By accident I found out our nanny of 5 months takes antidepressant medication. I have two children she cares for on a fulltime basis and she hasn't shown any ups or downs or erratic behavior but now I'm obviously concerned. I feel like this is something she should've revealed to us at interview. I'm aware there are very different levels of depression but worry it could be something more serious. We like her very much and she's great with the kids but what if she goes off her meds? Do I have a right to ask her about this? Should I or can I let her go? Please advise! - Anonymous
46 comments:
To answer your questions:
No, you don't have the right to ask her about it. The same workplace rules apply to nannies as in an office job. No, you cannot let her go because she's on medication. If you do and she finds out the reason, she can (and should) sue you for discrimination.
How did you view her before you found out about the medication? That should be the way you view her now.
I have had terrible horrific side effect to the drug Reglan, (these side effects were similar side effects that can happen with anti-depressants). I had a DNAdose test done and have found out I am poor metaboliser of certain drugs and that many drugs I will have these side effects. After what I experienced on Reglan there is NO WAY I would let my children be looked after by someone on such medication and anti-depressant and even some migraine medication. The thing is they may be fine but then they reduce, increase or go cold turkey on the dose and BHAM...they are insane, seriously it can happen like that.
No. You absolutely do not have the right to ask her. If she seems fine, she likely is fine because she is on the medication. So many people are on anti depressants and anxiety medications and you would never know! I'm a nanny, and I have been on them for years, and have been fine since I started them back in high school. As long as she's being responsible and her medication is out of the children's reach, you should be glad she's on them.
I have a severe anxiety disorder. My employer found this out when she had to pick me up and I had a severe panic attack. Like bad like screaming... And you know what...I'm still employed.
I'm not medicated. I'm also very agoraphic and spent 6 months homebound 4 years ago which she also.found out by accident.
There are days I am terrified to leave my house but I do because I would do ANYTHING for my job. I remember being to scared to take a kid to a sport because I didn't wanna have a panic attack in public but I did it because if I failed to I would loose my job.
You can't fire her. Unless she is a danger to your kids. And depression is a broad spectrum she could be on the meds for OCD oR even anxiety. Maybe she gets sad in the winter. There are so many reasons she could be on them.
The fact that you would even consider firing her is appauling. She has been good to your family and the fact that she is on meds is HER BUSINESS.
As someone with an emotional disorder I can tell you that everyday is a struggle but every day that I do my job and do it.well is very rewarding... Being a nanny saved me...maybe it saved her too.
People with those type of problems know their limits and the fact that she is on meds is a huge plus. If she didn't feel she could safely work in child care she wouldn't
Oh and she could take you to court if you fire her for that reason which would not be hard to prove especially since she has done no harm to your family.
Don't be so quick to assume you know why she's on the medication. I took Zoloft for a long time, but I have OCD. My mom took Zoloft for her PMDD. I'm just saying, it's not necessarily for depression. Lots of medications can help treat things for which they weren't intended. As long as she is a good nanny, and she treats your family with respect, you owe her the same as far as I'm concerned. I wouldn't say anything. Unless you hires her through an agency that requires candidates to give a medical history or something, she doesn't have to disclose that she's on any medication. I don't currently take anything for my OCD, and it's under control, but my MB and DB don't know that I've ever been diagnosed. It doesn't affect my job. I work for two psychiatrists too! Anyway, please don't worry. Good luck!
It's actually illegal to ask specifics,other than do you have a condition that would effect your ability to care for children. You should be more concerned about the majority of people who receive no treatment. It sounds as if this person has been performing her job.
i understand your concern but as a nanny with depression myself mine is well controlled with antidepressants and you know she is not required to tell you about this mental illnesses are protected under IDEA and people with them can not be discriminated against when hiring or firing. Although i do understand with the recent nanny things in NYC I would be concerned as a parent. I might if i were you just monitor the situation and if you do mention it to her do so in a way of concern not like you are irritated with her. A mental illness is not their fault. good luck
NO YOU DO NOT!!
