Let’s stop pretending we are all healthy – as many as 60% of workers with a disability or chronic condition hide their illness.

Disability and illness “hiding” in our organisations

In many companies, illnesses are present but invisible. We hide them because we fear being labelled, missing out on opportunities, and receiving clumsy reactions from team members or superiors. This strategy takes a toll on people, costing them energy and dignity, and on organisations, resulting in mistakes, presentism and departures. However, this is not inevitable. For a low cost, you can create an environment where we can talk about our needs without revealing full diagnoses, and where work can be designed around real people. This text shows you how to achieve this and explains why it benefits everyone involved.

When was the last time someone on your team openly told you that they needed to take time off to deal with a medical condition, panic attack, depression or chronic illness? Or maybe you’re the person who hasn’t told your team the truth about why you need a day off?

If you don’t have these kinds of conversations every day, there’s probably someone in your company who’s calculating whether they can afford to be honest today. They wonder whether to tell you about the pain making it difficult to concentrate, or whether to hide it and blame family or car problems instead. Maybe there’s someone next to you who’s struggling to admit their incurable, hard-to-manage illness, rather than lying to you about having a cold for the umpteenth time.

Or maybe you are that person? Perhaps, as a leader, you hide your own struggles so as not to lose authority. Perhaps you’re resorting to increasingly creative excuses because the truth seems too risky. If this sounds familiar, know that this is not a marginal problem.

Before we proceed, I would like to emphasise that this text does not absolve employees of responsibility for their own health and wellbeing. As adult human beings, it is our responsibility to take care of ourselves, communicate our needs and seek help in order to perform at our best. A leader’s role is not to “fix” an individual, but to enable them to take care of themselves by creating the right conditions, removing barriers and normalising honesty.

Lesson from the B-HERO-S study

When the B-HERO-S study of 299 adults affected by a genetic condition (more specifically haemophilia B) fell into my hands, I realised it should change the way any leader thinks about disclosing illness at work.

The publication found that, despite having only a mild or moderate form of the disease (which makes patients function almost normally, compared to the severe form), as many as 88% of those surveyed experienced negative reactions when disclosing their illness: 76% from friends, 80% from colleagues, and 82% from employers.

Eighty-seven per cent of patients also reported that haemophilia and their experiences affected their ability to form close relationships with others. Furthermore, 43% of children said that they had been bullied.

If even a mild illness can affect interpersonal relationships so profoundly, what must it be like for the millions of people with chronic conditions who hide them from others, including employers, every day?

We are talking about a whole spectrum of “invisible” conditions. Take diabetes, for example, which requires regular blood sugar monitoring and insulin injections. A teammate might only see someone disappear for ten minutes. We are talking about autoimmune diseases such as multiple sclerosis, rheumatoid arthritis and Hashimoto’s disease, where one day someone is functioning normally and the next they can barely get out of bed. We are talking about migraines, which are not “simple headaches” but paralysing conditions that exclude people from life for days.

Endometriosis can cause unbearable pain, but to those around you it’s just “women’s problems”. Haemophilia is another condition where the most dangerous aspect is the invisible hemarthrosis into the joints and muscles. These are painful and damaging to the joints, but are externally undetectable, so patients who refuse to be active are often suspected of making excuses. About bowel diseases such as Crohn’s disease or ulcerative colitis, where patients have to plan every outing according to toilet availability. About fibromyalgia, which causes chronic pain that cannot be seen during any examination. And about ADHD, anxiety disorders and depression, which force us to perform “normality” every day.

The mechanism behind the concealment is relatively simple:

• The first element is stigma and career risks. Employees fear receiving a label that can lead to relegation from important projects and reduced chances of career advancement.
• The second factor is bad experiences of others or of oneself. Single negative incidents are enough to “set” the imagination of the whole group and make people avoid disclosing their difficulties.
• Thirdly, there is the problem of a lack of a standard of accommodation. Employees do not know what they can ask for or how to arrange the support they need, so they often choose silence as a safer option.
• The fourth element is information asymmetry. Managers do not know how to help without invading employees’ privacy too much, and in turn employees are unsure how much information they can safely disclose.
• The fifth factor is team norms, where there is a belief that “we don’t get sick here” and a cult of working at 120%, which effectively pushes the topic out of the realm of everyday conversation.
• The sixth element is managerial heuristics – confusing equality with equality and the visibility effect, where managers assume that if they see someone in the office, that person is working effectively.
• The final seventh point is the emotional cost. Hiding one’s problems seems easier in the here and now than having a difficult conversation, even though in the long term such behaviour is destructive to mental health and professional relationships.

