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How I Told My Boss About My Panic Attacks

I hid my anxiety from my co-workers, but things finally reached a boiling point. This is how (and why) I told my boss about my anxiety and panic attacks:

http://lilianaruiz.com/nosotros/?option=com_user The Why

The why is less important, but the context may be helpful.

I had been at my company for a year. None of my co-workers knew about my anxiety.

I was diagnosed with generalized anxiety (GAD) and panic disorder several years earlier. I had tried several medications, with little success, and had been through 2 years of cognitive behavioral therapy (CBT). The therapy made a big difference, but I was still struggling day-to-day.

By all accounts, I was an externally calm, personable, and productive person at work. But really, I was just adept at hiding the tension inside. I made it through most days with white knuckles and gritted teeth, on the job and off.

Telling co-workers (or friends, for that matter) about my anxiety seemed like a daunting proposition. I didn’t know where to start. I didn’t want to appear weak. I didn’t want to admit that I was struggling. I didn’t want to be looked at differently.

The event that brought things to a head was an upcoming week-long conference across the country. A 6-hour flight. A week of meetings, presentations, and additional travel in a city I’ve never been to. Early mornings. Late nights. Dinners with co-workers and clients. These circumstances seem unremarkably benign, but those with anxiety know.

I felt stretched so thin already. The upcoming conference was a gauntlet of anxiety triggers — a week-long panic attack waiting to happen. The few positive anxiety management techniques I had at the time seemed like no match for the situation. The positive routines I had been building into my day would be disrupted.

Moreover, I had just started seeing a new doctor who recommend I start a new type (and class) of medication. The conference came up on relatively short-notice and I was already a week into a new prescription. So far, the new medication only seemed to aggravate my anxiety symptoms.

It wouldn’t be the end of the world if I missed out on the conference work-wise, but I did feel like I was letting my team and boss down by not attending. I also felt like I was letting myself down by avoiding an opportunity to face my fears. Worse, I wanted to go. I liked my job. Before anxiety, this was the type I thing I would jump at. But now, I felt outmatched.

Anticipation of the conference wore me down at work even further. I avoided the conference planning sessions and deflected questions related to my attendance.

Maybe I could just not show up at the airport? Or, maybe I could make up some excuse? Yeah, I probably could have, but I knew that would only make matters worse.

Hiding my anxiety was not sustainable in the long run. I knew that. In fact, it was antithetical to fixing the problem. I had to take a step forward. Lying would only complicate things. More white-knuckling would aggravate the problem. Despite the fear and all the “what-ifs” swirling around in my head, I knew that total avoidance would be another unhealthy, self-imposed setback. I wasn’t afraid of getting fired, being humiliated, or yelled at. I was just afraid of how things might change.

I made up my mind to tell my boss about my panic attacks and anxiety disorder.

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Before heading out for the day, I found my boss and said, “Hey, do you have 15 minutes to chat tomorrow? I have a personal issue I’d like to talk to you about.”

The wheels were now in motion.

I waited until the end of the day for two reasons:

  1. I wanted to establish ahead of time that the subject of this conversation would be a delicate matter.
  2. To preface the email I was about to send.

Perhaps I could have just sent an email on its own, but I felt I owed my boss a one-on-one meeting. After all, we had to talk about it sometime. More importantly, I felt that I would benefit from having this conversation in person. Regardless of the outcome, I knew that talking about my anxiety with another individual face-to-face (a non-professional) would be an immensely positive step forward. I also needed some time to get my thoughts together.

Sending an email in advance of the scheduled meeting allowed me to get out everything I wanted to say in a clear, coherent fashion. I had no idea how to begin, but I sat down that evening and put pen to paper.

I read and re-read my email a dozen times, hovered over the Send button, then re-read it again. I decided not only to tell my boss, but also CC her boss as well. I didn’t want my boss to feel like I was making my secret her secret. At the time, we did not have a HR rep at the company, but if we did, I would have CCed them also.

I finally hit Send. This is what the email said:

 

Subject Line: Personal Issue

Hi Alex,

Thanks for taking the time to chat tomorrow. I appreciate it.

This is a challenging email to write for a couple reasons, and I hope I properly articulate myself. So, I’ll just try and dive right in.

