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Mental health is still an issue in the workplace (medium.com)
659 points by bcx 159 days ago | hide | past | web | favorite | 330 comments



Great article. A few years ago (at a previous job) I took a sick day for "sanity", but told them I wasn't feeling well. I felt guilty about doing it. I think part of it is the association of sick leave with externally visible medical issues, and the corresponding "straightforward" medical verification.

In other words, if you have a temperature or are vomiting, that's obvious. Many infections or physical injury can be trivially verified by a doctor. But a "sanity day", as truthful and necessary as it might be, is neither of those.

Out of curiosity, I checked my current employment contract. It says sick leave is for "A personal illness, injury or medical disability that prevents the employee from performing his or her job, or personal medical or dental appointments." or "Exposure of the employee to contagious disease when attendance at work would jeopardize the health of others." There's a dozen or so other cases listed in the contract, mostly about allowing sick leave to care for sick family members/children. Our contract also allows for verification, "If the Employer suspects abuse, the Employer may require a written medical certificate for any sick leave absence."

I've never heard of anyone here being asked for a verification, but it would tend to discourage people doing the "sanity day" sort of thing.


>> I've never heard of anyone here being asked for a verification, but it would tend to discourage people doing the "sanity day" sort of thing.

I suspect that the lack of trust this indicates on the part of the company (not to mention foster on the part of the employee) is probably a sign that you're past the point of no return. I suspect a company that asked for verification was not doing so to see if you were genuinely ill, they're doing so because it's already a problem and they want a nice paper trail for when they terminate you. Of course if you are abusing it, I think that's totally reasonable.

But I think most of my employers (except for one, where I quit for exactly this kind of disrespect) would have had no problem with me saying, "hey I just need a mental break day in order to keep doing this job - I'm taking one of my sick days". If one significantly exceeds allocated sick days, then the reason starts mattering more.


You're generally correct for the folks who have decent salaried careers. If I got asked to justify a regular random day or two I took off as PTO I'd tell HR to pound sand as anyone rightfully should.

Get into hourly low wage stuff and you are treated like children, many shops require a doctor's note for any and all absences with 1 or 2 dermits until you're fired.

This has reasons from both ends of course. When I was younger I saw the need for this sort of policy or you'd get eaten alive by the low-wage masses abusing it (and abuse it they did). But on the flip-side, these policies tend to simply be abused by management once enacted - with no leeway for people to be human.

In the white collar arena it's pretty damn trivial as a manager to tell who is abusing a PTO policy and who isn't, so only the shittiest of companies enact such policies. Managerial laziness is definitely creeping into this area of life as well too though.


Culture can matter a great deal as well. In my experience working in Japan and Taiwan, everyone is considered an immature child that must be babysat minute by minute.

My go-to story: Friend in Japan's train route was significantly delayed by a suicide. Rather than sit in the train station for ~2 hours waiting for cleanup, he leaves, gets on his motorcycle, and rides to work. Shows up 30 minutes late, but his pay is docked those 30 minutes, because unlike everyone else that showed up 2 hours later, he didn't have the little ticket they give you in Japan when your train is delayed. Regardless of him telling HR the situation, showing his house on the train route, etc, nope, he didn't have the slip from mommy, so his pay got docked.

I love working there, but the work culture is infuriating.


If the work culture is infuriating, why do you love working there?


Because Japan is fun and the food is good.

Also Japan is just about the most photographical country I've ever been to.


Not OP, but besides the work culture, there is also the actual work. Which you can love doing :)


I have friends and family working in Japan and requiring a stamped slip for metro delay (not sure if it's still stamped or just printed) is just a cultural thing everywhere, or so I'm told.

That kind of tradition means a lot more to Japan society than it does for some Western countries, I suppose. You can search for articles on "Japanese corporate bureaucracy" for different perspectives.


And appeal to tradition is a logical fallacy


There is more to a job than the culture?


Depends on if you are working in a big corporation or no.


Another reason blue color jobs might be stricter about attendance policies is that many rely on someone's physical presence. If there's nobody there to make the sandwiches, the sandwich store can't open. If I'm not there to make progress on my code on a particular day, who cares.

Not advocating treating people like shit for missing work once in awhile, just sayin'.


It's not just managerial laziness -- if you want to terminate someone for abusing the paid time off policy, there needs to be a paid time off policy in place. Otherwise it would be relatively easy to claim wrongful termination.


>by the low-wage masses abusing it (and abuse it they did).

This feeds directly into the popular narrative that the working poor somehow lack moral fortitude. Do you have evidence to justify this claim?


I'm not the person you're asking, but I have my own experience which mirrors theirs.

Only 5 years ago I was working hourly just above minimum wage in a job I disliked. The management had a very strict tardiness and absence policy, and a strike system that meant if were absent without proper excuse more than 2 times in a 3 month period you were terminated.

I didn't exactly have a traditional support system while I had that job. Lived with some friends, but couldn't reach out to family or the like for help. That's how most people were at that job. Independent, but broke. Still though, the job was miserable. I think of myself as a work-loving sort of guy but I dreaded every day of it. So we all were absolutely looking for any way to get out a day. Even if it meant we didn't have a 40 hour paycheck, when you loathe your job it just doesn't matter. Maybe you'll not eat lunch or dinner for a couple of days - but at least you'll be free.

I used my hatred of that job to propel me into something more. A lot of people in those positions are held down by other forces which did not affect me. I hope they can find their own ways out someday.

I don't think people like that lack moral fortitude. Going to work is not inherently morally righteous. Nor is a perfect attendance record. But, in my experience, people who have bad jobs that they dislike will game whatever systems are available to get as much time away from them as possible - even if it hurts their financial bottom line pretty badly.


I think your post articulates what I was trying to say much better, without going into the tangents I typically do.

Absolutely mirrors my experience to a T. I wasn't intending to put a moral stance on any of this, but you did a much better job at explaining that.


If his experience was anything like mine it isn't the working poor. It is the young workers who are not poor. They are still living at home: they do not need to pay for their room, meals eaten at home, health insurance. That is every penny they earn is pure spending money and so despite making minimum wage they are rich with no need to work as many hours as they do.

When I was working minimum wage there was also the working poor: they needed every penny. If they called in sick you knew they were sick. If you asked them to work overtime they did their best to take it because the extra money was needed (they often couldn't find a sitter on short notice though). They didn't stay in minimum wage for long, their efforts were noticed and they were offered promotions to management (not all accepted because management often meant moving away from family, but in that case they still got maximum raises until they reached the top of the pay scale).

Note that many of the working poor got themselves into that position because of their choices, generally they had a kid at 16 and dropped out of school as a result (at best finished at the bottom of their class). They were failing to dig themselves out of the hole of their bad life choices because that kid takes the time needed to get a better education. In short they lack moral fortitude in that they were (and are...) sleeping around, but not in that they are not working hard for their employer.


> Note that many of the working poor got themselves into that position because of their choices, generally they had a kid at 16 and dropped out of school as a result

The vast majority of teenage mothers in the United States do not choose to get pregnant and do not have the choice of terminating their pregnancy. They either do not have access to abortion providers - the majority of women in the United States do not have access to abortion clinics because of fundamentalist Christian activists and politicians: https://www.guttmacher.org/united-states/abortion/state-poli... - or they are coerced by their fundamentalist Christian parents into not having an abortion.


Everyone has access to birth control though. It's common knowledge how reproduction works. You have condoms, birth control pills and copper rings among other options. If you miss that you got plan b. Let's set aside your personal vendetta against the pro lifer Christians. How can you claim that the vast majority of pregnant teenagers don't choose to get pregnant?


Respectfully, I'm not sure you fully understand these issues that you seem to have a very strong opinion about.

Teenagers around the US do not as a rule have convenient access to contraceptive pills. That's because the FDA refuses to approve them for OTC sale, despite their safety relative to many other OTC meds. The stated reason for refusing OTC sales is that allowing them would prevent women from seeing their doctors for other medical issues (this is also the reason you can't buy extremely useful and safe meds like Ondansetron OTC). I feel like I'm on firm ground when I add that this is unlikely to be the only reason you can't buy OTC contraceptive pills.

Meanwhile, about half of US states require parental consent for most minors before doctors can issue prescriptions for birth control.

As a fun additional wrinkle, churches, and in particular the Catholic church, run some of the largest hospital and health chains in US metro areas. Church-run hospitals routinely refuse to provide access to contraceptive services. In Chicago, the Loyola health system --- an otherwise well-regarded health services chain! --- won't prescribe contraceptive pills to adults even for non-contraceptive reproductive health purposes!

I don't think we need to spend too much time talking about Planned Parenthood clinics; the issues there are obvious to anyone familiar with the state of reproductive health in the US.

So, no, I don't think it's reasonable to argue that any teenaged girl in the US should be expected to be fully armed with all the tools of modern contraception.


The lack of access to chemical birth control is a major issue, I agree. However, to the best of my knowledge, condoms are still fairly universally available to members of both sexes - which, while not ideal for a number of reasons, are certainly more effective in preventing the transmission of STIs as well as being effective in preventing unwanted pregnancy. Perhaps that might be a more charitable interpretation of the grandparent post, even if it's clearly not correct on the whole.


Beyond pointing out the obvious fact that teenaged girls in the US are living in a society that goes to some lengths to actively obstruct them from using the most reliable forms of contraception, I'm not really interested in digging further into the details here.


Fair enough.


You didn't mention the most obvious solution which is condoms. I bought them easily as a teenager 18 years ago. You can get them for free in many places these days.

You're also giving teenagers a pass for having unprotected sex as if they don't know there's a risk of 1) getting pregnant and 2) getting an STD.

Certainly some birth control measures are less accessible to teenagers, but what I'm arguing is the parent's claim that "The vast majority of teenage mothers in the United States do not choose to get pregnant"

That's not accurate unless what is meant is that "the vast majority of teenage mothers don't want to get pregnant (but choose to forego readily available birth control / condoms)". I'd believe that.


Without getting into any of the rest of this comment: that's not what you said. You blamed teenaged girls in part for not taking advantage of contraceptive pills. Specifically, you wrote:

It's common knowledge how reproduction works. You have condoms, birth control pills and copper rings among other options.

That's simply not a reasonable argument. Don't move the goalposts now.


I'm not moving the goalposts. If you're a teenager and you don't use a condom or other means and get pregnant - that's on you. You wrote a long retort which ignored condoms. That's unreasonable.

If you don't use a condom no matter what age you are and get an STD - same thing - that's on you too.

Your argument about post-conception options - I agree that not everyone has the same access. But I'm not talking about that.

Condoms work. Teenagers know the risk. They're just being dumb and it's on them.

Now - your argument that making birth control more available - sure I think that's a good thing too. But the notion that "the vast majority of teenage mothers in the United States do not choose to get pregnant" is irresponsible because almost all of them got pregnant by being wreckless while viable options are readily available. Specifically condoms.


The comment that you wrote and that I quoted from just now is still right there for everyone to read. It's weird to write as if it wasn't.

(The comment I just replied to was edited extensively after I replied to it. That's OK; I said what I wanted to say.)


I just added more to it. That's all. If you want to ignore condoms, then we're at an impasse.


Ondansetron is associated with long QT. The FDA does not like that side effect for OTC meds.


Easy: a lot of states teach abstinence-only sex education, and there's a prevailing set of social norms (often imposed by "pro lifer Christians") that makes frank discussions of birth control, sex, reproductive biology, etc. all but impossible. It sounds crazy - and, IMHO, it is - but large parts of the US operate as de facto theocracies, especially where it comes to education.

Under those circumstances, it's not surprising that teenagers have sex, don't know how to do so safely, and end up pregnant without meaning to. That is: a teenager absolutely can choose to have sex without choosing to get pregnant, simply because the society around them has conspired to make sure they don't understand how one leads to the other.


[flagged]


That's exactly the line of thinking that leads to societies where women must be accompanied by men in public.

It's strategic: prevent women from accessing the tools and knowledge to keep themselves safe, then justify denying them rights "to keep them safe."


You had the kernel of a sensible point a while ago, but now you're just digging in. Acting as if most teenage pregnancies occur because the woman involved doesn't understand how babies are made is asinine unless you've unearthed some population I don't know about; and claiming that frictions standing in the way of perfectly convenient birth control absolves a person from all consequences is both asinine and actively insulting to the agency of human beings everywhere.

Things could be better, of course, and that's worth talking about, but your argument has turned into a caricature.


Americans don't have universal healthcare, can't just go walk in some clinic / pharmacy and get a doctor / pharmacist to Rx you some birth control.

You also have minimal->zero private money and come from a poor background so it's too expensive. Your parents are religious and it's difficult to privately have & use birth control. Copper IUDs create pretty bad periods and are more painful to insert if you never given birth. Giving yourself a megadose of hormones with other implants is pretty freaky.

But your 16 years old and have a lot of hormones...

That is part of the reason why the entire obamacare free birth control fight was pretty emotional in the USA.


I'm pretty sure that you can buy condoms in America. They're not that expensive and work reasonably well.


Last I checked condoms were the only birth control that prevents STDs. All the other birth control named is not appropriate for teens who are unlikely to have settled on a lifetime monogamous partner.


So basically you're boiling it down to sex and laying down the guilt at the feet of the healthy young adults whose behavior is all but unexpected.

Wouldn't you rather call it the failure of a community - a society - to prepare its new members to the complexities of life?

Oh but it's easy to climb up the high horse, brandish the sword of Morals and throw the erring off the tower (incidentally, it's the same ISIS does to its own "deviants")


It's nothing to do with morals. Unsafe sex at an early age is just plain a stupid dangerous decision, and there's plenty of people to tell you that. Sure - I feel bad for the people who are now going to be paying for the consequences for the rest of their lives, but it's not some arbitrary religious code. It's not so different from experimenting with drugs in that regard.


Kids make stupid and dangerous decisions because their brains aren't fully developed, they don't have the same sense of perspective that they will (hopefully) have as adults. Once upon a time, this was part of why we had a separate judicial system for them, too.

Religion comes into play because the lobby against making birth control available to teenagers is also the lobby against abortion clinics (and any clinics that offer health services and birth control to teenagers) is also the lobby to teach abstinence in schools (or not teach sex ed. at all), and that lobby gets most of its funding from religious organizations.