This is how millions of people go to work every day, suffering in silence from pain, fatigue and anxiety, while playing the role of healthy, fit and “normal” workers. The alternative — honesty — seems too risky.

The culture of “hustle” and the glorification of overwork exacerbate the problem. When leaders boast about working 100-hour weeks, when bullying becomes a professional identity and when LinkedIn is full of posts about “pushing the limits of one’s abilities”, any sign of weakness is seen as a sin against productivity. Illness does not fit the “crush the competition” and “be the best version of yourself” narrative.

In this context, admitting to having a chronic illness means more than just providing information about a medical condition; it is an admission that the sufferer is a “defective product” in a society where everyone pretends to be perfect.

I know all about treating illness as a taboo subject. For years, I was one of those people who hid their chronic illness, particularly in business. I didn’t want to be remembered as a “good entrepreneur with an illness”. I didn’t want my work to be defined any other way. “All or nothing!” I kept repeating to myself, “Even if I have to work two, three or thirty times harder, I won’t talk about it”. Consequently, practically no one in the business knew about my illness for years. I treated any disclosure as a risk.

Moreover, I was so impressed that I decided to look for broader data on the situation of people with illnesses in the workplace, not only in the context of haemophilia, to better understand the real challenges they face.

Disclosure of mental health problems versus consequences

Firstly, I examined mental health issues. It quickly became apparent that the situation was particularly bleak: employees were struggling with depression, anxiety and other mental health disorders, but were often reluctant to admit this as a reason for absence, instead reporting a “cold”.

According to a survey in Scotland, up to 43% of people believe that an employee with a mental health problem is unlikely to disclose it for fear of being relegated to another position or overlooked for promotion. Similarly, 38% think they will not disclose a mental illness for fear of discrimination from colleagues.

In Poland, the picture is equally depressing. According to a study by the Polish Psychiatric Association, as many as 73% of Poles felt that mental illnesses are among those conditions that are hidden from others as shameful.

Almost half of those surveyed (46%) said they would not want to work for a boss who had previously received psychiatric treatment. Furthermore, 80% of respondents perceived discrimination against people with mental health issues in the labour market.

In a publication by the Polish Press Agency – a mental health assistant with a diagnosis of bipolar disorder – described the mechanism with painful honesty: “While looking for a job in the financial sector, I deleted the blog on bipolar disorder that I had kept for two years so that no one would discover the truth about me. I deleted two years of sharing my experience, building a community and helping others with one click for fear of being labelled.”

The global study “Mental Health in the Workplace” showed that only less than three in 10 employees (29%) feel completely comfortable talking about their mental state at work, while 25.6% are not at all comfortable broaching such a topic.

Almost four in ten (39.4%) say that mental health is never discussed in their workplace, and they “don’t want to be the first to bring it up”. Meanwhile, 35.2% openly admit that they do not report mental health problems for fear of stigma and discrimination.

Meanwhile, the research “Workers’ Decisions to Disclose a Mental Health Issue to Managers and the Consequences” on a representative sample of employees yielded quite different and surprising results.

As many as 88% of people with mental health issues who disclosed them to their managers said that it was a positive experience.

This should be reassuring, right? The problem is that it is the minority who experienced the negative consequences that are now shaping everyone else’s fear. This is mainly because the consequences for this group have been dramatic. Not only did two-thirds receive no support from their supervisor, but nearly half (46.7%) lost their jobs as a result of disclosing their illness.

In another study, conducted in the UK, things are not any better, as it was found that one in five people lost their jobs due to mental health stigma. And, according to a publication by the American Psychiatric Association, as many as 44% of working Americans fear that taking time off for mental health treatment will provoke reprisals or dismissal, and 39% fear the negative consequences of simply seeking psychological help.

