a new department, she got to the point where she needed to take a monthlong medical leave to seek treatment. When she returned, her colleagues and supervisor—all of whom are also licensed clinicians—seemed hostile. Her boss “reamed her out” on her first day back in the office about not completing all of her assignments before she went on leave, and she felt like the rest of her coworkers had frozen her out. “I hid in the bathroom stalls and sobbed,” she says. She wondered whether her colleagues might have treated her medical leave differently if she had been seeking treatment for cancer instead of depression. Five years later, things have gradually improved, but she never got an apology. "My coworkers and I have a pretty good relationship now," she says, "but we never discussed what happened."
Stories like Liat’s make the idea of disclosing your mental health struggles to your boss even more intimidating. The reality is that some bosses will always be jerks, but most experts agree it’s worth looping in your boss or HR department if your mental health is impacting your job performance. Every employee should be safe to disclose her mental illness to her employer without fear of retribution—that's the law. And there have been huge cultural strides in destigmatizing mental health. “Better employers see it as a part of the process of what it means to work with humanity,” says Theresa Nguyen, vice president of policy and programs at Mental Health America. These companies know that supporting an employee often is a win-win, since it helps the staffer produce their best work. While mental illnesses can mean time away from the office (employees coping with depression miss approximately twice as many work days per year) and job performance issues, many women learn to master the juggle and thrive at work.
When Abby did eventually tell her boss what was going on, they worked together to make accommodations: a flexible schedule that allowed her to take time off during the day when she needed to see her therapist and extra sick days that she could make up when she was feeling better. “I always felt really supported,” she says. Looping her boss in allowed her to get back on track and even excel in her role—a year later, she earned a promotion.
How can you get that kind of support from your boss? Should you bring up your mental health condition at all? We asked the experts how to tackle these toughies, whether you need a long lunch for a weekly therapy appointment or a leave of absence for more intensive care.
1. Test the waters.
What will my coworkers think? Will my boss judge me differently? Will it hurt my career? Those are all valid questions, says Nguyen: “Even though everyone has rights to accommodations, the reality is that asking for them is scary.” You can check the company handbook or website for any official policies. If you feel comfortable with your direct supervisor, it’s ideal to speak with her first, says Tanisha Ranger, a Nevada-based psychologist who has helped many clients broach the topic of mental health with their employers. Start by testing the waters, asking general questions such as, “If I have a recurring doctor’s appointment during the work day, how do you want me to handle that?” Her response can be a good indicator of whether or not she'll be open to giving you some flexibility. Once you’re ready to talk to your boss about your specific situation, schedule some time to speak privately.
2. Do your homework.
Before you have a more private meeting, do some due diligence—it’s important to walk into your boss’s office as prepared as possible and offer a plan that you’ve discussed with your therapist, Ranger says, rather than just unload your diagnosis and wait for your boss to provide the solutions. It helps to provide a list of requested accommodations and explain how each will help you perform to your potential.
In other words, you want to present your boss with a solution, not a problem. So explain how your mental illness may affect your work and how specific accommodations will allow you to perform to the best of your ability. For example, if you deal with PTSD and sometimes struggle with concentration, detail how working from home, where you can control your environment, could help you stay on course.
3. Be open to their suggestions.
Employees have a right to “reasonable accommodations,” but it’s ultimately up to employers to determine what reasonable means. Your boss may not immediately agree to all your requests, so be open to working together to finding creative solutions that will work for both you and your employer.
If an accommodation is minor, such as taking a long lunch once a week for a therapy appointment, a brief conversation with your boss will often suffice. But for bigger accommodations that will more drastically change your schedule, be prepared to work with HR too.
4. Know when to involve HR.
If you don’t have a good relationship with your supervisor or you’ve tested the waters and gotten the impression that she won’t be understanding, you can opt to go directly to human resources to discuss your situation.
This is often a more discreet option, since they can’t legally share the reason for your medical accommodations if you don’t want them to, says Jessica Methot, Ph.D., an associate professor at the Rutgers School of Management and Labor Relations. “This information is confidential explicitly because supervisors cannot be given information that can be used to discriminate against employees,” she says. “In this case, you would be protected under the Americans With Disabilities Act.” This means that even if you need to take a leave of absence, your boss doesn’t need to know why—you can work with your doctor and your HR team to fill out the appropriate Family Medical Leave Act (FMLA) paperwork. “All you need to tell your boss is that you have a medical condition and you’ve completed the FMLA paperwork with HR,” Ranger says.
If your employer is hostile or discriminates against you due to a mental illness, remember that there is the option of legal recourse—and that there are plenty of companies and supervisors that offer a nurturing, healthy environment that allows you to thrive in both your career and your personal life.
Caitlin Flynn is a writer in Seattle, covering health, politics, and travel. Follow her @caitrose609.