Now what do I do?
By Esther Brass, Ph.D.
It takes courage to admit to yourself that worries, moods, fear, stress or lack of confidence are getting in the way of your work. It’s hard to admit it to yourself, and it’s hard to tell others. Many people who experience mental health difficulties do not seek help, and often try to hide their condition, hoping that everything will seem okay. A study by Rand found that 69% of employees said they would hide their mental health condition from coworkers and colleagues.
This happens for a variety of reasons, but most often it’s done to avoid judgement and any potential risk to their career and perceived capabilities because of the stigma attached to mental illness. Often, people with a mental health condition don’t realize they have certain rights under the Americans with Disabilities Act, and they remain uncertain about whether the benefits of disclosure will exceed the risks.
As a cognitive behavioral psychologist, I have been impressed and moved to see my clients use therapy to change their lives for the better, both in their personal and in their work lives. That’s why I’m writing about the importance of acknowledging mental health problems and seeking support: It’s important for individuals to pursue the help they need to better meet personal and work challenges. It’s also important for supervisors, managers and co-workers to know more about mental health so that they don’t react negatively out of fear of lack of understanding and can contribute to a work environment that supports workers’ strengths.
Whether you decide to disclose your mental health condition at work or not, you want to ensure that you take the proper steps for managing the situation as effectively as possible. Here are some ways to take care of yourself right now and ways to get support and help.
1] Know that you are not alone.
Other people have struggles too, don’t think you are the only one. Did you know the leading cause of disability in the U.S. for ages 15 to 44 is depression? And anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older.
2] Observe – what do you notice about the difficulties you are having?
Here are examples of questions to ask yourself.
Does my mood make it hard to do things?
Am I too irritable?
Does it feel like everything takes too much effort?
Do I get nervous about my work tasks, feel afraid I won’t do well, avoid people,
or delay doing things I need to do?
Am I having trouble sleeping, or not getting enough sleep?
These are some of the issues that can make work more difficult. You may be experiencing one or more of these, and (or) you may notice something else that is causing problems for you. It helps to know what is getting in your way and affecting your work.
3] Don’t criticize yourself.
Do your best to not be judgmental towards yourself. This is easier said than done. Nevertheless, do your best to cultivate a non-judgmental attitude, and later on you can find help developing this skill, for example, through mindfulness based stress reduction (MBSR) or self-compassion meditations.
4] Talk to someone you trust.
It’s really helpful if you can share your concerns with someone you trust. He or she may not be able to solve your problem, but it can feel better to talk to someone sympathetic, perhaps a friend, co-worker or family member. Mind Share Partners has developed a peer group resource for people coping with mental health issues at work. These peer groups offer an opportunity to share experiences, get and give support, and develop coping skills. These are in-person groups in San Francisco, and if you live elsewhere, you can join an online/virtual group.
5] Educate yourself.
There are organizations that are consumer-oriented and offer excellent information about mental health problems, for example, the Anxiety and Depression Association of America, International OCD Foundation, National Institutes of Mental Health, and the National Alliance on Mental Illness (NAMI). Just read about one or two of the difficulties that most distress you. Don’t spend a lot of time reading about every possible problem. Then seek professional help.
It’s Important to Find a Mental Health Professional to Work With
It’s important for you to know that there are good treatments for many mental health problems, so it’s really worthwhile to seek a qualified professional who can help you address your difficulties. Here are some ways to find help that meets your needs.
1. Ask your physician.
Many physicians have experience with local mental health professionals and may be able to suggest someone whose experience fits your needs.
2. Ask a friend or family member who is or has been in therapy.
A friend or family member may be willing to ask their therapist for recommendations for someone for you to see. A friend or family member’s therapist may not be a fit for you, either because your problems are different from theirs or because often therapists don’t work individually with people who are closely related. However, sharing even a bit of information about your difficulties with a family member or friend could allow them to give that information to their therapist so that the referral can be tailored to your needs.
3. Several of the sites mentioned above have referral information (ADAA, IOCDF, NAMI), as do organizations whose members offer particular types of therapy, such as abct.org for cognitive behavioral therapy, and behavioralsleep.org for sleep problems.
There are also national, state and local professional organizations that have referral information, such as your state psychological association.
4. If your workplace has an Employee Assistance Program [EAP], the EAP can help you evaluate your needs, offer initial counseling, and refer you for additional counseling or therapy.
EAPs are an employer-provided benefit that were developed so that employees could seek confidential help in a variety of areas, particularly mental health. Federal and state laws require they be confidential, and confidentiality protections are strongest when you refer yourself. If your employer refers you because of an issue of concern, the confidentiality protection is more ambiguous. Look into your company’s EAP – it may be an excellent first-step resource.
5. Many health insurance plans cover therapy, or you can seek private pay therapy.
If you get referrals or find them online, check out the professionals’ website, where you can get information about their training, licensure and therapy approach.
6. Choosing a therapist. Be sure that the therapist is licensed in your state.
Look at where they got their training, and whether they have experience working with the types of problems that concern you. See how they describe their treatment approach and whether they are describing a way of working that makes sense to you.
When you have one or two referral names, it’s a good idea to call rather than only email a potential therapist. You will be working with a therapist on things that matter very much to you, so it is important to find someone you feel comfortable with. Talking on the phone gives you an initial impression of what it’s like interacting with that therapist.
Before you call, it can be helpful to set aside a few minutes to think about, and briefly write down, what you want help with and what you would like to get out of therapy. List any questions you have, which may range from fees and location to asking the person about their experience working with the types of problems you want help with and how they approach these problems. Taking a few moments to write these things down makes it easier to cover what you want in the call.
It is critical to seek the help that you need. It takes courage to admit problems to yourself. It takes courage to make that call. It takes courage to address mental health problems and seek support, but it’s worth the effort.
Recovery starts with self-awareness and self-care, and you need therapy and outside resources to help you go further than you can on your own. Just as you would seek professional help for a broken leg, it is necessary to seek help for mental health conditions too. Mental health is as important as physical health. Get the help that fits your needs, your mind and body will thank you.
Esther Brass, Ph.D. is a cognitive behavioral psychologist in private practice in Berkeley, CA and an Assistant Clinical Professor in the Psychology Department of the University of California Berkeley.