Alyssa Mastromonaco is no stranger to tough conversations: she served as White House deputy chief of staff for operations under President Obama, was an executive at Vice and A&E, and is Senior Advisor and spokesperson at NARAL Pro-Choice America. So when Mastromonaco switched to a new antidepressant, she decided to tell her boss.
“I told the CEO that I was on Zoloft and was transitioning to Wellbutrin,” Mastromonaco said. “I can react strongly to meds, so I was worried switching would shift my mood and wanted her to know why. I talked about it like it was the most normal thing in the world —it is!”
Her boss was supportive. “You got it,” she said.
When Mastromonaco goes to work, she and her mental health struggles do not part ways at the door. “You want me,” she said, “you get all of me.” Mastromonaco brings tremendous talent to her workplace — but she also brings her anxiety. The same is true for high-performing employees everywhere: one in four adults experiences mental illness each year and an estimated 18% of the US adult population have an anxiety disorder. And yet we’re loath to talk about mental health at work. If we’re feeling emotional at work, our impulse is to conceal it — to hide in the bathroom when we’re upset, or book a fake meeting if we need alone time during the day. We’re hesitant to ask for what we need — flex time, or a day working from home — until we experience a major life event, like a new baby or the illness of a parent. We would more likely engage in a trust fall with our boss than admit that we have anxiety.
Mental illness is a challenge, but it is not a weakness. Understanding your psyche can be the key to unleashing your strengths — whether it’s using your sensitivity to empathize with clients, your anxiety to be a more thoughtful boss, or your need for space to forge new and interesting paths. When we acknowledge our mental health, we get to know ourselves better, and are more authentic people, employees, and leaders. Research has found that feeling authentic and open at work leads to better performance, engagement, employee retention, and overall wellbeing.
Still, less than one third of people with mental illness get the treatment they need, and this comes at a cost — to people and to companies. Failure to acknowledge an employee’s mental health can hurt productivity, professional relationships, and the bottom line: $17-$44 billion is lost to depression each year, whereas $4 is returned to the economy for every $1 spent caring for people with mental health issues.
So what needs to change? In the twenty-first century, human capital is the most valuable resource in our economy. And though much has been done (rightly) to promote diversity at work, there’s a giant hole when it comes to understanding how temperament and sentiment play into the trajectory of success. As we recognize neurological and emotional diversity in all of its forms, workplace cultures need to make room for the wide range of emotions we experience. Professional support needs to get better. We need to have the option to ask for help, and feel safe doing so (depression screenings are free under the Affordable Care Act, and some companies offer an Employee Assistance Program). In short, we need more flexibility, sensitivity, and open-mindedness from employers. The same treatment and attention they’d give to a broken bone or maternity leave. We’re not there yet, but some companies are trying to bring conversations about mental health to the forefront.
EY (formerly Ernst and Young) launched a We Care program two years ago to educate employees about mental health issues, encourage them to seek help if they need it, and be a support to colleagues who might be struggling with mental illness or addiction. They started the program out of a demonstrated need. “Our Employee Assistance Program was starting to hear more conversations about anxiety,” said Carolyn Slaski, EY Americas Vice Chair of Talent. “They told us that it was very taboo — something that people don’t normally talk about — but they were seeing more activity, so we decided to schedule a session to talk about anxiety. Just talk about it and see what would happen.”
Since the advent of the We Care program, 2000 EY employees have attended these sessions, which always have a senior-level sponsor and a mental health professional on hand. Someone in leadership kicks it off by sharing their story. This sends the message that anxiety is not toxic and attendance is not a career-dampener.
The company also has an employee assistance hotline that offers confidential support — calls related to anxiety have increased 30% over the last two years. “You have to notice first if someone is struggling,” said Slaski, “and ask them if they’re okay. Learn how to listen to their concerns, and then act. Our company has 47,000 US employees, and 250,000 globally. If I can get my team comfortable just noticing when someone has an issue, then there is so much more we can do for them. These are people reaching out for help. We want to help. We don’t want to have a stigma around it.”