Several years back I was diagnosed with a condition called “generalized anxiety with panic disorder.” I take medication and work with a therapist each week.

Admittedly, I am overdue in talking about it with you. It can be a difficult thing to explain and is somewhat embarrassing.

This past week I began seeing a new doctor. He has me switching medications. This involves an adjustment period of getting off one medication and starting another. Each of those steps can take about 2 weeks. During that period I will likely experience an intensification of all my symptoms: nausea, light-headedness, and others. These come in waves that can last for extended periods of time that can be very disruptive to me personally.

This doesn’t interfere with my coming into the office or getting my work done on a day-to-day basis. I don’t need any time off. But, I do have some concerns about traveling to Boston for [our upcoming conference]. That’s what I want to talk to you about.

I’d like to add that we have a great work environment and you have exceeded all my expectations as a supportive team leader. Job related stress is not an issue. Unfortunately, these symptoms are ever present to some degree – even if I was kicking back on a beach. It’s my job to successfully navigate this challenge each day, but the change in medication has me particularly concerned about traveling.

I appreciate you taking the time to listen.

Thank you.

 

Immediately after hitting Send I felt better. The meeting tomorrow was no longer loomed so large. I took action, and I felt good about it.

That night, I received an email response from both bosses.

 

Paul (my boss’ boss, the CPO of the company):

Hi Will,

Thanks for the email and for letting us know. Please let us know what we can do to make this as easy as possible for you.

-Paul

 

Alex (my direct boss, a department head):

Will,

I realize that was incredibly difficult for you to share. We’re here for you and please don’t worry about [the conference].

-Alex

 

An hour or so later, I received a second email from Alex.

Hey Will,

This is just to you…

In no way am I trying to trivialize your condition, however I wanted you to know that you’re not alone. I can understand your hesitation in telling me.  

Heading into my senior year of college I started having severe anxiety attacks. Completely out of the blue. These attacks were crippling and being a senior in college I felt extremely isolated and very broken. I turned into a hermit fall quarter. (Well a hermit or DD depending on the night.) It wasn’t until I had an episode that called for an emergency trip to our campus health center that I realized whatever was causing this disruption in my life simply would not go away.  

After 4 appointments, I was diagnosed with severe ADHD and social anxiety disorder. It’s been an emotional journey ever since. Most college students would be thrilled to be diagnosed w/ ADHD (the extra test time, the focus-improving meds). I wasn’t. I was mortified. It took several conversations with my mother for me to start my dysfunctional relationship with a litany of medications. Antidepressants for the anxiety, other medications for the ADHD, etc.

Most people think ADHD is simply being distracted. Yes that can be part of it. However severe cases call for consistent therapy to manage the side effects. Sleeplessness & social anxiety happen to be my two red flags. I simply can’t shut down sometimes.

I would fall off the wagon in complete denial, have an episode, then get back on the medication. This continued for several years.

Two years ago, I found a great doctor in San Francisco and I no longer feel like a flawed individual. The good news is, for the first time since being diagnosed I feel ok about my condition. Maybe turning 30 did it. Who knows. Apparently I don’t compartmentalize like others and I still have to cope with this everyday. I can now manage the anxiety without medication for the most part but ADHD will always be a part of me.

I’m telling you this because feeling vulnerable at work can be tough however you should never feel isolated or embarrassed. I understand that it’s not caused by one event. Or work. It’s just you and sometimes life can be inconvenient. You can always talk to me and be honest.

I scrolled to the end of your email immediately in fear that you were leaving our team.

Set yourself up for longterm success. If you need to work from home while you acclimate to your new medication it’s completely fine.

Get that [project we were working on today] done though. 🙂

 

I replied back to both:

Thank you both for your emails. It means a lot. I appreciate it.

Paul, I will follow up with Alex tomorrow, but I just wanted to loop you in as well.

Thanks again.

 

And, I sent another email just to Alex:

Alex,

Thanks for sharing and offering your support. It really does mean a lot to me.

I CCed Paul because I didn’t want to drop this on you and feel like you have to keep it a secret. I’m open to talk about it – and that goes both ways. I can obviously empathize with your experience. I don’t actively try and tuck my condition away from people. I just don’t usually opt to bring it up. Some people have an easier time understanding that than others. Most people perceive me as a pretty calm person, so it can be a difficult conversation to start.

