Should I disclose my PTSD and Generalized Anxiety Disorder to HR?
August 23, 2017 4:15 AM   Subscribe

In order to provide myself with more security at my job, I am considering requesting reasonable accommodation under the Americans with Disabilities Act. Despite years of participating in weekly therapy sessions and taking (many) prescription medications to manage the symptoms for diagnoses of PTSD, Generalized Anxiety Disorder, and Dysthmic Disorder, I have experienced bouts of insomnia, anxiety, or panic attacks that have negatively impacted my performance with other employers. I always managed to persevere and perform well, but only with a lot of fancy footwork and struggling. I want to know if I have legitimate options to handle this in a better way with my current employer (a large university). I would especially like to hear from a) people who work in HR at large companies or universities, b) psychiatrists or therapists who have played a role in this process for patients, or c) individuals who sought reasonable accommodations for mental health issues like general anxiety disorder, PTSD, or depression.

I know very little about the ADA, although I did try to read about it as much as I could manage before creating this post. My questions are below in bold.

About me: I am in my early-ish 30s in the USA (Illinois if it helps with specifics of employment law). I am a survivor of child abuse. I have been seeing therapists since 2005 and am diagnosed with PTSD, Generalized Anxiety Disorder, and Dysthmic Disorder. I have in the past been diagnosed with Major Depressive Disorder (that was four years ago and my condition has improved since then). I am taking four prescription medications daily to manage my symptoms. I meet with a therapist once a week. I experience anxiety that causes me at times to:
-be afraid to eat
-leave my apartment
-speak to other people
-sleep more than a few hours
I experience some combination of these symptoms at least once a week. As you can imagine, it has a significant impact on my life.

About my role at work: I work a large top-tier private university in a fairly demanding role in communications/marketing. I am salaried and exempt, full-time with health insurance. I do not supervise any staff, but I interact with a wide range of faculty, staff, and students in a collaborative setting. There are evening and weekend events occasionally (although I also have the option to hire freelancers for these events in some cases). My work is mostly based around tasks on my laptop, although it does involve many meetings as well as speaking with individuals in person or over the phone. It might be relevant to note that I do not have my own office (I work in a kind of cubicle). Furthermore, almost our entire building is made of glass to promote transparency and collaboration.

How I have gotten by so far: We have a fairly flexible office environment, so I have quietly made up accommodations for myself without disclosing details to my manager, including:

- We have an open office plan with A LOT of noise, conversation, and interruptions. I use noise cancelling headphones and often opt to work in a soundproof pod within the office area (if it isn't already being used by someone else). Everyone can see me in the pod, but I am insulated from the noise. Sometimes I have to work in a hallway or a lobby or in a nearby building if the pod is taken.

- I have a weekly therapy appointment that begins at 5pm, so I leave fifteen minutes early on that day of the week. I note that I am leaving early on my calendar each week, but I don't explain beyond that.

- When I don't sleep at all, I usually (although not always) take sick leave. I don't explain that I didn't sleep well. I just say "I am not feeling well" and stay home. I try to do this only when I am at a point where I am hysterical or essentially not functional. In other cases, however, I come to work very tired and anxious to the point where it is nearly impossible to concentrate. However, my struggle with insomnia means that I am at risk of looking like I call in sick last minute too often.

- When I need to call one of my doctors, I try to choose a time when my manager is not around and then I hide in a stairwell to make my phone call. This is stressful because I am usually discussing very private matters and anyone can walk by me at any time. There is nowhere in the entire building where I currently can go and close the door to make a private phone call to a doctor. The building is packed with students, staff, and faculty at all hours. Since I do not have an office, I often try to find an alley nearby or if it's very cold outside, I go to the aforementioned stairwell. Occasionally, I can use a meeting room, but only if students are not already using it (which is nearly impossible to predict).

- My department is fairly flexible about lunch times, so I try to go for a walk during my lunchtime and practice breathing slowly to calm down.

- I have a great deal of difficulty eating in front of other people due to the abuse I experienced and due to my anxiety, so I go out of my way to find other places on campus to eat in a semi-private area. This can be very difficult depending on the student population and time of year. I have gone without meals for 8 hours or more because of this issue when I cannot find a semi-private place to eat.