So, the slightly awkward week in sixth grade where my teacher gave us anatomy lessons and a birth video is something my daughter didn't get to experience, even though I brought my family back to my hometown. Instead, she gets the even more wonderfully awkward talk from her parents, which my wife likes to paraphrase as "your mouth won't get pregnant" (thanks Bill Clinton).

Teen pregnancy is not currently a common issue (it has been declining since 1990), but that doesn't mean it won't start going back up if we continue making it more difficult for young women (and men) to have access to birth control and education about safe sex.

We even had some discussion in school about how to reduce the risks of experimenting with drugs, though I don't think many people followed those directions.


Religion _was_ the birth control for a long time. It appears to have stopped working sometime in the late 1960's though.


In the old days they used to say "First babies can arrive whenever they want, the second baby better take nine months". Which is to say they knew unmarried people would have sex, but any girl that got herself pregnant was expected to marry the father before the baby was born and stay married.

Religion never worked great, but it was all they had.


Expecting kids to wisely abstain when their brains aren't fully developed yet and their bodies are telling them that having sex is the most important thing they could possibly do is foolish. Giving them ready access to contraception and sex ed so they don't harm themselves or others is easy and effective, and there's no good reason not to do it.

You are looking at a problem with a simple and well-understood solution, and instead of talking about implementation you're going "Tsk, tsk, it's their own fault for being stupid." So, yes, you're absolutely moralizing.

> it's not some arbitrary religious code.

Giving teenagers worthless abstinence education instead of proven sex ed is the definition of an arbitrary religious code.


I think you missed the part where I said unsafe sex. I'm trying my darndest to find where I said abstinence, but gee golly I just can't do it. But I guess it just has to be someone else's fault somehow.


You said: "Unsafe sex at an early age is just plain a stupid dangerous decision, and there's plenty of people to tell you that." In the US there are major political lobbies whose goal is to prevent kids from hearing that in favor of abstinence-only. You can't just gloss over that and say that kids should know better when people are actively trying to keep them ignorant.


There is more than sex involved, but that was the biggest factor - at least in my experience which could well be different from typical.

I carefully avoided passing a moral judgement on their acts. However the fact is sex at 16 immediately jumps into moral issues (not just Christian - most world religions encourage marriage). I did my best those to focus on the fact that as a result of that choice they have eliminated their ability to get a head.

YOU are the one placing moral judgement on their choices and trying to make it look like my judgement.


In what way does sex at 16 immediately jump into moral issues exactly?

I don't buy for a second that being sexually active as a teenager somehow equates to lack of moral fortitude.

There's plenty of teenagers that are aware of birth control and use it appropriately. Do they lack moral fortitude, too?


Having a kid at 16 will screw you up. Most people have a moral objection to screwing up their life like that, as well as the practical objection. Most religions of the world have some form of moral objection to sex outside of marriage, it can be easily argued that the moral objection comes form the practical issues. (most religions predates any form of effective birth control. Today you can argue that the moral is obsolete)

Or put it another way, you cannot talk about kids having sex without everybody bringing their own different morals up. The two are very intertwined.


Yeah okay that doesn't exactly equate to lacking moral fortitude. Think you're projecting a bit there.


fair enough. I should have put moral fortitude in quotes.


20th century+ humans have reliable birth control. There is a very strong anti birth control meme in the US.


>> That is every penny they earn is pure spending money

I never looked at it as pure spending money - it was mostly saving for an education and a start in my adult life. Might be why I'm one of the few of my generation that doesn't think the entire economy is stacked against them?


With the exception of a Nintendo DS, 1 game, and some beer, all of my money from 4 years of jobs went to rent,food, and the tiny little bit left over went to tuition. Anyone going to college in the past 20 years was not paying for it all with a job you could hold while going to classes


graduated with a B.S. 5 years ago debt-free with no help from parents. It's possible.


Id certainly believe that it's possible to do so. However, in the same way that anyone could be president, not everyone can be. Lots of colleges don't even have enough jobs in the area to support every student working, and the number of hours you'd have to work can prevent anyone with a difficulty major from doing so

Edit:I did say _anyone_ in the past 20 years so that is some unfortunate hyperbole on my part


> Lots of colleges don't even have enough jobs in the area to support every student working

This doesn't make a lot of conceptual sense. If 100,000 people move into a town of formerly-3000, they will severely outnumber the open job slots from before they moved in, but that doesn't mean no work is available for any of them. Most of them will find work just as most people everywhere find work.

Work is available to anyone who can do something productive.


The bar for "something productive" keeps rising though.


Step 1: Study somewhere that is not the US ;-)

Some US based acquaintances recently discussed the college options and choices of their kids. A year at the cheapest college they discussed cost more than twice (tuition, without a room) as much as my German B.Sc. and M.Sc. combined: that is, 5 years of study (or longer - I decided to study part-time and earn real money in parallel. It costs little extra).


My post was focused on those who were skipping work. As I recall the majority of the kids had enough work ethic to show up every day. They probably were saving a fair amount of their pay check, but we never discussed that.


That's a stereotype.


> the working poor somehow lack moral fortitude

NOPE. More like they feel abused by society, so they rightfully abuse it back by taking as much as they can and giving as little as possible. Of course, the result is a vicious cycle they can't get out of: if you play the lazy parasite once, you do get some kind of "abuse" back (even if it's just passive-aggressive attitude from colleagues) even if you mostly get away with it and as we're all wired up to do you then have to "retaliate".

Of course, people who don't have a history of being abused by the system, eg. people who've had good managers, don't feel the need to abuse the system themselves, so no problem here.

And breaking an established cycle requires a great manager (hint: probably the one you're not going to hire, because it makes more business sense to spend more on legal, accounting, or even a developer...), assuming not very stubborn employees and no underlying mental issues.

Most socio econ systems fail because some people feel abused and abuse the system back. Abuse your workers well enough an you get, surprise, communism, when they abuse you back. Circle of life and all that shit...

(And don't get me wrong, I think it's good that a sizable percent of population is pre-programmed to "abuse-back", this prevents us being turned into a mindless remote controlled flock of sheeple... And I kind of think lighter collar "information jobs" people should learn a thing or two from the abuse-back attitude of blue collars because nowadays they tend to be sheepified too, and some "abuse-back feedback" would help the system!)


I'd say there is a simpler thing that also contributes.

The poor have much less leeway in their lives. Sometimes, they need to choose between 'abusing the system' or e.g. dealing with a family emergency. Say your car broke down and you need to get it fixed. Do you call in sick and get it done or do you bus it until you get some free time when the mechanics are working?


With a request like this, the best you can hope for it lots of data points (ie anecdata).

What I've seen is that in the jobs filled by younger people with little skills on the worker side and near-exploitative conduct on the employer side, was a) a rather shallow loss function ("what if I lose this job? I'm underpaid, it's a dead-end, and I can easily get another job like this", that they often still live in their parents' basement exacerbates that effect) and b) a feeling of justification for these actions ("They exploit me, I'll exploit them back").

And those weren't simply rationalizations, so I'm not sure if it's a matter of moral fortitude or lack thereof, just of a different set of morals that (are understood to) underlie that type of job. There was a strong sense of moral in the people I worked with, just along other axes (eg. stronger loyalty between peers, but much weaker up and down the hierarchy).


I've seen the same rationalizations from salaried well-paid people.


Yea, it's not really a lack of morals to fuck over someone whose actively fucking you over like many low end jobs do. The few bosses I had that didn't exploit people ended up with much higher loyalty and rule following on the employee end. The other employees helped enforced it with social pressure too, as no one liked seeing the good boss get advantage taken of them


> This feeds directly into the popular narrative that the working poor somehow lack moral fortitude.

Not really. Not every bad job is held by an oppressed proletariat. Many times they're held by mischievous PFYs who still think they're immortal and that $20 is a lot of money. Youthful indiscretions are one the most common sources of this type of behavior. It's extremely common to not have a professional attitude in your "first real job", or to not even consider most minimum wage jobs as a "real job". There's an entire genre of movies that relies on this culture. Slacker culture has been part of pop culture for decades, now. When you don't have any actual responsibilities it's pretty common to treat any new ones like a big joke, or as "suggestions".

And it doesn't just happen at work - there are people with extremely cavalier attitudes towards education. I had a conversation with my kid about other kids getting around attendance rules in high school by showing up to class and then "going to the bathroom" and not returning to class again. Skipping class to go smoke, race, shop, etc has been a thing for at least 50 years. It's kind of telling, though, that most slacker movies were about college-age (or younger) kids. Ones for adults (e.g. Office Space) are pretty rare and rather niche.

It's important that we recognize that professionalism is not a natural (or an exclusive) trait. Babies don't pop out of the womb screaming "Please advise." The teenage years are full of people pushing boundaries to learn how they fit into society. We expect mistakes at that age, and those expectations are frequently met.

I've literally met hundreds of people who blew off classes because they weren't the ones paying for it, or who called in sick after a hangover or because they didn't like their job. I've stood around at parties listening to people tell stories of how they ditched work. I had a co-worker call in sick because he "couldn't get his car out of the garage." And having six dead grandmothers in a year is a trope now. It's not everyone, for sure, but it happens. It's just that people do it less with the jobs that they value in the careers they've invested into.

That said, we do need a lot of labor reforms around hours worked, employee rights and privacy, cost of living adjustments, etc. And we need better safety nets for citizens. But those will always extend far more slowly to a job that can be filled by 90% of the population. The supply of entry-level workers far outstrips the demand.


>> by the low-wage masses abusing it (and abuse it they did).

> This feeds directly into the popular narrative that the working poor somehow lack moral fortitude. Do you have evidence to justify this claim?

I wouldn't be surprised if it's far more common among low-wage-job-holders that aren't poor, actually.


That would make sense if we were talking about unpaid time off, but we're talking about PTO.


Sorry, I don't follow. The working poor have a lot to lose through abusing PTO -- losing a job is devastating for them. So I would expect them to be less likely to abuse it. Contrast it with the non-poor who work low-paying jobs... losing a job isn't that huge of a risk for them. So naturally there's a lower barrier to abuse. This is true regardless of whether the time off is paid or unpaid. Or I guess even whether we're talking about time off, or about anything else at work really.


It was pretty clear he was talking about his own experiences. Does he need evidence to justify his claim that management also abused their powers?


> It was pretty clear he was talking about his own experiences.

And I'd like him to elaborate on those, rather than make a broad generalization. Thanks.


I'd say its the other way around.

It only takes a few people abusing this before it becomes a problem. At the same time, those who lack moral fortitude are more likely to have low-wage jobs because those are the only ones they can hold down.

So, the shitty people end up over-represented at the low-end of the job market, so those jobs need to consider them more.


> Do you have evidence to justify this claim?

Sure, I worked a lot of retail/physical labor/etc. type jobs in my younger years. I was out of the house at an early age, and took these jobs very seriously since they paid my bills. My co-workers for many reasons did not, at least a very significant minority of them.

I don't think it's really "out there" to say that the typical minimum wage worker is not as high quality as the guy 4 years in making $20/hr. That is reflected in their pay, after all. The folks I worked with were either generally reliable and usually job hopped quite a bit every 6-12mo for raises, or they were just workers who barely had enough value to not get fired. The latter were more common, in my experience. Despite what you hear on HN and elsewhere - there are a significant number of people who have zero interest in working, and only do so to pay bills. If they could sit at home all day doing nothing, they absolutely would. Working with them is not fun, and until I found the whole computer/on-line community thing (in the early 90's) I felt extremely alone spending most of my day with those types that had zero ambition to improve their lot in life.

And I think it's more of a "masses" problem - not necessarily class based. Maybe investment based. You likely don't really care much about your $7/hr job, at least a significant portion of people do not. That same is not as true for the $100/hr job. It's simply a filter.

You see the same issues in other "body shop" style white collar offices too. Even relatively highly paid folks like insurance call center workers have to be treated like children, or you'd have half the office call out on a friday before a long weekend. Been there, done that as well. I imagine Infosys and similar companies have policies that look very similar to someone like Walmart.

I'm obviously having trouble describing my thoughts here - but in the end I'd say it's something like professional careerists vs. a just a job. The latter there is very little skin in the game for the average employee comparatively - and those that have that motivation generally don't stay in that socioeconomic class very long. You see the same effects in any space open to various segments of the public. The higher your admission fee the less you have to pay for people destroying things. More skin in the game.

Edit: I think it's important to state these are generalities. The actual working poor tend to be by far the hardest working most reliable folks out there. If they had issues making it to work - it was usually something huge in their lives. The thing is though? These folks typically got promoted or much better paying jobs elsewhere, so it's again a self-selection thing. Sort of like stack ranking your employees and only the lower 50% get to stay in your company.


> I don't think it's really "out there" to say that the typical minimum wage worker is not as high quality as the guy 4 years in making $20/hr. That is reflected in their pay, after all.

One other thing, is that minimum-wage jobs are often (not always) filled with entry-level workers. These are people who have never had a regular job. They don't know, or may have unrealistic ideas about the importance of being on time, showing up when scheduled, not taking random time off with short notice, etc. So policies are strict because many workers need to be "trained" about what to expect.


I remember at 19 having a summer job picking orders for a school book supplier. Order comes in, you pick it, then you laze around until the next order comes in. Now, I like to laze around a lot, but it still blew my mind the level to which some people would avoid work - they would spend more physical and mental energy 'not being around' when the pick came in, hiding somewhere in the stacks and keeping their 'radar' out for incoming picks... than just doing the pick and then lazing out relaxedly. There seemed to be additional value in specifically not doing work.


That's an aspect of minimum wage I haven't considered before - if I'm not feeling inherently passionate about my work, there's always the realization that I could get fired and have to take a lesser job somewhere else. If it's minimum wage you're more or less down to a binary situation. You might get fired. And then unless literally no one is hiring, you can get a similar job somewhere else. The long-term relative effects of not working short-term aren't as pronounced. I'm guessing a lot of minimum-wage employers don't do a ton of due diligence.


A technical analogy that people on HN people might understand better, is there's a difference in quality of service between paying a IT guy $100K/yr to keep your stuff like a webpage up, vs paying a discount hoster $3/month to keep a webpage up. Worst case situation will result in behavior where an outage is worth $100K/yr or the cost of sales of a $3/month AAS provider. I worked in engineering at a AAS provider a long time ago, and the realization that what I can do to fix something as a normal sysadmin is enormously greater than what I can do for less than the cost of sales of replacing the customer at a AAS shop is pretty shocking.