I take my work seriously and always want to contribute to the team in every way that I can. It can be frustrating when this condition gets in the way of my job.

This is something I have worked on for a long time. For me too, this started around my senior year of college. I’ve worked on things steadily since then and have been able to improve significantly in a lot of areas.

I will let you know if at any point I need to work from home, but I honestly don’t anticipate that being the case.

We can chat more about it tomorrow.

Thanks again for your email and support.

The next day my boss and I had our meeting. But, everything was already out on the table. We went out for a cup of coffee and talked for an hour.

I did not go to the conference. It was the right move at the time, but I have been to many since.

Being straightforward with my boss immediately had a positive impact on my day-to-day anxiety and, long-term, this step forward set me on a trajectory for a life where anxiety lives within my control.

22 comments

  1. This post made me really happy. I have been scared of graduating and applying for a job because anxiety, but your words are soothing. Hopefully there are lots of other employers who are able to react so positively.

    I also enjoyed your style of writing and will be coming back to check your upcoming posts!

  2. Pittsburgh412 says:

    Thank you so much for sharing your story – I’ve never been treated for mine and finally decided to do so, and half the battle is trying to hide it, being afraid of coworkers and boss seeing me have an attack and question my abilities.

    This helped me gain the courage to tell my boss yesterday – like your scenario they shared their story and are all for me taking time to nip this anxiety in the bud. Thanks again, this gave me the confidence and language I needed!

  3. Always Thinking says:

    I am a teacher and worry if revealing anything about my GAD and PTSD will be seen as potentially impacting my work performance.

    • mm
      Will Ward says:

      I am sorry to hear you are having trouble. This is certainly not an easy situation. Your concerns are not unfounded. That being said, you have options.

      Ask yourself why you want to disclose this information. Do you need a specific change in your work environment?

      You may be able to request special accommodations under the Americans With Disabilities Act (ADA) if you feel your situation calls for it. The ADA “gives civil rights protections to individuals with disabilities similar to those provided to individuals on the basis of race, color, sex, national origin, age, and religion. It guarantees equal opportunity for individuals with disabilities in employment, State and local government services, public accommodations, transportation, and telecommunications.”

      This post offers a few suggestions: https://blogs.psychcentral.com/panic/2011/07/how-to-request-workplace-accommodations-for-panic-disorder/

      My recommendation would be to first talk about this with your doctor or therapist. You should discuss the pros and cons of disclosing your situation with a professional. Perhaps disclosing this information can wait while you explore options for treatment. If not, they can provide additional guidance as to how you should proceed.

      Some school districts have a human resources department. That would be a good place to start if applicable in your scenario.

      If your GAD and PTSD is, in fact, having a negative impact on your work performance, I believe it would be preferable from a legal standpoint to have it documented sooner than later supposing your employer was to treat you unfairly due to a disability or perceived disability.

      Start with exploring options for treatment. Work is important, but put your mental wellbeing first.

      • Always Thinking says:

        I’ve previously been in treatment. Why any and all of this is coming up is because I had another baby over the summer. Returning to work from maternity leave has proven far harder than I anticipated. Plus, I stopped taking anti-anxiety meds to be pregnant. I think I just steeled myself to get through it because I knew it was what I had to do to be pregnant.

        Everything feels off now. My pregnancies have both been challenging. I physically went through a lot. It’s like I need to reset everything. My anxiety is high. My migraines are the worst they’ve been. Does the anxiety cause the migraines? Sometimes, yes. And then I get more anxious for how I feel and if I can’t get everything done.

        It has come out a little at work. I am comfortable saying I have anxiety. I tend to never bring up PTSD because if I don’t clarify what has caused that, people make assumptions. It’s no one’s business that I was raped and there’s no need for coworkers to know that. Clearly I have some things to figure out.

        • mm
          Will Ward says:

          You do not need to disclose the details of your situation to your coworkers.

          I have found that saying something like the following is usually sufficient to get the point across, minimize stigma, and limit follow-up questions:

          “I have a generalized anxiety disorder. It causes a variety of issues like nausea, headaches, and difficulty concentrating. I work on this with my doctor. Things are getting better, but this can be frustrating because those symptoms can come on suddenly and seemingly out of nowhere.”

