Bringing Mental Illness Out of the Shadows At Work

Having mental health issues in the workplace is like having an STD at a bar filled with potential but very little opportunity for success if you’re open about your disease. I have struggled with mental illness, deep depression, and anxiety about my value to this world for the past 10 years. This has been deeply debilitating and has led me to seek out many forms of treatment. I began with weekly therapist meetings, which quickly moved to twice a week, and then turned to placement at an in-treatment depression residential facility for 75 days. That was followed by a year of daily processing, psycho-education, and therapy for the next 9 months. It also included an endless array of psycho-pharmacology mixtures that resulted in the diagnosis that I have treatment-resistant major depressive disorder. I went through CBT, DBT, EDMR, ACT and now I am engaged in MBT (Mentalization Based Treatment). I am exhausted.

I am both physically and emotionally exhausted from running from one treatment to the next, always hoping that this one will break through the fog and I will again believe that I have value in this world. While I have been struggling with my mental illness, my sons have struggled too. One son struggled to see his self-worth and engaged in destructive behaviors to feel and be noticed. He has spent the past two years in therapeutic boarding schools, an in-treatment residential center and he is now in a Base Camp Wildnerness program in southern Idaho learning to love and trust himself. My younger son developed a hyper form of social anxiety during COVID-19 and he could not return to school when the pandemic restrictions were lifted. But after working with his therapeutic day school, therapists, and psychiatrists, for the past 3 years, we were able to get him on a good path and I am happy to report that in the fall he will return to our home district school for high school. So I know success is possible.

Mental illness remains in the shadows for the most part. I have been very vocal about my journey in hopes of normalizing it to allow others to be comfortable with talking to me and others. Those who suffer, suffer in quiet externally, yet in a chaotic manner internally. Mental illness thrives and grows in darkness and silence, I know that darkness and silence only make it worse. 

What also makes it difficult is the “newfound woke” acceptance of mental illness in the workplace. Many leaders today claim they are aware that mental illness is a disease, just like cancer MS, or diabetes and they promise to recognize its victims and their needs in the same way.  But they are not acting like they are talking. To me, it feels like mental illness still lives in the shadows in the workplace. Leadership wants to accept mental illness as a “real issue that needs real attention” but they don’t want it to impact their preset policies or their “usually white, male, upscale attitude” that mental health is not a real issue rather it is a crisis conjured up by the weak-minded. I am sad to report that I hear from others, and have felt myself, the jeers for the frequency of appointments, time off needed to heal, or a break for mindfulness. One friend recently told me he was getting underhanded comments about the time away from keys he was taking for a combined personal and group therapy appointment (that amounted to 3 hrs a day, once a week.) So to get around the back office gossip he started taking several of these days as PTO. His company had unlimited PTO. So rather than simply stepping away for 3 hrs once a week, he had to resort to excusing himself for the entire day. It was more acceptable to his leadership to take a full day off than to accept that he had a chronic illness that needed to be attended to. Attended to openly and with limited time away from work. But like the “bro rule” of never mentioning STDs in a bar, there is an unwritten rule not to speak about mental illness at work.

I too recently had a similar issue. I was recommended a new drug treatment that had an 8-10 week protocol. For 2 weeks I would need to go to the clinic daily, then I would titrate down over the next 6 weeks to weekly visits. I was sure my company would not like/accept this need given our recent back-to-office policies that would make this treatment much more time-consuming. I therefore muzzled myself and declined to take part in this treatment. To be clear, my work did not deny me this opportunity, I denied myself the opportunity out of fear. Maybe sometime down the road, I will return to this opportunity.

There needs to be a cultural shift in the office about mental illness and how to mitigate its stigma. Similar to the cultural debates about WFH versus BTO policies that are currently occurring. These are the shifts in the workplace that I see are needed:

• ·       A belief that mental illness needs to be understood for the chronic disease that it is, like other diseases

• ·       Acceptance that time away from keys is allowable for weekly appointments (with proper notice – but not details)

• ·       The need for private spaces in the workplace to have the all- to-common zoom therapy session – the trend towards glass offices and open workspaces makes private calls at work almost impossible

• ·       Understanding that people have bad days and one bad day does not mean the person is bad; workplace misunderstandings need to be recognized in the context they occur

• ·       Acknowledgment that crying at work is not a weakness, it is a release for people with incredible emotions and stress

• ·       Allowing for flexible work schedules

• ·       Businesses must demand that health insurance covers mental health like any other disease

Today companies right poetic values that portend to demonstrate their acknowledgment of all different kinds of people, situations, and environments with a multitude of needs. Companies say they are open and flexible to meet people’s different needs. In my experience too often this comes down to the person you work for. And rarely will company values trump personal preferences when conflict arises. If you’re lucky to work for an empathic person, you can likely manage mental illness in the workplace. If you work for a less “developed” boss, your mental illness will live and grow in silence and darkness. People leave bosses, not companies. So if companies want to live their values, leadership must step up and set an example. We need leaders who lead with empathy and want to nurture an environment where all illnesses are treated equally and without discrimination.

Mental illness is so difficult to understand because there are often no visible wounds. But there are wounds. Feeling worthless, anxious, depressed, or incompetent are not indelible characteristics. They are symptoms that must and can be treated. If I drank alcohol, I would be called a functioning alcoholic for how I use legal drugs to cover my pain. But my drug of choice is cannabis. I use it nightly on top of my prescribed medication to numb my pain and get from one day to the next. So I guess I am just a pothead or a weed geek. But what I really am is a person who needs much more help to get through my depression than my insurance will cover or my workplace will tolerate. So I live life in the shadows trying to get through each day without breaking down,  crying in public, or taking irrevocable steps to end my pain.

This month, Mental Health Awareness Month is a chance for all of us to have open discussions about the type of society we want to be and how we accept and treat people with hidden mental health diagnoses. I hope this article sparks conversation in your workplace and mine.