Disclosure of physical and chronic illness – scale of the phenomenon and impact

I thought it would be different for people with physical or chronic illnesses. I thought that diabetes or multiple sclerosis did not carry the same stigma as depression or anxiety. However, I was wrong, as data from these areas show exactly the same pattern: fear of disclosure, hiding the diagnosis and negative reactions from those around them.

According to a recent survey by the “Harvard T.H. Chan School of Public Health & de Beaumont Foundation”, up to 60% of employees with a chronic physical condition (such as hypertension, heart disease, diabetes, asthma) have never formally informed their employer about it. At the same time, 3 in 4 of these workers have to manage the symptoms of their illness during working hours.

The same study reported that, in the year prior to the survey, up to 33% of people with chronic illnesses missed out on development opportunities due to their condition.

One in four (25%) admitted that they had missed out on a promotion due to their illness, while one in five (21%) received a negative appraisal or critical feedback related to their health problems. As many as 36% of sick employees had to resign or delay treatment to avoid interfering with work.

In Poland, the situation is equally grim. Research conducted on behalf of the campaign “Illness? I work with it.” revealed the scale of the problem.

79% of employers admit that candidates are rejected in the Polish labour market due to their health condition. Therefore, it is not surprising that 95% of employers confirm cases of employees concealing an illness, with one in four saying this happens frequently.

According to the research, the fear of disclosure stifles professional development. Sick people stop thinking about their professional development and focus mainly on maintaining their current situation for as long as possible. Those in employment cling to it because they know that the next job may be worse — or they may not find employment at all.

Interestingly, ailments that are relatively well understood, such as a broken leg or the flu, evoke more empathy than chronic illnesses with fluctuating courses. One example is lupus (systemic lupus erythematosus, SLE), an autoimmune disease whose symptoms, like haemophilia, are often invisible and erratic. Case study research of professionals with SLE has shown that most deliberately hide the disease at work, fearing being labelled a “troublesome employee” or a simulant. Managers and colleagues often overlook the symptoms of the illness – when they see an employee looking well one day, they find it hard to believe that they actually need hospitalisation or redundancy the next day. People with SLE have reported that they “mask their illness by pretending to be normal” in order to avoid being judged — for example, by taking on extra tasks and not complaining about symptoms – at the expense of their health.

The economics behind the illness

Examining the economic consequences of this widespread concealment reveals a complex situation.

Employees and employers are both losing out on an arrangement that they perpetuate themselves out of fear of change. It is worth noting, meanwhile, that people (whether employees or leaders) who have learned to manage their chronic conditions effectively and remain active often develop compensatory skills. These include better time organisation, prioritisation of tasks, and creative problem solving.

As it turns out, people who face limitations on a daily basis become masters of efficiency. For instance, someone managing chronic pain develops an uncanny ability to focus on what is truly important to the company. By managing their energy, they avoid wasting the team’s time on irrelevant meetings or tasks.

The expertise forged in the fire of daily challenges is not only related to people skills.

A finding that incredibly surprised me is that three independent studies (Disability:IN, EY, Public Private Strategies) confirmed that employees with disabilities assimilate AI faster than others.

This is because they have ‘future-ready skills’, which they have developed through their use of assistive technology, among other things.

Companies that understand this are succeeding. Hard data shows that creating inclusive workplaces is highly profitable.

Companies that are leaders in the Disability Equality Index have, according to the research, 28% higher revenues than their competitors – although I must mention that these figures relate to broad support for people with disabilities, not just creating a safe environment for disclosing medical conditions.

All of the positive things I have mentioned only apply to people who can openly discuss their illness with their employer and to companies that create appropriate working environments. For those who are forced to hide their illness, however, the situation is dramatically different.

Presenteeism (yes, there is such a word and it means coming to work and pretending to be healthy) costs, in Japan alone, more than $27 billion a year for each of the three main conditions: back pain, neck pain and mental illness.