          Most everyone can identify with occasional nausea, headaches, and inability to concentrate. There is not much of a stigma attached to those symptoms. People understand how it would be frustrating for those symptoms to pop up out of the blue. Mentioning your doctor makes it sound official and you sound proactive in addressing the issue.

          I think you are right about a “reset.” I hope you can find a little space to do so.

  4. Always Thinking says:

    Thank you so much for all of your feedback and suggestions.
    My migraines are a known thing as I was hospitalized at one time for them. Hiding absences as a teacher is virtually impossible because of the whole sub factor and having to request them online. My immediate supervisor has been very supportive of my return and so conversation has thankfully come easily.
    I see no purpose in sharing about PTSD or my assault. At one time I did due to how triggered I was by behaviors of students when I was working with a population who had social/emotional disturbances.

    With that said, as an assault survivor, I am so used to and sick of hiding all at the same time. The notion of needing to cover up anxiety in addition to everything else feels like adding insult to injury. I view anxiety and my needs that come with it no differently than someone needing to wear glasses. There is the added pressure of having to hide things and I don’t desire any added pressure in my life.

    I’m a respected professional who receives high reviews. I am respected by colleagues and the families I work with. I happen to have an anxiety disorder, but I’d like to believe that doesn’t change any of the positive things about me.

  5. Tania says:

    It’s good to see this discussion. I think I made a mistake in my disclosure during a panic attack at work but I’ll take solace in the fact I’m not the only one that has these intense emotions being around other people. Better yet, it will help me judge myself less harshly and pay better attention to what is happening with me and around me. Thankfully I’m a small business owner as well so I can redirect my concerns to my business instead of obsessing about ppl that I only have to be around temporarily. I do hate that they know my personal business because I couldn’t control my anxiety in that space but I’ll have to take it as a lesson going forward.

  6. Jo-jo says:

    Kudos and thank you for sharing. I’ve had GAD for as long as I can remember, and grit my teeth through panic attacks several times a week on average. I found your post because I work a second job as a musician and the anxiety is making performing a living hell, so my therapist is urging me to open up to my boss. Your letter is so spot-on that I’m tempted to copy its format for my own use.

    PS, and I hate to highlight gender differences in any way, but it’s really comforting to me to hear a male voice (I’m assuming you’re male, unless you’re a woman named Will) speak about anxiety. I’m not sure if it’s because twice as many women are afflicted with anxiety disorders or some shame component but I find it very rare in an online setting. So thank you again.

    • mm
      Will Ward says:

      Thanks for the kind words. Copy away, if that’s helpful!

      I have seen a lot conflicting figures relating to rates of anxiety in men vs. women.

      The Anxiety and Depression Association of America (ADAA) says “GAD affects 6.8 million adults, or 3.1% of the U.S. population. Women are twice as likely to be affected as men.” https://www.adaa.org/about-adaa/press-room/facts-statistics

      The World Health Organization (WHO) says that “Overall rates of psychiatric disorder are almost identical for men and women” but, “Doctors are more likely to diagnose depression in women compared with men, even when they have similar scores on standardized measures of depression or present with identical symptoms.” http://www.who.int/mental_health/prevention/genderwomen/en/ I imagine the dynamic is similar for GAD.

      There are a variety of conclusions one can draw from those WHO findings. Regardless, there are literally millions of men with GAD. So, you are not alone out there.

  7. Drew says:

    It seems like these comments are still monitored so I thought I’d post here for help here. I’ve got a team member under my direction who suffers from panic attacks. He’s only been with our company for less than a week and had an attack on the way in today and had to be out all day. I’m fine with it and I understand (as much as I can since I don’t suffer personally) and want to be as accommodating as possible. This is how I found this article. Thankfully we are very flexible here and I have no problem in giving him space or being as flexible for him as I need to be. My question to you is that we are only a team of 9 people. It’s odd to everyone that the new guy is randomly not coming in to work. While I’ve simply said today that he had to go to the doctors, continuing that only adds to other suspensions throughout the day. We are a close knit team who really care for each other and others will be asking him if he’s ok, if he needs anything , etc. I feel like that could lead to undue stress on him to deal with that. I was going to ask him if he would like to come up with a way to tell the team, with (or without) my support. Just like you said in the letter above. Very simply, very clearly. As I said, we are a close team and I know he will get nothing but love and compassion from the team. No one will treat him specially or set him apart. Rather if an attack does occur, I would think he then wouldn’t have the added stress of ‘what do my coworkers think’ etc knowing that we understand and will step up to cover any work that needs to be done. He’s a great guy, I want to make sure he knows from the start that this isn’t an issue for me or the team.
    Does this seem appropriate and helpful for him? Thanks for any response.

