Transcript of Edge Note: What If Telling the Truth About Your Mental Health Could Cost You Everything?

Welcome to Notes from the Edge, where we have the conversations we should have been having all along. We talk about the things that we're not talking about. I'm your host, Lisa Lacey, writer, trauma educator, executive advisor, and author of the upcoming memoir Notes from a Certified Madwoman. Welcome to the Edge.

Welcome to another episode of Notes from the Edge. I am your host, Lisa Lacey, and this is the place we have the conversations we should have been having all along. There is something I need people to understand about living with severe mental illness. The hardest part is not always the illness. Sometimes the hardest part is knowing what could happen if people find out.

I have lived with labels that make people very uncomfortable. Bipolar I, a history of psychosis complicated by borderline personality disorder, complex post-traumatic stress disorder, a history of alcohol use disorder. Lots of disorders on top of my antithrombin III a blood disorder. Those words can change the way a room looks at you before you have said another sentence. I know what it is like to be hospitalized.

I know what it is like to trust my brain when my brain was not giving me reliable information, then come back afterwards trying to figure out what was real and what damage was waiting for me. I also know what it is like to have people take the worst season of my life and make it the permanent definition of who I am as a human. And here's the part that makes people uncomfortable. During some of those same years, I was building businesses, running companies, multiple, making major decisions, earning 6 figures, setting goals, hitting deadlines. I could walk into a professional room and perform confidence at a very high level.

And then fall apart somewhere where nobody could see. Both things were true. 2 truths can exist at the same time, and I played both. And that is what we do when we don't know how to hold. We want mentally ill people to fit one story.

Either you are sick enough to deserve compassion, then people assume you are incapable, or you are successful enough That they decide you cannot really be that sick. So someone can be brilliant and symptomatic, responsible and struggling, accomplished and hospitalized, a leader and still need treatment. A person can experience psychosis and still have insight, intelligence, value, talent, and a future. A diagnosis does not erase the rest of the human being, but stigma does. Now stigma makes people hide.

We learn very quickly which diagnoses are acceptable to talk about at work. Anxiety has become safe. Burnout is definitely safe. We're seeing it everywhere. Stress is safe.

Even depression is becoming safer in some workplaces. But say bipolar I, say psychosis, say borderline personality disorder, watch the air change. People's face turns white and they start wondering whether you are stable enough to lead, trustworthy enough to manage money, rational enough to make decisions, difficult to work with, unpredictable, dangerous.

Suddenly you are no longer being evaluated on your actual work. You are being evaluated on everything somebody has ever heard. About your diagnosis.

Someone else could have symptoms that are different than yours. That is not mental health awareness. That is fear wearing a corporate wellness t-shirt. I spent years understanding that disclosure could have serious consequences. Careers are built on perception, and when serious mental illness is still understood through Sensational headlines and movies and jokes.

Telling the truth about your brain can feel professionally reckless. So people become experts at hiding. We go to meetings after panic attacks. We answer emails from hospital rooms. We explain medication side effects as, I'm just tired.

And we call psychiatric appointments at a doctor's office. Just an appointment and hope nobody asks what kind. We become fluent in editing ourselves. Then organizations hold Mental Health Awareness Month and tell employees to bring their whole selves to work. Which whole self?

The marketable one, the inspirational one, or the one who had anxiety, got a therapist, learned boundaries, came back more productive? What about the employee who heard voices? The executive with bipolar 1? The person with borderline personality disorder who has done years of treatment and still knows those words can make a manager treat them differently? What about the person who was hospitalized and knows one disclosure could become the lens through which every future future disagreement is interpreted.

That is where systemic change has to begin. We have to stop making people prove recovery by pretending they were never sick. For me, recovery did not mean my history disappeared. It did not mean everybody updated their story about me. Some people will always remember the version of me who was in crisis because that version is useful to the story they tell themselves.

Recovery meant I stopped letting their version be the final authority on who I am. I have survived addiction. I've been in psych wards. I've been in jail. I've had periods when my own mind was not safe or reliable as a narrator in this reality.

I've also rebuilt my life, my relationships, my work, my voice, and my sense of self. I am in one of the healthiest and most stable periods of my life. None of that requires me to erase what came before it. And this matters beyond my story because millions of people are making the same calculation every day. Can I tell my boss?