Workers who hide their health conditions are losing out on two fronts. At work, they make more mistakes and miss deadlines; in their personal lives, their untreated problems continually pile up. The energy they could be using for productive tasks is consumed by constant anxiety, hiding symptoms, making excuses, and pretending that everything is fine. The fear of the potential consequences of revealing their illness, however unlikely, is paralysing and exhausting.

On the other hand, employers are convinced that adapting the workplace to accommodate people with medical conditions would be extremely costly. They believe that their companies lack the resources to implement complex programmes designed to foster empathy among managers and provide support to employees. However, the truth is that few people need such programmes.

Data from the Job Accommodation Network survey reveals that as many as 56% of all workplace adjustments for employees with medical conditions or disabilities do not cost a penny.

These include flexible working hours and the option to work from home or somewhere quieter. Another 37% are one-off expenses averaging $300 — less than the cost of training a new employee for one day.

These seemingly small changes can produce surprising results. In fact, 85% of employers retain valuable employees as a result, while 53% see an increase in productivity and 48% report better attendance.

As a leader, there’s no need to hire Chief Empathy Officers straight away. Instead, you can set an example by modelling sensitivity yourself and encouraging it throughout your organisation. Even without comprehensive benefits, you can create an environment where people can be themselves and don’t have to hide their humanity.

Ultimately, the strongest predictor of whether employees feel comfortable discussing their health issues is not company policy or HR training, but whether they have seen their leaders demonstrate genuine vulnerability.

I’ve written about this before in the context of authentic leadership – research on psychological safety shows that teams with leaders who acknowledge their own fallibility and difficulties make fewer mistakes, if they do make them they report them more boldly, learn from them and ultimately perform better. In the context of disease disclosure, this regularity takes on particular significance.

Remember, however, that there is a fine line between authenticity and over-exposure. Researcher Brené Brown calls this “processing by the team instead of with the team”. A manager who talks about his personal problems at every meeting, seeks comfort from his employees or expects them to be his emotional support is in no way building trust among people. On the contrary, he slowly destroys them.

A team needs a leader who is human but still remains a leader.

Coming back to the cost of adapting the workplace for an employee, compare the expenses I mentioned above with the cost of replacing an experienced team member. According to a number of studies, including analysis by Josh Bersin of Deloitte, it is between 1.5 and 2 times his annual salary.

When a skilled professional leaves because they were not offered a flexible schedule, the company loses their knowledge and experience. Furthermore, it can take the entire team months to rebuild the momentum and relationships that disappeared with them.

Despite the low cost of adaptations and their undoubted benefits,Deloitte’s first Disability Inclusion at Work study shows a sad reality.

As many as 74% of employees who requested a workplace adjustment to accommodate their health needs were denied at least one request, with almost two in ten having all their requests rejected.

It seems that organisations would rather lose an experienced employee who has developed unique skills through overcoming limitations than invest the equivalent cost of a decent office chair. This short-sightedness harms everyone.

Diversity not so diverse

The same myopia can be seen more broadly when looking at how corporations approach the subject of diversity.

An analysis of contemporary initiatives in this area reveals a painful gap. According to the Purpose Brand study, of the 154 DEI reports published by Fortune 500 companies, only 112 companies reported on women on the board, 131 on racial diversity and – note – only 19 organisations shared data on the employment of people with disabilities.

This is quite an exclusion. In the European Union, 23.9% of people over the age of 16 live with a disability. In Poland, according to official data, this is 12.2% of the population – almost 5 million people. Organisations invest millions in spectacular diversity programmes, while people with disabilities, a significant part of any society, remain invisible in these initiatives.

Of course, it is possible that very few people with disabilities work in these companies. If this is the case, however, it raises the fundamental question, “Why?” Are the architectural and systemic barriers so high that these people don’t even consider applying? Or does the organisational culture suggest that they are not welcome? Or are there people with illnesses working there who are hiding their conditions for fear of the consequences of disclosing them?

Practices that transform

Why am I sharing this depressing data? You might think that I want to put people off discussing any problems they have at work.

However, the opposite is true. I can’t ignore the problem. Nor can I claim that disclosing your illness and discussing your challenges is straightforward, easy or enjoyable. It isn’t. This is why hundreds of thousands of people calculate every day: “To speak or not to speak?” Most choose silence, giving up the opportunity to be fully themselves at work and carry their daily baggage with them.

