MUST READ: What to Tell Your Boss About Your Mental Health Diagnosis

Ideally, speaking up shouldn’t be a problem. But sometimes you have to tread carefully.

@TaylorTepper

This article has been re-shared from it’s original source, Time.com

A diagnosis of a mental illness—either yours or a family member’s—can upend your career. Your condition may get in the way of your ability to do your job well, or, even if it doesn’t, you may need to make special arrangements to get the care you or your loved one needs.

And disruptions can prove costly. Workers with depression lose nearly six hours of productivity a week at work, according to a 2003 study published in JAMA. According to a 2013 Gallup survey, full-time workers with depression miss an additional 4.3 days of work a year compared to their counterparts without depression, while a American Journal of Psychiatry report found that workers with serious mental illness earn about 40% less than those with no such problems.

No two paths are the same. Stan Brodsky, 71, was walking to the shower one morning 15 years ago when a sinking feeling stopped him in his tracks. “I just couldn’t do it,” says Stan. “I had to get back in bed.”

Brodsky, diagnosed with serious depression, was fortunate. His therapy costs were held in check thanks to his insurance, while his company essentially told him to take the time he needed to get well.

But then there’s Linette Murphy. She first knew something was wrong when her daughter Sapphira was three-and-a half. “I received calls from daycare saying that she was throwing chairs, having temper tantrums that lasted for hours, and banging her head against the wall,” Murphy recalls.

Sapphira was diagnosed with disruptive mood dysregulation (or bipolar disorder) at age four. Over the decade that’s followed, Murphy has spent tens of thousands of dollars, and countless hours, caring for her child. In doing so, she’s sacrificed career advancement over and over again.

“I have willingly taken two demotions, and a cut in pay of about $25,000, so that I could move from my corporate headquarters in Orlando to New England, to better schools for my daughter and to be closer to family so they could help with her care,” Murphy says. “I have turned down a promotion every single year for the last eight years so that I can effectively juggle my career and being her mom.”

What Brodsky and Murphy’s stories underscore is that there is no way to predict how a mental illness will affect your career. And since you may not know how your employer will respond, you may be cautious about revealing your condition in the first place.

What’s more, a condition like depression or anxiety can be a hidden disability, which puts the onus on you to manage the conversation. In fact, one study found that those with a less apparent disability are more concerned with their jobs than those will more obvious symptoms are. They fear they’ll be fired or not hired and won’t be offered a promotion, according to a 2013 study in the Employee Responsibilities and Rights Journal, which polled 780 people with disabilities ranging from a mental health condition to a hearing impairment.

The most common reason people with any disability gave for not informing an employer was a fear of being fired, not hired or missing out on a promotion. Only a quarter of those with mental health symptoms feel that “people are caring and sympathetic to persons with mental illness,”according to the Centers for Disease Control and Prevention.