Adam has a secret. He’s shared it with his family and close friends. In fact, he would like to talk about it more openly. But he doesn’t want to use his real name because he fears people at his new high-tech job will see it and think less of him.

Adam has depression. Since high school, the 27-year-old California resident occasionally has suffered periods when he is more than just blue; he has no energy to get out of bed, feels hopeless and like he’s “been hit by a truck”.

Recently, he considered allowing a reporter to mention his depression in a news story about a community project in which he was involved. His depression was one of the reasons he got involved: “I guess I was tired of feeling like I have to hide this piece of me,” he says.

But he was job-hunting at the time, and friends worried that prospective employers would see the story online and toss his application. The pragmatist in him conceded, and he asked to keep his depression out of the story. Coming off two years of unemployment in a tough economy, he needed a job. Also, he didn’t just need to work to pay his bills; having a job was crucial to his sense of self-worth.

Was Adam being overly cautious? After all, many of us think we live in enlightened times when people don’t lose jobs or opportunities because they have depression, anxiety, obsessive-compulsive disorder, bipolar disorder or schizophrenia.

But that’s not the case. Mental health advocates point to studies that show people with mental illness have the highest rates of unemployment of all disabled and that many employers are reluctant to hire someone with a past psychiatric history or undergoing treatment for depression.

The issue reflects our culture’s understandably ambiguous feelings about mental health issues.

In one news cycle, a celebrity such as Catherine Zeta-Jones or a film such as Silver Linings Playbook is hailed as courageous for presenting positive images of people with mental illness. But the next day’s story dwells on how the latest suspect in a mass shooting was hearing voices, fuelling the belief that people with mental illness are unreliable, emotionally unstable, even dangerous.

“We still have a long way to go,” said Lisa Smusz, executive director of Peers Envisioning and Engaging in Recovery Services, or PEERS, a California-based nonprofit organisation working to end mental health stigma and discrimination.

More of us are dealing with various forms and degrees of mental illness than we may realise, she said.

Mood and thought disorders are prevalent, but usually are less understood because they are “invisible,” said Nadine Dixon, a former member of the Berkeley/Albany Mental Health Commission in Berkeley, California. In a workplace, a person’s condition may only show up in subtle ways he behaves, or in gaps in his work history.

At the same time, the ability to work is an important part of recovering from mental illness – along with getting medication, a good therapist, family support and a healthy lifestyle, said Brian Hill of Black Men Speak, an organisation that helps African-American men with mental health challenges.

Work allows people who tend to isolate and feel inadequate to engage socially and feel needed and successful, experts say. But people say they’ve lost jobs or work opportunities because of their disabilities.

Chris Velarde, 33, would like to be open about his bipolar disorder. He receives plaudits for regularly sharing his story with medical schools and community organisations.

But being candid during an interview for a personal trainer job at a gym did not go over well.

“I told them because I wanted them to know there might be special issues. I wanted to be an honest employee and figured they were going to find out eventually.” His interviewer told him, “We don’t have the time for that”.

The lesson for Velarde? He won’t be an “honest employee” again – at least not until after he’s landed the job.

This article first appeared on The Courier Mail on 23 April, 2014.