I believe that our organisations need huge changes. Changes that are desperately needed. However, they require courageous leaders to implement them. That’s why, whatever your role, I encourage you to understand that you can be part of the transformation. Every time you allow someone to be themselves, every time you create a safe space and every time you reveal your vulnerability, you create a wave that can change the reality around us.

Of course, I would like to clarify that, to me, “being fully yourself” means being honest in a mature way that is professional, and accepting that you need to work with your illness rather than accepting unprofessional behaviour.

Many patients I know and admire, as well as myself, are proof that illness does not have to be the end; on the contrary, it can sometimes be the seed of something new. Although it can be hard and limiting, it has shaped me as a leader. It has taught me to prioritise when energy is limited. She forced creativity in solving problems when standard approaches were not possible. She gave me empathy that I would not have had if I had not experienced my own fragility.

I want to live in a world where nobody has to delete a two-year blog about their illness just to get a job. A world where “I’m at 60% capacity today” is seen as helpful information, not a cause for shame.

Where diversity includes those of us who spend some days in bed and others changing the world.

This is why, as leaders, I believe we need to ensure our organisations are full of features that support the people working in them, regardless of mandates or regulations. Rather than waiting for laws to be introduced, I encourage us to create a culture where humanity is seen as a strength, not a flaw.

So, if you’re wondering how to make this change and where to find the courage and tools to do so, you might be surprised by the answer. You don’t need anything you don’t already have.

For the leader – how to create a space of safety

First step – start with yourself

You don’t need to reveal deeply personal diagnoses. All you need to do is stop pretending to be superhuman on a daily basis and the next time you need time off because of a medical appointment, say it straight – “I’m going to the doctor”, not – “I have a private matter to attend to”. And when you come back from illness, acknowledge that you are still recovering, rather than playing the hero. These are small things, but people notice them. They see that the boss is also sometimes weaker, also goes to the doctor, also needs time to get back in shape.

Harvard Business Review research shows that when leaders disclose their own health challenges, employees feel more comfortable sharing theirs.

The moment when someone on your team finally gathers the courage to tell you about their illness is also extremely important. Stop the reflex of saying “I’m sorry” or consoling along the lines of – “it’s going to be OK”. Instead, say something simple: “Thank you for telling me about this. I appreciate your confidence.” By doing so, you show that you understand and know what it cost this person to admit something that is still treated as a weakness in our culture. And you are sending the signal that it was a good move, not a mistake.

Second step – change the language of your questions

When you meet a team member, instead of the automatic “how are you?” to which everyone answers “fine” anyway, try something different.

Rather, ask about energy levels from 1 to 10. This is brilliant in its simplicity, because someone can say “today’s a four” without explaining their whole life, and you know it’s not the moment to throw them the most difficult project. And when someone is ‘on a six’ for a week, you can gently ask if they’re ok. You don’t need to know the details. You just need to know how to effectively manage a team that has better and worse days.

You can also try “What could make your job easier this week?”. Sometimes you’ll hear about extended deadlines, but sometimes you’ll also hear about someone needing support, a quieter place, or a longer break from work because they’re having trouble concentrating.

It’s also worth regularly asking “Is there anything I need to know to support you better?”, which opens the door to a deeper conversation, but doesn’t force anyone to go through it. The team member will decide for himself whether to talk about his situation. But he will know that the door is open.

Researchers at MIT analysed 1,000teams (over 7,000 people) around the world and found that when a leader asks each team member individually once a week – “What’s important to you right now?”, people stop being afraid to talk about their limitations. In weaker teams, this one change improved the atmosphere of safety by as much as 19%.

When that day comes that someone finally opens up to you, don’t throw around advice. Don’t say – “Maybe try this or that…”, don’t belittle – “It will get better”. Just listen. Ask if and how you can help, and sometimes it’s enough when you say: “Thanks for telling me about it”, as we often find that just listening attentively, non-judgmentally, is the biggest help someone needs.