- I have tried very hard to compensate for times when my PTSD, anxiety, or lack of sleep affect my work by catching up on the weekends or evenings when necessary. I had a stellar (and very thorough) evaluation at work this past spring, which gave no hint that my manager noticed any issues with my performance or consistency. However, with previous employers, I have been both formally and informally criticized for taking too much sick leave, having too many doctors appointments during work hours, "seeming tired", and "seeming sad." I have been let go from two jobs for those reasons. All of my previous employers were small non-profit organizations in a different state (Virginia) with fewer than 6 employees and no human resources department.

Here are my questions:

1) To the best of your knowledge, would any of what I am diagnosed with (PTSD, Generalized Anxiety Disorder, and Dysthmic Disorder) "count" as a disability under the ADA?

2) What do you think "reasonable accommodation" could look like for me given what I've described above? I am especially concerned with needing to take sick leave when I do not sleep, taking time off or leaving early for therapy appointments, and needing more privacy and/or quiet than my current workplace generally has available.

3) Are there risks I am exposing myself to by disclosing this information to my HR department? Could this harm my job security in some way? Would you advise not disclosing this matter to HR and continuing on as I have?

4) When I applied to this job last year, I did not disclose my diagnoses. Is it okay to do so now or will that be viewed as a problem by HR?

5) What, if anything, should I be prepared for as I begin this process?

Thank you all so much in advance.

P.S. I read this previous question, but it didn't really go into the details of what I would like to know.
posted by anonymous to Work & Money (12 answers total) 12 users marked this as a favorite
You might find this information from the Job Accommodation Network helpful. PTSD that interferes with your daily ability to function to the degree that you describe almost certainly counts as a disability in the U.S. under ADA law. Your employer may not see it that way, of course, and I'm not sure how up you are feeling to defending your legal rights if they push back at you over accommodations, but I do have hope that a university will be somewhat more understanding of people needing accommodations than the average employer, since they undoubtedly deal with accommodating students with learning disabilities and chronic mental health challenges on a regular basis.

It would be a good idea to come up with a short list of the accommodations you think would help you most before going to your employer. Your therapist may have already worked with other clients on accommodations requests, and might be able to help you come up with a list that seems reasonable.

It sounds like you would really benefit from at the very least having a private, quiet area you could retreat to at work to avoid noise and interruptions while you are working, to make phone calls from on your breaks, and/or to get some alone time during your lunch break. A quiet, private work area is the sort of accommodation that would benefit a wide range of different people (people with ADHD, people with sensory issues, people with autism, etc.) so to me it seems like a very reasonable request to make, although I'm not sure how easy it would be for your particular workplace to set up for you.

I think it's great that you are thinking proactively right now about how to make your work environment easier to navigate so that you can take care of yourself AND be the most productive employee possible. Good for you. I hope your employer will turn out to be ready and willing to help.
posted by BlueJae at 5:40 AM on August 23, 2017 [5 favorites]

Hire a local employment lawyer who has represented university employees before and has helped clients with the ADA interactive process. The accommodation you would probably need--intermittent leave--is a hard sell and was cutting edge when Obama was president. But the university is a big employer.

A lawyer who does ADA work can coordinate between you, your psych, HR, and university's lawyer and make sure everybody plays fair. That's the best part of hiring a lawyer for you, btw--uni will get theirs involved, and ze will counsel caution and expansive accommodation, relatively speaking. If everything goes south, lawyer can negotiate a good severance package for you.

HR's job is to protect the university, not to help you.

Start thinking now about exactly what accommodations you would need in order to be able to perform the "essential functions" of your job.
posted by radicalawyer at 5:40 AM on August 23, 2017 [2 favorites]

Thanks for asking this question. I have the same multiple diagnoses as you do and am in Illinois and I have a similar skill set. I don't know what to do either but I know what not to do. Don't go straight to your boss and have a heart-to-heart about your challenges. I did this once and I got fired and re-traumatized and have been "work-shy" ever since. I'm now freelancing and trying to screw up my courage to re-enter the workforce.

Feel free to PM me if you want to talk to someone who can relate!
posted by Beethoven's Sith at 5:50 AM on August 23, 2017 [3 favorites]

It sounds like you have done a really good job of finding accommodations for yourself without having to disclose, which is pretty cool! If you're interested in looking for more ideas for accommodations you might want to look at this page about accommodations and compliance for employees with PTSD - I'm sure the site has similar pages for other disorders.

