Mental Illness: Navigating the workplace while symptomatic

Photo by Austin Distel on Unsplash

One of the hardest parts about living with mental illness is having to work while symptomatic. I wish I could say that the best way to navigate the workplace while symptomatic is to avoid the workplace. That’s just not possible for many people, either because there is no paid time off or their workplace has a strict attendance policy that doesn’t recognize mental illness or some other reason. For those that have to work, every job is different, and every instance of mental illness is also different. There’s no one approach that works, but I want to share some of the strategies that have worked for me, and some things work can do to make it easier.

What Works for Me

The premise here is for people who have to work even while showing symptoms of their mental illness, but the first thing I recommend is doing a spoon check before work. If the spoons are low enough, it might be best to stay home even if you won’t get paid. The spoon check is worth it even if you must go in. Knowing where you’re starting from will help you manage your symptoms throughout the day.

I know a lot of people would say here to work from home if that’s a possibility. I wonder how many of those people suffer from mental illness themselves. In my experience, being home makes actual working even harder. When I’m symptomatic and my bed is right there, I don’t have the willpower to resist. Also, isolation feels easy, but being around people sometimes adds enough pressure to be motivating.

Remember to eat. This means breakfast, lunch, dinner, and a few snacks in between. Many with mental illness lose their appetites when symptomatic. Going without food will only exacerbate the bad feelings, though. Plus, food is really the best energy source. My therapist is always telling me to get food, water, and sunlight even if I’m incapable of anything else. There’s no reason to make things harder than they already are.

While at work, navigation will depend a great deal on what kind of job you do. If it’s at all possible, don’t talk to strangers. Try to stick with people you know, and hopefully like. If you can pick your tasks, go with the easiest available. I actually like to find something physical to do. The movement eases my symptoms, and it allows me to put my brain on autopilot.

Finally, take breaks. I’d say take them early and often. Take as many as you can get away with taking. Try not to think of it as a bad work ethic. Think of it as self-care. When you’re feeling this bad, they’re lucky you even showed up at all. Even if it’s just a thirty second mindfulness exercise, it can help.

What Work Can Do

The big things work can do are, sadly, unlikely. They could start recognizing mental illness as illness. They could give adequate sick time to all their employees. They could give people generic paid time off instead of specific sick time and vacation time. They could take steps to lessen the stress that their employees are subjected to. These things would benefit everyone.

Work can also be more flexible. I know I said that I find it worse working from home when I’m sick, but that may not be the same for everyone. The more options a person has, the easier it will be. This can mean working from home, flex-hours, being creative rather than regimented with breaks, or anything like that.

Another thing work can do is just be understanding, sympathetic, and compassionate. Workplaces make accommodations for employees all the time for many reasons. Mental illness should be one of those reasons, no questions asked. One of the more exhausting things about mental illness is always having to justify yourself. A little understanding takes a lot of pressure off.

Finally, work could integrate wellness activities. This could be anything from mindfulness practices to encouraging walking and healthy eating. These would help the symptomatic people and also help stave off and lesson the severity of active episodes of mental illness. It would be good for work as well as the employees.


As someone who struggles with mental illness and has been in a position of having to work while symptomatic, this is my best advice. It’s a terrible position to be in. It’s not only hard in the moment, but it makes getting better significantly harder. No job is worth your health. But sometimes we have to sacrifice our health for our livelihoods and it’s bad for everybody.

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