Sorry to shout, but this shouldn't even be a question. Would you be ok with your boss asking you what meds you're on? It is absolutely none of your business and I have to wonder how you found out in the first place. It is also none of your concern if she and her doctor choose to taper her off her meds. If she does go off them cold-turkey, it won't be good and it will probably mess with her mind but most responsible people understand that and go with doctor's orders. Your responsibility is to make sure your nanny is doing the best job possible, regardless of what meds she's taking.
How did you find out? Honestly, people go on antidepressants for a number of reasons, many of which are not depression (like when one is trying to quit smoking, for instance). It's her private business, and since she's medicated, she's obviously taking steps to remedy her problems. I think your reaction is far overblown, and I don't think you should fire her. Your post is a great example of the stigma attached to depression, and a reason many don't reach out to receive treatment.
I understand your concern, but no, you do not have the right to ask her about it. If you like her very much and think she's great with the kids, why on earth would you fire her? Sure, keep a closer eye on her behavior, and if it starts to change for the worse, then talk to her and/ore let her go.
My mom was on antidepressants for several years, and none of us kids had any idea until she told us ages later. She was always a good, involved, loving SAHM to us.
if it's not broke don't fix it - many many people these days are on meds LOL
Antidepressants can be taken for anxiety or depression--it levels out the serotonin imbalance. If she had a heart condition, she would be taking medicine for that. If she had high cholesterol, she might be taking pills for that. All of these things level out the chemicals in the body to balance out the biological condition. So, no you shouldn't be worried. She was born with a chemical imbalance and she's treating it--and as you said, she seems absolutely fine, and she is!
As with any job, no, you cannot confront her about it, nor was she legally obligated to tell you about it.
How on earth did you find out she takes antidepressants 'by accident?'
You have to go with you gut on this type of thing. If it doesn't feel right, you need to let her go. I wouldn't keep her if I were you.
I do not think that it is any of your business about her taking antidepressants. I was a nanny for three years for a family and I took antidepressants the whole time and they do not know. In my opinion her taking medicine like that is none of your business since it is not affecting her work with your children.
This is really none of your business. Depression is extremely common and she's received the treatment she needs to lead a normal life. I might feel differently if she had bipolar disorder or schizophrenia, since going off those medications can make a HUGE difference, (although I'm still not sure if I would think she should have to tell you) but if she goes off her antidepressant, it likely won't cause her to bring any kind of harm to your children.
Some antidepressants also have off label uses, like smoking cessation, weight loss, etc. You have no idea why she's on it and I don't think her medical history is your business.
This really frustrates me, I cannot stand the stigma placed against nannies who have a mental illness. I guess first of all, how did you find out? Because quite frankly I do not believe an employer “deserves” to know if their nanny struggles with depression. I know everyone is super sensitive right now because of the NYC Nanny--- but that woman was not mentally ill, she was in an active state of psychosis. Yes. She hit psychosis BUT MOST PEOPLE DO NOT. I’ll include a link at the end of this to the National Alliance on Mental Illness, and one to NIMH—a government run site. However just some quick stats..
“The National Institute of Mental Health reports that One in four adults-approximately 57.7 million Americans-experience a mental health disorder in a given year”
This means 1 in 4 nannies, 1 in 4 teachers, 1 in 4 parents, 1in 4 school administrators, 1 in 4 doctors, 1 in 4 nurses, I could keep going are struggling with some type of mental illness. This is SO HIGH and look HOW RARE tragedies like the NYC nanny occur. Most people do not reach a level of psychosis, and especially with depression… it is probably the least stigmatized in this nation.
“The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.”’
She has been with you for 5 months and you haven’t noticed anything. So clearly her treatment plan is working, and that’s amazing. Why does it matter to you that she is being treated—all that matters to you is how her treatments are working. If she was being erratic, not performing well, etc I would understand but to me your question of “should I/could I let her go” is absolutely absurd. You are going to let her go because she got TREATMENT and behaved normally at her job? I am really trying to not get fussy with you, I just really want you to think about this. Think about what you would be saying to her. Because what I’m hearing from you is: “You are a great nanny, I really liked you for 5 months, but now because you took personal responsibility for your health, behaved in a proactive manner, and you take AN ANTIDEPRESANT (god bless imagine if you found out your nanny has taken lithium or another antipsychotic since she was a child) you are no longer good enough to work for me”. Is that how you feel? I really doubt it, I really hope you are just following in the path of the fear, and that you will take the time to educate yourself on mental illnesses before you make a decision.
http://www.nami.org/template.cfm?section=about_mental_illness
http://www.nimh.nih.gov/index.shtml
I used to believe that people who took antidepressants were somehow permanently damaged and to be avoided. And then... life tossed me some curve balls. I both appreciate and wince at this question. The stigma is so misguided.
