livingwithablackdog

sit. stay. good boy.

Do You Tell Your Boss? 13/11/2011

Filed under: Clinical Depression,Depression,Experiencing Depression,Explaining Depression,Function,Managing Depression,Work — jillnottelten @ 11:28 pm
Tags: , , , , , , , , , , , , , , , , , , , , , , , , , ,

If you have a mental illness do you tell your boss?

Are you obliged to tell your boss?  Why or why not?

With discrimination rife in society and difficulty getting friends and family to understand what you are going through, what are your greatest fears in the workplace? Or the study environment?  Or wherever it is you spend most of your productive time?

Does your illness affect your ability to do your job at times?  In what ways?

Does your boss know?  Do any of your colleagues? What led to them finding out?

Whether you are studying or working always consider ahead of time whether you are prepared to disclose your illness.  If your current position is non-disclosure, consider carefully any occasions which might arise which might make it more necessary and under what circumstances you may disclose if at all.

Disclosure is always best done in a planned manner.  You should have some idea what you are going to say, how you want to say it and how you are going to explain its relevance to your work.  If you need some adjustments to your work conditions or some time off, it is best for you to come to your boss with some options that you have considered and reasons for your request.  You need your boss to understand that you wish to be healthy and productive as possible and are trusting them so that they are able to best support you to reach a goal that is in both of your best interests.  A large proportion of ‘Western’ countries, including Australia, provide legislation to support your right to this.

When you plan what to disclose think in terms of how you are affected by your mental illness more than your diagnosis.  You may, in fact decide to disclose only the effects of your illness and not your diagnosis, stating that you have “a condition that affects …”.  You may identify symptoms or you may simply describe what it does to you and how that affects your work eg my condition means that I have less energy than I used to have.  This means that I have to be careful how I plan my time and that I have to take holidays at regular intervals throughout the year to maintain stable health.  I need to be careful to use my meal breaks and leave on time so that I don’t become over-tired.  Or my condition means that I need to take medication.  When I change medications, sometimes I am more sleepy than usual and over-sleep or become very drowsy in the afternoons.  Sometimes my speech even gets slurred and I sound a little intoxicated.  So if I’m changing medications I need to take a week off, otherwise I find that I’m coming to work late all week and I sound as though I’m tipsy for half the afternoon and I don’t get much done and am at risk of making faulty decisions or overlooking things because my head is all foggy – especially in the first few days.  After that I will be fine at work again, but might over-sleep a couple of times in the 2-3 weeks afterwards while my body gets used to the new meds.  It doesn’t happen very often.  I’ve only needed to do it 2 or 3 times, but each time I’ve been glad that I did.

You do not need to disclose specify personal or medical information if you tell them about anything at all.

You should also think about when to disclose.  That is – when you are applying for a job, before a job interview, during the interview, after you have been offered the job and before starting, during the time you are employed after you have worked there for a while, if you become unwell and need to or never.  There are pros and cons of disclosing at each point of the way.  Sometimes your circumstances will have presented you with little choice to prevent awkwardness – you may have become unwell at work and have it become obvious that something was wrong or you may have symptoms that you are aware will soon become obvious if arrangements aren’t made to cater for your needs.  Again, despite prejudice and stigma in some places you have legal rights to have your needs and confidentiality met and protected within your workplace in most western countries.  Further, in Australia at least, if you become unwell because the employer failed to attend to your needs having been made aware of them, you are entitled to compensation under work cover.  It is however, worth serious consideration whether or not you are going to disclose because unfortunately discrimination does still happen and there are people who do fail to respect privacy and you never know where they are until you find them.

Some helpful things to consider at each stage of the employment continuum.

Prior to interview

Why you might …

  • You are able to to discuss the organisations policies and support resources when exploring the prospective position
  • You are able to get an idea about your employer’s predisposition to your needs from the word go.
  • If you have restrictions on any key job criteria due to temporary limitations because of recent relapse/graded hours return to work plans.

Examples of Why you might not …

  • Risk of discrimination influencing whether or not you get an interview.
  • No work related needs arising from your mental illness.
  • You don’t believe that they need to know/believe it irrelevant to job.

