How do you know if you need time off work?

[phonecaseisbroken]

I've been on antidepressants for the last 5 years and I've attended weekly counselling for most of that time too. I had a serious crash in my mental health 5 years ago for the first time and if it wasn't for the medication I don't know where I'd be now.
I work full time in a reasonably stressful (but not totally unmanageable levels of stress) job. My manager is nice but not overly helpful even when I've been so overwhelmed I'm in tears - "just manage your time better". To be honest I now don't even tell him when I feel overwhelmed with work because he doesn't do anything about it because "it's part of the job role" so there doesn't seem much point.
I've had a lot of stress at home over the last six months and I'm reaching the end of my ability to cope. I'm aware that my mental health in general isn't the most robust and I really do need the weekly therapy to function. I've noticed some symptoms of how I felt 5 years ago start to creep in at times.
I'm not good at asking for help and my coping mechanism is to keep going. I'm afraid of what my manager would think if I phoned in sick with stress. I can manage the stress at work but I can't deal with that stress alongside the home stress. How bad do things have to be to legitimately take some time off sick? It's nearly the end of our annual leave year so I only have a couple of days left and ideally I'd keep them for emergencies.

To add, I've never had any time off sick in this job and in previous jobs in the last four years I've had 2 days off sick in total.

I went off sick for what ended up being 8 weeks due to non-work related stress. I was teary, I had fatigue and anxiety and was struggling to sleep, I struggled to make decisions. It felt like my brain was running in toffee, I felt 'stupid'. I took a week off to start off with, then a month, then tried to go back too early and ended up taking another month, then returning on a phased return.

Please don't leave it too long to take time off. Time off and a serious word with work is better than being off for weeks.

I got signed off with a UTI to start with. 2 weeks. However that was all I needed (well 2 weeks and a 2 week holiday already planned)

go to your GP and set out what you have set out here.

Explain that you are feeling [amend as needed] tearful / forgetful / unwell / not eating / over eating / sore throat / eczema flare / UTI etc and that it feels similar to what happened 5y ago. Explain what happened then and that this worries you.

ask them to sign you off but say you are so worried that if you say it is for MH reasons that you will be thought of as lesser and therefore can they say it is for one of the physical reasons this time and if you need longer than 2 weeks (which you probably will if you are burnt out) that you would be happier if it said burn out / MH reasons on the second note.

Thank you.

Can you get signed off from the outset? I thought you had to self-certify first for 7 calendar days before a GP would sign you off. It's the ringing up my boss and having to explain what's wrong with me for those 5 working days that worries me, whereas if I had a piece of paper from a doctor I think he'd be less likely to try to argue with that.

I remember being referred to a psychiatrist who told me I needed to triple my dose of antidepressants I was on when I was going through a bad patch. It did allow me to carry on working while I had weekly therapy and got better slowly.

Phone in with a UTI for the first week. And see your Gp on day 1 for your record.

doc will then sign you off for further 2 weeks & a good one should recommend talking therapy. Exercise. Sleep. Seeing good friends.

they may also suggest a tweak in dose of meds. Or even whether you have considered HRT.

Yes, take time off exercise, rest, see friends etc.

But here's the thing. In order to maintain good mental health when you go back to work, put yourself as a priority and still exercise, rest and see friends - whatever makes you feel well and good when you are off must be continued all the time when you are working. It's like a diet, it's no good if you eat less for several months and then go back to overeating.

You set up boundaries with work which are not crossed. You make time to do all the things that are important to you and fit work around that, never the other way round.

Great advice.

Meds give me the motivation and clarity to know that I need to pursue other positive stuff too - gym, time outdoors, social activities, hobbies (read/knit ) , eat well and sleep well.
Maybe reconsider your job (if possible I mean ) - I say this, as I have done this in the past !