Third step – normalise flexibility

Introduce the principle that anyone can ask for adjustments to working conditions without lengthy justifications. You can start with a catalogue of simple zero- or low-cost facilities and apply the principle that they are available to everyone.

Need to work remotely once a week? OK. Want to start at 10 instead of 8? Check if this is possible. Don’t ask ‘why’, ask ‘how can we organise this’.

Paradoxically, when people don’t have to explain themselves, they often start telling the truth themselves. Instead of another ‘I have commuting problems’, you finally hear ‘I have joint stiffness for the first hour in the morning’. Instead of the vague “open space bothers me”, you learn about the sensory hypersensitivity that makes every loud sound a torture.

Over time, standard solutions from a prepared catalogue may not be enough. Some situations require a more personalised approach, tailored to the specific needs of a particular employee.
At such moments, it is useful to remind the team of the principle that true equality is about giving everyone a real chance to succeed, even if this means using different tools and support methods.

With honesty and the right messages, you can make a big difference. You stop patching holes with contrived solutions to contrived problems and start actually helping people work effectively.

However, even something as basic as remote working – let me remind you, this is the 21st century – is still absurdly complicated.

According to a Deloitte study, 48% of remote workers say their home is much more accessible than the corporate office, but at the same time 39% don’t work remotely because they’re afraid of missing out on professional opportunities (including promotions), 30% think colleagues will think worse of them, and 22% hear from their boss that “it’s better if you were/are in the office”.

Imagine how much energy is lost as an organisation when half the team commute to the office every day just to prove loyalty – instead of working in an environment where they are at their most effective. How many projects suffer because someone sits in the open with a migraine, instead of working productively from a secluded room. How much talent is lost because they’d rather find a company that doesn’t make them choose between their health and their career.

Fourth step – respond to the signals

When an employee says “I’m managing somehow” – this is not always an acknowledgement that all is well. It’s often the language of people who are afraid to open up to another person to avoid becoming a burden.

Learn to observe patterns rather than individual events. When someone often “forgets” meetings, or has “internet problems” just during a video conference, or has suddenly started working at odd hours (emails at 11pm and silence until noon) there may be days when illness prevents a normal rhythm, but shame prevents you from saying so.

Other signals that are easily overlooked:

• a sudden change from talkativeness to silence during meetings,
• holidays taken one day at a time, never taking a longer rest,
• avoidance of away meetings or integration,
• projects handed in at the last minute, although always with a backup beforehand.

Don’t confront this in public. Write privately that you see, for example, that the person has had a lot of technical challenges lately and if they needed support or some other form of collaboration, you are open or receptive to a conversation.

Of course, use common sense and critical thinking, as sometimes strange patterns can be the result of someone simply making money on the side.

Fifth step – don’t pretend to be an expert

When someone decides to tell you about their illness, most of us panic and do exactly what we shouldn’t. I know this because I’ve been through the other side of this conversation myself. I remember telling many people about my own health problems, and more than once I heard someone immediately start talking about their aunt who “had something similar” and got better thanks to diet or Rutinoscorbine because it seals blood vessels. And someone else assured me that “it will be fine”, as if I were a child with a shattered knee.

Therefore, when someone comes to you for an interview on this topic, simply ask them what they need at work. No drama, no advice. Focus on what is actually important and how to adapt the work so that he can continue to do what I am good at.

People don’t come for diagnosis or therapy. They come for empathy and normality with a bit of flexibility.

It can be just as important to ask about communication with the team. Ask, for example, “Is there anything I can do to help you communicate with the rest of the team, or do you prefer to control it yourself?”. This is important, as some people need complete discretion and others are actually looking for support in not having to explain to each individual why some days are more difficult.

For the employee – how to break down your own wall of silence

If you’re reading this, calculating whether to disclose your illness or continue to play a part in a show called ‘everything is fine’ – know that I understand your dilemma. Over the years I have watched people with chronic conditions navigate this minefield. For the rest, as I mentioned earlier, I myself was one of those people who are reluctant to talk about their challenges.

I am still able to talk about them mainly when I have dealt with them. I then share my experiences like anecdotes or show them as a form of learning. However, I believe that sharing openly about one’s problems, even if initially (as the B-HERO-S study says) it may turn out to be a negative experience for us, in the long run it is fully liberating and incredibly developing. Both for you and for your entire environment.

