How to bring up depression treatment with employer?

May 8, 2011 3:26 PM

Should I inform my employer that I have just started taking Lexapro for depression and anxiety?

I understand it can take a few weeks for the side effects I am experiencing to pass (dizziness, nausea, insomnia) and these will certainly impact my ability to perform my job in marketing communications at a big company that seems to talk the talk on worklife quality. I think I will need a flexible work schedule (telecommute, half days) and maybe miss an upcoming trip. What is the preferred protocol? Talk to my manager and HR representative at same time? Just my manager? I am also concerned about the stigma associated with depression. I have a good professional relationship with my manager of 6yrs, but we RARELY discuss personal stuff..

posted by punkfloyd to Work & Money (20 answers total)

I wouldn't say, like, "YO I'M DEPRESSED," and then kind of sit there waiting for them to be all, "Oh, that's cool."

I WOULD and HAVE said something like, "My doctor recently prescribed me a new medication that takes some getting used to. She recommended that I take it easy at first. I'm really happy because I can still work. Is it okay if take some PTO from DATE to DATE and then telecommute X times per week until DATE? I've already checked with Florence in Accounting, and she can cover the widget project, and I've prepared a few foobar reports in advance. Do you need anything else from me?"

Bosses like it when you solve their problems for them.

I suspect they won't ask you what your medical thing is. Bosses don't like to ask about your medical issues, because when you say "doctor," bosses actually hear "lawyer." It's a little known fact about management.

If they do ask what your medical issue is, smile vaguely and say something like:
"I would prefer to keep that private."
"Oh, don't worry, it's nothing life threatening."*
"Oh, just something chronic that flairs up once in a while."
"Oh, I'm sure you don't want to hear the gory details."

If you're feeling really bold or really comfortable, use "plumbing issue" or, if you're a lady, "feminine trouble."

*This is not to discount the many people for whom mental illness is life threatening, which might of course include you, OP. If so, use one of the other options.
posted by Snarl Furillo at 3:51 PM on May 8, 2011 [30 favorites]

What Snarl Furillo said. There's that stigma around mental health issues that you don't want to open up and you really don't have to. In similar situations, I've not had to make any disclosures but got the flexibility to work through it. In my case, once the meds were working my boss actually noticed I was being happier and a better worker and ended up with a promotion.
posted by birdherder at 4:12 PM on May 8, 2011 [1 favorite]

By law, your medical history is protected and you are not required to share the details with anyone. Obviously, your HR department will know something about your illness because they get more information from your insurance company and doctors. However, they are obligated to protect your privacy. Therefore, so long as you focus on the work arrangement with your boss and colleagues, it should be adequate. In all probability, your boss will actually not be too keen to know the details of your illness. Good luck and get well fast.
posted by harigopal at 4:25 PM on May 8, 2011

Obviously, your HR department will know something about your illness because they get more information from your insurance company and doctors.

I am pretty sure that this hypothetical situation is both wildly unethical and illegal.
posted by elizardbits at 4:32 PM on May 8, 2011 [4 favorites]

If your manager is the only one who really gets involved with changes in schedules, I'd say start casually with the manager, with some medical literature in your back pocket should it come up. You never know, your manager might know someone on similar medication, and understand the changes that could take place.

Even if your manager needs to talk to HR about some temporary changes, start with the manager to get some internal understanding of your situation, then go with your manager to HR, or maybe even let your manager talk with HR.
posted by filthy light thief at 4:39 PM on May 8, 2011

Should I inform my employer that I have just started taking Lexapro for depression and anxiety?

Hell no.
Feel free to tell them that you are dealing with some medical issues, but you have no obligation whatsoever to give them any diagnosis or medications or other specifics. And it would be a bad idea, job wise. Sadly, mental health issues are not yet well accepted in the workplace.

Your HR department will know nothing about a diagnosis without your written consent.*

If you think that side effects could affect our work for a while, then SnarlFurillio suggestions are the way to go.