At the job interview

Why you might …

  • You are able to address people after creating a positive impression of yourself and demonstrating your capability.
  • You can gauge their understanding of your meaning and clarify appropriate questions about your needs.
  • You are able to discuss with the employer positive traits that you bring to the team that you have learned through your journey of recovery.
  • You are able to discuss your needs and what your potential employer would be able to accommodate or explore during the interview process.
  • You can brief them as to whether your referees are aware of your condition and how it affects your work and offer consent to discuss previous workplace arrangements with other employers if they have gone well.

Why you might not …

  • Risk of discrimination in job selection.
  • You don’t feel that you have needs that require accommodating or can manage them without support from your employer.
  • You might worry about where information gathered by panel members will go and whether people are trustworthy to maintain your privacy.
  • Concern that even if you get this job, opportunities for advancement could be limited by poor understanding of your illness.
  • You might be well and consider it unnecessary at this point in time.
  • You might not want to distract the panel from thinking about your abilities by talking about areas of need.

When contacted with an offer of employment

Why you might …

  • You are able to discuss your needs without risk of missing out on the job due to discrimination.
  • You can arrange to enter the work place with a plan in place that accommodates your employment needs and commence as you mean to continue.
  • If required and with your consent, the employer can arrange appropriate mental health sensitivity workshops for managers or staff by organisations such as Beyond Blue or circulate general anti-stigma/population health information among routine organisation circulars, yet not make it obvious that it was for your benefit.
  • Allow development of appropriate support and mentoring systems.

Why you might not …

  • Fear of stigma, gossip and/or discrimination.
  • Currently well and don’t feel that you are affected at work.
  • Work does not need to know.
  • Protection of positive image and opportunity for advancement.

During the course of your employment

Why you might …

  • You decide that your employer is trustworthy.
  • You become unwell.
  • You encounter difficulties or are not performing to standard because of symptoms or medication side effects and need to offer reasonable explanation or require support, alternate work arrangements or time off for medication reviews etc.
  • You are being harassed or bullied.

Why you might not …

  • It might not be necessary.
  • Protection of positive image and opportunities for advancement.
  • It might result in harassment and discrimination.
  • You are able to manage your needs without workplace support.

Never disclosing

Why you might …

  • Protection from gossip and discrimination.
  • Protection of positive image and opportunity
  • Privacy
  • Stable health
  • Lack of necessity

Why you might not …

  • Difficult to prove entitlement to compensation in case of illness, relapse or deterioration due to failure of workplace to meet needs for psychological health if they were not disclosed.
  • Relapse or need for hospitalisation might put your job at risk.
  • Might discover a positive attitude to mental health issues within workplace.
  • Legal obligations under occupational health and safety act where specific work related tasks are affected resulting in serious risk issues.

What did I do about disclosure to my employer with my job?

For me it was simple.  I told mine.  I disclosed at interview.  I felt that this was necessary because I had taken my previous job without learning to manage my mental health well and my references would have reflected that in the answers to some of the standard questions that interviewers ask referees no matter how careful the referees were.  I chose to take control of this situation at the time of my interview because having reached interview I could present myself as a competent individual in person, demonstrate that I was healthy and create a positive impression before and whilst disclosing.  I also needed to disclose because I wanted to work less hours than the position entailed and needed to offer a good explanation.  I told them that I had depression, how it affected me in terms of energy levels, concentration, seasonal patterns, medication changes and how I managed these things to be able to work.  I spoke of arrangements that I had previously made with my former employer that had been helpful and asked if they would be amenable to such strategies.  I also used the opportunity to tell them things that I had learned and accomplished through the experience of working, the determination and dedication that it entailed and the commitment to my job that resulted so that I could achieve personal satisfaction through working.  In my case this had a positive effect and outcome, although it doesn’t always.  I don’t disclose before I have the chance at interview to sit down and talk with the employer so that I can get a gauge on how they are reading what I am telling them and to avoid preconceived assumptions about what I will be like that are difficult to shift.  There are always risks associated with disclosure, but my reasoning is that if they are going to discriminate when I am well, I would rather not have to deal with them if I were to relapse.