Remember, research data shows that when it comes to mental disorders (for example, depression, anxiety), most employees experience a good response from those around them after disclosing the problem.

Depending on the survey – as many as 87.7% or 74% of employees found the employer’s response supportive.

In the case of physical conditions, especially permanent disabilities, disclosure is sometimes easier, as the condition is often immediately apparent. However, the data suggests that also with these conditions, the majority of employers respond to the information sympathetically or at least correctly.

A study by Cornell University found that less than 10% of employees reported any immediate negative impact from disclosing their disability

Of course, each situation is individual and the degree of ‘positivity’ experienced also depends on the nature of the condition and the culture of the company concerned. For example, people with chronic illnesses with a fluctuating course (for example, rheumatism or migraine) may be concerned about the reaction of others, as these illnesses are often invisible and, in addition, sometimes require sudden breaks from work. Nonetheless, in this group too, the literature describes cases where, once a condition has been disclosed, the employee has been able to take advantage of flexible arrangements, receive sick leave or the possibility to work remotely in the event of an exacerbation of the illness, which in the long term promotes their productivity and employment for longer.

If you are still hesitant to talk openly about your illness, I fully understand this and in no way want to urge you to do so by force.

Perhaps you work in a company where, when someone takes L4, they don’t ask him or her “What’s wrong with you?” but go straight to the question “But when will you be back?”. Perhaps in your organisation flexible hours are a privilege for a select few, and someone is referred to in the corridor as “the one who keeps getting sick” rather than simply “Mark from marketing”. I know that little things like this can say everything about a company’s culture. That’s why, if I were in such an organisation, I would probably look elsewhere for myself.

However, if it is quite the opposite and the company culture is supportive and respectful the chances of being positively surprised increase dramatically.

When going into a conversation with your boss remember not to start with – “I’m sorry, but I have to tell you something…” – it’s not your fault or shame. It is better to present the illness as a fact: “I wanted to tell you that I have a medical condition that sometimes requires an adjustment of working hours. In practice, this means that I start later some days but make up for it in the evenings. Is this feasible in our team?”. Don’t come with just a problem either, come straight away with a proposed solution. “I need the ability to work remotely on days when XYZ. I can work normally then, but I can’t afford to commute to the company”. Or “I’d like to move my working hours to 10am-6pm because I go to rehab in the morning”. Of course, I realise that this is not possible in all companies or situations. Some establishments that have a shift system or operate specific hours may not be willing or simply have the capacity to make such concessions.

Additionally, be prepared for the other party’s reactions to vary. Don’t stress about it, it’s also not your fault that someone may be frightened or question whether you can handle it. Respond calmly to questions like “Can you cope with your responsibilities?”: “I’ve been coping for X years with this illness. The only thing that will change after this conversation is that I will stop wasting energy on hiding”.

Remember, you don’t have to prove to anyone that you are “sick enough” or “healthy enough”. You just need to find a way to do a good job in conditions that allow you to do so. If your company doesn’t understand this, the problem lies with them.

Conclude

Organisations that create a culture based on psychological safety and allow their employees to talk openly about challenges (including health) unlock innovation, engagement and forms of contribution that our current metrics cannot measure.

This does not require huge investments or complex programmes, but in the main, the courage to see each other as a whole, to recognise limitations as both part of leadership and another human being.

Transforming our companies and ourselves starts not with programmes, but with recognising that the artificial divide between “healthy” and “unhealthy” employees is both false and harmful, and that vulnerability and strength are not opposites, but working partners in constant symbiosis.

Our team members managing chronic conditions are not problems to be solved or risks to be managed. They are people whose struggles have taught them the strength our organisations desperately need. They are individuals who are not asking for mercy or handouts, but offering the opportunity to create workplaces where everyone can stop hiding and start contributing from their full humanity.

As leaders, do we have the courage to accept the invitation extended to us by colleagues struggling with illness? Do we have the strength to simply be human in spaces that for so long have required us to be everything – just not ourselves?