Max stress factor: what do I ask the doctor?
June 6, 2023 3:57 PM Subscribe
My job is extremely stressful and uncertain right now. My home situation is also extremely suboptimal, so it's just sort of miserable on all fronts. I have a doctor's appointment to talk about allergies on Friday. Can I also talk to her about this stress and maybe broach the subject of medical leave?
I wrote a whole long thing about my job and my home situation and then deleted it as immaterial. Take my word for it, things are very rough right now both at home and at work. It is not, by the way, helped by all the people at work who keep solicitously inquiring after my health by saying things like, "You must be so stressed! This must be terrible for you! You look so tired!" or my family who are, well, more than I can really handle right now.
Anyway. I have had horrible allergies this spring so I finally made a doctor's appointment. I am starting to think that I really need to talk to someone about taking a possible leave of absence so I can a) really look for another job and b) clear my house out a bit because I might just give up and move out. I have applied for another job two hours away, which would mean moving and I'm seriously thinking about applying for another one even further away. Meanwhile, I keep thinking that this level of stress is going to kill me sooner rather than later and I'd rather avoid that. My beloved adult child keeps saying things like, "You're so stressed and you're not handling it right." Which is also super not helpful, thanks.
How do you get medical leave of absence? What should I ask for? Can you even get one for stress? Would it be okay to do this at this appointment or should I make another one? This appointment is not with my PCP but with another at the same practice; my PCP is booked solid until mid July and I cannot wait that long.
I'm sorry if this makes no sense. I'm not thinking all that well right now, I recognize that. My brain is all foggy and I'm bouncing off the walls; my anxiety, recently under control, is back and I'm also trying to adjust to a CPAP machine that I just got, which is also stressful. Please don't tell me counseling: I do not have a counselor and finding one doesn't seem to be in the cards right now. I have not had luck with telehealth - I have tried twice, they were both terrible - and there is literally nobody taking new patients in my small rural town.
I wrote a whole long thing about my job and my home situation and then deleted it as immaterial. Take my word for it, things are very rough right now both at home and at work. It is not, by the way, helped by all the people at work who keep solicitously inquiring after my health by saying things like, "You must be so stressed! This must be terrible for you! You look so tired!" or my family who are, well, more than I can really handle right now.
Anyway. I have had horrible allergies this spring so I finally made a doctor's appointment. I am starting to think that I really need to talk to someone about taking a possible leave of absence so I can a) really look for another job and b) clear my house out a bit because I might just give up and move out. I have applied for another job two hours away, which would mean moving and I'm seriously thinking about applying for another one even further away. Meanwhile, I keep thinking that this level of stress is going to kill me sooner rather than later and I'd rather avoid that. My beloved adult child keeps saying things like, "You're so stressed and you're not handling it right." Which is also super not helpful, thanks.
How do you get medical leave of absence? What should I ask for? Can you even get one for stress? Would it be okay to do this at this appointment or should I make another one? This appointment is not with my PCP but with another at the same practice; my PCP is booked solid until mid July and I cannot wait that long.
I'm sorry if this makes no sense. I'm not thinking all that well right now, I recognize that. My brain is all foggy and I'm bouncing off the walls; my anxiety, recently under control, is back and I'm also trying to adjust to a CPAP machine that I just got, which is also stressful. Please don't tell me counseling: I do not have a counselor and finding one doesn't seem to be in the cards right now. I have not had luck with telehealth - I have tried twice, they were both terrible - and there is literally nobody taking new patients in my small rural town.
When I did this, I had to use specific paperwork provided by my employer. I would start there, but also check whether this doctor provides that type of paperwork (some don't/won't if you aren't their regular patient) and whether they charge for it (some do).
posted by sm1tten at 4:26 PM on June 6, 2023 [1 favorite]
posted by sm1tten at 4:26 PM on June 6, 2023 [1 favorite]
Best answer: ASK ASK ASK
Doctors KNOW how bad stress is for you. They know what it does to your organs and your sleep and your ability to bounce back - physically and emotionally - from the slightest fresh insult.
"Hi. I made this because my allergies are super bad but actually I am being crushed to gravel by stress and I need help with that even more, please."
You're going to burst into tears, so I recommend bringing a written list of the anxiety, stress, CPAP, brain fog, any medications you've tried in the past.
We have a bunch of HR-type people here who can give you the keywords you need to use with your employer - all the doctor can really do is eagerly agree you need it and sign whatever you need signed, if you even do need a signature and not just a verbal encouragement to take some leave. They may well know some things about the process but I would not lean on them to be experts on the correct workflow.