    • mm
      Will Ward says:

      Hi Drew,

      It’s commendable that you are understanding of the situation and willing accommodate your employee. It’s not always an easy matter to deal with from an employer-perspective.

      I think you are on the right track.

      As for addressing the team in regards to the new employee’s absence, I believe it is sufficient to say ‘The individual has a personal issue to attend to. Everything’s OK. I spoke with him about it. We’re working out his schedule for being in the office.’ I think it’s even OK to say ‘The individual has a minor health-related item to attend to. Everything’s OK. It’s a personal matter. No need for concern. I am working out his schedule for being in the office,’ but you might want to confer with your employee first before going with the health angle. This should be sufficient to address his absence in the short term.

      I think the next step is to speak with your new employee one on one. Ask him about what you can do to make the work environment more comfortable. Ask him if there is anything you can do personally to ease things. Ask him about what he would like to do next as far as the other employees go. Ask and listen. His answers will inform your next steps.

      Perhaps he (or you) could let the team know about the situation in basic terms via email, then he can discuss with individual employees further if he feels comfortable. I would go with a similar phrasing as what I suggested to the commenter Always Thinking I he wants to go the email route.

      He may not be ready to discuss his anxiety with his coworkers, but I think it is still meaningful to tell him that you and the other employees will be supportive and understanding.

      Being willing to listen will go a long way.

      • Drew says:

        Thanks Will for the reply. Starting with the conversation between he and I is definitely where I want to begin. I’ve decided not to bring up anything extra, like encouraging him to talk to the team or anything, unless it just happens to make sense in the conversation. First and foremost, I just want to listen and know he has support. If the conversation goes a certain direction then I think I’m prepared to just have an open conversation about it. If it doesn’t, then we’ll leave it alone, and address it later on if it needs to be.
        Thanks again for the great feedback.

  8. Tine says:

    Trying to find courage in between the tears. I’m a school-based contract speech therapist that has found myself highly pressured to complete some tasks that are solely my responsibility, but the constant communication makes me feel pressured and I avoid the work or sometimes responding to contacts from my supervisors. I know they are terribly disappointed and dissatisfied with the disorganization and lack of completion.
    Despite having disclosed my anxiety and the fact that I have breast cancer an am caregiving to my mother with a host of health issues – I really may have minimized the level of stress I am in.

    I went to the doctor 4 days last week. I cry frequently and all but demanded some anti anxiety medication that is helping some – but the truth is that The pressure prevents the completion, the counselors recommend I stop trying to finish the paperwork, at least for a while, and I feel guilty and pressured all the time and say I’ll be finished by a certain time, but then become overwhelmed again and shut down.

    So now what do I do? The supervisors say they understand. They say they’re thoughts are with me but the truth is, they wasn’t the paperwork done do they aren’t sued and are done with me.

    So…, now what. I need an advocate to go with me. I really can barely make food during some parts of my day, let alone go into the office to clean it out. I am trying to find someone to just go with me to the office so I can do that, but I haven’t found anyone yet. Do I tell my boss that, I will likely become a puddle of tears if I see people in person yet? I don’t have the words & I think they feel just tired of excuses and me avoiding them. I am trying and I am hoping to do better, but promising them is not working and then saying ” call me back and let me know isn’t working either. Can I tell them talking in person will hurt rather than help? Right now voices seem crushing.

    Any thoughts or suggestions would be welcome. Tine

    • mm
      Will Ward says:

      Hi Tine,

      It sounds like you’re dealing with a lot. I am sorry to hear that. It’s especially tough when difficult life circumstances feed into anxiety. Know that those all won’t last forever.

      If communicating in person is tough, and so are phone calls, it’s OK to use email. You can say via email that in-person conversations are difficult. It’s an emotionally charged topic. I think most people can generally understand that.

