Author Topic: Depression and disability leave  (Read 3168 times)

confused_person

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Depression and disability leave
« on: February 28, 2019, 10:06:08 PM »
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« Last Edit: November 24, 2019, 09:59:27 PM by confused_person »

remizidae

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Re: Depression and disability leave
« Reply #1 on: February 28, 2019, 10:38:52 PM »
My first move would be to talk to anyone at work who has had to take longer medical leave. They will be better able than anyone on the internet to talk about how your particular workplace deals with this. At some  workplaces that are larger and good about confidentiality, you may be able to keep it confidential from anyone at work other than HR and your boss.

OT, but if you are contemplating taking SSRIs, make sure you are educated about their potential side effects.

Freedomin5

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Re: Depression and disability leave
« Reply #2 on: March 01, 2019, 12:37:30 AM »
When you talk to your doctor, don't just say, "I think I have depression". Explain the symptoms and signs that you are seeing that make you believe that you might have depression. Also explain how long you have been feeling this way. And then explain how the symptoms have been impacting your current ability to function.

With regard to explaining to work, your doctor can provide a request for medical leave of absence. Ask the doctor to keep it as general as possible. If you like, you can ask the doctor to focus on the physical symptoms (e.g., insomnia, migraines, fatigue) rather than on the mental symptoms (e.g., suicidality, feelings of hopelessness, anhedonia), as physical symptoms tend to be less stigmatized.

brute

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Re: Depression and disability leave
« Reply #3 on: March 01, 2019, 05:40:56 AM »
Depression is brutal. Ask me how I know.

Find an actual psychiatrist. Family doctors are garbage when it comes to mental health. (Or much anything beyond a cold. Or maybe I'm just unlucky.) Talk to them about your symptoms. Talk to them about your goals. Be honest.

Meds are awesome. SSRIs, not my thing. Suicidal thoughts put into the beginning stages of action, vivid visual hallucinations. However, plenty of my friends do great on them. Again, get a real psychiatrist and keep them updated on your mental state. They can figure out what works for you. Years of depression aren't going to disappear with a few sessions of therapy, and getting the right meds is often the first step to being able to change the pathways we are stuck in.

As to work, who cares about stigma for depression. Be the change in the world, help people get the assistance they need. I don't know that taking time off work while seeking treatment for depression is a way I'd go though. It's helpful to have other people around to let you know if you start getting weird without noticing it yourself. Being at home all day not interacting with others isn't really a great way to get better. At least not for me.

JLee

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Re: Depression and disability leave
« Reply #4 on: March 01, 2019, 06:33:32 AM »
Are you able to wear headphones at work?  I bought a set of noise canceling headphones last week and it was lifechanging. I have difficulty coping with "normal" people noise (eating at desks, whistling, gum popping, etc) and it's made a huge difference for me.

Psychstache

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Re: Depression and disability leave
« Reply #5 on: March 01, 2019, 09:57:37 AM »
Whether or not you are going to pursue medical leave, if you are concerned about your mental health and believe it is causing significant functional impairment in your life, you should talk to a mental health professional.

Regarding treatment, in broad terms I've often heard talk about the rule of thirds. 1/3 of people can be best treated with medication alone, 1/3 can be best treated with mental/behavioral intervention alone, and 1/3 are best served with a combination of the 2.

Best of luck in your journey on improved mental health.

dcozad999

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Re: Depression and disability leave
« Reply #6 on: March 01, 2019, 02:29:11 PM »
Depression is brutal. Ask me how I know.

Find an actual psychiatrist. Family doctors are garbage when it comes to mental health. (Or much anything beyond a cold. Or maybe I'm just unlucky.) Talk to them about your symptoms. Talk to them about your goals. Be honest.

Meds are awesome. SSRIs, not my thing. Suicidal thoughts put into the beginning stages of action, vivid visual hallucinations. However, plenty of my friends do great on them. Again, get a real psychiatrist and keep them updated on your mental state. They can figure out what works for you. Years of depression aren't going to disappear with a few sessions of therapy, and getting the right meds is often the first step to being able to change the pathways we are stuck in.

As to work, who cares about stigma for depression. Be the change in the world, help people get the assistance they need. I don't know that taking time off work while seeking treatment for depression is a way I'd go though. It's helpful to have other people around to let you know if you start getting weird without noticing it yourself. Being at home all day not interacting with others isn't really a great way to get better. At least not for me.


But find a good therapist too. Psychiatrists are good with the drugs, treating the symptoms, but know very little about real therapy.

therethere

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Re: Depression and disability leave
« Reply #7 on: March 01, 2019, 02:32:55 PM »
PTF.

edmundblackadder

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Re: Depression and disability leave
« Reply #8 on: March 01, 2019, 03:25:02 PM »
To take disability leave for mental health reasons -- which can be done! I've done it! -- you need a diagnosis (i.e., an actual DSM-5/ICT code), and a mental health practitioner who agrees that you should take a leave of absence from your job; it is very unlikely your employer will just let you take leave. Start with the diagnosis. Do you have a regular doctor? They may be able to refer you to a local mental health specialist, or you can find one on your own, depending on your insurance situation.

