How To Take Time Off From Work For Your Mental Health

Stress can affect all areas of your life, including your job. Here's how to determine if you need a break and how to take a leave of absence.

In the spring of 2018, my mental and physical health had deteriorated to a point where I felt unable to function. I wasn’t just dealing with a cold or a bad few weeks. Stress had ravaged my mind and body, creating a snowball effect that led to mental health problems including a panic disorder, major depression and generalized anxiety. And all of that contributed to flare-ups of chronic illness and a completely compromised immune system. So, I took a medical disability leave and it changed my life.

Many people in corporate environments don’t know about this option, despite the fact that depression is the leading cause of disability worldwide. I didn’t. There’s a huge stigma when it comes to addressing mental health in the workplace. There’s a valid fear of facing repercussions or discrimination at your job based on your mental health status.

But as more people reach breaking points, they may not have another option. Even before the coronavirus pandemic, the number of workers taking mental health leave appeared to be on the rise, according to Angella Lugioyo, a human resources executive and expert in California. Lugioyo said she has seen an uptick in mental health disability cases in recent years, with most of it being “stress and anxiety related.”

Stacy Cohen, a double board-certified psychiatrist at The Moment in Los Angeles, has seen this with clients in the clinical setting as well. “In the past few years, I’ve had a vast increase in the number of patients pursuing medical disability leave for more general mental health issues, with work-related stress being a major contributing factor,” she said.

And the need for leave may only increase: Experts predict mental health issues ― and the need to address them ― will continue to rise as the year goes on. The stresses of COVID-19, police brutality and racism are combining to produce a unique mental health crisis. Texts to one federal emergency hotline increased by 1,000% in April 2020 (over April 2019), and prescriptions for anti-anxiety and anti-depression medication have risen by roughly 10%.

Mental and emotional distress can have dangerous consequences if not addressed properly. That makes it’s more important than ever to take care of yourself ― especially if you have the resources to do so.

Here’s how to determine if you need mental health leave, what type of leave to take, how to obtain leave and how to make the most of your recovery time.

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Should You Take Leave?

The decision of whether to take a leave of absence is ultimately a personal choice that you have to sort through. This likely should be done with the help of a therapist or physician since you’ll need them if you do decide to go on leave (more on that in a moment).

But first of all, don’t feel wrong or bad for considering it.

“I would 100% advise anyone who might not be in the healthiest place — and they know they need help with their mental health — to take time away from work,” said Nina Westbrook, a psychotherapist and keynote speaker.

Unfortunately, this is not now an option for everybody. “There are those who don’t have the opportunity to take time off work ― particularly single-parent households or people who work for a business that doesn’t provide that type of support,” Westbrook said.

That’s why there need to be more mental health resources available, Westbrook added, both in the workplace and outside it.

If you are in a position to potentially take time off, one initial assessment should be whether you’re facing work burnout or a medical condition that’s affecting your ability to perform on the job.

W. Nate Upshaw, a board-certified psychiatrist and medical director at NeuroSpa TMS, explained that when work-specific burnout is the problem, there might be ways to fix that without taking a leave. For example, he said, “Can they talk with their boss? Can they transfer to a different department? Is there a way they can change either the situation or their perspective?”

Upshaw added that although “burnout is considered a legitimate justification for medical leave in some countries,” that’s not how it works in the United States. Yet burnout, if left unchecked, “can lead to symptoms that do qualify as a medical condition such as an anxiety disorder, or mood disorder such as depression,” he said.

“I always emphasize to people this is not a moral failing. This is a medical issue that can get better.”

- W. Nate Upshaw, a board-certified psychiatrist

Symptoms that may be signs of a mental health condition include panic attacks, chronic rumination or worry, overwhelming sadness or anger, changes in sleep, changes in appetite and mood swings.

“If you’re stressed and anxious at work and begin to also feel stressed and anxious at home, then you may be diagnosed with an anxiety disorder,” Upshaw said. “If you’re spending the majority of your time focusing on your mental health and you’re not getting better, it’s time to consider taking a medical leave. I always emphasize to people this is not a moral failing. This is a medical issue that can get better.”

What Types Of Leave Are Available?

There are several types of leave, depending on where you live and work.

“The U.S., unfortunately, makes leave of absence confusing, as each state is unique,” Lugioyo said.

On top of what your state requires, your employer may provide an additional program or means of support. “Some companies may have additional leave an employee can leverage as part of the benefit package,” she said. This might include sabbaticals or vacation time.

Start with the nationwide leave option provided under the Family and Medical Leave Act of 1993, which, among other things, allows employees up to 12 weeks of unpaid leave from work for serious medical conditions, all while maintaining health benefits (so you keep your work-provided health insurance).