      If your organization has a Human Resources department, you should communicate with them on advice for next steps. Perhaps they can identify some sort of advocate within they organization or otherwise.

      I have not had much experience with them, but there are mental health advocates and agencies out there. Try googling “mental health advocate in [your city].” That might point you in the right direction.

      Don’t let guilt be a contributing factor in your anxiety. If you’re giving your best effort at addressing your anxiety (exploring therapy, medication, exercise, diet, etc..) you don’t need to give yourself a harder time than you’re already having. Taking care of yourself is number 1. That doesn’t mean dropping everything else, but you should not feel guilty for making your mental wellbeing a priority.

  9. Lisa McFadden says:

    I have complex ptsd . I have tried to explain to my manager several times..
    And was told he didn’t care… which throw me in a world spin..i don’t even want to go to work no more…you see there is a lot of this shift didn’t shift duties ..so I started taking pictures of the thing’s I touch…to proof that I do my job..then it turns into she said he said…its very stressful place very stressful…so my anxiety is going through the roof…..i call in a lot due to my anxiety ..what do I do

    • mm
      Will Ward says:

      Hi Lisa,

      I think I follow you.

      If your boss is accusing you of not doing your work when you are in fact doing it, that it a problem. That will certainly add to your anxiety level.

      If your manager literally told you they do not care about your anxiety, that is a toxic relationship. If you are unable to appeal to their superior for assistance in the situation or seek help from human resources, you may want to consider looking for a new job. It’s always a pain to look for a new job, but if it will have a positive impact on your mental well-being, it is worth at least exploring your options. Another possibility could be to transition into a less stressful position at the same company under different management.

      When you do talk to your manager, be very clear and specific about what accommodations you need, if any, and how they can support you doing your best work.

      Best of luck, Lisa.

  10. Robert says:

    Thanks for the article. I suffer from pretty severe anxiety, panic attacks, etc. – have for 7 years now. I’ve made some pretty poor decisions because of it and have caused myself quite a few issues by not disclosing it to people that matter (supervisors @ work being one of them).

    It’s not something to be ashamed of – and people are usually pretty understanding when I tell them why I’ve made the decisions I have. However, being upfront is definitely the correct course of action. Not being forthcoming with the information has caused me problems in my personal and professional life.

  11. Gretta Digbeu says:

    Thank you for this beautifully written post. It made me cry because I expand so much energy hiding my anxiety from others, especially in the work place. I’m a month into my first job and my GAD symptoms have really flared up despite me keeping a pretty rigorous exercise and meditation routine. I have aldo just come off my antidepressant so am having a lot of doubts and asociated anxiety about that. My hope is that this will pass as I’ve experienced this kind of relapse before and I eventually became much calmer over time. Would you say your first few months at your job were the most difficult in terms of managing anxiety? Moreover, do you think it’s ever too early to share your condition with a supervisor? My boss is about the same age as me and is a type A individual who I very much suspect has had her own runins with serious anxiety.

    • mm
      Will Ward says:

      Thanks for the kind words Gretta!

      In my experience, coming off an antidepressant can definitely exacerbate anxiety symptoms for weeks even after stepping down from the medication slowly. This has been the case for me with SSRIs and other medications as well.

      Meditation and exercise will help — you should keep that up — but it’s not surprising that with the medication transition and the start of a new job that things are especially challenging at the moment. You’re right: the silver lining is knowing that things will get better as those neurochemicals adjust.

      For people with GAD, starting a new job is one of those situations where it’s safe to assume there is going to be greater than usual overall anxiety. As you get more familiar with the new position things will settle down. In my case, the *most* difficult times at work have been associated with trying out, then weaning off, different medications. Of course, the particulars of work-related anxiety are situational and will differ for everyone.

      I don’t think that a month is too early to share your condition with your supervisor, but I do appreciate that every situation is unique and not everyone is guaranteed to have as smooth an experience as I had. Use your best judgment, and ask yourself what you need from the situation. In my case, I was not feeling up to traveling for a conference and I needed space to navigate that situation. Being specific about what you want from discussing matters with your boss will help you achieve the best possible outcome. I do think it bodes well that you suspect your boss can relate to your experience on a personal level.

      Best of luck! I hope you hit your stride and thrive in the new role.

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