Anxiety Issues Disclosure to Employer?
June 7, 2006 7:20 PM   Subscribe

This last wknd I had a little mental breakdown...three days of crying, incredible anxiety, not able to eat. So I took some time off from work and thankfully have a vacation scheduled for the rest of the week. The problem is that in 1.5 wks I am slated to go back overseas (the day after I got back was when the melt down started)...

and I am not sure if I am strong enough to go back over to the project I am working on. It is a slightly hostile environment at this client site and I am supposed to stay for a month. The day after the start of the melt down I went to the Doc and was prescribed a new anti-depressant and going to a psychiatrist next week.

So, finally my question. If by Monday I am not feeling strong enough, do I tell my boss I cannot go back and even more importantly-- why exactly? I really have idea how they will respond to my reason why I cannot go back overseas right away-- that I had a minor nervous breakdown.

It is not the project that caused the breakdown, but really just the straw that broke the camels work environment is very stressful and super competitive.

So, I wrote a book. Any ideas how I should handle this issue with my employer? Do I tell them precisely why I cannot go back overseas now? There really is not anyone else who can take my place on this project either which makes matters worse (and makes me feel even more trapped!)
posted by psususe to Health & Fitness (15 answers total)
do you know enough about your boss to know what the reaction might be? how he/she would view personal problems of this nature?

it might be a good idea to consider what alternatives you could present to your boss that might be acceptable...the boss might look more kindly on your bringing possible solutions rather than just the problem...for instance, would you be able to travel if you could take an assistant or a trusted coworker with you to take off some of the pressure, so they would not lose your input?...or could you find someone willing to go in your place who could maintain contact with you for the sake of completing the project?

definitely keep your priorities on taking care of's just a matter of minimizing, if you can, the burden it places on others (which they might appreciate enough to give you some slack) and at the same time protecting yourself...

...and if you don't feel prepared to go, definitely don't and your boss both could have more to lose the later a problem surfaces...
posted by troybob at 7:36 PM on June 7, 2006

(oops...yeah, i see you said you have 'no idea how they will respond'...i mean more how they have responded in the past to something like this)
posted by troybob at 7:37 PM on June 7, 2006

Does your employer offer any kind of employee assistance program? This is usually a service that you can phone to get help with and referrals for all kinds of personal (and sometimes legal) problems. If so, you should call the EAP and get their advice. They should maintain your confidentiality and not tell your employer about your problem.
posted by Joleta at 7:44 PM on June 7, 2006

I think your doc could prescribe some antianxiety meds for you to tide you over, if push comes to shove.

You might also want to watch your thought life-there really is some benefit to simply refusing to think of stressful things ahead of time.

I'm bipolar on meds, so I am definitely not minimizing the med part, but I have found that taking one day at a time and not stressing over coming events is crucial. At the very least give yourself a definite time each day to worry-and then don't do it the rest of the day.

And while I am at it let me recommend exercise-long walks are fine. There are definite physical stressrelieving benefits to exercise-for me sometimes the diff between going totally off balance and staying well is a workout. Seriously.

As to work, if it is that much of a strain perhaps you need to try to switch jobs. Most employers don't really "get" these sorts of problems, and having to explain why you cannot go overseas might cause you even more stress-but then if your psychiatrist recommends you don't go, a doc's note might be the way to handle it.
posted by konolia at 7:50 PM on June 7, 2006

The fact that you said new anti-depressant implies that you were on some already. If you have emotional or psychological problems, I would guess that trying to do something about that in a healthy manner definitely trumps staying at a job which may be contributing to the problem.
posted by nightchrome at 7:52 PM on June 7, 2006

Personally, I would not disclose anything of this nature to my employer in any great detail. It's a major career limiting move.

I have, however, had a conversation with my boss that goes something like this: "I have a chronic medical condition that I manage with medication. My doctors and I have agreed to change the course of treatment for this condition. The transition period takes 4-6 weeks, during which time I may experience side effects and may have to take some time off work." I especially had problems with insomnia/lethargy so I negotiated later morning hours. However I never did have to disclose the nature of my condition (and my medication change went fine and I didn't have to take time off after all).

The way I see it, the only way to get out of the overseas trip is to go on short-term medical leave and not go to work at all. Is that an option? Get a letter from your health care provider recommending leave, then hand over that documentation. Do not go into any further details. That said, I doubt that your provider would write you out of work for a month with three days of break-through symptoms.

Unfortunately, a new anti-depressant won't kick in for your required timeframe. Your shrink should probably also write a scrip for something faster-acting than anti-depressants, like a benzodiazepine (such as klonopin or ativan).

Don't forget, you might also feel better in a week and a half. Stranger things have happened.

