Mental illness is the most common reason for sick leave, but there are also those who work full time and have a psychiatric diagnosis. What strategies do they have for managing their work and which factors make it difficult or enable. The investigation was a qualitative interview study with eight participants with the diagnoses of bipolar disorder, generalized anxiety and depression, post-traumatic stress disorder, social phobia and depression. Two of the participants also had an additional diagnosis. After the interviews, a thematic analysis was made.

Strategies for managing their work despite mental illness

All participants were keen to protect themselves and their professional career, and no one was open about their mental illness towards the employer. Two main strategies were distinguished to maintain the facade. All described putting on a mask or assuming a role at their workplace. They felt that they had more leeway to make mistakes if colleagues and managers were not aware of their mental illness. The mask could become less if you had a good relationship with your boss.

Distraction and employment working full-time means that there is not the same space for the bad feeling to escalate. Several participants highlighted the workplace as a breathing hole. There was a fear of taking sick leave for mental illness. Partly because the employer then becomes aware of its existence, and partly because it would mean not being employed – which many feared would make them feel worse in the long run.

Enabling factors

That since none of the participants in her survey were open about their mental illness, it has not been possible to introduce specific adaptations in the work. But four enablers emerged flexibility. For example, being able to perform based on daily schedule, having flexible working hours and the possibility to work from home. Clear routines some did not want flexibility at all, but felt secure in the routine and felt good about clearly structured tasks and knowing what to expect.

Context many had challenges in their private lives and therefore it became important to have a clear role at work. It could consist of tasks where you felt you performed well, but also to be a colleague. The essence was to feel that one adds something. Knowledge half of the participants worked in the field of mental illness. In their workplaces, there was a much better climate around mental illness than in the other workplaces.