When I am in the workplace I lay low for a while and watch what goes on around me.  As long as they are not untrustworthy, I tell someone if they are closely and directly affected by my health so that they are not left in the dark if I have to take leave at short notice.  That’s usually only one or two people.  Often they are among the first to notice that I am off my game,  so it can work in my favour because when someone who I work closely with starts asking if I’m okay and comments that I’m not myself before I notice anything, it gives me a cue to step back and check my early warning signs and triggers.  Over the course of years there have been a couple of people who have learned how to pick my good and bad days at least as well as I do myself and also to support and accommodate me through the bad ones and to lean on me in return when I’m good.  I’m pretty limited in what I disclose to start with, but with proof of worthiness comes more trust.

My current situation in my new workplace is new to me.  I have always had employers who were fiercely protective of my privacy before.  I have little in the way of evidence about my current manager, only the report of one other worker about two specific occasions of breached privacy.  I have, however worked in a place where it has been possible to work with my information kept private and so I am prepared to stand for my rights in both privacy and in workplace accommodation now.  If I expect the respect of others, there may be times that I need to stand up and remind them what it entails.  This is however new to me and the workplace is one with strange dynamics.

I have included in the Fact Sheets menu this week a document called “Choosing Your Path.  Disclosure: It’s a Personal Decision“.  It’s about disclosure of ‘disability’ (or illness) in education and training after High School and employment and the processes of application, entry and engaging in the roles.  The booklet discusses legal issues, reasons why one may or may not disclose at various stages of training or employment, responsibilities and some of the considerations to ponder in making your decision.  Also have a look around the Beyond Blue website as they have a number of resources for work sites and managers as well as fact sheets about telling your employer about your illness and maintaining good mental health for tertiary education students.  Lastly, I have listed a book called “Tackling Depression at Work” in the Books menu.  I’ve not yet read this one, but it was written by reliable people and has been well reviewed so should be worth a read.  I have listed the book at the publisher’s site, you may or may not be able to find it cheaper elsewhere if it interests you greatly.

 

Making Sense of It All 04/11/2011

Filed under: Clinical Depression,Depression,Experiencing Depression,Explaining Depression,Function,Managing Depression,self-management strategies,Social Supports & Networks,Socialisation,Talking About Depression — jillnottelten @ 4:45 am
Tags: , , , , , , , , , , , , , , ,

A while ago I spent some time blogging about how we can talk to people about Depression – or about mental health issues in general.  But I left out a very important group of people.  Kids.

How do you talk to kids about mental illness?  How am I going to explain my Depression to the important children in my life?  How do you explain it to those in your own?  While people often worry about upsetting kids or frightening them by talking about mental illness – and I’m talking about the kids in your family or very close to you here; the facts indicate that most of the time children worry less about something if they understand it.  Providing them with opportunities to talk and to find out what they think is happening is important.  So is clearly and simply explaining what is actually happening in a way that they can understand.

But finding the right words to explain what needs to be said in kid language is a tough business.  Plus, adults struggle to share their feelings.  Again, accurate and age appropriate information are the best way to go – and this usually goes down best coming from a parent or another adult family member or close friend of the family.

So – how do you know when and how to do it?

If they ask questions about your or  the other person’s health – this is a good opportunity.  A number of resources suggest strategies like asking the child how they are feeling at the moment, if there has been an incident recently then perhaps ask them how they felt when such-and-such did this-or-that; or even if they thought you or the person were acting differently lately – depending on the age of the child.  But whenever you do – pick a time and place where you’re all most likely to be comfortable and feel safe and where you won’t be interrupted.

It’s suggested that you explore the child’s understanding of what’s going on – not just accept their first reply because they could easily just repeat someone’s words without clearly them.  Plus it’s important to know how they learned what they do know.  Also, make sure that you’ve understood properly what they have told you.

Ask questions that are open – that is, they require the child to do more than say ‘yes’ or ‘no’.  Try to get them to say what they think in their own words.

Be ready to reassure them.  They might feel awkward.  They might feel distressed or disloyal or angry or be afraid of causing worry or getting into trouble.  Make sure they know that this is okay.

Now when you come to the explaining part:

There are lots of good resources take a look through some of them to prepare yourself for the talk or use them with the child.  (Please see links at end of post).

Keep some coloured pencils or pens and paper or some play dough handy.  Something that you can use to illustrate what you are telling them about or that you can ask them to draw something to help illustrate a point or  a feeling.  You may also write down thoughts or questions or plans together later (or draw their understanding of things for you when you are exploring what they know).