PS: Good luck with your recovery!
*This answer is US centric. Your mileage may vary.
posted by SLC Mom at 4:53 PM on May 8, 2011 [3 favorites]

*your* work, obviously.
posted by SLC Mom at 4:53 PM on May 8, 2011

I would not discuss specifics with either your manager or your HR rep.

What I would do is mention casually to your manager that you've started some new medication and it takes some time for your body to get used to it, and that in the near term you may not be "all there."
posted by dfriedman at 4:59 PM on May 8, 2011

I work for a very small company, and I haven't told them about my mental health issues. My boss may have guessed, but all I tell him is that I need to leave early to see a doctor every month. When I was on my meds, any side effects were passed off as tiredness or hangover.

I don't know if it would cause problems if they knew, but better safe than sorry.
posted by Lovecraft In Brooklyn at 5:05 PM on May 8, 2011

Unless you are very, VERY tight with your boss, I would not go into the specifics of your medication. If they ask for specifics, tell them it's your blood pressure. (Many of the currently available BP meds cause nausea for a bit.)

What time of day are you taking your Lex? I have been on Lexapro (10mg) for about 4 months now, and found that the side effects were the worst when I took my pill in the morning. My doc told me to switch to evening, so now I take it with supper and sleep through the side effects.

If this is impractical for you (particularly if you try taking it at night and you end up experiencing insomnia), there are things you can do to alleviate the nausea. Pickled or sugared ginger, ginger tea, or ginger gum help immensely. Small meals throughout the day, and avoiding high fat or spicy things for a bit will help, too. Except for the occasional bout of dizziness on rising, my side effects went away within two weeks. (Obviously, YMMV.)

Good luck to you, I hope the Lex makes as big a difference in your quality of life as it has in mine! It's really nice to not feel broken any more.
posted by MissySedai at 5:19 PM on May 8, 2011

You don't even have to say it's a medication. Just say that you're having some health problems (true), you need some accommodations, and you'd be more than happy to provide a note from your doctor if required. If it's a pdoc and you're not comfortable presenting that letterhead, you can ask your GP to write the note.

Depression can make everything seem harder and worse than it actually is. This is totally not a big deal, HR deals with it all the time, and your tenure at this company suggests that you have developed solid relationships and a solid reputation. Kudos to you for getting help and taking steps towards a happier future!
posted by charmcityblues at 5:25 PM on May 8, 2011 [2 favorites]

My manager would screech HIPPA!, hold up his fingers in a cross and back away.
posted by roboton666 at 5:39 PM on May 8, 2011

Response by poster: @MissySedai

I take it in the morning. 5 mg for the first 4 days then 10 mg on the 5th day. That's when nausea and dizziness hit big time. I have heard conflicting things about benefits of taking in morning vs. evening as it relates to side effects.
posted by punkfloyd at 6:03 PM on May 8, 2011

Maybe it's a generational or organizational culture difference but I'm surprised by the level of paranoia in most of the answers given so far. So many people are on anti-depressants and other psych meds now that I just don't think it's such a big deal anymore. Treating it like its some sort of a shameful secret just extends how long it remains a stigma. You say you have a good working relationship with your boss, and I'd assume that after 6 years you should have a pretty good idea of how fair, reasonable, ethical, etc. he/she is. If your manager is a good person, then it shouldn't be a problem. (If your manager is not a good person, why are you still working there?)

I've been 100% open with my boss and coworkers about my problems with depression and anxiety over the past year, including my hospitalization for a suicide attempt in March. They have been 100% supportive. The whole experience has really opened my eyes to how empathetic most people are when you give them a chance to be, and eliminated any lingering paranoia I had about sharing my personal life with the people I work with. (It also made them feel comfortable enough to share their own problems with me, which has led to some fascinating insights into their own characters.)

I don't know what your career/financial situation is and thus your level of risk tolerance. But personally, I finally decided that trying to maintain a wall between my personal and professional life was just too dehumanizing. If the people I work with decide to be shitty to me because I'm a human being with human emotions and not a piece of office equipment, well, fuck 'em, I'll go work somewhere else with people who don't suck.
posted by Jacqueline at 8:15 PM on May 8, 2011 [1 favorite]

I have heard conflicting things about benefits of taking in morning.