This effect extends thru the entire economy.

From observation its not that people who are poor have no ambition, they just have ambition in areas not involving getting lots of money from work or "reward" from management recognition. They want a happy family life, sex, be cool, get drunk often, ambition in all manner of things, just not into working 10x harder for 2x more money. I probably work 100x harder mentally than when I was a high school kid working at a supermarket and I barely make 10x as much money. For me working 100x harder is not a big deal because supermarket work is not exactly rocket surgery, but I can see a lower ability normie not seeing 100x harder work as achievable without excessive stress for them at their performance level, or perhaps being impossible for them. The "sit at home" under a UBI scenario seems incredibly unlikely. You might not agree with or appreciate the effort of "being cool" or posting high score posts on facebook or obtaining sex, but they will certainly sweat a lot of effort into achieving it. Playing video games is not very profitable but it is somewhat ambitious and takes a lot of effort.

To some extent a marketplace that doesn't meet the participants needs is a failure of that marketplace, which describes a lot of our labor system for a very large fraction of the population. Its not really their fault the system is irrelevant to their interests.


PTO is not the same thing as sick leave. Generally PTO, be design, does not require any justification whatsoever. I don't see how your anecdotal experience is relevant to this discussion.


>I suspect a company that asked for verification was not doing so to see if you were genuinely ill, they're doing so because it's already a problem and they want a nice paper trail for when they terminate you.

Eh, probably not. Some companies do it to everybody especially when they have an employee that they want to get rid of, but is in a 'protected class'. This so they can show HR and the unemployment commission they treat everyone equally and fairly. Unfortunately this leads to the average employee that does their job feeling they are being treated unfairly. The larger a company gets, and the more surface area the company is exposed to lawsuit abuse to, the more commonly these rules are applied to all people in an unfair manner.


I've seen people routinely abuse sick days and they considered it normal (they brag about it). Others coincidentally are "sick" for exactly 10 days a year, year after year. They think management doesn't notice, and wonder why they don't get much in the way of raises or promotions.

Basically, you're right. The verification thing is invoked to provide convenient evidence to get rid of someone they already want to get rid of.

Trust only goes so far. If a company does not have good cost control and verification procedures, they can and will get robbed blind. Heck, the cash register was invented by a bar owner who suspected the bartender was embezzling in a blatant and ruinous fashion.


What's wrong with people taking 10 days off per year? Why is management so short-sighted as to make promotion decisions based on ~4days/yr of presence (<2% of productivity)?

Why does it even matter why they take the time off?

Make a stupid policy, get a rational response from employees.


Another way of thinking about this, rather than "mental vs physical" or "healthy vs sick" is "how much discretion does your employer give you to balance work with your own well-being".

There are plenty employers who are willing to accommodate you if you have an actual DSM-diagnosed mental disorder but are skeptical of a "sanity day".

Likewise, there are plenty of employers who will let you take time off if you're actually chucking mucus across the room. But what if I just suspect my immune system is a bit weak from the long hours I've been pulling, and that going into work today is likely to trigger a cold? Or what if, in order to keep up with work, I've been drinking 8 cups of coffee a day and eating nothing but microwave meals because I don't have time to figure out healthier options? Technically, nothing prevents me from performing my job. It doesn't require a doctor's appointment, nor is there some illness that's easily verifiable. I'm not broken yet. I just have a hunch I'm breaking down.

And then there are a whole host of issues that might not qualify as "health issues" but are things I need time to deal with if you want me to function at my best later: childcare, DMV appointments, legal issues, car repair, etc.


I dunno man, any of those things and I'm just not feeling well, so I'm staying home.

There's absolutely something preventing me from doing my job on those days, by the simple expedient that I don't feel like doing it that day. If that doesn't happen more often than I have sick days, I don't see the issue.


You should learn a little about the politics around the DSM before assuming that anything in the DSM is "real" (and everything not in it is "fake").


I've seen some companies in the UK operate what they call a "duvet day" policy. It's basically just two floating holidays a year you can choose to use at any time, doesn't require explanation and doesn't count as a sick day. I personally haven't worked somewhere with such a policy, but know some people who do, using it largely as a "sanity day" as you describe. They really seem to appreciate it. I'm in no way trying to demean or imply mental illness isn't real and not deserving of 'real' sick days, but it's nice to have a range of options.

https://en.wikipedia.org/wiki/Duvet_day


Correct me if I'm wrong, I think that's called a personal day here in the states. They usually give you two a year too, along with sick days.

Though I do agree, that there's stigma towards taking it for personal sanity, mind healing.


Are sick days still a thing?

At my job we get PTO and holidays (floating depending on the year), but no specific sick days.

Apologies for any naivete.


CA has a sick leave regulation: https://squareup.com/townsquare/californias-new-paid-sick-le...

When I was at Yahoo, we had unlimited sick days (and my manager aggressively enforced that), but after this law passed they asked us to mark any sick days we took off to comply (still unlimited, but somewhat tracked).


I think sick days are generally a good idea as they encourage people that are sick not to come in, thus helping stem epidemics. If they're regular time off, people come in sick to save them up.

You might try to make a distinction between contagious and non-contagious diseases, but it'd probably be unwise as often people don't know if they are contagious or not, and anyway encouraging healing isn't a terrible idea even if they aren't.

That said, you shouldn't be cheap on the vacation days either.


As someone from Holland I read the comment from malnourish in the opposite way.

Why limit the amount of days your allowed to be sick? What happens if you are sick for more days than what your contract allows?

I would think that a finite amount of sick days will have the opposite effect of what you are describing. People will come to work even when they're sick, just in case they get even more sick later in the year. Except for the end of December of course, can let those unused sick days go to waste!


> Why limit the amount of days your allowed to be sick?

The number of days you are allowed to be sick is not limited; the number of days of paid leave to deal with being sick is limited.

> What happens if you are sick for more days than what your contract allows?

Depending on the nature of the illness and other factors, you may be eligible for unpaid (by the employer), job-protected leave under FMLA or similar state laws, and may be eligible for disability payments during that leave under state law. The employer may, even if that law does not apply, extend paid or unpaid leave beyond what it is committed to in your contract, but is under no obligation to do so.


> What happens if you are sick for more days than what your contract allows?

They threaten to fire you for taking too much sick time, and they don't pay you for the additional days. They complain that you aren't reliable enough and that they need someone who is reliable.


I found this interesting article that claims that flu days / sick days reduced the number of workplace cases by 6% by reducing the in-workplace transmission rate by 25% for one day and 40% for two days of time off.

https://www.sciencedaily.com/releases/2013/06/130613161831.h...


PTO is just merging sick days with vacation, usually to mask the low combined total (the nominal “benefit” to employees compared to classic separate sick plus vacation policies is that the whole amount can be used for vacation.)


I don't disagree, it was a bit alarming and while our PTO policy is better than many, there are still lots of competitive employers who offer better benefits wrt time off.

It is nice to never actually need to provide a reason/note to be out, but I think the combination does stress some of my coworkers (e.g. "I don't want to take vacation because what if I get sick", "Oh great, I'm sick, now I can't take vacation").


Depends on the company. I've been at places that separates them and places that don't. Before our acquisition we had 20 PTO and 10 sick days and after the acquisition we are at 25 PTO days with sick time included in that. My previous employer had unlimited sick time that was completely separate from PTO.


The USA is one of the few countries that doesn't enforce some amount of paid sick leave allowance[1].

[1] http://d3i6fh83elv35t.cloudfront.net/newshour/wp-content/upl...



Technically I think so, but from what I've seen some people use PTO days for sick days (or to go to the doctor)?

We have 6 holidays + 1 floating that we can use, and they don't roll over from year to year.


That's even worse than Amazon!


> Are sick days still a thing?

Why wouldn't they be? I assume they're mandatory in most countries.


In most (western, don't know otherwise) countries, you stay home when you're sick, and get paid because it's outside of your control. No matter if that is day 1 this year or day 20.


So employers need to be careful not to hire sickly people?


It's illegal to discriminate against someone because of their medical background or disability unless it's critical for the job. For medical background they wouldn't be able to get the information anyway.

Sickness is just part of the cost of doing business with people, not robots.


> So employers need to be careful not to hire sickly people?

Wow. O.o

So in US employers just whip sickly people into coming to work or how does that line of reasoning work?


Well here in the UK you don't have a limit on the number of sick days. You get sick you go off work. It's separate from normal PTO allocation.


I thought "personal days" are when they put sick days and vacation in the same bucket (which a lot of companies do)?


There's something like this in Poland, but it's four days and it's mostly used for emergencies. Using it deducts the planned holiday days.

http://polishemploymentlaw.com/index.php/tag/day-off/


I felt guilty about doing it.

You shouldn't feel guilty at all. They should feel guilty for making you need to take that day off.

Your workplace should be a refuge, where you charge your batteries and build sanity. Not a constant drain on those resources.


Your workplace should be a refuge, where you charge your batteries and build sanity.

That's a refreshing perspective, I haven't thought about it like this. Indeed, when you're solving tough problems, you'd better concentrate at the private office (which is nowhere to be found, so work from home it is), and the workplace is the place where you go to discuss your difficulties with colleagues to broaden your perspective, and ask senior ones for practical advice. Makes perfect sense.


Orthogonal to my other comment, I feel like most of those reasons for sick days are really good reasons to have your company set up to facilitate remote work. When my wife was on maternity leave, I was more willing to be flexible with when I took leave because I could be at home anyway and help her when she needed while she recovered (which was just occasionally throughout the day). Same with when my kids have been ill. When I have a contagious illness, it hasn't mattered because I just work from home. I don't remember the last time I actually took a full sick day because I personally felt like I couldn't actually perform mentally. Because my company is set up to make remote work almost seamless, I take fewer days off but can tend to the needs of my family even better. Win-win.


I ejected myself from my own business of ten years as my mental health and resultantly my physical health was failing. Stress does really bad things in the long term.

My co-founder was relentless in applying guilt and pressure while I vomited for years for weeks at a time - multiple hospitalisations due to severe dehydration. He denies that mental health is even a thing.

So - it's not just an employee thing - even business owners can be severely impacted by uncaring colleagues.

A year out of work and I haven't puked in eight months.


Yeah, that sounds like stress...


Throwaway.

My work requires a medical certificate for certain situations. No exceptions.

Sometimes it's easier for me to simply turn up to work sick for a day, than try and get a cert.

I'd feel worse about doing this, but I am pretty sure other people do this too.

And it's an open plan office of course, so diseases just spread through the office.

You should simply get a large pool of personal leave that accrues and you can take it when you need to.


I worked for an employer who had a large percentage of union employees. All employees were held to the same rules and as a result, you could only be out sick twice in one year. The third time meant you were written up. If you were out more than a day, you had to have a doctor's note. I had a procedure done and was so terrified about the rules, I went to work. The pain was unbearable and they sent me to the on-site doctor. He looked at my stitches and asked why the hell I came in. I could barely laugh through the pain at the irony of it.


I'm sorry you had to go through this. I do hope you are in better health now and don't have to endure this kind of an atmosphere again.

Good luck mate!


Thank you for the kind words!

I am happy to report I left that position after 13 months, but consider the plight of the skilled tradesmen who work under those conditions and do physical labor. I was just sitting at a desk programming.


My beloved works in health care (currently with oncology patients, previously hospice and Alzheimer's). The idea of taking days off for mental health is pretty normal and well accepted within the industry. Then again, it's a culture where mental health is treated as a health issue and sucking it up for the dollar is recognized as unsustainable over the long term.

Well that and even the bosses are ready to acknowledge that the job people are paid to do sucks at least sometimes. Many industries and businesses pretend that that's not the case.


Anecdotal, and on the opposite end of the spectrum, I've a friend who works in healthcare in the UK. Even though the official line is that they're not to come in to work while ill, not turning up ends up putting them under an incredible amount of pressure, and they have to justify every sick day to the post where even when she had some quite serious issues she was still working rather than face up to her management


There is a mental overhead from work piling up whenever a person in a line position takes a day off for whatever reason. Illness, vacation, holiday...it doesn't matter.


Medically speaking a mental illness is no different than a physical illness.

Mental illness does not have to be severe just as physical illness does not have to be severe.

Sick leave policies typically only require a doctors note/visit if you are absent for multiple days.

Taking a single day off for mild mental illness, something like elevated stress levels causing anxiety that interrupts your sleep, seems perfectly consistent with most of the corporate sick leave policies I have read.


There are two major differences between mental diseases and typical physical diseases.

First, "sick days" generally are a policy for handling acute disorders; e.g. last week I didn't have disease X, today I do, and next week I'll be healthy again. You can't "wait out" a mental disease; taking a day or two off may reduce elevated stress levels but that is not the disease, the underlying problems aren't going to be solved when you come back.

The second issue is that many common physical issues are contagious, and there's a strong benefit for the employer and the society for sick people to "quarantine" themselves instead of going to offices and infecting coworkers and customers.

Mental diseases generally all are chronic and not contagious, and so they're similar in workplace (mis)treatment to things like arthritis or diabetes complications; things that don't map neatly to "x days to get cured" but instead need ongoing maintenance and unscheduled downtime forever.


> First, "sick days" generally are a policy for handling acute disorders; e.g. last week I didn't have disease X, today I do, and next week I'll be healthy again. You can't "wait out" a mental disease; taking a day or two off may reduce elevated stress levels but that is not the disease, the underlying problems aren't going to be solved when you come back.

In the UK time off to manage a long term condition could be justified as a "reasonable adjustment" under the equality act.


>Medically speaking a mental illness is no different than a physical illness.

I am a proponent of taking time off for mental health, but I have to nitpick here. Medically speaking, physical illness is different from mental illness. One is diagnosed from objective scientific tests (pathology) while the other is not.