You should probably be looking for a new job anyway if this one is not good for your mental health.
posted by crazycanuck at 7:55 PM on June 7, 2006

Although this is a complex decision for others to give advice on, I think either way you would gain by letting your boss in on at least a little bit of whats going on. Best case the boss might come up with a contingency plan to help you or to help you manage... granted worst case they might lose a little faith in you --But managers especially appreciate being in the loop above all else, and respect someone who knows their limitations (are you at your limit? almost?) giving more respect to you than if you broke down. From another perspective, there is how much risk you are in for losing the job vs your personal risk. In most cases of people in good standing with experience such as yourself, another job will come if need be--but your health is not such a cyclical resource, and should be managed more carefully.
posted by uni verse at 8:51 PM on June 7, 2006

Memorize this sentence: "I need to take a personal leave to deal with a [personal|medical] issue." Then STOP, and wait for your boss to speak. No need to go into detail. Your personal life is supposed to be private; you don't have to share all the gory details.

If they need more info to grant the leave, then do get the doctor's note. However, if possible have your therapist report back to your GP, then let the GP be the one who writes that note for your employer. Ask him or her to keep details to the minimum pertinent facts: you're under treatment for a medical condition, doctor's orders to take some time off, it's temporary leave.

If that feels too drastic, talk to your therapist about how much of your job duties you could realistically keep up under modified conditions (work from home? reduced hours?). You might be able to get your employer to cooperate with that as a disability accommodation under the Americans with Disabilities Act.

Either way, a note signed by a psychiatrist or MFCC might as well come with a scarlet M for "mental illness". It's not fair that some people still react to it with less compassion than for other types of illness, but while that bias exists it's best to do what you can to avoid falling victim to it.

Good luck, and take care of yourself.
posted by nakedcodemonkey at 10:04 PM on June 7, 2006

When I write letters of this sort for my patients, I'm extremely vague. I'll say something like, "Ms. X is under my care for a medical disorder. I have recommended that she take 2 weeks (or however long) off of work. You can confirm this by calling my office."

I then have the patient vet the letter. If the recipient phones me, they get the information in the letter read back to them, and nothing else. I'm sure any doc would do the same.

Assuming you're a USAn, your elected representatives have gone to great lengths - really a lot of care taken - to ensure that your medical history lawfully can't be anyone else's business. You should rely on this protection in your negotiations at work.
posted by ikkyu2 at 12:54 AM on June 8, 2006

Response by poster: Thanks for all of your responses. I am feeling stronger each day. I have been on Celexa for 5 yrs and I think that it pooped out...causing some of my problems now. I am migrating over to Effexor and the doc also did give me an anxiety med (Klonipan?).

I think that I will wait until Monday, after a vacation in the sun with my close girlfriends. I think that will help. At least I have stopped crying so much!
posted by psususe at 3:36 AM on June 8, 2006

If you do end up going overseas, you might ask your doctor if s/he can recommend a colleague or some other mental health resources in that city. It is important that you make a plan to take care of yourself in what you anticipate to be a less-than-ideal environment.
posted by judith at 5:00 AM on June 8, 2006

You definitely need a fallback plan, because if you have one, you'll worry less.
You should have drugs with you that you can take in case of emergency (which you have), and being in a strange place, you can probably claim "food poisoning/strange water/allergy to (fill in name of local spice)" and go to your room for a day or two if you have to. Nobody wants to know your symptoms in these cases, and they won't question it.
If you can't make it, get drugged to the eyeballs, pour yourself on a plane, and claim family emergency in the morning. (These are merely suggestions, obviously, your emergency plan may vary, and let's not read anything into the details here, just this is the sort of thing I would come up with if I had to.)
posted by unrepentanthippie at 5:53 AM on June 8, 2006

Just be sure that before you do anything, you review all your company's policies, as well as any applicable federal/state laws. If you know what your rights and responsibilities are, you will feel much more in-control of the situation.
posted by elisabeth r at 10:35 AM on June 8, 2006

definitely keep your priorities on taking care of yourself

Seconded, because it bears repeating.

Your main job right now is to stay as healthy as possible under the circumstances. "Family (medical) emergency" is a good way of phrasing things to avoid unnecessary questions, and in your case, perfectly true.

Go have an excellent vacation and put all thoughts of work and worry out of your mind during that week. But if you still can't operate at 100% when you get back, don't beat yourself up about it. I'm pretty much where you are right now, meds switching and all, and make no mistake: it's not easy. Anti-anxiety meds do help smooth the transition, so talk to your doc (who specializes in meds/is not your GP, right?) about that if you can. Hang in there...
posted by Vervain at 12:44 PM on June 8, 2006

Above all good advice. How about the long run for you, and what are your strengths? If the job is too much for you whether you are at home or abroad and you feel you can't hack it then that's one thing. If this anxiety and breakdown is more situational and time-limited, then you might want to consider how you would approach this if you were in a better state of mind. To pull out of a project where you are essential is obviously not good for your career. So how important is this job, and can you get through this trying time and still do what you need to do at work for this period of time. You might consider not pulling out of the project and getting through the month, then addressing the problems in therapy or in other ways on your return. If you look back in six months on this decision, from a place of greater insight and feeling more together, would you have wished that you pulled out or stayed with it? or have you already decided you are not going and just want advice on what to say to your employer?
posted by madstop1 at 5:13 PM on June 8, 2006

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