Why We Must STOP the Stigma of Taking Sick Leave for Bipolar Depression

By Lynda Williams







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Sick leave is not a vacation but time set aside to treat a symptom that disrupts job performance. What happens to my brain during an episode isn’t visible, but it hinders my access to job skills, like decision-making, that I rely on to be productive.



Having an invisible illness like bipolar gives me the option to disclose, or not, based on what I feel is necessary and appropriate; for the better part of the decade I spent working in retail, I chose not to share my diagnosis.

I was afraid that admitting I have a mental health condition would make people question my competence and cause them to undermine my decisions—in all fairness, if it made me do these things, why wouldn’t others do the same? I had some limiting beliefs to work out, but the decision not to disclose did lead to some valuable insight into how people perceive both mental illness and absences from work caused by mental health conditions.

What has stayed with me about the conversations I heard has less to do with what was said than the hushed tones and raised eyebrows that invariably surfaced when someone was rumored to be on stress leave.

The implied doubt still burns my ears. At least if people came out and said they didn’t believe mental illness is a legitimate reason to miss work, I’d have my own reason to do a table flip and make a speech.

I know, it’s not a healthy fantasy. Writing about it would be more beneficial.

Ultimately, these suspicious whispers demonstrate a continued lack of understanding about mental illness. With the goal of helping people see how bipolar can cause a person like me to need a sick day, a leave of absence, or to require assistance, I want to discuss how this illness affects a critical aspect of everyone’s work life: decision-making.

I’ve noticed popular opinion about bipolar is associated more with the risk-taking behaviors of manic and hypomanic episodes, so I’m going to counter this expectation by examining the impact of depression on my decisions first. My next blog will address the other end of the spectrum, but please keep in mind that the bipolar experience isn’t always neatly divided. Rapid-cycling and mixed states complicate things even more.

If you’ve read my bio, you know I’m writer and artist. My work is freelance, and my productivity suffers greatly when I’m struggling with depression. Why?

Because depression makes me doubt my worth and my competence. This is not an easy mental state from which to create. Writing means choosing the words that convey the meaning I want to communicate. Flipping furniture means looking at a piece and developing a vision for what it could be.

When doubt takes over, I start waffling on my decisions. I get stuck staring into space, trying to find the perfect word; I start drafts and don’t finish them; I agonize over how to improve a sentence I should just cut. I put off painting items because I can’t make up my mind over the color, and I paint first coats only to change my mind about that color. During these episodes, procrastination is my default response to decisions. I waste time and it loses me money.

I’m talking about my time and my money, but for most of my work life that wasn’t the case. Although I had many different duties in the positions I held, they all had the same purpose, which was to make a profit for the company. When my decision-making is compromised to a point that I can no longer do this effectively, I need time off.

Most of my decisions are influenced by a combination of three factors: logic, emotions, and habit.

I might chose what to eat for breakfast based on what I think is good for me and what I feel like having among those things, and that decision, perhaps a morning smoothie, may become a habit.

This is not how I decide what to eat when I’m depressed: I stare at the food in my cupboard, at a loss as to how I could combine any of it to make a meal. I have no idea what I’d like to eat because I don’t taste things I normally enjoy, and I don’t care what’s good for me because I don’t have the emotional bandwidth to care about anything, even the things I know are important to me.

Sometimes I just walk away, and other times I eat a few tablespoons of peanut butter from the jar.

Now, if this is how I decide what to feed myself, do you really want to see me trying to prioritize my tasks for the day, or resolve a conflict with a co-worker or a vendor or a client?

I have never had the type of job where people put their well-being and safety in my hands, but you don’t have to be a doctor or a pilot to have people relying on you to make sound decisions. Conflict resolution and time management are factors in all kinds of work, and my ability to do both of these things is compromised by depression.

Unfortunately, when depressed, avoidance becomes my universal conflict-resolution strategy. Certainly there are times when this approach is acceptable, but it’s a lousy default.

“Am I willing to die on this hill?” is the type of useful question I find myself unable to answer properly during bouts of depression. It would require evaluating what I stand to lose versus what I stand to gain by engaging in a conflict, and, not surprisingly, when I’m eating peanut butter out of a jar because I can’t figure out how to assemble a meal out of the ingredients in my pantry, that process seems too complicated.

Addressing a conflict would also mean believing that whatever I perceive to be at stake—idea, opinion, belief—is worth fighting for, but the sense of worthlessness that accompanies my depression extends to those things as well.

I’m not going to suggest an idea or challenge an established procedure because I’ve already told myself not to waste anyone’s time with all the stupidness floating around in my head. There’s no accounting for the true cost of depression in the workplace, because we can’t measure the cost of creativity that doesn’t get expressed or solutions that don’t get proposed. Maybe someone else comes up with those ideas later, maybe not.

Problems that get ignored certainly don’t get solved, and problems that don’t get solved usually cost money. When I take my mental health day, my sick leave, or benefits, I am acknowledging the impact this illness has on my ability to manage conflicts and time, which are critical to job performance. If you’re in business, it affects the bottom line; and, no matter where you work, it affects the people you work with.

If an individual is unable to work because his or her mobility has been impaired by a car collision, we don’t question the legitimacy of the resulting absence.

What happens to my brain during an episode may not be visible, but it disrupts the abilities I need to perform—abilities I may not have been struggling with yesterday.

Treatment may allow you to resume your work, but that isn’t feasible for everyone.

If you’re like me, you may find yourself having to redefine your work life entirely.

I live with an autoimmune disease and bipolar. I stopped holding my breath for the workplace to accommodate me and the world to accept me. I cannot attend to my work unless I attend to my health, and sometimes that’s a full-time job.

When someone is unable to “work” due to mental illness, please consider that they may be working harder than they ever have before, just to stay alive.