Calling In Sick: Dealing With Mental Illness At Work, Part 1

Inspired by discussions with allnurses members and others, this is the first in a brief series of articles about how anxiety, depression and other mental health conditions affect nurses in the workplace. These illnesses are among the most common reasons we miss work, and they contribute to billions of dollars in lost productivity each year. They also carry a high cost to sufferers in terms of stigma, loss of job security, and self-esteem issues. Nurses Disabilities Article

Calling In Sick: Dealing With Mental Illness At Work, Part 1

The alarm clock jolts you awake as it does every morning at 0500, alerting you to the fact that today is yet another work day. You groan and pull the covers over your head momentarily, wishing for nothing more than to crawl into a warm cave like a hibernating bear until you feel human again......if you ever do, that is. And you're beginning to doubt that more with each passing day.

The prospect of another shift filled with unceasing demands and busy-work tasks threatens to overwhelm you as you force yourself into the shower, and once again you suspect that there really are worse things than death.....namely, going on like this. Certainly no one appreciates the fact that you have to throw yourself against a metaphorical wall every day: not your family, who counts on you to put food on the table; not management, who calls you on the carpet for every minor infraction of their million-and-one rules; and definitely not the patients who run you ragged with endless requests for warm blankets and Coke, and then complain when you're not fast enough.

You're depressed and very much aware of it, but other than taking the medication the doctor gave you at your last visit, there doesn't seem to be many options. You can't be in your therapist's office every afternoon; you don't want to burden your friends with your troubles; and you certainly can't talk to your co-workers. They're all dealing with their own stresses (both on and off the job), and besides, you don't want to end up in the unemployment office, like one fellow nurse did after suffering a 'nervous breakdown' at work.

So what can you do? You heard what people said about her.....that she was crazy. Looney-tunes. Psycho. What if they were to say the same things about YOU?

The truth is, if you need medication and/or therapy to cope with your condition, you are among the one in five Americans said to have what authorities call a diagnosable mental illness. Depression and anxiety are the most common of these, and while they are treatable, they are two of the major reasons why workers call in "sick".

It doesn't stop there, of course. Nurses are human, and as such we're subject to the same psychiatric issues as anyone else: schizophrenia, manic-depressive illness, personality disorders, even dissociative identity disorder (formerly known as multiple-personality disorder). The fact that the general public has no idea of this speaks well of the thousands of nurses who battle mental health problems and still manage to take good care of their patients.

For the most part, we struggle in silence, fearing the stigma that surrounds those who carry such a diagnosis. Everyone has seen news stories about people with whispered rumors of mental illness being accused of all sorts of horrible crimes; who wants to be associated---even remotely---with the likes of the Sandy Hook school shooter or the Aurora, CO theater killer?

But sometimes, our 'nonconformity' is discovered despite our best efforts to hide it. A nurse with depression may stop coming to work and fail to notify her supervisor; one with bipolar disorder may have a manic episode that increases her productivity at the same time it creates inappropriate levels of hostility which she cannot control. And if we are unlucky, we may find ourselves being eased out of our jobs, or even terminated outright when our employers deem it "unreasonable" to make accommodations for our disabilities.

This short series of articles on dealing with mental illness in the workplace is inspired not only by events in my own life over the past couple of years, but by conversations with others here at AN and with former co-workers who have shared their stories with me. It is my sincere hope that one day, healthcare professionals with brain disorders will be viewed with the same compassion as those who suffer from other medical conditions.

To be continued......

Long Term Care Columnist / Guide

I'm a Registered Nurse and writer who, in better times, has enjoyed a busy and varied career which includes stints as a Med/Surg floor nurse, a director of nursing, a nurse consultant, and an assistant administrator. And when I'm not working as a nurse, I'm writing about nursing right here at and putting together the chapters for a future book about---what else?---nursing.

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Specializes in General Surgery, NICU.

I appreciated this article...I know I have called out of work before for feeling either anxious or depressed.

And you can't call the ADA about the lack of reasonable accommodation for your disability because you never told management, because you KNOW they will look at you as less than a person, and will be wary of every step you take in the building and maybe report you to the BON for being an impaired nurse. You brush it off with, "I'm having a bad day," or "Family stuff," or some other oversimplified explanation that evades the real issue and makes people stop asking questions.

I even deleted half of this post because I'm worried about the reaction I'll get on an anonymous forum. That's how bad it is.

Geez some of you work with some real winners both coworkers and management. I have worked all kinds of nursing jobs. I was even working psych and the unit TV was on when the Aurora movie theater shooting happened (that caused some agitation on the unit, and is another story). I have supervised nurses that were bipolar. Hands down some of the best nurses I have ever had the privilege of working with. I knew they were bipolar and they even shared what medications they were taking. I felt good about being kept in the loop as to how things were going. I could spot them starting mania before they realized what was going on. Nursing sure is losing its compassion.

Specializes in LTC, assisted living, med-surg, psych.

Thank you for that. ^^ It's a rare workplace that allows and even encourages nurses with MI to be who they are. And it's true---an objective observer can see an impending mood episode long before the patient does, because one of the symptoms (especially in hypo/mania) is lack of insight. Good on you for being such a responsive and supportive boss! :) Can I come work for you?

Viva: thanks so much for the insight....much appreciated & helpful. i truly consider myself to be cognizant of my coworkers feelings & what is going on with them- but like someone posted, a lot of compassion, understanding has been lost- for various reasons- by our profession. i am very fortunate to work with/for some very considerate people- in general. :) but i'm very well aware that is not the norm. i very much look forward to the reaminder of your "series"!!

Great Article. Sometimes I go to work all day with a smile on my face but on the inside I'm sad, depressed, and just want to curl up in a ball. I've tried meds, counseling, and etc. and nothing seems to help. I'm so tired of this sometimes.

I got out of management, too much time at work too little time with my family. Due to the lack of compassion, varied policies, diminishing support I am considering leaving nursing.

Specializes in NICU, ER, OR.

Thank you. Just thank you for writing about this issue. I am ashamed to say, I had to take FMLA, and days in adition to those days allowed, and lost my job, all due to depression. And I am mostly ashamed to say.... I dont even want to WRITE it...... I told employers/co workers I had CANCER (GOD forgive me, please) and that was why I was out so much. What ELSE was I going to say that was believable??? I eventually lost my job, and Im still heartbroken. Because I finally found the right combo of meds.... to make me be able to GET UP and SHOW UP for work...but now, its too late. Now I have CRAPPY JOB. A job, but its nothing compared to what i LOST. again, I THANK YOU FOR BROACHING THIS SUBJECT.

Specializes in NICU, ER, OR.

depression is soooo real. and debilitating. I was behind in my rent, everything.... I STILL couldnt manage to go to work. I may

have even lost my marriage over it.

Specializes in LTC, assisted living, med-surg, psych.

I am so sorry for your experiences! You know, if I could have kept my mania under control and hidden, I probably would have used cancer or some other chronic medical condition as a reason for being sick so much. But I couldn't, and unfortunately I have the world's biggest mouth at those times and I over-shared to the point where people thought I really was losing it. As indeed I was.

Specializes in NICU, ER, OR.

VIVA... I dont ever have the mania, thats why I disagree with my doc with my bipolar dx. I have no highs.... only lows!!!