Can I ask for an accommodation? Can I explain why I disappeared for 3 days? Can I say the name of my diagnosis without losing credibility? Can I admit that my medication changed? Can I say I'm struggling before it becomes a crisis?

If the answer is no, Then we do not have a mental health system. We have a crisis response system. We wait until people break loudly enough that we can no longer ignore them. Then we ask why they did not ask for help sooner. Maybe because asking for help can cost people something.

Maybe because they have watched colleagues get quietly sidelined after disclosing. Maybe because the language of inclusion has moved faster than the culture underneath it. We need something better. We need workplaces where mental illness is treated as a health issue without turning a diagnosis into a prediction about a person's character. We need managers trained to respond to disclosure without lowering expectations.

Withdrawing responsibility, or treating every emotional response as evidence of instability. We need psychiatric care people can access before they reach an emergency room. We need leave policies that do not require people to publicly perform their suffering to justify time away. We need stronger privacy protections and healthcare professionals willing To confront stigma inside healthcare itself, especially towards borderline personality disorder and psychotic disorders. And we need to stop treating lived experience as disqualifying.

Sometimes the person who has walked through hell understands something about human behavior, fear, resilience, conflict. And survival that cannot be learned from a textbook. Suffering does not automatically make someone wise, but it should not make someone disposable. There is also a language problem. We use words like crazy, psycho, manic, borderline, delusional, and schizophrenic casually, usually to describe somebody we dislike.

Then we wonder why people carrying these actual diagnoses Do not feel safe telling us. If every joke says people like you are dangerous, exhausting, impossible, or ridiculous, do not be surprised when someone hides the fact that they are one of those people. I've been called crazy in ways that were meant to end conversations. That word can become a weapon because once somebody convinces a room That you are crazy. They no longer have to engage with what you are saying.

Your anger becomes a symptom, your boundaries become a symptom, your disagreement becomes a symptom, your memory becomes a symptom, and eventually you begin questioning yourself before anyone else has to. That is one of the most damaging things stigma does. It does not just change how other people see you. It can teach you to distrust your own humanity. And I want us to build systems where people can say, I live with bipolar disorder, with the same matter-of-factness that somebody names another health condition.

Because a diagnosis should not be treated as a moral confession. I want people to be able to say, I experienced psychosis, without watching everyone mentally rewrite their resume. And I want people with borderline personality disorder to be treated as human beings capable of growth, accountability, love, amazing leadership, recovery, and a lot of change. And I want somebody to be able to ask for help while they are still functioning Before the hospital, before the collapse, before the resignation, before the divorce, before the substance abuse spirals, before the moment everyone points to later and says, we had no idea. Sometimes we did have an idea.

We just built a world where telling the truth felt more dangerous than hiding it. And that is what has to change. Not just awareness, not another poster in the break room, not another medication app, not another executive saying it is okay not to be okay while employees wonder which kinds of not okay will still get them promoted. We need psychological safety that survives contact with serious mental illness. We need cultures that judge people by behavior, performance, accountability, How they are showing up, how they are functioning now, not by the most frightening word in their medical history.

And for those of us who can speak about it, I think we need to speak about it. Not because everybody owes the world disclosure. You do not. Your diagnosis is your information. It's your story.

It belongs to you. But I am speaking because secrecy protected my career at times While also reinforcing the idea that people like me were not already in those rooms, and they were. We are parents, we are executives, we are clinicians, we are artists, teachers, entrepreneurs, coworkers, spouses, and friends. Some of us have been psychotic. Some of us have been hospitalized for mental health.

Some of us have records we wish we could rewrite. And some of us made mistakes while sick. That we still have to take responsibility for. And we are still here. A human being should not have to choose between telling the truth about their mental health and being taken seriously.

That is the change I want to see. A world where recovery does not require secrecy and shame, where accountability and compassion can exist in the same sentence, where a psychiatric diagnosis is data or information, not a verdict. And where people do not have to become inspirational enough to earn back the humanity they never should have lost in the first place.

We need change, and it only comes by having the conversations we should have been having all along. I'm going to close out with the question I always ask you guys.

What are you performing in order to survive or just get by?

And what might setting that role, mask, or performance down do to help improve the ride you're having? I'm Lisa Lacey, your host, and when you find the answer to that, I'll see you at the edge.