How long have you been employed at your current employer, and how many employees do they have? FMLA leave, which is federal (NYS's Paid Family Leave law doesn't apply to taking care of yourself, unfortunately), has qualifications both for your & your employer: https://www.dol.gov/general/topic/benefits-leave/fmla NYS short-term disability benefits are confusing, but the DOL page is here: http://www.wcb.ny.gov/content/main/offthejob/db-overview.jsp

I'd encourage you to focus on getting a diagnosis and a mental health specialist, whether that's a psychotherapist (Ph.D) or LCSW (MSW) or someone else. Most practitioners will want you to commit to a treatment protocol for some time before they'll be comfortable saying you need to go on leave. They may want you to try a few different options. Medication can be among them, and it's not a silver bullet, but it can be pretty important as part of a larger treatment plan -- but no one will force you to take medication if you don't want to. (If you don't want to start with medication, your MH specialist shouldn't be a psychiatrist, as that tends to be their first choice for treatment.)

I'll be thinking of you, and I hope you feel better. It really is possible to recover.

COEE

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Re: Depression and disability leave
« Reply #9 on: March 01, 2019, 09:06:35 PM »
Before getting a proper diagnosis for depression make sure you have good term life insurance for the term you believe you need.  This should be external from any employer life insurance in the event that you leave your job at some point in the future.

Freedomin5

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Re: Depression and disability leave
« Reply #10 on: March 02, 2019, 03:33:16 AM »
Your patient file is considered your personal health information (PHI). It is one of your rights to access your PHI.

chasesfish

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Re: Depression and disability leave
« Reply #11 on: March 02, 2019, 06:00:34 AM »
Okay, lots to add here.   Not because I've personally filed this, but have helped my wife work through mental health issues after a life threatening injury and long recovery AND I've dealt with helping an employee get everything in order and get leave approved.

What you need to explore is a 12 week leave of absence under the Family Medical Leave Act.   There are a few forms that'll need to be filled out by a medical doctor (either general practitioner or psychiatrist).

There are three health professionals you need when it comes to mental health:

- General Practitioner
- Psychologist or Licensed Professional Counselor
- Psychiatrist, who in my experience is primarily working to manage medication.

General practitioners aren't usually good at managing this, but if you start there you can get referrals/recommendations to the other two and you start the documentation of seeking treatment.  Some insurance carriers require a doctor's opinion of medical necessity before they'll cover the Professional Counselor.  Your general practitioner can probably produce that more efficiently and is probably your starting point for the FMLA paperwork.  You might need to try a couple of counselors until you find the right one.

Expect a wait for the Psychiatrist.  The feds have scared a bunch of doctors into writing prescriptions, so medication management is now sometimes getting referred up to the highest level specialty, creating wait times for psychiatrists.   

I hope this helps


Dr Kidstache

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Re: Depression and disability leave
« Reply #12 on: March 02, 2019, 12:09:07 PM »
Lots of good info already about getting appropriate medical treatment and FMLA.
Whatever you do, do NOT self-initiate a leave from work. You must have a physician determine that you require a leave. Otherwise, you will not qualify for any STD or LTD disability benefits. Additionally, not all STD policies are the same and may have restrictions about "mental and nervous disorders", pre-existing conditions, or your terms of employment. Linda Nee's blog is a great resource to help you understand what you and your psychiatrist will need to document in order to be eligible for STD before taking a medical leave. Here's one post:
https://lindanee.wordpress.com/2013/04/01/resignations-a-disability-claim-no-no/

goatmom

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Re: Depression and disability leave
« Reply #13 on: March 02, 2019, 03:19:12 PM »
Depression is brutal. Ask me how I know.

Find an actual psychiatrist. Family doctors are garbage when it comes to mental health. (Or much anything beyond a cold. Or maybe I'm just unlucky.) Talk to them about your symptoms. Talk to them about your goals. Be honest.

Meds are awesome. SSRIs, not my thing. Suicidal thoughts put into the beginning stages of action, vivid visual hallucinations. However, plenty of my friends do great on them. Again, get a real psychiatrist and keep them updated on your mental state. They can figure out what works for you. Years of depression aren't going to disappear with a few sessions of therapy, and getting the right meds is often the first step to being able to change the pathways we are stuck in.

As to work, who cares about stigma for depression. Be the change in the world, help people get the assistance they need. I don't know that taking time off work while seeking treatment for depression is a way I'd go though. It's helpful to have other people around to let you know if you start getting weird without noticing it yourself. Being at home all day not interacting with others isn't really a great way to get better. At least not for me.


But find a good therapist too. Psychiatrists are good with the drugs, treating the symptoms, but know very little about real therapy.

I work in the Mental Health field and many psychiatrists are excellent therapists.  Psychiatric residency is four years and requires training in psychotherapy.  Many psychiatrists focus more on medication these days because therapy is poorly reimbursed not because they do not have proper training.  If you want to know what your diagnosis is you can ask your doctor.  That is a very common question that patients have.  You might consider an intensive outpatient treatment program.   You can take disability leave for a mental health issue but they can make it very difficult for you and make the bar a difficult one to reach.  Being in a program rather than sitting home is usually eaiser to justify to the employer.  Best of luck!

civil4life

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Re: Depression and disability leave
« Reply #14 on: March 02, 2019, 04:29:31 PM »
I guess I will chime in.  I have pretty much dealt with depression my entire professional career and college before that.