Sure, because everyone reacts differently to different meds and dosages. For some people, Lex doesn't work at all, and they have to switch altogether.

Talk to your doc about ways to minimize the side effects. For me, taking it around 8PM works a treat - much later than that, I'm still a little dumb for a couple hours after I get up.
posted by MissySedai at 8:30 PM on May 8, 2011

If it was me I would say I started taking a prescription medication that could have some side effects while I get the dosage straightened out. Most bosses won't push for more info and dizziness and nausea are common side effects of many drugs including blood pressure medication. I would also say that it might not affect your work at all and you just wanted to give her a heads up to the possibility. Tell her you will let her know if it becomes an issue and invite her to approach you if she notices your work slipping. Only at that point would I discuss things like modified work schedules or telecommuting (however, if you're allowed to telecommute, by all means ask for it). I wouldn't go into it assuming you will need a modified work schedule or anything like that because you might not and that might concern your boss for no reason.

Keep it factual and simple - I'm starting some medication that might have temporary side effects. If it does I'll let you know (or you let me know) and we can come up with a plan.
posted by thebriguy72 at 9:42 PM on May 8, 2011 [2 favorites]

Never go into personal details with your employer - it will most likely end up being used against you in a way that you do not anticipate. If you need to take off because you are not feeling well, then take off. If your employer requires a doctor's excuse, then have your doctor write an excuse. Doctors know enough not to provide sensitive and personal information on the written excuse form.

If your employer wants details then all you need to say is that you are on medication that will temporarily impair your abilities without going into any more details. Do not let your employer coerce you into providing personal information. If they insist then keep track of what they request, dates and times, etc that will be necessary in a lawsuit.
posted by JJ86 at 6:19 AM on May 9, 2011

@doublehappy: Yup, I know that I am fortunate to be blessed with an extra-cool boss and workplace, which is why I began that paragraph with "I don't know what your career/financial situation is and thus your level of risk tolerance."

However, I didn't realize just how extra-cool everyone at my workplace is until I did start letting them in on what was going on with me. So I encourage others who can afford to take such risks to do so -- you will likely be pleasantly surprised by how empathetic your boss and colleagues actually are and how willing they are to reach out and help and support you through your crisis.

For me personally, the outpouring of support at work has had a huge effect on reducing the situational factors contributing to my depression and anxiety disorder (although there's still clearly something chemical going on as well). If I had kept it all to myself and had to force myself to struggle to "act normal" every day at work then I would be in a lot, lot worse shape right now.

I guess my overall point is, if the OP has a good working relationship with his/her boss of 6 years, then he/she shouldn't automatically write off the boss (and possibly other work colleagues) as another source of emotional and other support while he/she copes with depression. But of course this is left to the OP's judgement about how those people would react and his/her risk tolerance when it comes to managing his/her career.
posted by Jacqueline at 9:45 AM on May 9, 2011

Response by poster: Thanks for all the thoughful responses. All it took was a quick, nonspecific chat with my manager and I feel much, much better about the coming weeks. Very typical of me to get worked up over something like this. (Thus the Lexapro).

By the way, my side effects with Lexapro in a managed switch from a 10 yr stint on Paxil have been extreme nausea, dizziness, insomnia and pulses of heightened yet unfocused anxiety during the day and night. After about a week on Lexapro things are beginning to calm down a bit.
posted by punkfloyd at 10:20 AM on May 9, 2011

I'm coming off Effexor myself, and was on Lexapro previously. I would bet, from what I have heard about Paxil and experienced with Effexor, that your side effects are going to be a lot less significant going on the Lex than they have been going off the Paxil. That one is hard to get off of. I always found Lexapro to be rather gentle, as these things go. I only switched because it wasn't helping me as much as I needed it to. But for the most part I hear very good reviews of it from friends who are on it. Good luck!
posted by Because at 6:25 PM on May 9, 2011