Work? I’m Terrified!*

When contemplating the idea of going back to work, many fears and questions can arise. These are normal. Often a person’s self-esteem and confidence has been affected, and they feel incompetent to do the job. They worry about how they will cope. Will the workload be too much? Will they be discriminated against or will colleagues gossip? Will things be too much and trigger a relapse, or worsen their condition?

These fears and worries can snowball, and soon enough, they can be paralyzing.  It’s enough to be recovering or coping with a mental health condition without all these worries on top of it! However, most fears are really just that—fears—and though they may seem overwhelming, the reality is there are things that can be done to ensure a smoother transition back into work, and these fears minimized.

Benefits of Work

You do not have to be 100% well to return to work. Indeed many studies show that working has a therapeutic affect upon mental illness, and can contribute to recovery; hence the benefits outweigh the downsides.

The benefits include:

  • Helps to promote recovery and rehabilitation
  • Improved financial situation, and thus, greater control over one’s life and choices
  • Increases confidence and self-esteem
  • Creates a feeling of contribution and social inclusion
  • A greater sense of identity and purpose
  • Greater independence
  • Improved general mental health
  • The opportunity to make friends (Mental Illness Foundation of New Zealand, 2007)

Isn’t work stressful?

There is no doubt that work can sometimes be stressful, and some jobs more so than others. However everyone’s level of stress tolerance is different, and what may stress one person severely may have little impact on another. In managing a return to work, it is helpful to understand what stresses you. Is it working alone? Is it juggling many tasks? Is it deadlines? Is it feeling like you don’t know what you are doing?

Stress Not the Same for Everyone

Note that although these may be stressors for some people, another person may find them ideal. For example, some people prefer working alone, some people are stimulated by managing many tasks, others are invigorated and enjoy the adrenalin rush created by deadlines, feeling like you don’t know what you are doing can be a reason some people use to challenge themselves to master a task.  As you can see by these examples, one person’s stressor can be another’s stimulation or work satisfier. It’s important to identify what stimulates you, and what stresses you.

 Benefits Outweigh the Risks

However, just like a doctor weighs up the benefits against the risk of side-effects when prescribing a drug, so too have studies found that the beneficial effects of work outweigh the risks of work, especially against the harmful effects of long-term unemployment or extended sick-leave (Waddell & Burton, 2006).

Work, even if a person is not 100% well, is generally good for well-being and quality of life.

Communication-the Key to Solutions

Fears about returning to work are normal. Rather than keep your fears to yourself, talk them over with your Employment Coach/Counselor. He or she is in the best position to assist you in allaying your fears, and to ensure strategies are put in place that will assist you.

Speak Up About Supports

Consider what support(s) you might need in the workplace, and also what stresses you. Although it can sometimes be difficult to ask for help (many of us think we should just tough it out for fear being seen as a ‘wuss’), if you are honest beforehand about your concerns, then your employment coach can assist you.

Additionally, if your concerns are known, your manager is in a better position to accommodate you, and make what’s known as ‘reasonable adjustments’. It’s worth a little discomfort or embarrassment to let  people  know beforehand what may become a problem for you so that supports can be implemented, before it has a chance to escalate.

Reasonable Adjustments

Commonly, when people think about ‘reasonable adjustments’, they think of changes like an access ramp for a wheelchair, or modified computer for the sight-impaired. However when it comes to mental illness, ‘reasonable adjustments’ may take a different form. Here are some examples:

Flexible Working Hours

  • If you are affected by medication that leaves you drowsy in the morning, it may be possible to negotiate with your employer for a later start.
  •  You may also need flexibility to attend counseling or medical appointments
  •  Sick leave arrangements, without pay may be appropriate.
  • Adjusting work schedules so that you are working at your peak times. In many circumstances, it doesn’t matter whether the work is done to a strict schedule, (and sometimes, where), as long as it is completed, and on time.
  • Part time or casual work is often the best way to start out, gradually building up hours as your work ‘muscle’ strengthens, and you feel able to take on more.

Other Adjustments

Having a private space to work, if needed, especially if noise aggravates mental illness

Taking breaks-ensure there is somewhere you can take a break or ‘time out’ if you need to.

Having written instructions instead of verbal instructions; or a white board you can refer to.

These are just some examples of adjustments that can be made that will save you the anxiety of trying to work in a way that might sabotage your performance.  The important thing is to talk with your manager and Employment Consultant, no matter how silly you think your needs might be.  Most adjustments are really quite simple to implement. The key is to be creative, sometimes the simplest things work wonders.

Supported Work

Some Employment Coaches could design, in consultation with you, a plan to help ease you back into the workforce or training, in accordance with your condition. The plan will include any recommendations from a Job Capacity Assessment if you have had one.  Once you have secured work, your Employment Coach may continue to support you once you are on the job. He or she acts as a liaison between you and the employer, and as a sounding board for you. In this way, you are not left to cope in a new job on your own.

Company Supports

Some organizations offer counseling and other assistance through their Employee Assistance Program (EAP), run by an outside company that offers confidential telephone or face to face counseling. Ask HR or your manager.

Find a Mentor

If it is a large enough organization, it can be helpful to have someone in another department as a mentor, whom you can meet with and discuss any problems or issues you may have. They can provide advice without being directly involved.

Buddy Support

It may be possible to have a buddy support with a colleague who is available to act as a sounding board and be willing to assist you with tasks.

Keep in Touch With Your Manager

Review meetings with your manager enable you to talk about any problems you may be having. It is important to let your manager know if you are having difficulties. If you can, go into the meeting with an idea of what you think might help solve the problem. The important thing is to keep the lines of communication open. Although sometimes problems can seem overwhelming, talking about them will often yield a solution.


Volunteering in an area of interest can be a way to gradually ease yourself back into the working life, while giving you experience that will improve your chances of getting a job. Sometimes, volunteering positions lead directly to an offer of employment. Volunteering has the added benefit of raising self-esteem.

Be Kind To Yourself

If you’ve been out of work for a while, your confidence and self-esteem may have taken a beating. It’s normal to feel anxious when starting a new job, or going back to your prior employment. And if you have been dealing with a mental health condition as well, this anxiety can take on a life of its own, sometimes making it all seem too hard. While it may seem scary at first, work can turn out to be a surprisingly positive influence upon your overall well-being. While some people may always have to cope with a mental illness, given the right job with the right supports, you can experience a significant improvement in your quality of life. Three or six months into the job, you may be wondering why you were so worried in the first place. It’s worth working through fears and anxieties to get there.

* This document was slightly revised to fit the needs of an American audience.


Mental Health Foundation of New Zealand, 2007, ‘Return To Work: Returning to Work after experiencing mental illness and other mental health issues’ Auckland,

Waddell, Gordon & Burton, Kim 2006, ‘Is Work Good For Your Health and Wellbeing?’ The Stationery Office, Norwich, UK