Counseling isn't really for this situation anyway, this is more like you are drowning and therapists are swim instructors - might could have helped in the past, might help at some point in the future, but not the lifeguard you need just at the moment. You are in burnout, and the primary thing you need right this second is relief - extended rest, probably meds for anxiety and sleep at least and maybe also bloodwork to see what's up with your B/D/Thyroid/A1C, reduced draw on your bandwidth, a chance to let your body heal from the terrible damage stress does.
And then you can worry about onboarding advanced coping skills. When you're rested, and maybe some of this other stuff has been more resolved.
I'm sorry you are so burned out and hurting and overwhelmed. You make perfect sense even though you are in a lot of pain. You're not exaggerating or mistaking a mild concern for a serious one; you are clearly fried to a crisp and are already miles down the highway past "perfectly OK to ask for help". You have all the necessary qualifications to ask for and receive some relief, don't let the head-goblins try to contradict me.
posted by Lyn Never at 4:29 PM on June 6, 2023 [38 favorites]
Doctors KNOW how bad stress is for you. They know what it does to your organs and your sleep and your ability to bounce back - physically and emotionally - from the slightest fresh insult.
"Hi. I made this because my allergies are super bad but actually I am being crushed to gravel by stress and I need help with that even more, please."
You're going to burst into tears, so I recommend bringing a written list of the anxiety, stress, CPAP, brain fog, any medications you've tried in the past.
We have a bunch of HR-type people here who can give you the keywords you need to use with your employer - all the doctor can really do is eagerly agree you need it and sign whatever you need signed, if you even do need a signature and not just a verbal encouragement to take some leave. They may well know some things about the process but I would not lean on them to be experts on the correct workflow.
Counseling isn't really for this situation anyway, this is more like you are drowning and therapists are swim instructors - might could have helped in the past, might help at some point in the future, but not the lifeguard you need just at the moment. You are in burnout, and the primary thing you need right this second is relief - extended rest, probably meds for anxiety and sleep at least and maybe also bloodwork to see what's up with your B/D/Thyroid/A1C, reduced draw on your bandwidth, a chance to let your body heal from the terrible damage stress does.
And then you can worry about onboarding advanced coping skills. When you're rested, and maybe some of this other stuff has been more resolved.
I'm sorry you are so burned out and hurting and overwhelmed. You make perfect sense even though you are in a lot of pain. You're not exaggerating or mistaking a mild concern for a serious one; you are clearly fried to a crisp and are already miles down the highway past "perfectly OK to ask for help". You have all the necessary qualifications to ask for and receive some relief, don't let the head-goblins try to contradict me.
posted by Lyn Never at 4:29 PM on June 6, 2023 [38 favorites]
I get that you are extremely underwater right now and I'm guessing the last thing you need is another research project, but you almost certainly need to get familiar with your employer's policies and paperwork before your appointment.
Assuming you're in the U.S., the most general (though not universal) access to medical leave would be through the FMLA, which does cover mental health and stress-related conditions under certain circumstances. You're legally guaranteed to get the benefit if you and your employer meet the requirements, but employers still have different processes and forms they use to process FMLA applications so you'd still need to do some research before your appointment. With your doctor, the key words here are "requires regular treatment by a healthcare provider (regular treatment generally means at least twice a year)" and "recurs over an extended period of time." Importantly, FMLA leave is typically unpaid - you can't lose your job for taking it but you also aren't entitled to a salary.
Apart from the FMLA, your options depend entirely on company policy. Your employer might offer sick leave, short-term disability, a sabbatical policy, etc., and your doctor can likely help certify that you qualify for whichever benefit you qualify for, but you'll need to know exactly what you'll be applying for, and what forms/certifications your employer asks for, ideally before your appointment.
posted by exutima at 6:00 PM on June 6, 2023 [2 favorites]
Assuming you're in the U.S., the most general (though not universal) access to medical leave would be through the FMLA, which does cover mental health and stress-related conditions under certain circumstances. You're legally guaranteed to get the benefit if you and your employer meet the requirements, but employers still have different processes and forms they use to process FMLA applications so you'd still need to do some research before your appointment. With your doctor, the key words here are "requires regular treatment by a healthcare provider (regular treatment generally means at least twice a year)" and "recurs over an extended period of time." Importantly, FMLA leave is typically unpaid - you can't lose your job for taking it but you also aren't entitled to a salary.