It sounds like the main accommodation you need but have not yet figured out how to get is private space at work (for eating and important phone calls and to a lesser extent for general decompression time). You could try asking your boss about this, not necessarily with a full disclosure of your PTSD etc., but just in a "Hey, I have some medical things I am working through and I need to make sensitive phone calls sometimes - is there any way we could arrange for me to have a private space for that?" Maybe there's an soundproof study carrel in the library, or a music practice room, or a lactation room, or a single-stall bathroom with a locking door that you don't know about. Maybe someone is on leave and you could use their office.

If you feel that you need a whole office with a closing door to yourself, then it sounds like that's something you would probably need to formally disclose and ask for ADA accommodations for in your particular workplace, since it's not the norm.

It also sounds like you would like some reassurance that you are not taking too many sick days - that's something you probably need to talk about with your boss. Some bosses would be more tolerant of sick time if they know you have a diagnosed condition, others would hold it against you just as much. The best way to not seem to be taking too much sick time is to make up the time whenever possible, and to be as productive as possible during your non-sick time. If your boss isn't holding the sick days against you, I don't see any reason to disclose the reason for the sick days.

Basically you need to weigh the potential benefit of the accommodation against the potential stigma of being labeled as mentally ill... unfortunately the ADA really can't do anything to change your coworkers' attitudes or feelings (although in a good workplace shitty coworkers might get disciplined for overt stuff).
posted by mskyle at 6:39 AM on August 23, 2017 [1 favorite]

So, I think you might have better luck addressing this informally at first. As BlueJae says, universities can be among the most accommodating workplaces, in my experience. I would suggest the following things.

1) Talk to your supervisor informally about your work environment. Tell them that you have found the open office plan a little challenging and ask them if they have any ideas for how you might get a little more peace and quiet when you need it. You could mention that it is particularly tough when you are on phone calls. They may have some ideas and suggestions that you wouldn't have thought of. This is a very normal and understandable request, and doesn't need to have anything to do with your mental health issues.

2) If your manager doesn't have any suggestions, my large university has a campus-wide meeting room reservation system that covers everything from large lecture halls to individual rooms used for phone and video interviews. You might look into whether something like this exists at your university and begin reserving small rooms in your building or a nearby building for your lunch and for your doctor's phone calls. Is there a university library near you? That would be an ideal place to look for a suitable space. If it's not in your building, you can even combine it with taking your relaxing walks. It is also a very normal desire to have a private place away from your workspace to eat lunch and/or make private phone calls.

3) Talk to your manager informally about your sick leave. Explain that you have a chronic condition that flares unpredictably, and it usually requires you to take the day off when it does. If you can set their expectations around it (once a month, every couple of weeks, etc) and you have the leave available, it shouldn't be an issue, especially if you are good about getting stuff done and not leaving things dangling until the last minute. It can be inconvenient for meetings if you are an essential participant, but maybe you can arrange to call in to meetings on those days?

It sounds like you are doing a really great job at managing your health and your life. I'm impressed, and I hope everything works out for you without having to disclose anything you don't want to disclose, or go through with the whole official ADA accommodation procedure. Good luck!
posted by Rock Steady at 6:57 AM on August 23, 2017 [3 favorites]

Look up your university's FMLA process, if the use of leave is a concern. PTSD qualifies as a serious health condition, so on those days where you are recovering from sleeplessness and should not go to work because you will not likely have a " meets expectations" day -FMLA covers that leave use and protects you as a worker. The key is you need to have logged several months of work, not typically a year to qualify unless your employer's policy is more generous. If you have not been there long enough, this is something that you can consider as an accommodation - an early start for flexible leave use.

There are a lot of telework options in academia - check your hr website, and check yourself - is this a good occasional option for you? Do you communicate well with a work team remotely?

Are you a salaried employee or an hourly employee? If you are salary, or newly-salary, you may need to step away from a hard-line reporting culture. Keep an eye out for office culture as well.

When it comes to accommodations, *you* need to know what works best, in Partnership with your healthcare professional, so read over your job description, get a sense of what your essential functions are, and what, based on past performance, are your fragile points and how your get through it. What limitations does your disability cause? How can your employer work with you? Early start days on days you have an appointment? Flexible leave? Think about how you work best when your ptsd is under control, on the warning track, and flaring, and what gets you through, and that's your plan. Some may not require more than an awareness of existing policies and proceduress, if there is decent flexibility for attending to medical appointments and leave use.