Afraid that's not true. Around 60-80% of diagnoses in primary care settings are made purely on the basis of the patient history (followed by a brief clinical examination which usually aims at eliciting subjective responses)[1]. In principle it's true that you could find a pathological explanation for all somatic ("physical") diseases which in practice are diagnosed off patient histories (with the exception of diseases for which the pathogenesis is unknown, f.ex. fibromyalgia, IBS, CFS, etc). However - in principle - the same goes for mental illnesses, although the pathogenesis of mental illnesses are generally poorly understood. If you don't think there's a physical basis for mental illnesses though, skim through the figures in this article[2] for a prime example of the ways modern medicine is disproving that. Diagnoses of both mental and somatic illnesses are heavily based off subjective factors, and both mental and somatic illnesses have very real pathophysiological etiologies.

[1] Source: medical school. Not finding a study with exact numbers from a quick search. [2] https://www.nature.com/nm/journal/v23/n1/full/nm.4246.html


>fibromyalgia, IBS, CFS

There are objective tests for all of these pathologies, though those tests are often inconclusive in the face of the symptoms.

>If you don't think there's a physical basis for mental illnesses though, skim through the figures in this article[2] for a prime example of the ways modern medicine is disproving that.

There are physical symptoms of mental illness, but as yet there is no proof of physical causes, which is why the chairman of the Department of Psychiatry at Duke University School of Medicine and the DSM-4 stated "psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests". You'll find no objective biological tests in the DSM.

https://en.m.wikipedia.org/wiki/Allen_Frances


>There are objective tests for all of these pathologies, though those tests are often inconclusive in the face of the symptoms.

Nothing good, sadly.

My wife was in banking for twelve years and worked her way up from a teller to a fairly senior position. Her work ethic was spectacular - she had just two sick days in the previous five years and she was promoted almost yearly, always receiving an excellent review.

A few years ago, she went from having occasional discomfort to waking with fairly severe pain daily. It got so bad that she had to take time off, and eventually took FMLA for a full twelve weeks to see if it would help. It didn't and she was fired soon after.

She filed for disability after being diagnosed with Fybromyalgia. Our lawyer sent her to bother specialist doctors and independent testing labs to get complete documentation. They had her complete various tasks like screwing in a screwdriver, raising a weight above her head for X seconds etc. and then asked her to rate her pain levels and other self-reported things.

In the end, she was denied for disability, mostly because disability is no longer about actually being disabled - it's now about essentially filling the gap between welfare and medicaid. In the written opinion however, the stated reason was that all the evidence was self-reported, implying she could be making it all up (because who wouldn't want to give up a successful and lucrative career for some minimal-level disability payments).

Anyway, I learned two main things:

1. There are no commonly accepted objective tests for pain - it's almost all self-reporting.

2. The disability system in the US is heavily used as supplemental welfare.


> There are objective tests for all of these pathologies, though those tests are often inconclusive in the face of the symptoms.

No, objective tests are in these cases used to exclude other causes to the symptoms, not to diagnose the mentioned illnesses. These are diagnoses of exclusion[1].

> There are physical symptoms of mental illness, but as yet there is no proof of physical causes, which is why the chairman of the Department of Psychiatry at Duke University School of Medicine and the DSM-4 stated "psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests". You'll find no objective biological tests in the DSM.

I'm not disputing the fact that it's not possible to do pathophysiological tests for mental illnesses in current clinical practice, but you're creating a false equivalence by implying that being unable to test for a pathophysiological factor is the same as that factor not existing. There are plenty of pathophysiological changes that occur in mental illnesses [2-4], but for obvious reasons it's not feasible to haphazardly take biopsies of the brain to test for them, especially when the patient history and subjective examinations suffice to make a diagnosis in most cases.

Conversely, my point still stands that the vast majority of somatic illnesses are diagnosed off subjective symptoms - doctors don't bother doing objective lab tests for a cold or a sprained ankle when the diagnosis is glaringly obvious based off subjective symptoms.

  [1] https://en.wikipedia.org/wiki/Diagnosis_of_exclusion
  [2] https://en.wikipedia.org/wiki/Mechanisms_of_schizophrenia#Pathophysiology
  [3] https://en.wikipedia.org/wiki/Biology_of_depression
  [4] https://en.wikipedia.org/wiki/Causes_of_schizophrenia


>it's not feasible to haphazardly take biopsies of the brain to test for them

It is feasible post mortem but scientists still have no conslusive proof from such examinations.

>Conversely, my point still stands that the vast majority of somatic illnesses are diagnosed off subjective symptoms - doctors don't bother doing objective lab tests for a cold or a sprained ankle when the diagnosis is glaringly obvious based off subjective symptoms.

That is not in dispute because a cold and sprained ankle are objectively diagnosable post mortem. Mental illness is not.


You're creating the same false equivalence again by stating that an objective post mortem diagnosis not being practically feasible is the same as an objective cause(s) not existing. In my previous post I linked to multiple pages listing objective causes/mechanisms for two mental illnesses. Diagnosing a mental illness post mortem isn't as simple as finding rhinovirus in a person's nasal cavity, but just because the current knowledge of the disease isn't sufficient to create a satisfactory model that can reliably make a diagnosis post mortem doesn't mean that it can't be done. And if you don't think mental illnesses subside in molecules and physical structures in the brain, where exactly do you think they come from?

Oh, and you kind of can diagnose certain mental illnesses post mortem: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181616/


>if you don't think mental illnesses subside in molecules and physical structures in the brain, where exactly do you think they come from?

No ones knows for sure because no one can objectively explain the nature of consciousness and the mind in the first place. That is of course not to say that chemicals do not have a strong influence on the mind.

>Oh, and you kind of can diagnose certain mental illnesses post mortem: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181616/

The study has no control group and therefore is not objective. If you read the Methodological Issues section, you'll see that this is essentially a study of the neurochemical effects of antipsychotic drugs.


> No ones knows for sure because no one can objectively explain the nature of consciousness and the mind in the first place.

True, but I'm still waiting for a single proposal as to where a mental illness would subside other than physical structures/molecules, because the only other explanation I can think of are in the realm of the metaphysical

> The study has no control group and therefore is not objective. If you read the Methodological Issues section, you'll see that this is essentially a study of the neurochemical effects of antipsychotic drugs.

The article isn't a study/original research, it's a review based off of existing research - generally - in which brains from individuals with schizophrenia are compared to the brains of individuals without schizophrenia (controls). Antipsychotic drugs as a confounding factor is definitely an important factor in these studies though. There are however a number of factors that are are not affected by antipsychotics, notably genetics[1, 2]. Certain genetic variants strongly increase the risk of mental illnesses - by what mechanism does this work other than by translating to proteins that exert an objective, physical effect? (Note that studies on this are primarily GWAS based on large populations, not simple hereditary/familial studies in which one could argue that environmental factors were confounding)

  [1] https://en.wikipedia.org/wiki/Causes_of_schizophrenia#Genetics
  [2] https://en.wikipedia.org/wiki/Bipolar_disorder#Genetic


This is partly because when a specific physiological cause for a "mental illness" is confirmed, it usually becomes its own diagnosis in a different specialty. This happened relatively recently with anti-NMDA receptor encephalitis, which is believed to be responsible for some cases diagnosed as schizophrenia (and, historically, as demonic possession).


> Medically speaking, physical illness is different from mental illness. One is diagnosed from objective scientific tests (pathology) while the other is not.

Isn't this just because we don't actually understand medical illnesses nearly as well as we understand physical ones in general? I don't we actually know that there is anything innate about mental illness that makes it different from physical illness in this sense. That being the case, mental illnesses are just like those physical illnesses that we have yet to understand as well no?

Please correct me if I'm misinformed as this is a topic that I am very interested in.


As a counterpoint, there are no objective scientific tests for, say, back pain or neck pain or nausea or menstrual cramps.


That is because pain is not a disease, it is a subjective experience (or symptom) generated by the nervous system.


So? A disease (or injury) is what causes the pain. Why the specious distinction?


Fair point. Counterpoint: in the sense that it is dis-ease (the absence of feeling well and easy going) it may still be a sufficient reason to take a day off work.


Agreed. You shouldnt need a diagnosis to take a day off work


A doctor administered evaluation or a patient self-survey is just as objective as any other test.

These tests take a measurement and based on peer-reviewed statistical studies make a determination as to whether or not the measurement falls into a pathological range.

This is exactly the same as measuring blood pressure or cholesterol. You read a number and decide if there is a statistically valid correlation between that number and an identified disease.


This isn't true. These tests are NOT objective if the patient has an incentive to lie about their self-reporting, either in the stoic "it's fine" sense or in the "I want more opiates" or "I want to get some paid sick days" sense.


>patient self-survey is just as objective as any other test.

Subjective: based on or influenced by personal feelings, tastes, or opinions.

Objective: (of a person or their judgment) not influenced by personal feelings or opinions in considering and representing facts.


What is the difference between being depressed and "feeling" depressed?

What is the difference between being schizophrenic and having the "opinion" that Satan speaks to you through your neighbor's cat?

Mental illness is defined by what a person feels and believes.

What you feel and believe is subjective but you can objectively establish that a particular cluster of subjective feelings and beliefs is abnormal vis-a-vis a populate.

Then when you ask people the same questions and their cluster of responses fits the abnormal definition you can objectively say that they have a mental illness.

The objectivity does not come from the doctor observations or patient self-survey, it comes from the study that created the questions and proved that a certain score or cluster of responses is statistically abnormal.


> >What is the difference between being depressed and "feeling" depressed? >What is the difference between being schizophrenic and having the "opinion" that Satan speaks to you through your neighbor's cat? >Mental illness is defined by what a person feels and believes.

Honestly, a lot of the time it comes down to observable impact. If a patient comes to a doctor and says that they feel depressed, that's one thing, if they have lost their third job this year because they can't do anything but lie in bed and seem to not care about their own lives (especially if they used to not be like this in the past) that's something else.


Not what you asked exactly, but response to drugs sometimes leads to an (objective) differential diagnosis: if someone is depressed and flips out in a manic attack when starting antidepressants... that's not Major Depressive, that's Bipolar.

How do you objectively verify "manic"? You can track hours slept. No one fakes sleeping two hours a day for a month while having, say, good motor skills in the daytime.

This matters because recurring brief hospitalization is necessary for some people to get back on their axis. This is NOT "sanity days" or "mental healing", it's a clear cut medical issue.


Is "asking a patient how much they sleep" the same as "watching them to measure how much they sleep"?


> Medically speaking, physical illness is different from mental illness. One is diagnosed from objective scientific tests (pathology) while the other is not.

Not all “physical” (the term is not really the correct distinction, since all illness, including mental illness, is physical) illness is diagnosed directly in that manner (not all physical illness can be, because not all is understood well enough to have definitive tests, and it's not always clinical practice to do so even when it is possible in principle.) And, on the other side, some psychiatric conditions have lab tests of the same sort available.


>some psychiatric conditions have lab tests of the same sort available.

Which ones?

"psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests" -Allen Frances

https://en.wikipedia.org/wiki/Allen_Frances


Schizophrenia had one on the market briefly, and there is one for bipolar disorder that is (or was, as of last year) in clinical trials.

See, e.g., http://www.thedailybeast.com/can-a-blood-test-diagnose-menta...


Do you have a source for these claims? Because the DSM-5 says otherwise

>Diagnosis is based on observed behavior, the person's reported experiences, and reports of others familiar with the person...As of 2013 there is no objective test. [5]

https://en.m.wikipedia.org/wiki/Schizophrenia

Edit: the source you edited in simply states the corollary to what I've been saying all along: that scientists are still searching for a biological test for mental illness but as yet still do not have one


wow. ummm... yeah, that's straight mythology. you should read up on brain scans before spreading old falsehoods.


>Given how much we've learned about the role of the brain in mental illness, many people are surprised to learn that we can't know what psychiatric diagnosis a person has—or even if the person has any diagnosis—by examining that person's brain.

https://www.scientificamerican.com/article/can-brain-scans-d...


> Medically speaking a mental illness is no different than a physical illness.

I'm sympathetic, but don't make the discussion worse by throwing falsehoods like this around.

Besides the fact expressed by others that physically illness is more diagnosable, you typically don't get mentally ill from being in proximity to a mentally ill person. (At least, I never have.)

Physical illness is a different situation. That's why my workplace offers near unlimited sick time for this reason. As much as we'd love you have to working, we don't want your diseases.

---

(Granted, having an anxiety attack in the middle of work may not do wonders for the mental state of your coworkers, but blithey asserting this "no different" is dubious at best.)


>you typically don't get mentally ill from being in proximity to a mentally ill person. (At least, I never have.)

You also don't get physically ill from being in proximity to someone with a non-contagious disease or a sprained ankle, so that's an irrelevant distinction.

Sick days are not just for flus and colds that are contagious...


> Sick days are not just for flus and colds that are contagious...

Agreed. I meant to mention that.

> so that's an irrelevant distinction.

Flus and colds are by far the most common uses of sick days, so I wouldn't say it's "irrelevant."


> Besides the fact expressed by others that physically illness is more diagnosable, you typically don't get mentally ill from being in proximity to a mentally ill person.

Contagious diseases (and, a fortiori, those that are contagious on casual contact) are a distinct subset of so-called “physical” illness.

You don't get cancer from being in proximity to someone with cancer, either.


If I recall correctly, Morgellon's Disease is a mental illness that spreads via social interactions with an affected person, or journalism featuring such a person.

The disease itself is a delusion, regarding microscopic fibers in the skin. Sufficiently impressionable people simply hear about it, convince themselves that they have it, then they go on to try to convince others that it is a physical ailment rather than a mental illness.

If you are politically incorrect enough to classify religions as mental illnesses, many of those appear to be contagious as well.

But on a smaller scale, workplace morale is definitely infectious. If someone is having a particularly stressful day, they may be rude to someone else, who then feels worse as a result, and may propagate that to yet another co-worker. Of particular interest is that such transmission need not take place in person. A person with a common cold could work from home to keep everyone else from catching it, but someone with malaise or anxiety could transmit that via any medium that can include emotional undertone, such as a voice or video call.


As far as I've read, Morgellons is only "contagious" in the sense that people who already had symptoms of delusional parasitosis or undiagnosed/misdiagnosed skin conditions gravitate toward it as an explanation.


Contagions always spread through only the susceptible fraction of the population. Prior to mass communications, there were too few susceptible individuals in any given population for it to spread. The herd was immune, because any infected person would die before ever meeting another susceptible person.

