“We tend to talk about race inequality as separate from inequality based on gender, class, sexuality or immigrant status. What is missing is how some people are subject to all of these, and the experience is not just the sum of its parts.” — Kimberlé Crenshaw
Types of Mental Health Conditions and Substance Use Disorders
The Job Accommodation Network's (JAN) Mental Health Conditions webpage outlines a number of definitions and descriptions to help explain common mental health conditions and substance use disorders. Employers are encouraged to review this information to better understand these conditions and disorders.
Bipolar disorder “is a medical illness that causes extreme shifts in mood, energy, and functioning. Bipolar disorder is a chronic and generally life-long condition with recurring episodes of mania and depression that can last from days to months that often begin in adolescence or early adulthood, and occasionally even in children.”
Borderline personality disorder is “an often misunderstood, serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. It is a disorder of emotional dysregulation. This instability often disrupts family and work, long-term planning, and the individual’s sense of self-identity.”
Major depression is “persistent and can significantly interfere with an individual’s thoughts, behavior, mood, activity, and physical health. Among all medical illnesses, major depression is the leading cause of disability in the United States and many other developed countries.”
Obsessive compulsive disorder (OCD) “often includes persistent, compulsive thoughts that lead to the development of rituals used as a way to cope. OCD can significantly impact daily life and may require specialized accommodations in order for people with OCD to manage their symptoms effectively at work.”
Panic disorder occurs when a person “experiences recurrent panic attacks, at least one of which leads to at least a month of increased anxiety or avoidant behavior. Panic disorder may also be indicated if a person experiences fewer than four panic episodes but has recurrent or constant fears of having another panic attack.”
Post-traumatic stress disorder (PTSD) is “an anxiety disorder that can occur after someone experiences a traumatic event that caused intense fear, helplessness, or horror. While it is common to experience a brief state of anxiety or depression after such occurrences, people with PTSD continually re-experience the traumatic event; avoid individuals, thoughts, or situations associated with the event; and have symptoms of excessive emotions. People with this disorder have these symptoms for longer than one month and cannot function as well as they did before the traumatic event. PTSD symptoms usually appear within three months of the traumatic experience; however, they sometimes occur months or even years later.”
Schizophrenia “often interferes with a person’s ability to think clearly; to distinguish reality from fantasy; and to manage emotions, make decisions, and relate to others.”
Seasonal affective disorder (SAD) is “characterized by recurrent episodes of depression usually in late fall and winter—alternating with periods of normal or high mood the rest of the year.” SAD is not regarded as a separate disorder by the DSM-5, but it is an added descriptor for the pattern of depressive episodes in patients with major depression or bipolar disorder.
Substance use disorder is the loss of control of use of alcohol and/or prescription or illegal drugs and may co-occur with mental health conditions (see: “Prevalence of Mental Health Conditions in America” above). Visit MentalHealth.gov to learn more about the symptoms of substance use disorder. (Source: National Institute on Drug Abuse)
In addition, Long COVID can impact mental health conditions. Long COVID is defined by the World Health Organization (WHO) as the long-term symptoms of COVID-19. Long COVID can take various forms, including physical symptoms such as fatigue, emotional distress, and psychological conditions. EARN and JAN developed a guide, Supporting Employees with Long COVID: A Guide for Employers, to provide information and resources for employers to help support employees with Long COVID and its associated conditions. The U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) also created a fact sheet, Working with Long COVID (PDF), with information for employers and workers with Long COVID who wish to return to or remain at work.
Long COVID can exacerbate mental health symptoms when its effects prevent someone from being able to work, take care of their family, or engage in activities they enjoy. Long COVID: Assessing and Managing Workforce Impact suggests that mental health supports should focus on ways to allow employees to remain at work.
During the height of the pandemic, people from marginalized communities were more likely to be essential workers, putting them at a greater risk of contracting COVID-19. It is important that organizations recognize these groups may also be more likely to experience issues with Long COVID related mental health symptoms. Moreover, people with disabilities from marginalized communities may face additional barriers when attempting to access support and resources.
Mental Health Impairments and the Americans with Disabilities Act (ADA)
For information about the connection between mental health impairments and the Americans with Disabilities Act (ADA), visit the Job Accommodation Network (JAN) website. According to JAN, the ADA does not have a specific list of medical conditions that qualify as disabilities. Instead, the ADA has a broad definition of disability, which requires that “an individual has a physical or mental impairment that severely limits one or more significant life activities, has a history of such an impairment, or is perceived as having an impairment.” To learn more about determining disability under the ADA, read JAN's guide, "How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).”
This broad definition of disability calls on employers to focus on ensuring employees have what they need to success in their jobs rather than whether or not the person qualifies for protections under the ADA. Regardless of whether a mental health issue or substance use disorder is classified as a disability, it is always advisable for employers to address the mental well-being of their staff and cultivate an inclusive work environment.