The main qualifiers are that you must have worked for your employer for at least 12 months and at least 1,250 hours, and that you must work at a location where the company employs 50 or more employees within 75 miles.

The FMLA entitles you to unpaid leave regardless of which state you work in. California, Connecticut, Massachusetts, New Jersey, New York, Oregon, Rhode Island, Washington state, and Washington, D.C., have paid programs as well, so you can receive at least a portion of your pay while on leave. If you’re on unpaid leave in any of the other states, you may be able to collect unemployment benefits, although this is not required under federal law.

From there, look into whether your leave would be covered by short-term or long-term disability insurance, which may be provided by your employer. This is usually the point where things become a logistical nightmare in most companies.

“Some workplaces have great HR departments and have learned how to streamline the process. Some are not experienced at it, and the paperwork and process can be a headache,” Cohen said.

Ask the human resources office about your options. They can outline if you have a company leave policy, if you should go forward under the FMLA or if there’s another route you can take, Lugioyo said.

Has Any of This Changed With COVID-19?

According to Lugioyo, it’s not supposed to change. If it’s still business as usual with your company, they should be able to provide you with information on leave options and how best to take care of your mental health.

“Regardless of where our country and world is — pandemic or otherwise — an organization should be thoughtful and recognize the current employee experience,” Lugioyo said. “This should result in proactive communications from the leadership team, with an acknowledgment of the current climate and organizational resources that could support employees and their families, including employee assistance programs and disability information.”

“Regardless of where our country and world is — pandemic or otherwise — an organization should be thoughtful and recognize the current employee experience.”

- Angella Lugioyo, a human resources executive

Lugioyo urged those in management positions to make sure they’re providing this level of care for their workers.

“Employees need transparent communication and trust that their organization is well-informed about the current social climate and how it could potentially impact their employees,” she said.

How Do You Get Started On Taking Leave?

There are a few steps you must take if you think you need a medical leave from your job.

First, see a mental health care provider if you haven’t already.

If you’re feeling like you’re more than just a little off, it’s time to confer with a mental health specialist, said Juan Santos, a licensed professional counselor and certified rehabilitation counselor in Greensboro, North Carolina.

Santos said that your doctor will typically administer tests (which, in my case, were sometimes as simple as filling out a form) or ask questions to evaluate the severity of your condition. “The questions the clinician asks can be connected to work, ability to complete activities of daily living, and overall functioning of the person,” he noted.

They may also dig a bit deeper into your family history and your past medical history. From there, Santos said, the clinician will evaluate if you meet the criteria for an official mental health disorder diagnosis. They’ll also help you manage the condition on an ongoing basis.

Figure out how much time you may need off.

Only you and your doctor know your case well. Some people may just need a few weeks; some may need the full three months offered under the FMLA.

Upshaw offered one example: “I met with a patient who came in experiencing burnout and found that underlying depression was the source of his issue. We completed the FMLA paperwork for him, he began receiving [treatment], and he was better and able to go back to work in a few weeks.”

(Note that if you still don’t feel fit to return to work at the end of your leave, you may be let go from your job or you may choose to resign. At that point, some states will allow you to collect unemployment as you’ve left work for medical reasons.)

Finally, meet with your HR department about those leave options.

This process will vary from state to state, but HR should be equipped to explain your specific options and any particular landmines to avoid. “Always inquire about the state and company paid options,” Lugioyo said.

With the help of the HR team, you’ll fill out forms — sometimes a lot of forms — get a doctor’s sign-off, send the forms into the state and eventually take your leave. Then, it’s up to you and your health care team to focus on your healing.

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What Should You Do During Your Time Off?

Melinda Ring, executive director of Northwestern Medicine’s Osher Center for Integrative Medicine, suggests creating a plan to make sure you get the most out of your leave.

“I recommend setting up a daily and weekly schedule of goals and appointments to help someone keep on track without getting overwhelmed, and also identify a support team that includes both health professionals and a personal network,” Ring said.

This may be somewhat easier during a time of social distancing and quarantine, since you may have fewer distractions from outside obligations and more time to focus on you-time and healing.

Your plan should include healthy lifestyle habits, like eating regular meals, exercising and seeing a mental health professional consistently. Keep in mind that this isn’t a vacation; it’s a necessary time for you to prioritize your well-being and make radical changes in order to get better.

Cohen said that sometimes “patients will struggle with wishing they did something cool or interesting during this time, when they really need rest and therapeutic activities like yoga, psychotherapy, journaling and sleep.”

Whatever you do, don’t let outside opinions ― or sometimes even your own ― undermine your commitment to getting your mental health back on track.