Think about examples of illnesses that children are familiar with that could be helpful in your explanation eg asthma, diabetes, broken bones, colds, chicken pox (some will depend on what they or their friends/family have had).  Be specific in the comparison that you make  eg asthma and depression both have triggers and physical signs even though they happen in parts of the body, both can seem to come out of nowhere … ; it is not like a cold because you can’t ‘catch’ it.

Or a common example is to compare the body to a car with different parts – different things work together to make the whole car work, but if something goes wrong then it can make the whole car run badly or not start.  In the case of Depression … (a good example of such an explanation can be found in Talking to Children and Young People )

The big ideas to communicate no matter what are:

  • Mental illness is nobody’s fault
  • It’s not YOUR (the kid’s) fault
  • It doesn’t mean that the person doesn’t love you or care about you anymore
  • It is not your responsibility to make the person better.
  • You can’t “catch” it
  • Just because someone else in your family has it doesn’t mean you’ll get it
  • It happens to lots of people, in lots of families – not just this person
  • The person won’t be like this all the time
  • There are treatments like medicine and people to go to for special conversations and doctors who know about this illness
  • It’s not just about the person thinking or feeling differently.  What is happening to the chemicals in their brain is different.

Here is a summary of an outline that I found about how to explain Depression to a child in an Australian COPMI program booklet.

Children can sometimes understand the impact of your illness more easily than they can its cause.  This means that it may be best to describe what the depression does to you rather than what depression is.

So you might tell them that Depression can cause:

  • no energy (making it harder to play)
  • difficulty sleeping or sleeping too much (making it harder to get out of bed or keeping you up late at night)
  • crying a lot (sometimes when there is no apparent reason)
  • losing or gaining weight (because you don’t feel like eating or you eat too much)
  • not enjoying the things that you used to (means that sport or dancing or cooking or whatever it is doesn’t make you smile anymore)
  • make you tired and cranky (can make you get grumpy at the children for no real reason)

What does your depression make you do?

Depression is an illness.  It’s like having a cold or having asthma except it affects your brain.  Your brain controls the things you feel, think and do.

Everybody feels sad sometimes.

Everybody thinks bad things sometimes.

Everybody has things that they wish they could do, but can’t.

What makes your/this child(ren) sad?

What sort of things do they think about?

What do they wish they could do but can’t?

When someone has the illness called Depression, they can feel sad for a long time and not know how to feel better.

Depression can stop people being able to do things that they used to do and enjoy.

I hope that this gives you some ideas for some starting off points.  Seriously – do take the time to check out some of these links.  The first three have really informative and detailed guidelines in them.  The resource lists include children’s storybooks, links and all kinds of things and the other links have some wonderful things in them too.

I have found some other FANTASTIC resources for parents, siblings, extended family and close friends of children who have parents (or family members) with a mental illness.  Even one about babies for those with bubs or planning pregnancy.  There are more out there just waiting to be discovered.

COPMI stands for Children Of Parents with a Mental Illness.  It’s Australia’s national project over this area.

Piecing the Puzzle Together: Raising a Family When Mental Illness is Part of Your Life

Family Talk

Best for Me & My Baby

Talking to Children and Young People

 

 

Resources for Children aged up to 6yrs

Resources for Children aged 7 – 12 yrs

Resources for young people aged 13-18 yrs

Resources for Parents

Care Planning for a Family

Links for young people

 

Australian programmes offering support for children and young people with a parent or sibling with Mental Illness

Family to Family project booklets

When Things Are Sad And Gloomy : Understanding Mental Illness in your Family

 

Depression? … No, it’s not just … (sigh) … Forget it … 12/10/2011

Filed under: Experiencing Depression,Explaining Depression,Managing Depression,Medication,My Black Dog,self-management strategies,Social Supports & Networks,Talking About Depression,Therapies,Work — jillnottelten @ 5:30 pm
Tags: , , , , , , , , , , , , ,

If there are around 7 billion people in the world, then I reckon that there are about 7 billion ways to explain depression.   Seriously.  Everyone is so different.  Just when you think you’ve nailed a way to explain what it is and how it affects you, you come across someone for whom that explanation just doesn’t cut it.  Now, I know that it’s not necessary to tell everyone what is going on.  It is not everyone’s business and not everyone even wants to know.  But sometimes it’s necessary – and necessary that they have an understanding of what depression actually is rather than just what they assume it to be.  If someone is going to support you, live with you, take your sickness certificates seriously when they start piling up or you relapse in the work place – they need to understand more than just what they see at surface level.