If you are on a probationary period, read the fine print on what that is, too.
posted by childofTethys at 8:36 AM on August 23, 2017

The large public university I work for has a Disability Management Services office whose purpose is to work with individuals to develop accommodation plans. They then work with a department's HR rep to ensure that the plan is put into place. It's a very client-oriented service. They do require a letter of justification from a physician or therapist. Is it possible your university has something like that?
posted by mudpuppie at 9:47 AM on August 23, 2017 [2 favorites]

Honestly, I wouldn't. The one job where I disclosed the very same disability, I was fired the day after I dropped my disability accommodation paperwork for BS "unrelated" reasons. I would advise not disclosing to HR - even though you are legally allowed protection against such retaliation, in practical terms, if you don't have the money to hire a lawyer, you don't have a lot of options.
posted by corb at 12:21 PM on August 23, 2017 [1 favorite]

From experience as somebody with a letter of reasonable accommodation on file who works for a university in an HR/employment practices-related field, your medical professionals should be able to write a letter for you that describes your accommodation needs but doesn't state what your disability is. For example, my current letter (recently updated) says "Patient has a chronic medical condition and benefits from working from home 1 day per week and being provided reasonable accommodation to have a quiet and semi-private work environment. Noise-cancelling headphones are recommended."

Also, as a cubicle worker who needs to make private phone calls or duck away briefly for self-care reasons, I've learned how to check whether a meeting room is booked for the current hour/half hour, and will sometimes duck into a non-booked one when I need privacy. Would that be possible where you are?
posted by Lexica at 5:19 PM on August 23, 2017 [5 favorites]

Oh, and OF COURSE you didn't disclose during the application process, and no reasonable HR person with a brain in their head or familiarity with employment practices issues would expect you to.
posted by Lexica at 5:22 PM on August 23, 2017 [2 favorites]

Is it ever possible to work from home, especially when you haven't slept the night before? Occasionally (or regularly, like every Friday?) working from home seems like a reasonable request for any worker in that atmosphere, even without bringing any personal medical details into it.
posted by SuperSquirrel at 5:06 AM on August 24, 2017

1) To the best of your knowledge, would any of what I am diagnosed with (PTSD, Generalized Anxiety Disorder, and Dysthmic Disorder) "count" as a disability under the ADA?

Yes, it does.

2) What do you think "reasonable accommodation" could look like for me given what I've described above? I am especially concerned with needing to take sick leave when I do not sleep, taking time off or leaving early for therapy appointments, and needing more privacy and/or quiet than my current workplace generally has available.

Mostly it would involve formalizing the accommodations you have quietly built for yourself. With the issue around sleep, you may want to file for Family and Medical Leave (FMLA), which would allow you to take uncompensated time when you need to do things like recover by sleeping. This is basically a federal program designed to protect people who are in your position, or who have to care for a family member occasionally.

3) Are there risks I am exposing myself to by disclosing this information to my HR department? Could this harm my job security in some way? Would you advise not disclosing this matter to HR and continuing on as I have?

Honestly this depends on your relationship with HR and your bosses. There's still a lot of stigma about mental health conditions, as I'm sure you've noticed. What is your workplace culture like around disability issues? Do you know anyone who is being accommodated? Any history of it?

The other thing to look at here is whether your condition is stable, worsening, or improving. If it's stable and you've been getting along okay as you've been going, it may be good to keep doing that - the option where you keep your head down and don't call attention to yourself is always good.

The big problem I see is that it sounds like you have X amount of work that you have to get done, and while you have flexibility to miss a day and make it up, you have to make it up - is that correct? If so and you need a slightly lighter load, that may be where you run into trouble with having to disclose and with work getting cranky at you about it. Unfortunately the current narrative about the "good disabled person" is that we blend in 100% and compensate heavily for the things we have a harder time with rather than getting accommodations that we actually need.

4) When I applied to this job last year, I did not disclose my diagnoses. Is it okay to do so now or will that be viewed as a problem by HR?

These are conditions that can develop at any time, and if HR is run by reasonable people they will understand why you didn't disclose initially. You can also tell them that it had been mild and has gotten harder to manage.

5) What, if anything, should I be prepared for as I begin this process?

My serious advice is to talk to an attorney in this field and do whatever they tell you. You want someone who does labor law and deals with the ADA.
posted by bile and syntax at 12:44 PM on August 24, 2017 [2 favorites]

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