I was standing in a phone room in an unfamiliar building, the bare walls and cramped space barely a glorified storage closet. On the phone with my parents, I finally spoke the truth I was avoiding: “I’ve fallen behind again.”
I was behind on my work, my delays were going to impact projects, and this wasn’t the first time it had happened. Against this backdrop, I had the first panic attack I’ve ever had in my life. My heart pounded, my throat constricted, my body suffocated as a wave of nausea passed from my stomach up my throat. Tears rolled down my face bereft of any accompanying sobs or hiccups. My panic attack was observably silent yet simultaneously deafening from the thoughts rampaging in my own head.
I talked to my parents a few minutes more. My dad — a trained medical professional — gently talked me through how I was feeling. We managed to get my breathing back down to normal. I wiped the lingering tears off my cheeks and told them I had to go. My next meeting was starting in a few minutes.
I left the phone room and walked through a hallway to my meeting’s conference room. As I entered, I threw a confident smile on my face and cracked a joke, convincing everyone, including myself, that the glistening in my eyes was only an effect of the brisk fall air blowing in through the window.
The day of my first panic attack in September of 2018 stemmed from a habit of mismanaging my mental well-being at work. On the days leading up to that moment, I had let my mental health slip through my fingers like sand slowly sifting through an hourglass until, without realizing it, I was completely drained. That day persists as one of the low points in my career. But from those moments of pain we learn. And on that day, I learned.
You can manage your mental wellness in the workplace, and through my years of managing a mental illness at work, years of trial and error, years of successes and failures, I can show you how.
Almost 15% of employees experience mental health issues in the workplace. About one in five US adults are affected by a mental illness in a given year. Sedentary working conditions, like in an office setting, aggravate mental illnesses, encouraging lack of exercise and movement, limited time with loved ones, and sleeping and eating habits ruled by a clock instead of the needs of one’s body. The takeaway from these statistics is that mental health issues in the workplace are incredibly common. Understanding how to manage mental well-being in the workplace, however, remains largely unaddressed.
The gap between mental illness prevalence and perception is unfortunately understandable, especially in the workplace. Mental illness is stifled by a heavy stigma, one that people often can’t risk their jobs to upend. Data further demonstrate that revealing a mental illness at work can lead to incredulity from leadership. According to the Harvard Business Review, “One-third of employers would not believe the information on a sick note from an employee with a mental health problem.”
The corporate world’s disbelief in the reality of mental illness is a precursor to more drastic repercussions mental illness sufferers face at work: compared to neurotypical peers, employees who have taken mental health leave from their jobs are likely to be more closely supervised at work, demoted, or dismissed altogether. People who merely disclose a mental illness to their employers are perceived as less capable at their jobs, discriminated against in the hiring process, and are more often denied opportunities for training and promotions.
The first step in owning your mental health at work is to understand that it is not easy and that there is risk. But that doesn’t mean there isn’t hope.
The job that led to my panic attack was incredibly stressful. The team was a bad fit, my boss and I were consistently out of sync, and I had accepted a position in a country I was entirely unfamiliar with. To put it mildly, things were not going well. By September of 2018 I had been at that job for a year and a half, each subsequent trial at work building on the last, collectively constructing a heavy, Atlassian globe on my shoulders.
I’ve had depression for ten years, and my situation at work was further deteriorating my mental health, and fast. I had been considering requesting medical leave for months, in the hopes of removing myself from workplace triggers and recuperating my mental well-being. During my panic attack I confessed as such to my mom: “I can’t take this anymore; this was the last straw. As soon as this meeting is done, I’m setting up a doctor’s appointment to take leave.”
“Wait,” she said.
My mom, extraordinarily versed and resourceful, knew medical leave laws exponentially better than I did. She sent me into a different kind of shock when she told me that it’s still possible to be fired while on medical leave.
She was right. In the United States, if you’re on track to be fired, your employer maintains the right to legally fire you while you’re on medical leave (though in some cases you may have grounds to sue for wrongful termination).
In my situation, I wasn’t in the United States, so I wasn’t sure if employers still had those termination rights. Additionally, I had no indication, warnings, or track record that my employer was thinking of firing me. In considering formal leave, I’d already started the conversation with HR and also did meet with a doctor to get my paperwork. But even with my perceived low risk of termination and the legwork I’d already done to take leave, I gave up. I didn’t want to jeopardize my career. Instead, I resigned myself to trudge through a job that was actively undoing the heavy lifting of my Lexapro.
According to a Mental Health and Work report, I’m not alone: “Understandably, people with mental health problems may be concerned about how taking of sick leave will be viewed and as a result remain in work and sometimes become more ill.” Yup.
At that time, staying in my job hurt, and it was unbelievably scary. But it may have been the right thing to do. According to a study by the Workplace Safety & Prevention Services in Canada, two-thirds of employees who return to work after taking leave for depression “have trouble concentrating, remembering things, making decisions, and performing tasks — even though they may no longer be depressed.”