Enter the Internet. Now all the susceptible people can aggregate around their own forums/boards/podcasts/groups/subreddits and infect each other with their unique strains of madness.

There's no more herd immunity, because all the susceptible people can find each other instantly.


Sorry, I should have been more precise: they are both recognized as treatable illnesses by the health care professionals, the government and insurance companies.

In the sense that you can go to a doctor, get diagnosed, get treatment, get that treatment paid for by an insurance company and get legal protections under laws applying to health care they are "no different."

Since we are talking about how corporate HR policies apply to mental health and not the philosophy of medicine I would argue that these are the similarities that actually matter.


> You don't get mentally ill from being in proximity to a mentally ill person. (At least, I never have.)

I tend to agree with you, but the concept of "contagion" is widely used in mental health settings. Self harm, or suicidality, can be "contagious".


Mental illness can cause physical illness. Anxiety can cause gastrointestinal disorders for example. So should someone having an anxiety attack not take the day off just because they weren't exhibiting any physical issues? And many gastro disorders can happen without being obvious until the situation worsens.

Waiting until the worst happens isn't sustainable and just makes things harder to recover. Perhaps burnout isn't just simply mental but a larger, systemic degradation of the body.


I work at a place that has "Paid Time Off" or PTO. It's used for vacation and sick days, and I get about 25 or so a year (haven't checked the number recently).

On my particular team, we can call in day-of often, if we don't have imminent deadlines or important meetings. "Hey, not feeling good, PTO". No one questions it. It's not abused, in that I have never felt it impacts the team's work.

And I guarantee I've used it for sanity days, especially recently!


> Our contract also allows for verification, "If the Employer suspects abuse, the Employer may require a written medical certificate for any sick leave absence."

That sounds pretty standard in any contract here in Denmark, and we have some very strong unions which have created good conditions for employees. I personally think it's fair for the employer to ask for a doctor's note if he/she thinks an employee is skipping work just for the hell of it. Though said unions have made it so that the employer has to pay for the doctor's note, when they request it, so it happens rarely.


Every company I've worked for has required a doctor's note for 3 or more consecutive days of sick leave.

It means that I cannot simply take care of myself, but that I have to go to a doctor and have them tell me that I'm sick and to do the things that I'd have done anyhow, like get plenty of rest and take some Nyquil at night.

The end result is that I almost never take 3 sick days in a row, even if I'm really sick. I end up coming to work, getting others sick, and getting nothing done. (Or worse, doing damage that I later have to repair before I can get work done.)


I'm diagnosed w/major depressive disorder so I could take any day as a sick day... even though a daily ssri keeps the depression/anxiety/panic attacks in check.


Basically they want to align sick leave with FMLA. It's not really evil.

The alternative is PTO, which is usually worse because sick leave gets mashed with vacation.


I'm a bit confused, how is a mental sick day different from just taking a day off? Right now I can just request a day off with no explanation required as long as it's one day in advance. Is a "mental sick day" like waking up, going "!@#$%@#^! I'm sick of dealing with work" and calling in sick on the same day?


There are times when I get a really bad night of sleep and mentally can't function the next day. I could take the day off get rest and come back the next day at 100%. Or I can come in anyway working at 10% mental capacity not get any rest and likely still not be at full capacity the next day.

The problem is that this scenario is socially viewed as my foult or being irresponsible; I should have seen to it that I got good sleep. If I slip off of my porch and hurt my back no one questions me not coming in; No "You should have used the handrail" or "maybe de-ice your steps regularly"


No, an example of a mental sick day would be someone who has been diagnosed with an anxiety disorder having a severe anxiety attack that prevents them from doing their job so they take the day off to try to recover.

Mental illness is a real thing, it is not just "I don't feel like going to work"


It's the difference between using a vacation day and not using one


There is a kinda secret code for OOO or WFH emails that managers should respect. Definitely got to "Respect the code" (say in a pirate voice). As a manager I'd write purposely vague emails to contribute to this, "Sorry will be late, got jumped by a gang of ninjas" because I really don't like to set a cultural tone that isn't trusting of employees. I basically need to know you aren't going to be here but I don't need to know why.

There was an eng manager that would pester people about vaguer emails asking for clarification. I really wanted to just sit him down and explain that he isn't being clever and he was basically being a jackass for prying into people's personal lives - vague email is vague for a reason.


I decided years ago to avoid detail in "I'm sick" emails, because I don't want to one day think "do I need to say I have horrendous diarrhea, or can i just say I'm sick?"


It's kinda an all or nothing situation. If the habit is to usually provide detail and then one day someone doesn't - people will assume the worst. Thus, it's better to encourage less info than more. Which is a bit counter-intuitive because, ideally, people genuinely feel bad about missing work and want to provide some justification.


Me too, I also used to say "I have an appointment on Thursdays" instead of telling people I was going to the shrink. Though I'm guessing that code was not exactly impenetrable.


I did exactly the same when I was in therapy the time before last. The only person who knew where I actually was, was my Manager (and I guess HR as well) - but my team (peers and subordinates) didn't know. I felt at the time this was the correct way to handle it.

Third time around in therapy (last year), I decided to be very open about my mental health, and the steps I was taking to help myself. So my emails became 'I can't do that then, I'm in therapy.'.

I found personally, that being honest and open to everyone about my problems actually contributed in a small way to my recovery effort. Even now, stabilised and medicated, I'm still honest and open about my [ongoing] journey, and who I was as person then, and who I am now.

I am never going to lie about being crazy again, it's not healthy.


Might I ask if the using the word 'crazy' at the end was a conscious choice? I do not wish to pry or pose a rhetorical question. I'm curious only because from the rest of the email you seem to be speaking in a dispassionate manner about the situation but that bit stood out as being different.

I could be way off the mark of course. I intend no disrespect or ill-will of any kind. I understand if you just say "None of your business" or something like that.


Nah, it's fine :)

'Crazy' is how I view myself. It helps me accept my broken brain, and more importantly, makes it easier to stay on the meds. Without the meds, I'm into serious depression and anxiety territory. It's no fun being there, so better to call myself Crazy. It is what it is. Also, I use self depreciating humour as defence mechanism. People I know personally don't like it when I call myself Crazy though, not sure why.

One day I do intend to get an 'I AM crazy, the doctor had me tested.' t-shirt. (see what I did there?)


IMHO defining yourself as "having" or even "being" some mental health label can be reinforcing and self defeating.

And if I had a friend who defined themselves as crazy that would honestly strike me as obnoxious. (I'd give a pass for schizophrenia or the like. Then your brain truly would be broken).

I say this having struggled in my own way (as, many, many - probably the majority - of people do at some point) with forms of anxiety and depression.

Everybody is trying to focus. Everybody is trying to be happy and stable. Everybody is trying to get by.


Just to dispell some common misunderstanding in this area: People with anxiety, depression, and bipolar disorder can act in ways that make people think they're just as "crazy" as people with schizophrenia. There isn't a hard dividing line between schizophrenia and other "less severe" psychiatric conditions. The definitions of them are fuzzy and it's better to think of the whole thing along the lines of a spectrum of affectedness.

My point is that anyone can be "broken"... Not just people with schizophrenia. And sometimes, for both schizophrenia and other conditions, accepting that you're somewhat broken in a way can be very helpful. It allows you to accept help more easily and relieve yourself of personal blame for the ways you may have acted or continue to act due to the condition.

Source: I have a schizophrenia-spectrum disorder.


Thank you for your openness and honesty.

Good luck!


This mentality of feeling the need to justify why you're late or out comes from industries where employees are only paid shorty wages and are monitored for time on the clock.

I have had to mentor many people in my life that your reasons for being put are your own, and if you give some overly wordy specific reasoning it looks fake even when truth...

An email calling in late or sick should never be more than one sentence.

"OOO today - but reachable

OOO today off grid

WFH - reachable by normal channels

Etc

Even better is #OOO slack channel and people just post in there any day they are out...


Have you tried a policy honesty and discretion?

"OOO/WFH: be back Tuesday at 11am"


My only issue with this is how he seems to lump in the "mental health" days that people without diagnosed mental health disorders face with the stigmatization that the other group feels. I fully support people who need to deal with mental fatigue in these ways, but if just taking time off "cures" your mental health issues, it's a different class of problem from what others are dealing with.

The "still" is incredibly premature when it comes to mental health in the workplace. We're just scratching the surface when it comes to acknowledging, accepting and understanding those with mental health disorders. Depression, ADHD and even Autism Spectrum and OCD are all on the leading edge of disorders that are receiving less stigmatization and more acceptance over time. But there's a lot more in the DSM-V that are completely misunderstood or completely unpublicized. And our workplaces are completely unprepared to deal with them.

I saw this first hand at my previous employer. We had a coworker who had a number of personal disagreements with other coworkers. In discussing it with my mother, a psychologist, she mentioned that much of his behavior sounded, to her, like someone with Borderline Personality Disorder. He was everyone's best friend up until they did anything he interpreted as being against him at which point he'd flip and try to sabotage them at every opportunity, including filing numerous baseless claims with HR. The organization was completely unprepared to deal with an individual like him. Each HR claim he filed was treated seriously, but there was never encouragement or a requirement that he talk to a trained mental health professional who could have been helped guide the company to a productive outcome. Instead, his conflicts with other employees caused at least 3 of them to quit before he was eventually forced out of the company for taking on someone who had too much pull with upper management. I can only imagine the carnage that would have been caused if he had been a she and had been able to abuse the sexual harassment policies.

HR is only trained to help the company avoid getting sued. But there's damage to both the employee and the company that can happen without the lawyers getting involved. The company's HR failed him and the rest of us that had to work with him by not knowing how to deal with that sort of psychological disorder.

Rather than "it's 2017 and mental health is still an issue," I'd say, "it's 2017 and we're finally starting to acknowledge the long road ahead of us."


When I worked for a large bank right out of college, they had buckets of planned time off and a smaller subset of unplanned days you could use. They didn't care why you used your unplanned time off and one my bosses even told us to use them all even if it wasn't for sickness, just use them.


> like someone with Borderline Personality Disorder

A small note that borderline personality disorder, like many mental disorders, is a complex condition. Specifically, a person must meet 5 of 9 diagnostic criteria in the DSM to be diagnosed with BPD; since they can meet any 5 of those 9, this means that many individuals with BPD can present very differently. This is a weakness of the DSM.

BPD specifically is problematic: it has only been well understood in the last few decades, and has an undeserved reputation due to media portrayals. Even the name is controversial, with the 'borderline' name a throwback to the very early days of psychiatry. Alternative names like "emotional dysregulation disorder" are now commonly preferred to avoid these associations.

All this to say: while the OP's experiences are valid, care must be taken not to generalize behavior from one person with a disorder to other people with the same disorder. This is how stigmas arise.

[Disclaimer: not a professional, have just read a little on these matters and, like many of us in this thread, have known people who struggle with mental illness.]


You are very very right.

When people have disorders like you list they are disabling. That's expensive for the worker and the employer and ultimately our social systems but it's just kind of expected that those people are forgotten with no resources but their own to cope. That's a horrible broken system.

What scares me is the undiagnosed (as you pointed out). There's way too many people in public perception that when analyzed closely have some kind of personality disorder. Not to play psychobabble but way too often these disorders are recognized for the success they provide but the destructive aspects are ignored. Some of these people have been so successful that they'll die untreated and it's a loss for them and everyone else.

Jobs had something wrong with him that he appears to have recognized and mitigated over time. Trump has something wrong with him, he'll never get treated. There are some other popular figures that are less controversial but in the same boat. Straight up sociopathic behavior that is applauded until enough people get hurt.

Then you've got the unsuccessful delusional people who end up committing mass murder. How many shootings and terrorist attacks could have been prevented through relatively cheap mental healthcare?

It seems like an obvious weak point in society that we don't really address. Worse, you gotta wonder if social media is exacerbating it in some people. It's easy to become a delusional narcissist these days. Maybe it always has been?


Two dangers around this perspective seem evident to me:

1. Diagnosing others based on second hand information. Presumably not as a professional either.

2. Attempting to define right and "wrong" behavior in a psychological context.

On (1): you experience a vast minority of Trump's or Job's life (unless you know them personally). How can you possibly hold to those claims? You have no idea how either of them acted in non-public contexts.

On (2): I would assume that establishing a proper range for "sanity" sits as one of the larger difficulties around the psychological field of study (although I do not know). Too narrow of a definition and you risk identifying everyone with something wrong. Too wide and you risk alienating those who could benefit from some kind of help.

I completely agree with your categorization of mental health services as a "weak point" in society largely unaddressed. With that, I think individuals need to exhibit care throwing around 'diagnoses' casually outside of a proper psychological context.


There's plenty of material out on the personal lives of Jobs and Trump. Steve exhibited a range of very odd behavior and some of it was clearly detrimental (see how he denied his paternity to the point of delusion). If we can't call that bad behavior than we have no stance on proper morals.

Trump also projects as someone with a personality disorder. We have plenty of material to suggest that his behavior is in fact unhealthy and detrimental.

My point wasn't to diagnose those two (you'll notice I did not), but to point out just two individuals which have signs of personality disorder. They may not in fact have any disorders, but how many Jobs wannabes do and that kind of behavior is not just tolerated but celebrated? That context is a real enabler for people with disorders.


By claiming that public figures can be diagnosed by someone who doesn't know them personally, I get the impression you have no idea what is actually involved in a psychological diagnosis. For example, many mental health issues can be the result of physical health issues. In such cases the mental effects are considered part of the physical illness and a separate mental diagnosis is not given. This means that someone's full medical history is necessary for a diagnosis of mental illness. Clinical psychology isn't just running around throwing diagnoses at people who seem sufficiently "crazy", there's lots of specific rules. To get a sense of what is actually required for a diagnosis, reading sections of the DSM-V is invaluable. Here's a link: https://docs.google.com/file/d/0B_xpcySB9uWfejF1S0xlLU95Y2M/...


Not diagnosing them, just saying there's something off and that may be linked to a personality disorder. That's not a controversial statement is it?


You're absolutely right that there's a lot more that goes into a clinical diagnosis of a psychological issue. It's important in that setting because it informs the likely treatment and it's very important to use all the information at your disposal to arrive at the most complete diagnosis.