Many many parents are on meds at this point. A number perhaps unnecessarily, some have had their lives changed for the better in a big way. Many use meds temporarily. I did. And I went off of them both the wrong and the right way. No babies were harmed. No adults were harmed. But I would not have been able to work without them at the timeand I've changed my mind about judging others who experience depression and seek medical care. It could most definitely be you one day. Yes, it could.
Im not a doctor, but in my experience- the major signals that your nanny is struggling would be: irritability, lots of crying, marked change in introversion (assuming she's not manic also), lethargy, complaining and general unhappiness. These are all pretty obvious in a short period of time. AND depression occurs for "normal" people who suddenly aren't feeling "normal". So anyone you hire may potentially become the monster you seem to fantasize in your nanny. It's an understandable question, considering recent news about the NYC nightmare (and considering your unfamiliarity), but that your nanny is taking care of herself by taking meds for the time being is a major sign that she is self- monitoring and healthy. People with emotional pain do all kinds of jobs in the world as long as they aren't debilitated by it. You will know when you see debilitation. It's impossible to hide I think.
This is a very complicated issue, especially as you have already hired this nanny. If her depression is severe, she is covered by the ADA Act. If not, then she is not. Either way, you cannot ask about mental illness, but can require a routine physical exam IF you do this for all nannies you hire. Beyond that, you may not inquire nor was she in any way obligated to disclose this to you during hiring if her illness has never impacted her job performance.
This is the best summary wording I could find from the eeoc.gov website, "Basic rule: The ADA strictly limits the circumstances under which you may ask questions about disability or require medical examinations of employees. Such questions and exams are only permitted where you have a reasonable belief, based on objective evidence, that a particular employee will be unable to perform essential job functions or will pose a direct threat because of a medical condition."
Thus, if your nanny has continued to perform her job at her usual, presumably excellent level (since you are not complaining about her performance), you would not have any basis to ask her about medical issues. If she does show a concerning change in job performance, you can ask for a medical eval and doctor's note. If you have ANY safety concerns you can ask questions related to the disability and require medical clearance. You are then required to make "reasonable accommodations," but NOT to automatically continue employing her if it would cause you "undue hardship" such as significant expense.
People take antidepressants, as you said, for a variety of reasons some of which are not even for depression! This includes: anxiety disorders which includes OCD, premenstrual mood symptoms, occasional treatment of sexual disorders, eating disorders and chronic pain. So do not just assume she has a history of depression. Regarding depression, I have worked with very high functioning people whose job performance has never been adversely effected and very low functioning people who are on SSI/SSDI for severe depression.
Generally, for a first episode of Major Depressive Disorder (MDD), we recommend staying on meds for 4-6 months after symptoms resolution, longer if the patient wants to be on the meds. For a second episode, opinions vary, but commonly we recommend staying on meds for 2 years after recovery. After a 3rd episode of MDD, we generally recommend lifelong maintenance therapy.
You have no idea what your nanny's history is and no right to ask unless you have job performance or safety concerns. She may go off her meds at some point and it may be the right clinical choice, or not. That is not for you to judge.
You can fire her or lay her off at any time for no reason or any reason EXCEPT discrimination for a protected class (which includes mental illness with no impact on performance). Ultimately, it is your choice and your children. You need to feel safe leaving your kids with her. But I gotta say, even as a psychiatrist, I would not refuse to hire someone with a history of MDD or being on SSRIs unless I saw concerning behavior or changes. Please, if you do let her go simply because you cannot get your mind at ease, give her an excellent letter/reference and a good cover story. It really does not sound like this nanny did *anything* wrong based solely on your post.