So how do you get there?

How do you explain that you have this black dog that is constantly with you, even when under your command and at heel?

How do you help someone get past the idea that you could just put mind over matter if you wanted to?

How do you convince your boss that you’re not being lazy? Or taking sickies?

How do you convince your grandfather who is not very aware of mental health issues that you are not a hypochondriac?

Do you find yourself getting into arguments over these things?  Being left feeling guilty and doubting yourself because of the things that people say?  Feeling frustrated and defeated because they just don’t understand? Or just feeling out of your depth explaining the nature of depression, it’s causes, what perpetuates it and what helps to treat it and to support your recovery? You are not alone. Do you struggle to understand these things yourself?

The first step in becoming more confident explaining what is happening to you to someone else is to become more confident in your own understanding. Write down what you know.  Organise your ideas under headings like

My Diagnosis (there are different types of depression):

Definition of diagnosis and Symptoms:

Body chemistry:

Thoughts (ie what it does to them, not necessarily yours although you may include a couple of less risky examples):

Behaviour (ie what people do because of depression):

Effects on function and everyday life:

Treatments that people use (ie medication and therapies):

Treatments I use: How well my treatments are working (and if you are thinking of trying any others some time):

Things recommended to help recovery:

Things that I do/am doing:

Things that are recommended for carers/supporters/workplaces who are supporting people who have depression:

Resources that I have found that might be handy to give people:

How did you go?  Where are the gaps?

The next step is to dig around and fill in some of the gaps in your own mind.  Make a list of the questions that you still have.  You don’t necessarily need to have them all answered before you talk to someone about your depression – but they are there for you to follow up on for your own benefit.  Sometimes you can also make a joint venture out of finding the missing information with the person you plan to talk to if they are someone who you trust.  If anyone would like me to work through a series on these or to post any heading in particular I’d be happy to include something like this in future entries.  Please put any suggestions or requests in the comments section for this post.

When you have thought through these things for yourself and written them down – if you come to a time when you need to pull your thoughts together for an explanation it is so much easier to do. The next thing to think about is this.  What type of person or question are you dealing with?

People like your grandparents and some parents have been brought up in a generation where sickness is seen in form of a disease or medical issue – so with them, I would start by explaining to them the aspect of depression caused by biological factors and that it’s an episodic illness.  Perhaps I would give them some information to read, or would talk to them and describe what happens – maybe draw a diagram of a synapse and show them how my neurotransmitters are out of balance.  Then I would tell them the symptoms that causes and how they affect everything else.  Then I would go back to my drawing and show them how my medication works and talk to them about why I need to keep on taking it.  If they were interested and wanted to know more about my treatment, I might also explain that I go to a psychologist to learn techniques to overcome other symptoms too because they have become fairly stubborn and I get lost in them at times – but that I don’t expect that this will be like the medication, and it’s not like lying on a couch talking.  It’s about learning specific skills and having time limited therapy that has been show in the research to be very effective in strengthening recovery and preventing relapse.  I might then tell them about my goals and what I’ve been working on and how things are going.  Lastly I would talk to them about what kinds of things experts say that family and friends do that help.  If they wanted something to look at for more information, I would try for something from a doctor or official health site, in large print if I could find it.

Your boss might need a medical kind of approach too.  With them I would also look for information for employers on one of the mental health support websites.  BeyondBlue has a good one (http://beyondblue.org.au/index.aspx?link_id=7.980&tmp=FileDownload&fid=1176 ).  It has another one about whether or not to disclose if you are considering the decision (http://beyondblue.org.au/index.aspx?link_id=7.980&http://www.beyondblue.org.au/index.aspx?link_id=6.1068&tmp=FileDownload&fid=356 ).  I would stick to workplace issues only and be clear about how your efforts are going in relation to getting or staying on top of your work.  Make sure that you are clear of your work place rights.  If you are in Australia, BeyondBlue spell them out more specifically or direct you to a source.  I’m not sure where international readers would need to go.  Mr Google would, I’m sure.

