American Association for Physician Leadership

Quality and Risk

Should You Talk to Your Boss About Your Mental Health?

Deborah Grayson Riegel

July 5, 2022


Abstract:

Talking about your mental health at work shouldn’t become additional stress for you. If you find yourself in a situation where it’s hard to engage with senior leaders about your wellbeing, it may be time to look for opportunities at organizations that value your whole, authentic self. Ultimately, it is the responsibility of the employer to create conditions that make you feel safe and valued.




When I started my first job, I worried about disclosing my struggle with obsessive-compulsive disorder (OCD) to my boss. I was almost certain that she wouldn’t understand. Once she knew, I told myself, she’d assume I was unreliable and uncommitted. I imagined she’d deem me unworthy of a promotion, or worse, be entirely dismissive.

For two months, I ruminated about how the conversation would play out, envisioning every negative outcome. Eventually, I came to this: If I didn’t talk to my boss, I wouldn’t be able to ask for the support I wanted.

So, one day, I mustered up the courage, and contrary to my fears, she was empathetic and reassuring. Slowly, I began opening up to my peers and colleagues. I learned that I wasn’t the only one living and working with a mental illness.

Looking back, it’s surprising that I believed my experience was unique. Nearly one billion people in the world live with a mental health disorder, including 47 million Americans. Since the pandemic began, symptoms of anxiety and depression have also risen in the U.S. Around 80% of people aged 18 to 24 reported moderate to severe symptoms last year.

Still, discussing mental health in professional settings continues to be a stigma. The problem is that when we deliberately avoid addressing mental health at work, that stigma grows. Breaking this cycle often starts by acknowledging our struggles.

When we do (and research confirms this) we are likely to be happier, less stressed, and more confident and productive in our jobs. Opening up can even nudge others to share their experiences — creating a more trusting, psychologically safe, and inclusive space for everyone.

That said, while there are many positives to speaking up at work, it can be difficult to navigate — especially for those of us who are new to a job or just beginning our careers. So, remember: Never pressure yourself to disclose if you’re not ready. If you feel you have more to lose than to gain, or need more time to come to a decision, don’t force it (and be patient with yourself along the way).

Here are some things to keep in mind when (and if) you feel ready to have this conversation.

Understand what you’re disclosing.

First, identify whether you’re experiencing a mental health challenge or a mental health disorder.

A mental health challenge takes place when there’s a major change in your thoughts, feelings, or behaviors that interferes with your ability to work or live your life as usual. It may be temporary if it is triggered by a specific stimulus or event. For instance, a trigger could be social isolation, experiencing discrimination or bullying at work, a recent breakup, a sick family member, or another significant occurrence.

A mental health disorder, on the other hand, is often long-lasting, and formally diagnosed by a medical or mental health professional. It may disrupt your ability to work, carry out daily activities, or engage in satisfying relationships. Examples include depression, anxiety disorder, substance use disorder, eating disorder, post-traumatic stress disorder (PTSD), and bipolar disorder.

Pay attention to your symptoms and how they impact your day-to-day functioning. If you’re having a hard time getting work done, sleeping well, or interacting with others, it might be a sign to seek help — from a professional, as well as at work.

Even if you recognize that your condition is temporary – such as sadness associated with a recent breakup – know that many people benefit from some support. Think about what has worked well for you during past mental health setbacks, if you’ve had one before: Was it speaking with a close friend or family member? Attending a support group for people experiencing similar challenges? Talking to a professional?

Take some time to figure out what’s going on with you, and what kind of support you need or do not need both in and outside of work.

Lastly, know that you don’t have to share your struggles if you don’t feel comfortable doing so.

Think about your “why.”

Before disclosing your challenge or disorder, think about what outcome you want. Are you sharing information to build trust with your manager and team? Do you have specific requests that you would like your employer to meet? Is your goal to better understand the workplace policies around mental health?

For instance, if you are facing a mental health challenge, like taking care of a sick parent, and this is impacting your headspace at work, you could plan to tell your manager that you are experiencing additional stress. In this case, you may think about requesting some time off or asking for permission to step out of meetings if an emergency arises.

If you are disclosing a longer-term mental health disorder, your goal might be to ask for more permanent accommodations. For example, if you are dealing with a disorder that impacts your concentration, you might request to have a quiet workspace or a more flexible schedule.

Either way, you should be clear on what you want and why prior to the conversation.

Know your rights.

Before you approach your boss, know that you are not required to share your medical record with anyone. Only refer to the details that you are comfortable with, or that you feel are relevant to your performance and wellbeing at work.