OP: I was wondering...how did you find out about her meds "by accident?" Like, did you see the meds in her purse? I am just being nosy...
Anyway, there is a huge stigma regarding mental illness and like any other illness, it is very treatable. It looks like your nanny is taking the necessary measures to treat her disease. And it appears to be working fine since you see no ups and downs. Why would you think she would go off her meds? Would you still think this if she were taking meds for high blood pressure or diabetes?
I know many nannies and mothers who are on anti-depressant/anxiety medication who function very well. They have a disorder and are effectively and responsibly treating it and it does not interfere w/their duties regarding the children.
Your nanny probably did not disclose it to you prior because she had no legal or moral obligation to do so. Perhaps she sensed you would react the way you are and decided against it. She had absolutely no obligation to disclose she was on these meds and for you to be upset over this is very unreasonable OP.
Enjoy the great nanny you have. Count your blessings.
A great nanny is priceless.
Terminating her employment would be wrong at this point, I believe. If her behavior is not an issue, and there are no "mood" issues, you should leave it be. Someone's personal medical issues should be and are none of your business if it doesn't effect her work performance. Making a judgement based on her taking anti-depressants would be very wrong, especially because there could be a multitude of reasons for her taking them.
One of my friends takes them because of her Pmdd irritability, and nothing else. Would severe Pam's symptoms be something that are YOUR employers business? Would it be acceptable for you to have to be sat down and have a discussion about your personal medical stuff... I think not.
I myself was on an anti-depressant for something that had nothing to do with depression. I had insomnia for a while and one specific med for for depression is used as a med for insomnia. Should that prevent me from maintaining may chosen profession? Is insomnia something I should have to disclose at an interview? Hell no.
Also, who says that this is not something she started to take AFTER she was hired.
If her work performance is not an issue, than you have no reason to discuss this with her. If you have concerns because of her behavior, then THAT is what you need to address. If there are no issues other than you found her prescribed medication... Leave it be.
Medications can dispensed for a multitude of reasons. Jumping to conclusions based upon a potentially incorrect assumption would be a big mistake on your part. Especially if you really like your nanny and her work thus far.
Not only that, but please remember that if you let her go based upon something like this, and she finds out... You are opening up the door to being sued for discrimination and wrongful termination... Even in at at will state.
If you have concerns based upon finding her medication, I suggest you just be more observant about things around the house and with the kids. If there is no issue, great. If there are issues, address those. Not her Rx.a
Please post this anonymously....I am a nanny on antidepressants. It does not interfere with my ability to do my job well. All it means is that your nanny is managing her condition. I have for over 10 years. You could always have an open discussion about it. But please don't hold it against her if you feel she is more than capable of taking good care of your children.
Oh and some people take Anti-Depresants for Menere's Diesease (spelling sorry) its an inner ear thing. Anti Depressants can also help with quitting smoking. When I posted my comment, I was sure people would tell me to quit my job but as you can see...we have all been there.
As a nanny who has struggled with depression for many years, I think that you would be able to tell if she goes off her meds or needs her meds tweaked. The signs might include:
Irritability, sleeplessness or excessive sleeping, loss of or increase in appetite, calling in sick more frequently, or coming to work but not being "on", lack of care about personal grooming, a detached attitude, lack of willingness to do the normal activities she does with your kids, apathy, and a generally "disconnected" attitude.
If she's been doing a good job for you up until now, then your best bet is to adhere to what you are legally allowed to do, and ask her nothing.
I am going to guess that you are concerned in part because of the horrible tragedy that occurred in NYC with the Krim family. Please remember that people who were around that nanny all say they DID NOTICE some of the signs I listed above. I don't know if any of them acted on what they saw.
And just to emphasize a point made a few times above - you already likely know a number of people who have a mental illness. The stigma persists, despite the fact that many folks live perfectly normal lives with the help of meds, therapy, or a combination of the two. That's why no one goes around declaring, "I am mentally ill!"
Please don't buy into the stigmas.
I'm glad so many people have agreed that mental illness is not someone's fault and that there are plenty of people on antidepressants who are great at their job.
However, "A nanny named bear" FYI I am an unmedicated bipolar patient. Does this make me unfit to be a nanny? Rhetorical question, because no of course it does not. I'm great at my job and I know how to hold myself together at work.