Chasefish I think had the best basic advice.

It sounds like you went to your General Practitioner (GP) and he has referred you to a psychiatrist.  Hopefully the GP ran some basic tests based on your symptoms.  Sometimes things that have similar symptoms to depression.  Getting CBS, Thyroid, and CMP etc.  If he has not, I would ask the psychiatrist.  You seem hesitant to start medication.  The psychiatrist is most likely going to push that as that is what they are trained to do.  If you would like to avoid medication, I would start with a therapist who can help with basic skills and suggestions to naturally lift depression.  For example:  Exercise, journaling, meditation, healthy eating, sleeping, other coping skills, etc.  Basically all the common sense stuff we know we are supposed to do to take care of ourselves, but usually do not.

FMLA - I think it may be hard to find a doctor who will provide paperwork/documentation for being off completely unless you are severely depressed to the point that you do need or close to needing hospitalization. At least after only seeing you once. I have intermittent FMLA which allows me flexibility in using my leave as needed to manage my depression. 

Another option or thought is ADA accommodations.  Mental illness is a qualifying disability.  One of the biggest things that helped me in my previous job was getting my workspace located to a quieter location.  Additionally, it allowed me to telework one day a week.

You said you are lean FI so I am guessing finances are not an issue.  During FMLA the law does not stipulate you must be paid.  Most employers that have sick leave allow you to use your leave to maintain your salary.  The other thing which would be more of an issue if you sought a sabbatical is health insurance.

I guess the last thing is since you are lean FI, I am guessing you have FU money.  Do you really like this job?  What is keeping you there?  Have you considered finding something else?

Miss Piggy

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Re: Depression and disability leave
« Reply #15 on: March 02, 2019, 06:34:31 PM »
Regarding getting a diagnosis, how do I know if I get one? Some hospitals/clinics have websites where you can access doctor's notes, but I don't know it the doctor i'm going to see has one. If he doesn't, how can I find out my diagnosis?

I'm confused by this question. Doctors generally share/discuss the diagnosis with the patient.

civil4life

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Re: Depression and disability leave
« Reply #16 on: March 02, 2019, 08:23:59 PM »
Regarding getting a diagnosis, how do I know if I get one? Some hospitals/clinics have websites where you can access doctor's notes, but I don't know it the doctor i'm going to see has one. If he doesn't, how can I find out my diagnosis?

I'm confused by this question. Doctors generally share/discuss the diagnosis with the patient.

Mental illness is one big exception to that.  I know of a few reasons why.

1.  Mental illness is hard to diagnose in a short time.  It may take several visits to really know what is going on.
2.  Diagnosis of mental illness can be somewhat of an art.  There are no blood tests to tell diagnose depression etc.
3. General stigma related to mental illness. 
4.  Depending on a patients stability they may or may not be able to handle the diagnosis.

The latter being the most common I have encountered.  I have been diagnosed with depression, anxiety, recurrent depression, dysthymia, borderline personality disorder, personality disorder not otherwise specified, and eating disorder not otherwise specified.

My current diagnosis is Bipolar II.  I have never had a manic or hypomanic episode.  I have the diagnosis more so because I respond better to mood stabilizers than antidepressants.

I think most in the profession would prefer not to provide diagnosis, but with American health care you need a diagnosis for the insurance to pay.

I learned very early on that the diagnosis does not matter much when it comes to treatment.  Each person can experience a wide array of symptoms.  Especially with depression it is about treating the symptoms not the diagnosis.

Miss Piggy

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Re: Depression and disability leave
« Reply #17 on: March 03, 2019, 01:54:22 PM »
Regarding getting a diagnosis, how do I know if I get one? Some hospitals/clinics have websites where you can access doctor's notes, but I don't know it the doctor i'm going to see has one. If he doesn't, how can I find out my diagnosis?

I'm confused by this question. Doctors generally share/discuss the diagnosis with the patient.

Mental illness is one big exception to that.  I know of a few reasons why.

Fascinating. I had no idea.

DaMa

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Re: Depression and disability leave
« Reply #18 on: March 04, 2019, 11:41:24 AM »
Finding a good therapist can be tough and is very important.  If you don't feel like you are making a connection after 4 visits, ask to see someone else.  I've had 8 in 15 years, and only 2 were good for me. 

Don't be afraid to try drugs -- SSRIs worked great for me for many years.  Mental health is a combination of physical and emotional issues, and every individual is different.

A really good psychiatrist is GOLD, but they are almost impossible to find, because the best ones don't participate with insurance.  I've had one in 15 years, who retired after I'd been seeing her for 4 years.  The rest just wrote Rx.  I got to where I preferred a nurse practitioner.

You are not alone.  I had several coworkers that felt exactly the way you do about work.  All of them got better with treatment.