You may be entitled to certain legal rights in your city, country, and organization. Take the time to read about the current laws on disability protection and mental health in your country of residence or employment, as well as the policies in your organization. You may want to ask your HR team for additional information if you feel comfortable doing so and you trust your HR team to keep your request confidential.

Many protections around workplace disabilities include mental health disorders. For instance, if you have a U.S. employer, it is illegal for them to fire you, modify the terms of your contract (including your salary and benefits), or withhold opportunities like promotions, transfers, and professional development programs from you for disclosing your mental health conditions.

Prepare to share your experience.

You might have been living with depression, anxiety, OCD, or another mental health challenge or disorder for years. But remember, this could all be new to your boss.

Even if they are familiar with your experience — either personally or by association — it doesn’t mean they understand you, your experience, and your unique needs. So, come to the conversation ready to share what your challenge or disorder means and doesn’t mean for you.

Explain to your manager that each person’s experience with mental health is unique. For example, you might say, “I have obsessive-compulsive disorder. For me, that looks like invasive thoughts that can affect my focus at work. When I’m triggered, I have a hard time focusing on a single project for more than one hour at a time.”

Educating your manager also means being open to their questions. But know that you are allowed to set boundaries when questions feel too intrusive or personal. If you disclose that you’re in recovery for a substance abuse disorder, for instance, you might be willing to share that you attend regular Narcotics Anonymous meetings. However, if they ask about what substances you’ve used in the past and their question feels like it’s crossing a line, all you need to say is, “I’m not comfortable sharing that.”

While you don’t have to talk about topics that feel too personal, you can always assure your manager that you have resources in place to support you outside of work (if this is true). That way, they understand that it’s not their job to be your counselor or therapist.

Tell your manager what you need.

If you’re looking for support from your manager and team, make a clear request.

You might say, “I take medication in the morning to help me manage my ADHD. It doesn’t really take effect until 10 in the morning. So, if you have something to discuss with me that really needs my focus, I would appreciate us scheduling those meetings after 10 so I can be fully present.”

You can also reassure your manager that you will reach out for help if needed. You can say, “When I’m taking medication, I can sometimes get a bad headache. I know you and the team care about me — and I promise to proactively share what I need and how I’m doing if I’m not feeling well. How does that sound?”

I also recommend asking your manager or HR department whether your organization offers the following benefits:

  • Access to an EAP (Employee Assistance Program), a confidential workplace service that employers pay for and that provides free counseling for employees

  • Health insurance with no or low out-of-pocket costs for mental health care

  • Free or subsidized coaching, counseling, or self-management programs

  • Workshops on stress-management and mental wellbeing

  • Quiet workspaces or headsets if you’re going to the office

  • Extended PTO or sabbatical leave for mental health reasons

It’s okay to ask about any or all of these. Know that the resources your company offers are for everyone. You’re not alone in seeking this support.

Reinforce helpful behaviors.

When you disclose information about your mental health, it’s likely that your boss will feel concerned — about you, about the team, about the workload, and even about themselves.

Ensure that you give them regular feedback on what’s working and what’s not. Acknowledge their small gestures, and reinforce behaviors that are helpful to you. This will not only improve your relationships and work environment, but it may also help others feel more comfortable opening up about themselves.

For instance, you can say, “When you asked me whether you were overstepping by suggesting I take a day off, I really appreciated that. It felt like you cared about me, and how you could be most helpful. Thank you. Also, you were not overstepping. It was just what I needed!”

Ideally, being honest with your boss will help you both create a plan that satisfies your mutual needs. However, if your manager or company culture promotes an “always-on mentality” or doesn’t appreciate your vulnerability, it may be a sign of a toxic relationship or workplace.

Talking about your mental health at work shouldn’t become additional stress for you. If you find yourself in a situation where it’s hard to engage with senior leaders about your wellbeing, it may be time to look for opportunities at organizations that value your whole, authentic self. Ultimately, it is the responsibility of the employer to create conditions that make you feel safe and valued.

A job is just a job. No project, deadline, or meeting is worth sacrificing your physical and mental health. It is possible to be an effective and productive employee while still taking care of yourself.

Editor’s Note: The opinions expressed here are for general informational purposes only. If you have concerns about a mental health disorder, we recommend you consult with a medical professional.

Copyright 2021 Harvard Business School Publishing Corporation. Distributed by The New York Times Syndicate.

Deborah Grayson Riegel

Deborah Grayson Riegel is a professional speaker, as well as a communication and presentation skills coach. She has taught for Wharton Business School, Columbia Business School, and Duke Corporate Education.


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