Future Nurse, thanks for the links. You are always so level-headed and full of medical info.
Chris, what did Reglan do to you? If its been less than two years since your injury, find a lawyer. Reglan locked my jaw for six hours. Awful, dangerous medication. I took it post surgery for nausea.
Iphone user who cant pick a moniker :I'm not even going to read anyone else comments but I will tell you: 1. How would you feel if your nanny wanted to ask you if you were stable and if you were taking any antidepressants or anti-anxiety medications? After all, what if you suddenly stop taking meds and become a lazy uncaring mother who cant get out of bed becausee you are too depressed? Sure she's working for you. But don't assume the worst? Is this a med for sleeping? Flight anxiety? Or a minor daily maintenance dose for some emotional troubles she is going through? Honestly if it bother you so much, and you won't fire her, just tell her you wanted to check in and ask if she needed someone to talk to bc you noticed her medication. And you want her to always feel like she can open up to you if she needs an ear. May I ask how you know what she is taking? And can you say what it was called?
This is one of the best posts I've ever seen on ISYN. I know it doesn't personally have much to do with nannies/children in particular but like another person said above, so many people take medication for depression and other causes, this was a very necessary conversation. Many of us, myself included, need to be educated. When I was younger I was seriously abused and the Drs told me I had PTSD. I thought that was only something a soldier coming home from war could get but that isn't true. I was placed on an anti anxiety medication and it's helped tremendously. Many employers don't know the people working for them have some kind of disorder and if it doesn't inhibit them from doing their job it really shouldn't be anyone's business. Most people function very well with the aid of medication and shouldn't be judged for it. Thank you for writing in, OP. It's better you came here for advice then just firing your nanny over this. You say you love her and she's good to your children so just try your best to be supportive of her. Quite a few here listed symptoms to watch out for just in case your nanny is taking medication for depression, etc. Do keep in mind please that many of these drugs have duel purposes though! Good luck, I hope the best for you and your nanny. :)
I'm very curious to know how you accidently found this out.
If you were snooping maybe you do need to let her go as you obviously do not trust her.
That is what your choice to keep her employed or not needs to be based on. Do you trust her completely with your children? It's a yes or no answer.
My Dad has bipolar and has successfullly raised 5 kids. Since my mum tried to sue my Dad for custody he had to prove to the courts that he was fit to be a parent - he is a really wonderful parent and I am super greatfull to have him as a Dad. My best friend is on anti- depressants to retrain her bladder. Not everyone is on medication for depression and sometimes those who are, are really amazing brilliant people.
I am kind of on the fence with this one to be honest...I have had friends with Bipolar disorder who really did have some extremely scary behavior. They were able to hide their illness amazingly well from those who they were uncomfortable opening up to. I know that many people who suffer from these disorders are able to keep their disease under control through medication and therapy. I guess it really should be judged on a case by case basis, but to compare a nanny's employer to an office employer when it comes to mental health is really unfair. The nanny is in charge of young children and the parents need to feel 100% confident that their children are safe. If this mother feels uncomfortable for ANY reason, she has a right to let the nanny go. I'm not saying she is right to do it but she needs to follow her gut. Many nannies are at will employees, which means they can be let go for any reason and can also leave for any reason. OP, follow your gut, do what it tells you to do.
Ask if you would like to be sued if you ever fire her. It's none of your business unless it negatively effects job performance, and it doesn't sound like it is.
As a person who suffers from an anxiety disorder and manages it with a combination of prescription drug and other therapies, I am sort of offended you would have such a knee-jerk reaction to be "concerned" even though you have no reason to. The stigma of mental illness continues to hurt functional people suffering from disorders around the world, and your reaction perpetuates that cycle.
How did you find out her personal medical information?
I definitely do not think you should ask her as it is none of your business. If she is caring for your children fine then the medicine is doing its job. As above posters have mentioned she could be on the medicine for a variety of issues. I take a depression medicine for my anxiety, not for depression and while I manage it fine on my own it is genetic and my doctor would rather me be on the medicine. It does not affect my ability to care for children in the slightest. So before you jump to conclusions just take a deep breath and realize she could have it for many different reasons and instead of seeing she is taking the medicine watch for differences in her behavior instead.
