How Honest Should You Be About Your Mental Health?

I'd planned a response to Ruby's piece in my head.

A response saying:

I get it. I get that I've been lucky, and many others haven't. But that I'm not naive in wanting to be honest, because surely that's how we move past stigma. And people aren't all bad.

That would have been the crux of it. Optimistic and probably quite pushy.

I angrily titled it in my head, "Why Ruby is wrong, and you should be honest about your mental health."

A bit of context, mental health campaigner and OBE recipient Ruby Wax recently told The Times:

"When people say, 'Should you tell them at work?', I say: 'Are you crazy?' You have to lie. If you have someone who is physically ill, they can't fire you. They can't fire you for mental health problems but they'll say it's for another reason. Just say you have emphysema."

Reflecting on Ruby's piece and my ideas for a response, I then saw @MarkOneInFour asking on Twitter, why is the tendency to talk in imperatives when we talk about mental health. "You must do this, you mustn't do that."

And I realised he was right. Completely right. And I wondered why that was. Maybe that our experiences around these issues feel so loaded, fueled either by anger around a negative reaction, or gratitude around a positive one. The reactions can vary so vastly, but our reaction either way will be strong, particularly around the negative feelings.

All we have is our world view, backed up by our experiences. We can listen to others but we're going to be shaped emotionally by what we know and what has happened to us. For me in this case that's heightened by a sense of optimism (people aren't all bad; we're moving on) and such a strong desire for change (we have to move through this: honesty is the way).

Then how we share these thoughts online is filtered through what's worth clicking on: something to be angry at, or to ardently agree with, but something strong and plosive, and not necessarily balanced. Essentially click-bait, and that doesn't feel right: it's black and white, and not how the world works.

So, how honest should you be about your mental health to an employer? It depends. The cop-out answer but the reality.

Personally, I would hope people could feel they could be honest but it does depend on so many things.

It can depend on how open you are generally as a person but specifically regarding mental health. Personally I'm now very open, something that started in person, at Ruby's theatre show Losing It. (Sidenote: I think she's generally brilliant, I just don't agree with her statements on this issue) Then, online - blogging about my experiences.

From there talking about these issues in real life became a lot easier. I also became such a strong supporter of shattering the stigma around mental health, even when that's difficult, so that's inevitably going to give me a bit of a different answer to the question of honesty.

Another factor in honesty is how you experience your illness, which could mean many things but specifically meaning whether episodic or chronic. For me, it's been acute and episodic, but at the time - when I had to be honest about it (I needed time off, I was falling apart, I felt like I couldn't not say) - I didn't know it was acute. It felt like it would go on forever, and I felt in no place to reassure my employer.

I've told three separate managers when I've been having mental health problems, causing varying degrees of impact on my ability to do my job, and all three were fantastic. I had good relationships with all three but believe they would have reacted the same to anyone.

So was I just lucky, or are things in a better position than people think? Maybe we talk about the worst case scenarios more than the quiet moments of acceptance?

I just don't know. I'd love to know the statistics but that's problematic in itself.

I also have the comparison point of having a physical chronic illness. This made Ruby's suggestion of inventing a physical ailment ("just say you have emphysema") to mask the mental health difficulties an uncomfortable one.

My condition, POTS, used to be unpredictable and pretty intense, causing me pain and fatigue but also very public fainting episodes, which felt like an inconvenience to both myself and my colleagues. I let my manager know after I'd got the job and he was great.

Surprisingly I found it a lot more scary to talk to my manager for the first time about this then anything mental health related, perhaps related to the ongoing nature of it, and it being a daunting thing for others to see and experience.

Comparisons of what is better or worse in terms of living with the conditions and the stigmas involved are ridiculous, but let's just say that talking about a physical condition is not the easy option.

So there are lots of factors at play as to whether someone would be honest and why, but in terms of whether people should be honest about mental health I'd say (cards on the table, acknowledging this is just my view point): yes.

Because stigma is probably more about ignorance than malice, and if we're all honest the stigma has to lessen.

Because our expectation shouldn't be the worst case scenario, even if that is a possibility and does happen (if anything is going to make you anxious this will).

Because you're protected by the law.

But crucially because it's about looking after yourself. If your manager knows what's going on and what you need they can help you. They can back off, swoop in or lessen the workload - if they're supportive - or at the very least they can listen and be aware.

And maybe if it's the first time they've experienced the situation, they'll learn and be more prepared the next time.

So, essentially this article has been a mash-up of conflicts, anxieties and uncertainties. I was wary of sharing anything at all but I wanted to, to put my experiences forward. To say that being honest can work out just fine. But that I acknowledge I'm not in a position to tell you what to do, because no one is.

Articles like Ruby's, and even like some of the response pieces, can make speaking up and continuing the conversation around mental illness incredibly daunting: you worry you'll say the wrong thing, but there is no wrong thing, only multiple, conflicting truths.

Every person is different, with different experiences and different opinions and that is valid: so let's hear them all. Let's put it out there and give people the confidence to do whatever they want (when they feel able).

Mental health stigma has moved on so much, even in the past five years. So let's keep going. I think we're getting somewhere.

Originally posted at on performance & positivity.