How to Talk with Your Boss About an Invisible Illness

Working a 9 to 5 job with an invisible illness can be challenging. You want to prove yourself so no one thinks you can’t do the work, but you also don’t want to ignore your mental and physical well-being on the regular. It’s bad enough to miss or struggle at work when you’re sneezing, feverish or need regular doctor’s appointments, but having your job affected by symptoms no one else sees and that don’t just go away after treatment—like chronic pain, irritable bowel syndrome or an anxiety disorder—comes with unique problems.

If you find yourself needing more mental health or sick days than your coworkers or needing special accommodations like working remotely, clueing your boss in on what’s going on might be a good idea. It can make work less stressful, improve your relationship with your boss and strengthen your commitment to self-care. But it can also be a scary idea, since workplace discrimination is still, unfortunately, a thing.

Thai Nguyen, the social security payee program coordinator at Harborview Medical Center, knows this firsthand. Nguyen has bipolar disorder. At previous jobs, she disclosed her condition to employers she thought would be nonjudgmental, only to have them change their tune when she hit a low period.

“Sometimes managers will seem understanding as long as it doesn’t affect your job, but that isn’t always possible,” she says.

She has also had good experiences with disclosing. She was once a psychiatric inpatient at the hospital she now works for and wanted to confide this to her current supervisor and several coworkers. They have largely been supportive, she says.

How to talk with your supervisor—or deciding whether to talk with them at all—can be tricky and often depends on the situation and your dynamic with your boss, says Kristi Dore, a mental health practitioner and an employment specialist at Harborview.

You aren’t required to disclose your medical condition to your boss, says Kim Francis, a human resources specialist at UW Medicine. If you’d prefer not to, you can instead get your HR department involved. They can work as a go-between, helping you figure out what accommodations or leave schedule you may need and relaying to your supervisor how your restrictions will impact your work, says Francis.

If you prefer to be open with your boss or if it would be hard to hide your condition, here are some things to consider before starting the conversation.

Seek peer support

Consider confiding in your work friends if you haven’t already. No matter what you decide to say to your boss, it can help to have someone in your workplace environment who will support you and be understanding. Nguyen says she has a small group of coworkers she came to trust and who are there for her when she needs extra help or just an empathetic listener.

Focus on the work impact

Instead of telling all to your boss, frame your conversation around how your condition will affect your job, Dore suggests. You don’t even need to specify exactly what you have, only how it will impact your work life. That way you’re being honest but still protective of your personal information. Your boss won’t have an opportunity to come to conclusions on their own about what you can and can’t do and will be less likely to judge you in case they have preconceived ideas about the abilities of people with your particular condition.

Know your rights

Another good reason to get HR involved? So you can clarify your organization’s non-discrimination policy and make sure you are protected in case your boss has a negative reaction. This can also help give you confidence if you do talk with your boss, because you’ll know how to respond if they react poorly.

Be honest

Hiding what you’re going through usually isn’t a good idea, for your own mental health as well as your supervisor’s perception of you, Nguyen says. It can also lead your supervisor and colleagues to form false assumptions about you. It’s better they know you’re taking those extra sick days because you need them, and not because you’re slacking off.

Fight fear and trust yourself

Don’t stay quiet just because you fear being stigmatized. It’s more socially acceptable now to be honest about how your health affects your work, and though some may still face stigma, that doesn’t necessarily mean you will. Constantly hiding what you’re going through can be exhausting as well as create a sense of shame when you have nothing to be ashamed of. Do what feels right to you regardless of fear, and trust in yourself that you made the right decision.

“We can’t control what others think or do. You at least know you did your best no matter their reaction,” Nguyen says.

Practice self-care

Don’t forget to prioritize your health and wellbeing at work. Take your breaks instead of eating at your desk, grab coffee with friendly coworkers for an afternoon pick-me-up and recognize when you’re feeling stressed or overwhelmed and need to make some changes to your process. Managing stress can be critical for keeping symptoms in check, which can in turn decrease worry about how a flare-up will affect your job performance.

The takeaway

Ultimately, Nguyen is glad she has been honest with her supervisor and colleagues about her mental illness, and hopes more people will feel comfortable coming forward and fighting the stigma that surrounds invisible illnesses.

“The more I tell my story, the more I realize other people are going through something similar. It is amazing how the more steps we take not to hide, the braver we become,” she says.