The NYC nanny backlash starts.
1. You can't ask her. She was not obligated to tell you. You cannot give that as a reason for firing.
2. As a parent you have the right to feel 100% comfortable with the person caring for your child. Maybe the reasoning behind your comfort or discomfort isn't fair, but it's still your right.
If you feel comfortable keep her. If you don't let her go.
You & your kids deserve a nanny you trust and your nanny deserves to work for employers that trust her.
My opinion is - they are your kids. If you are uncomfortable in the least with someone caring for your kids that needs to be on meds - then let her go and hire a new person. Everyone here is jumping on you because it seems half of the world loves to take pills for every little problem these days. Bottom line is this is not an office job, these are your kids. If you have a doubt, you have a right to let her go no matter what the reason. Nannies get let go for lesser things than this - that is why the nature of the job in itself is unpredictable. The work is extremely personal, and you can never take a chance with your children. Don't listen to anyone, listen to your heart.
I want to thank everyone for the amazing advice, I learned a lot.
I never even thought of our nanny having something other than an
emotional illness, like insomnia or migraines. And I never meant to
imply I wanted to fire her, we love her, I just want to be a
responsible parent. I will leave things be and just keep a watch for
some of the signs that were given for a change in behavior, just in
case it is something more serious than depression. As for how I found
out, I saw the medication through a mesh side pocket of her backpack.
Be on the look out for changes in her behavior. If you notice them let her go before the kids suffer at the hands of someone who isn't well. That's your job to protect your kids. Looking out to make sure the nanny is still doing well is smart and is nobody elses responsibility but your own. Good job for being a concerned parent. Parenting isn't the area that you should be careless in. So I agree with you OP. Keep an eye on her.
OP,
How do you know she's taking it for depression? Some medications have multiple uses.
My brother used to take Prozac. Prozac can be used for depression and there are a great many people who only know this use.
But Prozac can also be used for anti-anxiety.
The question remains, how do you know it's for depression?
anon,
There is such a thing as law and it does apply. No, you're not serving any higher purpose without another reason. As OP said, no ups and downs, no problems. Therefore, no reason.
It's one thing to take this information and do further investigation (nanny cameras, anonymous checks, communication with the children, etc.) and then react to subsequent information. It's wholly another to freak out on this one tidbit and terminate a person's livelihood.
If for no other reason than, God only knows what the next person is on.
You certainly have the right to fire any person, for any reason, that is working with your kids. I am a psych RN and know that meds are very common, I also know how they can cover severe problems. I had a nanny that suddenly stopped Effexor and became psychotic and tried to kill my son. It is called AT WILL employment for a reason, go with your gut, I wish I had. Your kids are your first priority, over anyone's privacy, employment, whatever. An employee could certainly quit a job if she felt her employer was unstable, like it or not, the stigma is there, and sometimes for good cause.
Also, the ADA does not cover a single, private employer. People are free to discriminate in their homes, for obvious reasons, the Courts are not going to force someone to have a nanny they feel is unsafe.
I would like to point out that there are may different things anti-depressants are used to treat.
1. some sleep issues
2. Fibromyalgia (a chronic pain disease)
3. seasonal depression on occasion
4. anxiety problems
5. to treat OCD
6. to treat PMS
7. to stop smoking
8. to treat depression like symptoms)
Anti depressants are used for a LOT of different things. Many people take them for chronic unexplainable pain, and sleeping issues such as chronic fatigue....
OR maybe your children make her anxious lol, and they are used to treat that.
Regardless of if she i son them because her granny died, she needs help with her pms or to quite smoking, or she has a sleeping disorder, her being on antidepressants has not affected her job, and therefor does note effect you
I'm on Citolopram, but not for depression, for severe anxiety. I realize there is a stigma, and I didn't tell the family I was working for, I know that it has nothing to do with how I care for their kids...turns out, both MB and DB are on the same drug.
if you are feeling depressed then consult with because it is caused by a sleeping issue known as clinomania. Where a person has no control over their sleeping desires and that person called clinomaniac
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