Apart from the FMLA, your options depend entirely on company policy. Your employer might offer sick leave, short-term disability, a sabbatical policy, etc., and your doctor can likely help certify that you qualify for whichever benefit you qualify for, but you'll need to know exactly what you'll be applying for, and what forms/certifications your employer asks for, ideally before your appointment.
posted by exutima at 6:00 PM on June 6, 2023 [2 favorites]
Best answer: Side note: stress makes my allergies worse. So if you were at all worried about bringing up a seemingly unrelated topic at your doctors appointment, it’s probably actually related.
posted by eviemath at 6:11 PM on June 6, 2023 [3 favorites]
posted by eviemath at 6:11 PM on June 6, 2023 [3 favorites]
I went to see my doc because I thought I wasn't coping. He listened carefully, then wrote me a note saying I needed two weeks off work. It can be done and you should ask.
posted by i_am_joe's_spleen at 7:58 PM on June 6, 2023
posted by i_am_joe's_spleen at 7:58 PM on June 6, 2023
Best answer: If my story helps here goes:
A few years ago, I was super stressed by my family and my job. The details are immaterial. Murphy’s law, once I realized I desperately needed a leave of absence from work my psychiatrist was unavailable. Of course. Sigh. But, I made an appointment with a doc at my primary’s office- my primary herself was full. The fill-in doc was nothing but compassionate. I explained that I needed some time off of work. This doc was happy to help. Despite only having been a doc for a couple of months this was not the first time he had encountered this. He wrote me off for a few weeks? and I followed up with my psychiatrist when he was available. So, even though the process was a bit awkward it went fine.
This happens! It’s common. Needing breathing room is normal and good on you for recognizing it!
I tried to do “one hard thing” per day and that helped me manage during my FMLA leave. Just one. You’ve got this!
posted by ticketmaster10 at 7:59 PM on June 6, 2023
A few years ago, I was super stressed by my family and my job. The details are immaterial. Murphy’s law, once I realized I desperately needed a leave of absence from work my psychiatrist was unavailable. Of course. Sigh. But, I made an appointment with a doc at my primary’s office- my primary herself was full. The fill-in doc was nothing but compassionate. I explained that I needed some time off of work. This doc was happy to help. Despite only having been a doc for a couple of months this was not the first time he had encountered this. He wrote me off for a few weeks? and I followed up with my psychiatrist when he was available. So, even though the process was a bit awkward it went fine.
This happens! It’s common. Needing breathing room is normal and good on you for recognizing it!
I tried to do “one hard thing” per day and that helped me manage during my FMLA leave. Just one. You’ve got this!
posted by ticketmaster10 at 7:59 PM on June 6, 2023
Yes, absolutely it's okay to bring it up with your doctor. When you first get shown to your room and talk to the medical assistant, bring it up with them and then bring it up again when the doctor walks in. If you have MyChart or similar you could send a message now saying "During this appointment I'd also like to discuss how to get a medical leave of absence for my physical and mental health. I am experiencing extreme stress at home and at work and am overwhelmed."
posted by The corpse in the library at 8:53 PM on June 6, 2023 [2 favorites]
posted by The corpse in the library at 8:53 PM on June 6, 2023 [2 favorites]
I would bring it up first thing at your appointment. More recently I’ve encountered doctors saying insurance (some sorts—when I told her I had Medicaid she said Medicaid does not do this) and billing pushing them to handle one “complaint”/issue per visit. So it is possible you will need to choose between addressing this or allergies.
posted by needs more cowbell at 6:55 AM on June 7, 2023
posted by needs more cowbell at 6:55 AM on June 7, 2023
Best answer: Just chiming in to say the worst asthma attacks I get are when I am anxious and super-stressed *and* it is allergy season - the stress is 100% relevant to your symptoms and should be mentioned.
posted by aiglet at 12:27 PM on June 7, 2023 [3 favorites]
posted by aiglet at 12:27 PM on June 7, 2023 [3 favorites]
Best answer: Just to add another anecdote, when I took a medical leave I just needed to have a form that basically said "nixxon is unable to work for X amount of time due to a medical condition". It didn't have to offer a reason (I guess different HR departments might be different). I got the note from my PCP, but my therapist and another specialist I see do this ALL. THE. TIME.
One bit of advice I'd offer is to ask for more time than you think you need. You probably need some time just to catch your breath before you start tackling all these things, and then some time to recalibrate after you've gotten things sorted.
I hope things start looking up for you soon!
posted by nixxon at 1:23 PM on June 7, 2023 [2 favorites]
One bit of advice I'd offer is to ask for more time than you think you need. You probably need some time just to catch your breath before you start tackling all these things, and then some time to recalibrate after you've gotten things sorted.
I hope things start looking up for you soon!
posted by nixxon at 1:23 PM on June 7, 2023 [2 favorites]
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Some years back I saw a dermatology specialist and mentioned problems I was having, and on the spot he gave me a prescription for an antidepressant and a referral to a psychiatrist. So it comes down to the individual doctor and it's certainly worth a try for you.
Good luck!
posted by anadem at 4:24 PM on June 6, 2023 [1 favorite]