I was on shaky ground before I considered leave. Knowing that I wasn’t legally protected while on leave, and knowing that underperforming upon my return was a very real possibility, I gave up on the idea of leave altogether, and watched my mental health continue to diminish.
Though I decided not to take leave, medical leave of absence may still be the right thing in some circumstances. You are legally protected from termination without cause by the Americans with Disabilities Act. The exception I feared above only occurs if you take leave when the company was already planning to fire you. Further, the difficulty returning to work can be mitigated with a supportive team and gradual ramp-up plan for returning to work. If you and your doctor believe taking a medical leave is the right thing for you, absolutely do it. In the end, I only know what I decided. That doesn’t mean that I chose correctly.
With the possibility of taking leave from my job off the table, I was forced to figure out how to manage with my aggravated mental illness and a workplace pushing me further away from mental wellness.
In those months where I fought a two-fronted battle against my brain chemistry and my job, I was blessed that my path in life had fortuitously led me to long-term residency in the European Union. At a practical level, this meant that I was legally guaranteed 20 vacation days per year, and my job gave me 25.
Those vacation days were a temporary reprieve from the stress.
Science also says vacation days help. According to an article by Psych Central*, “ the anxiety-creating tendency to focus on something causing us distress, instead of thinking of solutions or getting over it, called rumination, lessens during vacations, and stays low even two weeks after vacation.”
This is great news, but for many, it’s not practical. The US has some of the worst vacation policies in the world, guaranteeing no paid time off for any working American. If a vacation isn’t possible, the silver lining is that US News and World Report posits that weekend trips give you the same relief without the logistic- and time-based overhead.
Tip: Vacations reduce tendencies to ruminate, or get caught up on painful past events. This reduction lasts up to two weeks post-vacation. If a full vacation isn’t available to you, weekend trips can accomplish the same effect.
Every morning I walked into the office, I hung up my cell phone as I passed through the entrance doors. Every morning I was talking to the same person — my dad. Even approaching the office and trying to see if my boss’s feet were sticking out under his desk made my heart race. Talking to my dad reminded me that there was a world for me beyond that office. That even if I got fired, I still had a place to go, and that despite all the pressure on my shoulders, the earth would still turn and my company’s stock price would be disappointingly unaffected by my departure.
In the evenings I called my boyfriend, recapping the day’s events, the unanticipated ups and the nauseating downs. I talked to fast-track the processing of those events, hoping that I’d free enough brain space to bear tomorrow’s stress, and then repeat the routine the following day, and the day after that, and the day after that.
Support networks — like I had with my dad and my boyfriend — are inseparable from mental health. During my days at this job, I leaned on my dad like I did when I was a kid, when his kindness was enough to brush away the harsh words of a bully or the scrapes from the playground. And as immature as I felt asking my dad to make me feel better after a rough day at work, it was one of the only life-preservers keeping me afloat in that job.
If you’re experiencing a mental health strain or crisis at work, have a support network teed up. It’s okay to warn them that they may not be able to help, but that you need someone to listen and someone to decompress with. If you don’t have that network, and you’re in or anticipating a time where your mental health’s footing may be at risk, establish that support.
Tip: Establish and use a support network to carry you through rough times at work.
In December of 2018, after harrowing months of resume reviews, applications, and interviews, I was overjoyed and painfully relieved to receive a job offer for a new position back in the United States.
I was finally done. I could see the light at the end of the professional tunnel.
I started on my new team in March of 2019. Now, I am steadily walking on a recovery path to being mentally well again.
To jump-start my recovery, the first thing I did was communicate my mental health needs to my new boss in terms of business impact. She knows about my diagnosis and she’s extraordinarily supportive of my endeavors to speak out for mental health and against its stigma. I am incredibly grateful to her for that.
Tip: If you need help from leadership at work, communicate it in terms of business impact. What effect will your diagnosis have on your work? What accommodations do you need? Your boss is your boss, not your personal therapist. Remember to treat her as such.
Next, I signed up for my employer’s mental health support benefits through my insurance. Right now I’m two sessions into my three free therapy sessions per year.
Tip: Leverage your work’s and your insurance’s mental health resources, if available to you.
Finally, in May of 2019, I became certified in Mental Health First Aid, where I learned to identify, approach, and help someone in a mental health crisis.
Tip: Learn how to identify and mitigate mental health crises, both in other people, and in yourself. This can be done through formal training, like Mental Health First Aid and QPR.
In short, those are precisely my final pieces of practical advice to you.
2018 was a personal hell for me. During the fire of that year, however, I stabilized my mental health under extreme strain, and I came out successfully on the other side. Post-mortem, I’ve reflected on that experience to fully refine my personal steps for mental wellness at work, even amid extreme adversity. The above is my polished plan, one that I hope to personally embrace as I fight to make sure I never drop to that level of unhealth in the workplace again. I hope you can learn from my story so that instead of hell, yours is, at worst, only purgatory.