But that doesn't mean that it's not valuable to use incomplete information to speculate on a diagnosis in other settings. Historians do this when they can use psychological theory to explain the actions of the people they're writing about. The example that stands out in my memory was Alice Miller's exploration of Hitler's possible psychological profile in "For Your Own Good." Just because she wasn't working from a complete medical profile doesn't devalue that exploration, it just means that the conclusions reached should be interpreted differently. Her diagnosis wasn't aimed at crafting a course of treatment for the individual since he was long dead. Instead, it was meant as a way to understand how a set of normal and understandable circumstances can yield an individual so far from normal that he could otherwise defy understanding.

It seems quite natural that Steve Jobs would be psychoanalyzed in much the same fashion. He was someone who was highly successful and impactful, so to the extent that his psychological profile can be mined for traits and practices that led to that success, it should. And he was highly polarizing, so we can also find areas of his profile that current and future leaders should be aware being possibilities in themselves as well. But since Jobs is dead, the need for a clinical accuracy in the diagnosis is gone. A more probabilistic diagnosis that looks at what was likely going on rather than concluding what is going on is all we can do.

Trump, while still alive, is also a candidate for this type of psychoanalysis. Like Jobs, no part of the diagnosis will lead to any course of treatment. In fact the most common diagnosis people seem to claim (narcissistic personality disorder) would mean that Trump would be very likely ignore any of that speculation, no matter how accurate it is. But where this type of analysis can be useful is in guiding the rest of us in how we respond to Trump's actions. Again, it's not important for us to be perfectly correct, it's only important to inform our actions based on the most likely diagnosis. Because the consequences of a "we can't know, so we shouldn't guess" are just too high. This is a man that can start wars, launch nuclear missiles or exercise any of the myriad powers granted to the US President. Even a limited understanding of the thought process of the man wielding those powers can be vital to opponents and allies in the US and other world leaders abroad.


>> But that doesn't mean that it's not valuable to use incomplete information to speculate on a diagnosis in other settings.

Jesus man, how do you write something like that in the comments for an article about removing mental health stigmas and improving care for those effected?


Try reading literally the next sentence following the one you quoted out of context. Please stop taking things that people write out of context and triggering off them for faux-outrage. You're attacking a strawman and not adding anything positive to the community. It's a form of bullying that results in less nuance in the discussion.

Sorry to vent, but this is becoming alarmingly common in discussions here and I feel the level of respect and reading comprehension of the average discussion participant here is dropping pretty quickly.


There are good, non-hypothetical reasons that publicly diagnosing living people without their consent is considered a bad thing to do. This came to a head with psychiatrists trying to diagnose Presidential candidate Barry Goldwater in the news media [1], but the general principle that it's uncouth or even unethical to publicly speculate about a person's mental health status has been more broadly adopted in many circles. Please consider the possibility that what you're seeing is not "faux-outrage", but people who genuinely disapprove of your overall line of argument.

[1] https://en.wikipedia.org/wiki/Goldwater_rule


> Trump has something wrong with him, he'll never get treated

A bit off-topic, but in case you're interested in that 'something', here's one analysis from a psychologist that made the rounds of liberal psychologists that my mother associates with: http://www.nationalmemo.com/psychoanalyzing-donald-trump/


Please stop sharing that tripe.

The author himself admits it's horribly unethical and overwhelmingly likely to be entirely wrong in the very first paragraph, but somehow justifies his continued speculation because a random group of peers (as if these peers being located within the grounds of Yale for a conference gives them some sort of authority) decided it was okay this one time because they don't like the subject in question.

If you truly care about creating political change and/or defeating Trump you'll focus on policies that the majority of the electorate are willing to vote for instead of sharing feel good tabloid pablum to justify your superiority complex.


Not only that, they are basically turning this whole mental health thing into a farce.


That was really interesting, thanks.


Not that long ago, I was considering joining a startup where an old manager of mine was the head of eng. They seemed to be doing some cool stuff, another friend had recently joined and spoke well of it, and I thought I'd give it a go. As part of that process, my old manager took me out for coffee to talk about the company, etc.

When we chatted, he basically laid down that he was concerned- when I had worked for him, I'd been depressed. He wanted to protect his startup from that kind of attitude. So there I was jumping through hoops to assure him that I had gotten therapy, that I was keeping an eye on it, on and on... only afterwards did I realize how fucked up that was.

Yes, he's got a right to try to protect a fragile young startup. But on the other hand, he's doing it via discrimination due to health issues.

In the end, I also realized something else that mattered: I was always feeling like shit those days that I worked for him in large part because of how he ran things. After he left, we got a much better manager who honestly seemed to work hard to make me happy. Why the hell would I want to go work for that guy again in the first place?


This is where it gets tricky.

Is your negative attitude due to a medical condition or you just being an asshole who has an attitude problem?

And is that even material to the decision to hire you or not? No one really cares why you act like that, they simply care that you do.

I'm going to say it's entirely on you to present yourself in a positive light at work, and I honestly think your ex-manager was doing you a solid there. The typical way this plays out is your mental condition (or possibility of one) gets discussed by management behind closed doors and you never know why you didn't receive that offer or promotion. And yes, based on my limited experience with larger companies this is exceedingly common at the executive level. The one thing you don't want on your "record" is a history of mental health issues - there is no recovery to your (management) career once that is known.

In your case I think you simply had the curtain pulled back a little, out of consideration from your past manager.

Your other points stand though.


> Is your negative attitude due to a medical condition or you just being an asshole who has an attitude problem?

I'm always unsure. These days, I'm generally a pretty positive guy but I know I've struggled in the past.

On this particular team I was definitely not the biggest asshole. In fact, after this manager left, the biggest asshole was fired pretty much based on the fact that the new managers weren't willing to tolerate his attitude. The bro culture of the team was curtailed (which is why I was so much happier on it afterwards).

It's very hard to be a manager, a people leader. I don't think he was wrong to bring up the fact - he was doing it because he wanted to protect his company - but it certainly danced around a line of legality. After I withdrew my application he made sure to tell friends of mine that he had rejected me because of my depression. Really mature, that guy is.


> After I withdrew my application he made sure to tell friends of mine that he had rejected me because of my depression. Really mature, that guy is.

Sorry, I just wanted to post to say I completely misread that. I dropped the sentence before the mature statement. I felt a seperate post was warranted.

In that case where he talked about it to others? You should have sued the fuck out of him. That is unacceptable in any situation. This kind of changes the entire tone of my follow-on posts, so I do apologize.


> Really mature, that guy is.

This is really the only issue I have. Maybe your manager sucked, I don't know. But this specific story is absolutely the opposite. He put himself out on the line (as you say) and was honest with you. Typical folks would simply not talk to you whatsoever, but have the same reasoning.

Maybe I'm strange, but I'd far prefer the latter.

Story time. My best hire I've made was an employee with a speech impediment. This job was for a night shift as a sysadmin/support role, and that required answering the phones at 2am when customers called. Customers don't call at 2am to have a friendly chat - so those calls typically were high stress, and it really caused his speech to falter quite a bit.

I could have easily simply bounced him on the phone interview, since we were a tiny startup at the time and one wrong hire had the potential to sink us. I had other livelihoods to think of - not just the "legal" situation.

So what I did was I asked the guy back for a second informal interview and laid my cards out on the table. He could have gotten up right then, left, and immediately sued me. But he didn't - we had a productive talk about it, and due to that talk (and other self-starting qualities he had shown) he got the job.

I've now worked with him for over 10 years, through thick and thin and switching companies.

If I had followed your advice here - as the hiring manager I would have simply round-filed the resume due to the potential issues, and went on with my day. I took the risk, and it worked out. I don't believe what I did should have been punishable by death of my company - but it absolutely was if that potential hire had been ethically challenged. I also started the career of someone who was having challenges finding work elsewhere due to "unknown reasons" - aka people seeing his impairment and silently crossing him off the candidate list. Due to the insane legal framework around this stuff, very few companies will take risks like I did any longer.


Since we're playing the "here's an issue I have with what you just said" game...

You "laid your cards out on the table" -- which, as you note, is likely grounds for some sort of legal proceedings -- and it turned out.. I don't know even know. You got lucky that you weren't sued, as you willfully trampled through anti-discrimination laws. Why did it take some sort of put-it-on-the-line moment for you to consider the candidate beyond their physical disability?

You even go on to say that if the candidate was "ethically challenged", your company might suffer. You admit here that you were considering not hiring them because of a disability. How is it ethically challenged to possibly fight back over a dismissal based on being in a protected class? Do you view people with disabilities as simply a liability to companies?

Your closing sentences really smack of backdoor bragging. Good thing he found you, how lucky of him, someone that would tell him flat out to his face that they were worried he couldn't perform his job... and then decided to grace him with employment.

As the OP said, really mature. :/


> Your closing sentences really smack of backdoor bragging. Good thing he found you, how lucky of him, someone that would tell him flat out to his face that they were worried he couldn't perform his job... and then decided to grace him with employment.

Fair enough, could be seen that way. I only mentioned it because he's made that specific point himself to me many times. No one was willing to give him a shot for over a year due to his disability, yet in pop culture (as you have so clearly pointed out) I'm the evil one. I suppose that was an ill-advised addition, and should have been kept personal.

> Why did it take some sort of put-it-on-the-line moment for you to consider the candidate beyond their physical disability?

I really don't get this point. Why would I have taken the actions I did if I did not consider the candidate beyond their physical ability? I loved everything about him, but his disability put into severe question if he could perform the job. I had three choices at that point.

1) Round-bin the candidate. The vast majority of all employers do this at this stage.

2) Hire him blindly and hope for the best. In a 5 person startup this likely isn't a great plan for success. Plus if you make a hire like this and have to fire due to the disability not allowing him to perform the job I'm in a much stickier legal situation. Most likely I now get to hire another person to also do his job, and as a 5 man startup that just ended the company.

3) Talk with the candidate about my concerns, and see if we can come up with some reasonable accommodation. This is hugely risky as an employer if we end up not being able to come up with anything that works for us both. I took this option as I consider #1 absolutely immoral, and #2 had financial realities attached to it all the wishful thinking in the world wouldn't make go away.

And I do think you missed my point. The vast majority of employers completely ignore candidates like this because of posts like yours (e.g. the social climate) and legal liability if they say the wrong thing. In your estimation, I'm required to hire someone with a disability that cannot do the job. That is not true.

It took that moment because there were serious and legitimate concerns about his ability to do the job. Since he was a reasonable person he discussed those concerns with me like an adult, and we found a solution that worked for both of us. Hired. Had we not been able to find a workable solution, I shouldn't have had to open myself up to a potential frivolous lawsuit due to that fact.

And yes, you can say I trampled through anti-discrimination laws I suppose. But doing so got him hired, when before it would have been an open question if he could legitimately perform the job duties required. In this case, following the letter of the law would have hurt him since I could not have even broached the subject.

> Do you view people with disabilities as simply a liability to companies?

Again, I think you are having severe problems separating what reality actually is, to what the law says. I never said this in any way - I specifically noted how there were legitimate concerns over the employee's disability to do the job required. There are no reasonable accommodations to be made if the job is talk on the phone and you are incapable of doing so, and I would have had zero way to know if this problem was able to be mitigated in any fashion until I asked. Which I legally cannot do.

My point was if I had followed the law, that guy's resume would have been trashed like it was for the 50+ companies he got into and interviewed with to that point. Magically zero companies were interested the second he had to speak in person or on the phone and his disability revealed itself. He was otherwise solid, and me taking the time and liability to actually engage him in discussion about my concerns allowed me to feel comfortable hiring him and got his career started. My secondary point is good managers will absolutely color outside the lines with you and work with you to be successful in your career. OPs manager took him aside and outlined his concerns - in my opinion (as someone who has suffered the same condition) that's extremely respectful. The typical manager would have simply never even talked to the guy again, as it wasn't worth the risk.

I guess I simply will refuse to feel bad about this, even though you'd like that outcome. I'm absolutely proud I stuck my neck out and did the right thing - very few companies will these days. There are entire classes of untouchables I could talk your ear off about that everyone has utterly forgotten where the laws supposedly "protect" them but do the exact opposite. I put my money where my mouth is, where most simply ignore the problem exists due to perceived liability while simultaneously patting themselves on the back over how progressive they are being. It's sickening to me.

Edit: cleaned up some prose, less confrontational.


> This is where it gets tricky.

> Is your negative attitude due to a medical condition or you just being an asshole who has an attitude problem?

See, if it's diagnosed depression then it's not tricky all. It's because of a medical condition. Why even say this? Why even imply this?

For people with depression, sometimes "being positive" is "getting out of bed and finding a way to make it through the day" or even simply not taking your own life. Writing a blurb about positive attitude suggests you're dismissive of the issue. I'm not sure if you meant to be, but you're dismissing this person's condition in the most insulting way possible.

You're further warning them that if they do treat it their career is over and they should avoid that? You're being awful.


> It's because of a medical condition. Why even say this? Why even imply this?

I didn't imply it. I said it is irrelevant. No one cares if you being an asshole is due to your depression or you just being you. The impact on the business is the same either way.

> I'm not sure if you meant to be, but you're dismissing this person's condition in the most insulting way possible.

Right, obviously this is a very emotional topic for you. I think you will find that I probably have lived this situation more than you realize, and my advice is given as direct experience from my own life as the "victim" of my mental health being known professionally. I re-read my comment, and absolutely nothing about it was dismissive or implied to "think positively" as you imply.

If I could go back in time I'd never tell anyone I was severely depressed. It is not a good career move, no matter how much you wish that not to be the case. It's absolutely downright dangerous to think anyone actually cares about you in this aspect of your career.

> You're further warning them that if they do treat it their career is over and they should avoid that? You're being awful.

Didn't say that at all. I said make sure it's not known you received said treatment, as your career in many managerial/executive fields is now over. Again, you can hate that statement all you want - but I'm telling a truth from my personal experience. I made no illusions as to me wanting this to be the case? Where did you get that?

My point is thus: If you are known in executive circles in your industry to have had past mental health issues, your career is going to be severely impacted. Do you disagree with that statement? You don't have to want that to be the case, but you sure as hell need to know the game you are playing before you begin.


> I didn't imply it. I said it is irrelevant. No one cares if you being an asshole is due to your depression or you just being you. The impact on the business is the same either way.

I care.

> Right, obviously this is a very emotional topic for you. I think you will find that I probably have lived this situation more than you realize,

I am very sorry if you had terrible experiences, but they don't change that what you're saying is that a medical condition is an objective and valid thing to discriminate upon. There is a somewhat obscure word for this: "ableism."

> I said make sure it's not known you received said treatment, as your career in many managerial/executive fields is now over. Again, you can hate that statement all you want - but I'm telling a truth from my personal experience. I made no illusions as to me wanting this to be the case? Where did you get that?

Stop being a willing tool of people that want to make this so. What you're describing is not "the way things are." It's "the way you're helping to make them." We are this industry now. We can remake it as we see fit.


> I care.

Point taken :) I will rephrase as: The vast majority of your co-workers could care less why you're being an asshole to them, if it's a sustained problem.

> I am very sorry if you had terrible experiences, but they don't change that what you're saying is that a medical condition is an objective and valid thing to discriminate upon. There is a somewhat obscure word for this: "ableism."

So your position is that you can act any way you like to your co-workers at work, undermine entire projects with your negativity, cause morale issues for other staff, and if you happen to have a medical condition to explain all that your employer just has to deal? Having been that guy, fuck that. I deserved to be fired and re-evaluate my life, medical condition or no medical condition.

I don't think the world works that way, and I honestly don't think I'd like it to. Not everything needs to pander to someone with a problem - and I say that as someone with problems I don't want anyone pandering to. The workplace should be as much of a meritocracy as possible.

There is a reason the words "reasonable accommodation" are used in this context. We could argue all day on what reasonable is, but even the courts understand you need the base ability to do the job regardless of your disability.

> Stop being a willing tool of people that want to make this so. What you're describing is not "the way things are." It's "the way you're helping to make them." We are this industry now. We can remake it as we see fit.

This is a decent point. But unfortunately I am not in a position of power in the industry to affect change, and at this point my career would be harmed if I tried to take the moral high ground. I will absolutely say this would be a personal failing of mine - I'm not willing to be the one sacrificed for the greater good here, and that is certainly part of why this problem exists.

I shouldn't have opened my mouth on the topic, and I certainly already regret it. It's far too emotional and nuanced of an issue to really discuss in an open forum on the Internet, and there are certainly personal things I'm sure we'd enjoy discussing in detail. Cheers!


> So your position is that you can act any way you like to your co-workers at work, undermine entire projects with your negativity, cause morale issues for other staff, and if you happen to have a medical condition to explain all that your employer just has to deal? Having been that guy, fuck that. I deserved to be fired and re-evaluate my life, medical condition or no medical condition.

No. That is not my position.

Let's reframe this around a physical problem to remove our inbuilt stigma based around centuries of dualism. If you had carpal tunnel and needed to take a week off or maybe schedule regular physical therapy this would be normal and fine. Someone might say, "Can you work on this right now?" and you might say, "I'm sorry, I'm not capable right now, I have a disability and I need to deal with it or it will get worse."

It is ludicrous to say, "Why are you so negative? Your refusal to work impacts the team badly. You're fired." No one bats an eye at this because physical pain of this type is not stigmatized in the US.

Despite a very similar kind of long-term treatment and slow realization of these conditions, one is normal to support and the other has you begging to be fired for negativity and shaming yourself in pubic for having dealt with it.

Your position is that it's okay to abandon people if they have problems you're not comfortable talking about.

> I don't think the world works that way, and I honestly don't think I'd like it to. Not everything needs to pander to someone with a problem - and I say that as someone with problems I don't want anyone pandering to. The workplace should be as much of a meritocracy as possible.

Making basic affordances (like offering disability time) for people with mental health illnesses is no different from making time for folks to deal with a sudden infection, heart issues, etc. It's a health problem. It's one that can lead to someone leaving their job, but doesn't always.

Please, stop stigmatizing mental health illnesses.

> I shouldn't have opened my mouth on the topic, and I certainly already regret it…

I've got to tell you, if this is actually reflecting hiring practices you've helped engage in then you should not talk about it as this is a pretty significant violation of the ADA you're justifying. This behavior isn't just immoral and unfair, it's illegal.

I'm sorry if you feel pressured or uncomfortable about this. I truly am. But you're actively promoting unfair treatment of people based on health issues that they almost certainly did not try to acquire, but are very often treatable! The pressure you're applying to others here is part of why MHIs run rampant through out industry. It sounds like you yourself suffer at the hands of this stigma.

It's difficult, but we all need to start pushing back against it. It's not the moral high ground, it's everyone's legal obligation. Not following these rules leads to incredibly costly (and qf justified) discrimination lawsuits that can and should crush startups that dare violate them.


> I've got to tell you, if this is actually reflecting hiring practices you've helped engage in then you should not talk about it as this is a pretty significant violation of the ADA you're justifying.

What did I justify? The conversation the potential manager had? If so, sure I did justify and stand by that statement. That guy worked for him before, and had built up (presumably) solid rapport. I see nothing wrong with putting everything out on the table. If you meant anything else though, you're putting words in my mouth. A random interviewee? Yeah, I would agree with you that it's inappropriate and legally actionable.

We're going to have to disagree here. In your world, the guy never talks to his manager and never knows there is that issue floating out there others talk about behind his back (if your manager is asking you about it, I would bet good money they've discussed the topic with their peers for advice). In my world, at least the guy knows and can confront that how he wishes. Your world the guy wonders why he wasn't hired for no explainable reason. I agree that this is the legal framework we work in, but due to your attitude there are entire classes of untouchables that could otherwise find gainful employment.

The culture of silence and "oh I better not talk about it!" is absolutely immoral, and the typical response to these things is simply round-binning the resume to avoid any potential liability whatsoever. If you haven't seen this wink wink nudge nudge behaviour by HR and hiring managers in even huge corporations, you simply haven't been looking. I'm saying I find it actively damaging to society. Talk about it! Get shit out there and be human for the love of $deity! This culture of silence and simply writing people off through "legal" means is insane.

> Your position is that it's okay to abandon people if they have problems you're not comfortable talking about.

I.... what? I really must be doing a poor job conveying my actual point. My actual point is that if you cannot perform your job, and reasonable accommodations cannot be made (e.g. you bring down morale of your co-workers due to your shitty behaviour and refuse to correct it) over the course of time you can and should be fired regardless of any underlying medical condition - could be back pain that makes you impossible to work with - it's immaterial. A company is not a charity or health center. I'd highly prefer a culture where we could talk about this in the open (regardless of mental or physical issue, I don't care in the least) instead of secrecy.

Taking a week off once or twice a year and a day here and there for a condition is perfectly acceptable. Acting as a long-term cancer on your team is not, and cannot be accommodated. Much different than someone saying hey I'm having issues and need to take a couple weeks off. Absolutely no one would argue with you on this point, so I'm not sure why you made it. It's the long-term non-performing employee who has a disability that cannot be accommodated for where it absolutely leaves room for discussion. Guess one way untreated clinical depression typically manifests itself in angry folks in IT? Stereotypes aside, I have to say I must live in a bubble if that's not generally true. Accommodating that is not reasonable, clinical diagnosis or not. A sabbatical I would argue is far more appropriate, if any accommodation at all could be made.

If you meant the case where someone battling depression needs a few days here and there, or a week off to recharge? I have zero problem with that, have taken advantage of that policy at my company, and have unquestionably been supportive of any employees that have needed it in turn. That's a textbook example of a reasonable accommodation.

Really there were two main points I was trying to make.

1) Having a potential hiring manager ask these questions doesn't offend me in the least, and I honestly feel the laws saying otherwise are immoral due to the huge chilling effect this has put on hiring people with disabilities. Perhaps my cure is worse than the disease, but this is a massive unspoken problem in nearly every major corporation in the US. Look at any of the studies based on blind applicants vs. racial indicators - the disability applicants are much worse off. The inability to feel out a candidate with an obvious disability to see if they can legitimately perform the job is not an option, and I posit this is actively harmful. That coupled with the fact good managers actually give a shit about you, and will be happy to tell them their personal worries and concerns in return.

2) Due to the current climate, you're not being very smart if you advertise you had a mental condition in the past. I make no moral claims that this is OK, my only "evil" action here is I advise people to play the current game vs. shaking it up. It's fine to have the opposite position, but it comes at severe personal penalty you have so far completely ignored. I'm not talking about how I want the world to be, I'm talking about how it is and how it affects people today - and becoming a martyr for the cause at the expense of your career is a pretty arrogant thing to ask anyone but yourself to do. I made this suggestion as an employee who has experienced the fallout - it's simply not worth it at this date in history. Unless you are independently wealthy and just don't care. Not sure how you twisted this advice into my hiring practices, and I feel that was a pretty disingenuous leap of logic to make based on my post. This is why it's dangerous to talk about this stuff, people hear what they want to fit their narrative (including myself).

I think we largely agree, perhaps not on everything - but my goal is to get more employable people employed and in happy lives (both the disabled, and those with criminal records). The laws actively work against this in many cases, where you can't even have a discussion on the topic without some potential legal liability. So the default action is to try as hard as possible to not ever get into that situation and thus makes entire classes of people effectively untouchables.

I posit that more openness and less perceived (and lets be honest here - the vast majority of this is perceived legal risk with no grounding in actual reality) legal risk is a good thing, and will result in more candidates getting call backs if the hiring manager isn't afraid of either getting hit with a discrimination lawsuit, or a candidate who legitimate cannot perform the job (since he's not legally allowed to ask). As a hiring manager you don't get many mulligans, so it's your career on the line as well. What option do you think the vast majority of folks take? It's simple game theory. We are incentivizing the wrong behaviour, with predictable results.

You have absolutely reminded me why I will not wade into these as devils advocate any longer. I thought I made a rather tame post coming at the issue from a different angle, and gave a little hard-fought advice from personal experience. You interpreted that to state I think it's OK to fire anyone for an inconvenient disability, which is no where near the point I made.

Edit: As I posted up thread, holy crap.

> After I withdrew my application he made sure to tell friends of mine that he had rejected me because of my depression. Really mature, that guy is.

I went back to re-read the thread, as I was utterly confused at your rather combative responses - it felt like I was on Reddit there for a minute.

I had completely misread that, and not seen the leading sentence. This changes my entire stance on the guy, and I agree he should have the everliving hell sued out of him. That is not acceptable at all, ever, in any situation. The tone of my followup post would have been decidedly different, but my main points generally stand had that not been the case.


I got pulled into this discussion because of seeing the quote of you saying "I care." And I am not at my best today, but wanted to thank both of you for this part of this discussion.


That sounds like a really great realization to have had!

For the record, what your old manager was doing (directly asking you about your mental health status in a quasi-interview setting) was probably illegal, at least in the US (IANAL). There are pretty strict rules around the kinds of things that employers are allowed to ask prospective employees about, and health (mental or otherwise) is very much on the "not allowed" list.

Employees have a legal right to protection from discrimination along those lines, and companies (no matter how small) most definitely do _not_ have the right to discriminate in that way.


Not quite. There are laws about why an employer can decide not to hire you, and it is easy to argue that if an employer asked about a protected condition and then decided not to hire you, they did so because of that information - so generally employers try very hard to avoid knowing about protected conditions for a candidate so they can't be accused of discrimination if they don't hire you. (In this case, the manager did more than just ask about it, he pretty much said they would reject him because of the condition, and that bit would be the evidence of illegal behavior).


Ah, thanks for the clarification- that's a really important point.


>health (mental or otherwise) is very much on the "not allowed" list

This is a gross oversimplification to the point of being untrue.

In addition to what the sibling comment said about asking itself not being illegal, you're allowed to discriminate based on health/disability status all you want if the disability prevents an employee from doing a bona fide job requirement and there isn't any "reasonable accommodation" you can provide for that employee.

For example - if you're a interviewing/hiring for a job that requires the employee to, say, move heavy boxes all day you're going to need to ask that employee "can you lift and move boxes up to 60 pounds?" and you're going to have to reject candidates that can't due to health conditions. Likewise you may have to reject a candidate who is a bad coder even if he has a learning disability.


Agreed that it was an oversimplification, and thanks for the additional clarity and info. In the box-lifting example, doesn't that sort of thing usually have to be made very explicit in the requirements job posting?


I was always feeling like shit those days that I worked for him in large part because of how he ran things.

This is an excellent point. It sounds like things are better for you and I am glad of that.


One of the big problems with mental health is that it’s aggravated by bruising that you can’t see. If someone came up to you and gave you a paper cut every day for the next 3 years, you’d show some major scars and there would certainly be enough evidence to gain some sympathy. All the interactions you have in your day can also have a cumulative effect on the mind.

We can have laws or corporate rules or whatever but at the end of the day people just have to stop being so lousy to one another. Obviously this means there shouldn’t be people screaming at each other but it’s a lot more than that. It’s also the little things: don’t cut in lines, don’t be a jerk in traffic, don’t eat stinky meals in the middle of crowds, don’t get in peoples’ way or be generally oblivious to what’s around you, etc. These are all the “paper cuts” of the mind, gradually aggravating people day after day until they just can’t handle it anymore.


I say this with as much compassion as possible (though it's going to be hard to sound that way over the Internet). A lot of those aggravations are more perceived than actual, thanks to the mental illness itself. You could say "how's it going, buddy" to a depressed and a non-depressed person, and the non-depressed person could see it as a genuine and caring remark and the depressed person could see it as sarcastic or uncaring or whatever. A depressed person could see someone cutting lanes as a jerk, a non-depressed person may see them as in a rush and busy.

Depression is something that colors the entire world dark and gray. It turns a bunch of normal remarks into thousands of little papercuts. No one is right or wrong here, but for a depressed person, understanding how depression colors the world can be useful.


"If someone came up to you and gave you a paper cut every day for the next 3 years, you’d show some major scars and there would certainly be enough evidence to gain some sympathy."

Actually, I think folks would talk behind your back and wonder why you put up with the abuse - but they'll generally stay out of it. If you are lucky, they'll call the cops for a checkup.

If you give yourself paper cuts, folks will still talk about you. A few will offer an ear if you need to talk. And some folks will decide to shower you with complements so you stop ruining your body with scars.

Unfortunately, mental health is more horrid than that. It is like watching everyone get a papercut and go on with life, while it cripples you for a day.


My partner works at Olark. It truly is a human-focused business. I love that she is there. The intention that their team and leadership have applied into creating a safe environment is deeply rooted and honest.

As someone who struggled with depression for two decades, while ultimately thwarted, it was a hopeless, numbing plague. As a coping mechanism, I developed my career working remotely. I was unable to function within a typical office environment. At home I could steal away to my bedroom and hide from the black under cover of blanket, when I needed to.

It's encouraging to see the silent struggle find words and champions. May others who are going through the darkness find supportive and loving environments; any change to find them is worth it. You are the author of your journey and the hero: write a happy story.


  My partner works at Olark. It truly is a human-focused business.
Perhaps that explains the lack of openings on their jobs page?


First hand experience. As a founder it's terrifying to let people know that you are experiencing debilitating levels of burnout, anxiety and moderate depression that prevent you from being effective at your job. There are days when you're just sitting there staring at your screen for 10 hours hoping nobody can tell you're checked out.

You put on a smile, try to follow the usual routine as a robot, and secretly go to your therapist to try to fix it before someone catches on. I was lucky therapy got me out of it, or at least mostly smoothed it out, in under 6 months.


As a founder you could also set a positive example and say "I can't get anything done today" and take a break.

Fixed working hours are one of the biggest problems in a profession like software engineering. On some days you just can't get anything done. It would be better to just take the day off and come back fresh the next day instead of sitting around and pretending that you are working.


Aaaand... over here we just received formal notice (very informally worded) that mandates us to work for certain durations and be present at specified times, and required to log this by any means we see fit, full log being due to management each month.

This kind of attitude just sends the wrong message, devaluates everyone's work by subsuming it to mere tallies, and just outright crosses everyone, obliterating trust and turning it into a culture of fear. Turns out quite a bunch of us aren't efficient at all before 10AM because that's how our circadian rhythm is, yet it's viewed as laziness to come mere five minutes late as we're supposed to show up at least an hour earlier, preferably two. Net result, actual work is hardly done during this forced downtime, and reluctantly so afterwards. Everyone is just pretending to comply in order to bridge the impedance mismatch. As a result, everyone gets increasingly tired fighting their natural rhythm, and slowly growing bitter with each day passing as we witness ourselves wasting everyone's time.

Software development and engineering is a highly mental, creative process. We are not laying bricks 8 hours a day, we have to find and build new solutions to new problems, one by one. This process cannot be shifted, sliced, rearranged at will because it's not mindless, numbing, robot work.


This entire post echoes my feelings precisely. My circadian rhythm makes getting ready before 10am a problem, much less making it to the office.

I'm currently employed at a place that is relatively completely opposite of requiring a log to be submitted to management. Even so, there is still passive-aggressive chats about being to work on time and the total number of hours per week.

Whenever I make myself feel shitty for having a rough time making it into the office I have to remind myself that this isn't a factory position where working 30 more minutes means I produce 5 more widgets. Every single day is a unique work experience where I may work well beyond the time I should leave or I'm hit with all manner of distraction that makes it rough to accomplish anything other than surfing HN. Having (project) management types that have a similar work experience likely should produce a little more empathy than I feel is conveyed by my peers. I have to assume that being primarily driven by meetings and time-delimited tasks makes it difficult to see my perspective, even if there is some venturing into the nebulous side of things.


I hope we can differentiate between mental blocks and illness, but if you are in the former category, try switching to different classes of tasks. If you are in the "illness" category, ignore this comment all-together.

I do have days where I cant get code done, but luckily there are other things that work well on those days -- like catching up on research paper queues or audit/accounting/cleaning. Accounting/cleaning has a strangely and remedial quality, there is something soothing about getting things to balance perfectly and into order.


Uhg, I am in that exact situation right now. I've done the therapy thing in the past, didn't help. Meds in the past seemed to help but hard to isolate them as THE factor that helped me out of a rut. So now I feel out of options.

I am so burned out. So much on my plate, so much work to do, and literally not one neuron fires to get me going. My memory and mental function, at an all time low.

I gotta believe this just goes away, otherwise I lose my job for sure.


Ask for a sabbatical.

Take a month (or better yet, three). It will benefit both you and the company. Discuss options here, and whether or not it's paid (or paid partially).

It's a hard ask and a really hard conversation to start, but it sounds like you need the time.


I've just started my 3rd month of sabbatical. It's wonderful. Best money I've spent.


Ya'll are lucky that you can afford therapy. There are many who cannot and whose insurance won't pay for it.


I believe that lack of access to mental health care is one of the fundamental problems with modern society.


I would absolutely concur.


There's never going to be one factor that gets you out. It's a combination of tools working together that makes it livable. For me it's meds, exercise and social contact.

Meds might help your present chemical situation but they're not going to change the mental ruts & habits your brain has formed (eg. I'm stressed, I want a cookie/beer/etc. I made a mistake, I'm so stupid).

Therapy can help you understand and notice those patterns, why they formed, and what you can do to gradually correct them, but you'll have a hard time if you're going uphill against your brain chemistry.

This book really helped give me a framework for understanding the exercise part of it: https://www.amazon.com/Power-Full-Engagement-Managing-Perfor...

And of course, like physical pain, in some situations mental illness is a signal the body is sending that something in life isn't right. I've had some serious depressive episodes evaporate as soon as I broke off a toxic relationship (personal or professional).

Happy to chat more in private if you want.


Yep, I'm in the same boat as GP. I am currently exiting to take several months of rest. I might even cook/bake again, part time, if I get restless.

While I'm very happy that the author seems to be getting what they need, a day or even week here or there is not fixing my problem. I've always been the kind of person anyways who doesn't really settle into a vacation or travel excursion until around week 2, so maybe I just move more slowly.

Eventually I would like to contract again (been salaried for a few years now). I am lucky enough to have a partner in a different, but still also well-paying and in-demand industry, to help with finances. We live minimally anyways, so I'm hoping it wouldn't be impossible to maintain our quality of life without working myself to death chasing leads and payments. Partner is trying to do something similarly unorthodox. We have no aspirations for hockey stick growth or jackpot payouts, we just want to enjoy our lives while we can, while creating and helping in a way we like.

Edit: meant to reply to the comment regarding sabbaticals below.


Have you tried various types of therapy or different therapists? In my experience, in order for therapy to be effective, I need to form a kind of trusting relationship or bond with the therapist. There are _many_ different techniques employed in modern therapy; trying different things to find out what works for you is key.


I applaud the author for destigmatizing mental health issues. More companies need to be like this. Its really hard for people to understand mental health issues because you have to take many optional classes to even get an idea of what they are. Also, many people throw around terms like psychopath / ADD(ADHD) and either diagnose themselves or others and that can lead to more stigma or even misunderstandings. I think better education of mental health would help solve this.


I suffer with OCD - and I mostly let it go when people say "I'm so OCD" about needing something organized, or wanting something cleaned, etc.

But I do try and educate others on what OCD actually does to people like myself when the opportunity presents itself as it's definitely one of the most misunderstood disorders. It can easily ruin a day/week for me if I let the intrusive thoughts take over.

Anyone interested, take a read through the "symptoms" here:

https://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_d...


I just want to highlight one line from that article that is easy to overlook:

> People with OCD understand that their notions do not correspond with reality

It's like having two thought processes running simultaneously - there's one set that is exactly how I was pre-OCD, and there's another that is _constantly_ trying to inject the various obsessions and compulsions. It's really disconcerting to have thoughts that don't really feel like your own thoughts, recognise them as dumb and irrational, yet end up acting on them anyway.


> Also, many people throw around terms like psychopath / ADD(ADHD)

I can't stand this because I suffer from a double whammy: true diagnosed comorbid ADHD and OCD which people assume means that I'm just really hyper and picky. Also, people nowadays tend to assume that I was self-diagnosed (I wasn't) which I find to be a rather disrespectful and demeaning assumption.

Living with ADHD and OCD as a computer programmer is a daily struggle. I have to constantly stop myself from getting hyper-focused on problems unrelated to my job and stop myself from needlessly spending hours getting meaningless details just right. These distractions negatively impact my productivity, so I'm thankful everyday that I've accumulated enough smarts over the years to make up for it with what I produce.

It sucks having to fight yourself everyday in order to live some semblance of a normal life and it really sucks when people minimize your problems by adopting them as monikers for quirky personality traits.


> Living with ADHD and OCD as a computer programmer is a daily struggle.

I've struggled with this for as long as I remember, but I didn't really understand what was wrong with me until I was diagnosed a couple of years ago after having a particularly difficult time.

I was as open with my manager about it as I felt I could be, and they gave the impression of being supportive. When I got a new manager, I laid it all out (which my therapist encouraged me to do), and explained how I was trying new medications and that some of them had negatively affected me. He said he understood and that he'd make sure I got the support I needed. When review time came, he said things hadn't been perfect, but he considered that to be because I hadn't received the appropriate support from my previous manager. Things improved: he made sure I was assigned longer-term work that didn't involve having to switch between tasks too often. Unfortunately, everything I'd done suddenly became irrelevant when they decided to reboot a project, invalidating nine months of work.

Then one day, out of the blue, just as I was getting into the restarted project, I was called into a Hangout and told that that would be my last day, with no formal explanation given, other than that they were suddenly no longer happy with the quality of my work. I was devastated. My son had just started at a private school (because of his own problems with ADHD), and I was due to lease a new car later that day. We ended up homeschooling him for the rest of the year.

What really gets to me, though, is that there was no process. The VP of People had given a talk not longer before about "How to get fired from <company>", and one of the key takeaways was that no one should be fired without knowing it was coming, but for some reason I was treated differently. And all this from a company that preaches "love" as a core value. I'm not naive: I understand that it's all about the bottom line, not caring about people, but this was a company that wanted us to believe it cared about things like mental health.

I've learned my lesson, though. In future, I'll keep personal things to myself, and just try to do my best. I've learned not to think of colleagues as friends, and I will never again fill out a self-assessment except in the blandest, most generic of terms.


It's not controversial, there's even a term for it - airing dirty laundry.

People don't talk about it because they don't want to all of a sudden be treated differently because 'mental health', and now people around you are walking on egg-shells or being fake supportive.

Why can't it just be a personality thing - some people need time alone more than others, for whatever reason that is. When you start labelling it mental health, all you're doing is self-diagnosing yourself into a hole that's hard to get out of. Unless you have debilitating problems of course, in which case the employer should know from day 1.


> Why can't it just be a personality thing...

For the same reason a cold isn't "just my body." Just like a virus can put your body in a bad state, so too can various stimuli to your mind. You don't just chalk it up to "how things are", you attempt to resolve it. For a cold, your body does that on it's own and you mostly just wait it out. Mental health issues can be similar (I'm just feeling off today), or they might require some effort on the part of the sick person to resolve. Either way, you don't treat it as a personality quirk, as that undermines the severity of the issue (it really is a health issue) and implicitly shifts the blame to the person who is sick[0].

> When you start labelling it mental health, all you're doing is self-diagnosing yourself...

I don't see it as any different than self-diagnosing your cold as a physical ailment. Sometimes people are not capable to doing meaningful work due to their mental state, and people should feel comfortable saying that they need a sick day for their mental health.

[0]: Which, it could be their fault. But ideally we want to describe issues without implying blame. But just like you could unable to work due to a hangover, you could knowingly put yourself into a scenario that you know (or should know) will put you in a bad mental state.

Edit: Forgot the dirty laundry quote. I want to comment on that too.

> It's not controversial, there's even a term for it - airing dirty laundry.

Airing dirty laundry is providing "too much information", saying "I need a sick day for mental health" doesn't strike me as an inappropriate amount of detail anymore than "I need a sick day for physical health". I suppose you could shorten it to "I need a sick day" if knowing any more information is too much.


I agree with everything you're saying. I think you summarized it very well with

> I suppose you could shorten it to "I need a sick day" if knowing any more information is too much

It's not at all unreasonable to say you need a couple of days off and say it's for personal reasons, and leave it at that. By providing personal information that's going to make other people see you in a lesser light, you're shooting yourself in the foot.

You can muse all you want about society being more accepting of this that and the other - the time and place you do and say things matters. A lot! When you're in a position of power - go ahead and make people under you feel safe to talk about mental health etc. Don't assume other people are interested in accommodating your needs when you're a relatively replaceable employee.


I couldn't afford to do this.

My mental illness is sufficiently severe that I need months, not days, to unpack and unwind, and I haven't felt not-burnt-out in about half a decade. I only get to do this between jobs.

I'm glad that this situation worked out alright for the employee, but there often isn't enough sick leave available.


That's a good point. It's trivial for almost any company to accommodate a 'mental health' sick day here or there - in fact nobody cares what you take a sick day for. So the situation in the blog post is a bit contrived and the boss pats himself a bit too much on the back for his response.

I would think true mental health accommodation would involve long periods of leave, or limited hours, or limited days (e.g. 3 day work-weeks) or all of the above. Not many businesses are setup for that.


In the Netherlands, it's a legal requirement that businesses must accommodate any employee requests for reduced hours, at proportionally reduced pay.

The average person in the Netherlands works 25 hours a week, yet they still have a higher GDP per capita. Not per hour, just overall. They work less, yet generate more.


Small point of contention. Netherlands have lower GDP per capita than USA.

https://en.m.wikipedia.org/wiki/List_of_countries_by_GDP_(PP...

Generally small and/or resource rich countries tend to have a high GDP per capita, so comparisons usually aren't very fair.


That said, I suspect in many cases for any given individual person, there very well likely may be "a" solution out there that would work for them, perhaps not as a "cure", but as a way to manage. The big problem is, in most places it is incredibly difficult to get in to see a mental health professional, but even worse than that, many of the successful approaches for managing mental health (spirituality & meditation, alternative nootropic supplements) are not conducive to traditional "scientific" study, and are even considered outright quackery by many (and many of them are by my reckoning, but then it depends how you look at it).

To find such approaches, you have to do a lot of personal investigation, reading forums, talking to people, etc. My suspicion is that formal mental health practitioners would rather you came in for regular, recurring one hour sessions for years, rather than pointing you in this direction. But that may just be the cynic in me.


Does FMLA leave apply for cases like yours?


From personal experience, it does not.


Is it possible to find a less demanding (also less payment) job? Would this help?

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