NEW YORK (AP) — Her initial panic attack occurred during a company-wide meeting, just before her presentation. Carolina Lasso had delivered many similar presentations about her marketing team's achievements. However, this time, when she was called upon, she was unable to speak.

“I felt a knot in my throat,” Lasso said. “My head felt like it was inside a bubble. I couldn’t hear or see, and it seemed to last an eternity. It was only a few seconds, but it was so profound, and in a way, earth-shattering for me.”

Lasso was facing challenges after a cross-country move followed by a divorce. Her boss suggested a mental health leave, an option she was unaware of. She was concerned about how taking time off might affect her team's perception of her or impact her chances for future promotions, but ultimately she decided to take the leave.

“I’m grateful for that chance to take the time to heal,” Lasso, 43, said. “Many people feel guilty when they take a leave of absence for mental health reasons. ... There is an extra burden we carry, as if it were our fault.”

Despite fears of negative consequences, more adults are realizing that stepping back from work to manage emotional burdens or psychological issues is a necessary decision, one that a growing number of employers understand.

ComPsych Corp., a provider of employee mental health programs and absence management services, advises its business clients to prioritize worker well-being before individuals reach a breaking point, while also having procedures in place for those who need leaves of absence.

“Since the onset of the COVID-19 pandemic, we’ve collectively been in a constant state of turmoil,” said Jennifer Birdsall, the senior clinical director at ComPsych. “We have been faced with a barrage of change and uncertainty.”

Depression, anxiety, and adjustment disorder, which involves excessive reactions to stress, were the top three diagnoses among employees who took mental health leaves in the past two years, according to Alight, a Chicago-based technology company that manages leaves and benefits for large employers.

Structuring a leave

A mental health leave can extend over weeks or months. In some instances, employees may receive approval to work a reduced schedule or take short breaks as needed, using a method called “intermittent leave.”

At most U.S. organizations with 50 or more employees, individuals can request leave through the Family and Medical Leave Act. This federal law entitles workers with serious health conditions to paid or unpaid leave for up to 12 weeks, depending on state and local regulations.

Some employers require the use of sick days or accrued vacation days to continue receiving a paycheck while on leave. For extended leaves, employees can access short-term disability plans, if offered by their employer.

Lasso’s leave lasted six months and included therapy and travel to India for further treatment. She returned to her job but decided to leave permanently after a year. She later started a business to train people on cultivating a more humane work culture.

A mental health leave is “not only acceptable, but it can truly unlock new possibilities once we have the time for therapy, medication, or whatever is needed, and enough distance from work to reconnect with ourselves,” Lasso said.

Talking openly about struggles

The social stigma surrounding mental health challenges prevents many individuals from seeking treatment or requesting a leave of absence. Newton Cheng, director of health and performance at Google, aims to change that by sharing his own experiences.

His first self-disclosure occurred during the pandemic, when a senior manager invited employees at a meeting to express how they were doing. When it was his turn, Cheng began to cry.

He explained that he was struggling to meet his own expectations as a father and was unsure how to improve the situation.

“It was completely horrifying because, firstly, I had just cried in front of my coworkers, and I was always taught as a professional — and as a man — you don’t do that,” Cheng recalled. “Secondly, I had never articulated those words out loud. I hadn’t even allowed myself to think that. But now they were out there, and I had to confront them.”

Colleagues responded by sharing their own struggles, but Cheng’s difficulties persisted. By February 2021, he was unable to get out of bed due to a paralyzing sense of dread, he said. A therapist diagnosed him with major depression and anxiety.

“I just realized, ‘I’m struggling significantly and this goes deep. I can’t keep just patching it up. I probably need to take some leave,’” Cheng recalled.

Hoping his decision would help others, he announced to 200 attendees at a conference that he planned to take mental health leave. Rather than derailing the event as he feared, his honesty encouraged others at the conference to open up.

“It was like a fireworks display,” Cheng said. “They were like, ‘Wow, I can’t believe he did that.’ Then they moved on. But the tone was set. It was like, ‘Oh, this is what we’re doing. Let me talk about what’s happening with me, too.’”

Take the time you need

While managing classes and a full-time job during her final year of college, Rosalie Mae found it difficult to get out of bed and cried uncontrollably. Yet she felt the need “to hold it together” to avoid burdening her colleagues at the University of Utah bookstore, where she worked as an accounting clerk.

Eventually, she reached a point where she called a suicide hotline. “Once it got to that stage, I knew, especially with my husband’s encouragement, we needed to do something more,” Mae, 24, said.

For her, that meant taking a five-week leave from work to prioritize her health and well-being. She advises others in similar situations to do the same.

“Taking a mental health leave isn’t necessarily a cure-all, but it’s important to give yourself a break and allow yourself to regroup, formulate a plan for moving forward, and take steps toward feeling better,” Mae said.

Telling managers and colleagues

Before discussing a mental health leave with a manager, consider the workplace culture and the strength of your professional relationships, Cheng advised. He recalls saying, “For my health and well-being, and the sake of my family and what’s best for the business, the least risky action for me is to go on leave soon.”

Those expecting an unsympathetic response can simply state, “I need to go on medical leave. I need time to recover,” he suggested.

There is no legal or ethical obligation to disclose the nature of your leave to everyone you work with.

“Your coworkers don’t need to know why,” said Seth Turner, co-founder of AbsenceSoft, a leave and accommodation management solutions provider. “They just need to know, ‘I’ll be here during this time, I’ll be away during this time, and I’ll return.’”