Other companies, like Michigan-based furniture store, Herman Miller, offer free onsite counseling sessions to employees and their families, and courses on mental health first aid that teach them how to recognize signs of mental illness in others. The goal is to empower people to achieve their optimal state of well-being.
What organizations like EY and Herman Miller realize is that, given the right support, employees who struggle with their mental health can do great work. Most people who suffer from chronic anxiety or depression are excellent at faking wellness. We put on our makeup, get dressed, and show up on time. But we never know when an attack might be around the corner. This is why a work environment that is open and understanding is so important. Anxiety is a lingering expectation that something bad is going to happen, and if we don’t talk about it, it’s harder to recognize our triggers and learn healthy ways to cope. But when we do talk about it, we can actually teach ourselves to harness it in ways that play to our strengths.
Christina Wallace is a Harvard Business School graduate, a three-time startup founder, and an accomplished executive and creator of an innovative STEM education program. She also has panic anxiety. When asked if she ever considers her anxiety a strength, she didn’t hesitate to answer, “Absolutely.”
Christina had severe childhood trauma, and has done a lot of work to manage the after effects. “Even still,” she says, “situations where I feel like I can’t trust the other person, or the rug has been pulled out from under me, throw me into a fight-or-flight mode.” For her, this means panic attacks and crippling anxiety. To cope, Christina has taught herself to communicate openly with her managers and colleagues. For example, she has asked both her managers and the people she manages to give her written feedback on important projects before they meet in person. This way she has time to process it and prepare instead of feeling blindsided.
According to feedback from direct reports, Christina is an incredible manager. Because she has openly acknowledged her anxiety, she has learned not only how to manage it, but also how to communicate and share her needs — a skill that helps her stay attuned to the emotional needs of others, and navigate difficult situations with grace and ease. “I’m much more aware of how to help my team show their best selves,” she said.
The good news is that times are changing, and people like Christina, along with the millions of others who struggle with mental illness, are more likely to get the help they need at work than ever before. Stew Friedman, professor at the Wharton School of Business and founding director of the Wharton Leadership Program, says “the next great sort of liberation movement in our society is about mental illness.” He sees shoots of awakening in corporate America. “Look at the huge growth in wellbeing research, practice in the private sector, and society at large. That’s one really good indicator of change.” It’s much more understood and accepted that people have emotional and mental health needs. Yet Friedman still acknowledges that there are costs to the digital revolution and how it’s affecting communication, identity, and the amount of stress we regularly experience. “There are trends that are incredibly worrisome. Rates of suicide, depression, anxiety, and drug use are all on the rise. So, our response is clearly inadequate.”
Along with employee assistance programs, conversation and education are fundamental if our goal is to increase understanding and reduce the stigma around mental health. Friedman notes the importance of conversation in his own experience: “Twenty years ago, in 1987, I started talking about what it was like to become a father and how that changed my career and my life. It was taboo for a man to talk about children at the Wharton School back then, and it got a lot of attention. I was part of a wave of change. The conversations you instigate and your awareness in choosing topics of discussion are an important piece to the process of change. Openness encourages executives to share more about their own experiences, and that normalizes the experience of others.”
In the spirit of being open, I will share that I cried in many workplace bathrooms as I cycled between anxiety attacks and clinical depression throughout my career in corporate America. It never occurred to me that I could share my struggles or create a schedule that allowed me to manage my anxiety, such as working from home or managing the flow of meetings in a day. So I just quit, over and over again. Now I know that when an employee leaves a job, the typical cost of replacement is three months of salary. Think of what the cost is — for the people and the employer — when a whole slice of the population struggles to express their most basic needs.
The burden of depression and anxiety is shared by all members of a workplace, and it’s a vicious cycle. Change starts with managers and HR professionals recognizing the ambivalence and inner conflict many insanely talented people feel, and doing something about it. Because when people get the space and the support they need, it can change their careers, and their lives.