Ask Dr. Annie K: Legitimizing Mental Illness

I recently felt the need to take a mental health day off work. I had to tell my boss I was also feeling physical illness symptoms in order to justify my absence. Why does society act as if leave from work is only justified if I am physically ill?

– Anonymous

Dear Reader,

You have touched on a very sensitive topic for me. What you are describing is having to “legitimize” your illness by adding physical complaints. 

Unfortunately, even in this day and age, mental illness is treated differently than other illnesses. It is considered a weakness to have a mental health problem. People expect you can just “get over it.” Just eat healthy, exercise, breathe and it will go away.

I argue that there is no difference between mental and physical illness. As a psychiatrist, I know that there is a biological basis associated with every mental illness – we may not know exactly what it is yet.  There is a psychological component and a physical component to all diseases. Heart disease is not only a physical disease, it also has a psychological component. All diseases are both.

This false differentiation between mental and physical illness only adds to the stigma already so prevalent in mental illness. This MUST change. It keeps people from getting the help they need. 

When you take a day off, in some countries, you are under no obligation to report the reason to your employer and they may have no right to ask.  Privacy laws are helping to maintain this important right. Slowly the tide is turning in this direction but some employers may ask for a diagnosis. 

In countries like Denmark, sick days are legit for both emotional or physical illness, and even for the illness of a child. They know happy employees are more productive and dedicated. Generous benefits for workers are part of the culture. So much to learn from the Scandinavian countries when it comes to balance between work life and home life! 

Most people wait too long to take time off. Societal pressures make people feel guilty for not going to work, especially when the reason is anxiety or stress. This does not make you a lazy or a bad employee. It shows self awareness. Recognizing when you need a break is a key step. You want to take the break before the situation gets worse. 

Use the day off for whatever you need to recharge. It is a day for self-care like catching up on sleep, exercising or seeing a helpful friend. Deciding whether to discuss the reason for your absence is an individual decision based on your particular circumstances. Hopefully with time and awareness of the importance of taking time off (within reason) attitudes will change and it will be an acceptable policy in every workplace. But we have a long way to go…

Thank you for your question, you are helping L+M readers!

Anne Koplin, M.D.

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