Last winter, I was declined by five health insurance companies. I am 26, do my preventative screenings like clockwork, and have no physical health problems. As my boss told me when I started working at a small start-up a few months ago that has no group health plan: “You’re young and healthy, I assume you’ll have no problems finding a new plan.” I smiled and weakly said, “of course.”
Five applications and four declines later, I anxiously awaited my last and final letter. The verdict came: Declined. Reason: Bipolar II/ADHD.
So there is my secret: Like millions of other Americans, I have a mental illness.
The most frustrating thing isn’t the insurance—with Cobra I can stay on the plan from my last job for 18 months. It costs $675 a month, but at least for now I have that option, which makes me luckier than many. No, the most frustrating part of my situation is that I can count on one hand the number of people who know about my mental illness. The stigma that surrounds mental health is suffocating, and I don’t feel comfortable talking about it with most of my friends and family, and certainly not my boss or colleagues.
But my illness is a huge part of my daily life. Just shopping for the perfect mix of medications is a full time job, with side effects from drugs tried and failed ranging from the merely awkward (flushed cheeks) to annoying (dry mouth) to incapacitating (flu-like symptoms that last for weeks). To keep my illness secret and managed, I go to therapy every week (for a while I did phone therapy at 6 a.m. so I could get to work on time), sneak to the kitchen or bathroom to take my morning and afternoon medications while at work, and make sure I go to my psychiatrist once a month during my lunch hour—often rescheduling and putting it off a week because a meeting or conference call comes up.
I mainly just want to tell my friends. I feel awkward even around my three close friends who do know. They get quiet and cock their heads, nodding and trying to understand—and I love them for that. But from the outside, they can’t fully understand—I’m 26, I graduated from Duke, I have a full-time job at an excellent company, I come from a nice Boston suburb, I lead what appears to be a typical twentysomething life—how could everything not be perfect?
There is a documentary that was recently released called Of Two Minds. It profiles several individuals around Los Angeles living with bipolar disorder, but no one featured was from the corporate world. In one review, the director mentioned that they had a Wall Street banker confirmed to be interviewed, but he dropped out last minute because he was afraid to lose his job. This is why I keep my mouth shut.
I worked an intense corporate job for four years before joining the start-up I’m at now. I work in a highly-coveted industry, and it was generally known that if you didn’t like your entry-level job, you were welcome to leave, and there would be a line of people out the door, happy to be your replacement. Few people have the opportunity to move up. After working hard for years, I was at the head of the pack, and felt like showing the slightest weakness would hurt my chances of getting a promotion. No one would say that out loud of course, but in every office I’ve worked in, I never once heard another employee openly mention dealing with a mood disorder, and given the size of my company, statistically I know I can’t have been the only one.
My doctors long suspected I was Bipolar II and I’ve had a diagnosis of Major Depressive Disorder and ADHD for years, but last summer I experienced my first hypomanic episode (the first of many), thus sealing the Bipolar II diagnosis. By continuing to work 14-hour days throughout the episode (which caused me to sleep less and expend way too much energy), I found that when it finally ended, I crashed much harder than usual. Making sure no one saw a difference in my work was my number one priority, and I was exhausted, spending my nights and weekends in bed either sleeping or too depressed to get up.
I needed to change meds quickly, but diverged slightly from the doctor’s recommendations to make sure the withdrawal and new side effects wouldn’t make me too sick to show up each day. I considered taking a medical leave of absence, but was worried about the repercussions when I told my boss why. I just kept on working, definitely to the detriment of my sanity, because I felt like I had no choice. My only goal was to make sure no one knew what was happening and it meant my recovery took much longer.
I was able to keep working without letting anyone know I was sick. I was and continue to be just as reliable as the rest of the employees at my company. I work hard, constantly get stellar reviews, and hardly ever take a day off. I have always shown up earlier and left later than most, and am confident that despite the extra work it requires, I have never once let my mental health affect my job.
But I still feel like I can’t tell anyone. At my former company, everyone gossiped in mock horror about a manager who "had a mental breakdown” and went away for awhile, as though he had a contagious disease no one wanted to catch. And he was a manager. As a millennial in the early stages of my career, I can’t afford to be seen that way.
When one of our high-profile clients committed suicide last year, for days my co-workers said that they couldn’t understand why he would ever feel that way. He was so successful. I sat there mute, thinking about how many times I’ve been on the edge, and how many times I’d heard offhanded comments describing colleagues as "crazy,” "schizo," and "bipolar.” At one point I mentioned the ADHD part of my diagnosis to a colleague I was close with, trying to test the waters on the mental illness topic, and her response was “Whatever, you just love taking Adderall,” which ironically, is the drug I hate taking the most. I realized after that conversation that I wouldn’t be mentioning I was bipolar to anyone anytime soon.
I know I’m being hypocritical. Though I may wax poetic about erasing the stigma of mental illness, I’ve changed my name and the particulars of my life. I’m still scared of people treating me differently and of my boss feeling like I’m less capable of doing my job. I want to be the person that uses my real name and admits what I’m going through to put a face to the stigma of mental illness in the workplace, but I can’t. It terrifies me.
My doctor said I need to see this like having diabetes—it is a lifelong chronic illness that I just have to manage. Instead of insulin, its daily meds, therapy, making sure I get enough sleep, avoiding alcohol, and limiting high-stress situations. None of that advice is compatible with working in an inflexible corporate setting where I can’t be open about this. When I travel for work, I need to make sure the flights aren’t too late or early. When I go to work dinners, it’s awkward not to partake in the expensive bottles of wine going around—I often end up drinking at least one glass, even knowing that it could set off a hypomanic or depressive episode. The constant balancing act of managing my illness and keeping people from knowing about it creates its own stress, further compounding the issue.
I would love to be able to sit down with my boss and/or HR and explain what my illness is, the precautions I need to take, and how lessening that stress would make me a better employee. But I can’t do that while feeling like I could put my job at risk. If companies really treated mental illness like diabetes, it would do wonders to make these diseases more manageable for people dealing with them.