How to Talk to Your Boss About Your Mental Health

By Steve Calechman
September 29, 2022

For some who are living with mental illness, navigating the workplace can feel like negotiating a series of hurdles. There’s the worry that your condition will affect your ability to do your job and the fear that colleagues will grow to resent you if you need to take time off.

Underpinning these concerns is the fear of what will happen if you reveal your mental health issues to your boss and coworkers. “For some people there is a stigma around mental illness and they worry about how they will be perceived,” says Debbie Sorensen, Ph.D., a clinical psychologist in Denver and coauthor of ACT Daily Journal.

One survey of more than 1,000 employees found that 54 percent reported feeling uncomfortable talking to their managers and supervisors about mental health, and just 21 percent actually went through with the discussion (with 5 percent saying they spoke with an HR representative).

While it's understandable to be uneasy about the prospect of sharing your condition with your manager, making your mental health a priority, including maintaining ongoing care and treatment, is key to your well‑being. That might mean looking past the fear and focusing on the benefits—you can get a helping hand when you need it and you no longer have to expend energy trying to pretend everything is fine when it's not. “Being upfront removes the pressure to be perfect,” says Karen Cassiday, Ph.D., a clinical psychologist and owner and managing director of the Anxiety Treatment Center of Greater Chicago. “You don’t have to worry about looking or acting better than you feel. It’s OK to not be OK.”

While there’s no one right way to broach the subject with your boss, there are some steps you can take to increase your chances of being heard and engendering empathy. Here are some suggestions for getting to that place.

Assess Yourself and Your Needs

Before you say anything, get a read on how you’re coming off. Ask a family member, friend, or trusted coworker something along the lines of, “Can you tell that I was off today?” What might be obvious to you isn’t to the outside world. It might guide how much you share, if anything, or how you present the information; but, it’s also a good check on runaway thoughts, Cassiday says.

Then, think about what accommodations could help you be productive and successful at work. Maybe you'd benefit from being in a quieter part of the office, or perhaps you need to be able to schedule time for a walking meditation every day. Then, let go of any sense of shame in making these requests.

Reporting a mental health problem isn't any different than reporting a physical one. Neither you nor your boss would begrudge a person who uses crutches any adjustments they might need—the same is true for you.

Frame the Conversation

When you do decide to have the discussion, first realize that you don’t have to share every detail, just what’s pertinent and explains your situation. Cassiday suggests talking about symptoms rather than the disorder. "Instead of allowing clinical terms to dominate the conversation, explain how your concentration hasn’t been ideal or you’re not sleeping well and that sometimes you might need a little extra time for a project, always stressing that your focus is on doing great work," she says.

That clarity is essential, since, while your boss may be supportive, their main concern is that the job gets done. "You want to let people know what you’re doing to help yourself and come with ideas, so the message is, 'Here’s what will make it work,'” Cassiday says. Ultimately, you need to fill in the picture, not force the boss to figure things out.

That’s what Chylene Babb did. The 24-year-old creative producer at a small Baltimore advertising agency revealed her anxiety and major depressive disorder. “I told them my anxiety presents physical feelings—headaches and shaking, which sometimes make it difficult to type or hold things," says Babb. "I also revealed that sometimes I might ramble or not be focused.” Babb followed by asking her manager to be over-communicative about what was needed from her to counteract her occasional lack of focus, and to tell her if she started to slip up. This candor not only clued her boss in to what to expect, but also opened the lines of communication that they both felt comfortable with.

Be Proactive

One thing to be aware of is that mental health struggles don’t usually affect every part of your job, but they can make certain areas more challenging. For example, you might be great at writing reports or during one-on-one interactions with clients but the prospect of giving a big presentation sends you into a tailspin. Instead of saying nothing and trying to get by making excuses or avoiding projects, which can hold back your career advancement, anticipate potential problems and suggest adjustments that can help.

You can explain how you want more responsibilities but are struggling with nerves in front of crowds, and then ask for suggestions on how to improve. That way, you’re engaging the boss and it’s to his or her benefit to find a solution. “Employers are interested in helping employees be more effective and do their job better,” Cassiday says.

Creating a shorthand can be useful. Babb says she’ll say she's feeling “nervy” or “anxy” and when asked what would help, she’s ready with an idea, such as taking an hour off or getting a deadline extension.

Keep Talking

Since your condition isn’t static, keep checking in with your boss about how you’re doing; and, as obvious as it sounds, if you’re feeling well-supported and better, let the employer know that you appreciate their help.

“In my head, I used to think of myself as broken,” says Babb. “But this company changed my life. I can wake up motivated and look forward to work. That was not a thing before. I can accept that I have anxiety and I can still get my work done.”

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