For siblings and friends – it probably depends upon how they relate.  Some will understand best if you describe it by its symptoms and numerous courses, some will need a scientific approach, others will need an explanation of the treatments that they see you taking and using as an entry point.  Usually family and close friends want to know what they can do and feel frustrated when they feel helpless.  It’s important to make sure to give them information about your symptoms, your treatment, what your doctor thinks is causing it and what they can do to support you.  Sit down with them and talk about what helps if they are involved in your life.  If they are not talkative people, gradually feed them things to read.

I’m not going to talk about young to school-aged children here because I want to talk to a friend who is a specialist in this area and do a special post specifically on this topic at another time.  However, for adult children my advice is similar to that which I have written for siblings.  Generally they want to feel that Mum or Dad is okay.  Yes, it’s strange and they start hovering as though they were the parents and can get overbearing at times.  Other times they may be so caught up in their own lives that they don’t even seem to notice.  In both cases, it’s important that you are ready to educate.  If you don’t have the energy for the conversation, young adults will respond to websites.  Sending them to http://www.beyondblue.org.au , http://www.blackdoginstitute.org.au and http://www.scottishrecoverynetwork.net will get them well oriented to Depression, treatments and some people’s experiences stories if they look around.  There are also great resources there for family and friends.  Then they can come back and talk to you about what they have learned.

Then of course there are your parents.  All the strategies in the world will not stop their concern at times.  This is part of their world.  For most people, when things are hard – all a parent wants to be able to do is make it better, easier somehow.  It’s the nature of the role and love that they have had no matter how old we get.  I am aware that there are people who are not lucky enough to have families who have cared for them like this – but on the whole, a parent’s response to any perception of threat to your wellbeing is a desire to protect you (remember, that one that’s been driving you nuts since you were at least as young as 14).  When talking to your parents about your depression remember this.  Once a parent – who has considered themselves a carer or a protector throughout your life when you have been unwell or threatened – accepts that you have depression and understands the nature of the illness, they will find it difficult to respond to as well.  It is good to have information designed for families and carers for them if they find watching you struggle hard.  Make sure that you spend time talking with them about what helps and what doesn’t.  Calmly.  Write it down first if you need to.  I share things to read with my family.  They don’t say much, but their education shows in the things that come up when we are talking about my health or my plans for the future.

My observation from working with people who find their parents “too interfering” is that often in by not telling them anything about what they are doing for their depression – is that a lot of the parent’s interference is related to ignorance; and that more, rather than less information about what is going on, better education for the parent and some help to reassure the parent that their son or daughter is making healthy choices goes a long way toward defusing the situation.  I know that this is not true in every case, but frequently it is.  And while some of the parents need to learn better adult boundaries, others are just desperate for the wellbeing of their son or daughter.  It may not be possible to put all of your parent’s concerns to rest.  This is not your job.  Nor is it your job to protect them from ‘finding out’ – because ten to one odds say that they have already noticed that you haven’t been yourself for a while and are already worrying in secret if bothering to hide it.  Explaining the true shape of the issue that you are dealing with and telling them how they can help rather than leaving them to shadow box with the ghosts they imagine is all that you can do.

Sometimes, unfortunately, like we might have been to start with – the people we care about or people we need to know may also remain in denial of depression in someone they know.  This is very hard.  Sometimes a family member might respond if they come to the doctor with you.  Other times it may be a case of letting your treatment and the efforts that you are putting in prove themselves over time.  It is hard to be motivated to do this with someone saying that you are being lazy or playing sick.  It doesn’t help the thoughts.  It can increase anxiety.  It is humiliating even to one’s self.  If the person won’t respond to your attempts to talk to them or to give them information, unfortunately it is difficult to make their choices for them.  However, the best way to deal with them is to prove them wrong.  The best way to prove them wrong is to prove that the treatment that you are undertaking and the effort that you are putting in is having an impact.  Even if it’s a partial impact that goes in fits and starts – change can be a catalyst for more change.  Perhaps seeing a change in you as you progress will convince them that there was something to that information that you tried to give them a few months ago…

 

 
%d bloggers like this: