Do you need to take a mental health day?

You might not know Madalyn Parker by name, but you may have heard of the email she wrote to her coworkers in 2017. It was retweeted more than 16,000 times and helped sparked a new awareness of mental health in the workplace.

“I’m taking today and tomorrow to focus on my mental health.” Parker wrote. “Hopefully I’ll be back next week refreshed and back to 100%.”

The email response from her company’s CEO, Ben Congleton, was applauded across social media.

“I just wanted to personally thank you for sending emails like this,” Congleton wrote. “Every time you do, I use it as a reminder of the importance of using sick days for mental health—I can't believe this is not a standard practice at all organizations. You are an example to us all, and help cut through the stigma so we can all bring our whole selves to work.”

Here’s the story behind Parker’s email—and what you need to know about advocating for mental health in the workplace.

When treatment fails over and over

“I have almost definitely struggled with mental illness my whole life,” says Parker, of Ann Arbor, Michigan, who was diagnosed with anxiety sometime in middle or high school. (She’s not sure exactly when because she wasn’t treated for it at the time.)

During her college years, she experienced panic attacks and her schoolwork and relationships suffered. When Parker began to feel suicidal, she reached out for help. Parker was ultimately diagnosed with depression and began therapy.

Parker has a form of depression called treatment resistant depression, which means it doesn’t improve even with therapy or medication. Treatment resistant depression is common. Out of the roughly 16 million people who have depression, as many as 30 percent don’t respond to treatment.

Throughout her life, Parker would try a medication for three to four months, only to have her symptoms return. This vicious cycle happened over and over again, and she began to consider it normal for her.

Dealing with ‘real world’ depression

After college, Parker started her first job as an engineer at a software tech startup. She was 10 months into her position when her medication stopped being effective. When familiar symptoms came back, she knew she had to tell somebody about it.

Parker confided in a colleague who she considered a mentor within the organization. She took him aside and explained her mental health struggle as well as her fears about what her coworkers would think. Parker told him she didn’t want people to think she was lazy or bad at her job, but that she needed help.

“It is incredibly hard to be honest about mental health in the typical workplace,” wrote Congleton in a July 2017 essay for the website Medium. “In situations like this, it is so easy to tell your teammates you are 'not feeling well.' I wanted to call this out and express gratitude for Madalyn’s bravery in helping us normalize mental health as a normal health issue.”

Parker has since become an advocate for mental health in the workplace.

“There is so much that I wish people understood and knew about mental health,” she says. In the years after her famous email, she has shared her story and spoken at conferences in hopes of creating awareness around the importance of considering mental health in the workplace.

“I'm hoping that we are moving in the right direction and we're sort of breaking away from all of these things that have been ingrained in us about society and about the way one should act,” she says.

Despite the prevalence of mental illness and growing awareness about its impact on individuals and society, it’s still largely taboo to talk about mental health in the workplace.

“I think that we need to break down the stigma and realize that this is something a lot of people we know and a lot of people that we love deal with,” says Parker. “I think it's up to those who are higher up at these organizations to realize this is a big issue that affects a lot of people. They need to make an effort to make sure that people feel supported.”

How you can manage your mental health at work

Although Parker has worked in supportive work environments, not all companies are the same. In a poll of more than 15,000 people conducted in February 2022 by Gallup, fewer than a quarter of employees (24 percent) felt strongly that their employer cared about their well-being. That number had peaked at 49 percent just two years previously, in May 2020, when many employers reacted proactively to the stress of the COVID-19 pandemic by communicating clear plans of action. In the years, since, however, the number has dropped to pre-pandemic levels.

Even at the height of the pandemic, when workers felt their employers were looking out for their well-being, there was a disconnect between the perception of actions employers had been taking to address mental health in the workplace and how workers experienced those steps. According to a McKinsey & Company survey conducted in late 2020, 65 percent of employers reported that employee mental health was supported well or very well, while 51 percent of workers agreed.

Among frontline workers, the disparity was more striking: 71 percent of employers with frontline employers felt they were taking steps to support their workers’ mental well-being, while only 27 percent of employees agreed.

Not sure how to manage your mental health while at work? Here are some suggestions.

Remember, you’re protected

Under the law, your employer can’t discriminate against you for having post-traumatic stress disorder, depression, or any other mental health condition. The Americans with Disabilities Act protects employees with physical or mental impairments that limit daily functions.

Use your support systems

When you have depression and are working full time, you might feel like you have nobody to turn to. Parker suggests attending local meetups for people with your condition.

“People with depression tend to isolate, so any way that they can get a sense of belonging and being with other people is really helpful,” says Mike Ashworth, PhD, a psychologist in Dallas, Texas. To find local meetups or support groups in your area, check out the National Alliance on Mental Illness.

Know when to stay home

Having a bad day is different from living with depression. “Think of a bad day as temporary and fleeting. You're likely to get back on track tomorrow,” says Ashworth. Depression, on the other hand, lasts nearly every day for two weeks. “With depression, it's more chronic and it affects almost every part of you.”

In addition to low mood, depression can also disguise itself in the form of headaches, gastrointestinal problems, and other forms of chronic discomfort. If symptoms of depression last for two weeks or longer, make an appointment to see a healthcare provider (HCP). Do not assume that symptoms will suddenly go away on their own or that you have to live with them.

There’s no right or wrong way to take a mental health day

Mental illness manifests in many ways and so does taking the time you need. For some people, just getting out of the house is huge. For others, a mental health day might mean taking a walk, making tea, or just lying on the couch.

“Be deliberate about planning your mental health day and being mindful about asking yourself, ‘What do I really need to do to nourish my mental and emotional health?’” says Ashworth.

For example, do you feel like you need to recharge your batteries? Or like you need to plan something fun? Or have you been feeling lonely and in need of getting together with family or friends? Plan your day based on your answers.

Parker says that finding things to replenish her energy is important during her mental health days. “I need to do what I need to do to take care of myself,” she says. Parker’s mental health days never look the same mostly because her mental illness never looks the same. She always caters her mental health days toward how she’s feeling.

Know when it’s something more serious

“If you take that mental health day or two and you continue to feel irritable or overwhelmed in your personal life with day-to-day tasks, have struggles refocusing your energy or feeling motivated at work, those are warning signs that something bigger may be going on,” says Ashworth. If you’re experiencing such signs, speak with an HCP.

You can also check to see if your company has an employee assistance program, or go online and look at resources, such as those made available by the Substance Abuse and Mental Health Services Administration at SAMHSA.gov. If you or someone you know is having thoughts of suicide or self-harm suicidal thoughts, call, text, or chat 988 to reach the 988 Suicide and Crisis Lifeline. You can also call 911 to get immediate help.

As for Parker, she hopes to continue chipping away at the stigma surrounding mental health—especially at work.

“I hope that the conversation continues. People need to keep talking about it so that we can normalize it. It shouldn't be this thing that we don't talk about.”