I went back to work last week. I had been off several weeks after a tough, two-week, out-of-town assignment that brought me to my knees on the edge of my black hole.

In all, I was gone five weeks – some pre-planned vacation and some comp time. Still, when you’re out of the office for that long, for any reason, people are going to wonder why you have been gone so long.

If you don’t have a mental illness – whether it’s depression or alcoholism or an anxiety disorder – you’ve probably never been confronted with these questions: How do you call in sick when your mental illness prevents you from work? What do you say when you go back to work after an extended absence  because of your mental illness?

When you have to answer these questions, you realize how much stigma there is about mental illness.

If you had to take off a couple of weeks because you had pneumonia, you would simply tell your boss that you could not work because you had pneumonia. But what do you say when your depression prevents you from working? How do you call in sick with depression?

In my career I have had to take extended time off because of both pneumonia and depression. When I called in sick with pneumonia I never worried that my boss might think I was faking it or that my colleagues would think I was a wuss because I had pneumonia.

Eight years ago, when I was off work for 8-weeks because of my depression and ended up in treatment to deal with behaviors that contributed to my depression, I didn’t know what to say. Actually, I didn’t say much at all besides “I can’t work” because I couldn’t talk much at all. I texted my boss and spoke briefly with the head of HR.

I was fortunate to have boss who was very understanding and enlightened about mental illness. I had been with the company nearly 20 years and no one questioned my loyalty or work ethic. I was told to get better – however much time I needed.

I cannot tell you what a huge relief that was. If you are a boss, I hope you will consider how you would handle an extended absence by an employee with a mental illness. Ask yourself: Is there anything that I have done or said that would lead my employees to believe that I don’t consider mental illnesses legitimate illnesses? Do I belittle or judge people who cannot work because of depression? Do I consider them weak?

Trust me, if you can’t answer those questions, your employees with mental illnesses can. We listen to your off-handed comments about “happy pills” and quips about someone being “off their medication.” Those are NOT off-handed comments to us.

That is what we think about when we are trying to decide how to tell you that we cannot work because of our depression. That is what keeps us up at night. Raw anxiety. Few things are as unhealthy for someone in a major depression as anxiety and a lack of sleep. Trust me.

That anxiety plagues us as we recover and return to work. What will my boss think of me? What do I tell my co-workers? Privacy laws prevent bosses from divulging your illness to your co-workers. Often they are clueless and left to speculate and gossip about our absence.

More anxiety and stress.

I am one of the lucky ones. I work in an office where mental illness is accepted as a legitimate illness and disability. Depression is the number one workplace disability and costs employers billions of dollars each year in lost productivity.

A wise boss will embrace these facts and realize that an employee who is both physically and mentally healthy is a better, more productive worker. My bosses “get” this. I was greeted with smiles, hugs and “glad your back.” No big deal. No questions.

I was back and glad to be back.

This article first appeared on Psych Central on 1 June, 2014.