‘Disability’ has a special legal meaning under the Equality Act, which is broader than the usual way you might understand the word. Even if you don’t think you have a disability, the Equality Act may protect you from discrimination if your mental health problem fits its definition of disability.
The Equality Act says you have a disability if you have a physical or mental impairment that has a substantial, adverse, and long-term effect on your ability to carry out normal day-to-day activities.
The focus is on the effect of your mental health problem, rather than the diagnosis. So you need to show that your mental health problem:
has more than a small effect on your everyday life
makes things more difficult for you, and
has lasted at least 12 months, is likely to last 12 months, or (if your mental health problem has improved) that it is likely to recur.
Examples of ‘substantial adverse effect’
Simon has obsessive-compulsive disorder (OCD). He has to check and recheck whether lights are switched off and doors are locked. This can make him late for work or other appointments. His obsessive thoughts often distract him from activities that he is doing and disrupt his daily routines. His mental health problem therefore has a substantial adverse effect on the way he does things.
Examples of ‘long term’
Jenny has had depression for 10 months and the doctor says it will be likely to last at least another 4 to 5 months.
Selina has bipolar affective disorder. She had her first and second episode in January 2013, then a third episode in January 2014. Even though there was a gap between her second and third episode, her mental health problem is considered to have continued over the whole period (in this case, a period of 13 months).
What if I’m getting medication or treatment for my mental health problem?
If you are getting some treatment or taking medication for your condition, you ignore the effect of your treatment when deciding whether your condition is having a substantial, adverse effect on your daily activities. This means the law is looking at how your condition affects you without your treatment or medication.
Mohammed has long-term anxiety and is being treated by counselling. Anxiety would normally make him find simple tasks difficult. Because he has counselling, he is able to get up and go to work.
The Equality Act says you have to ignore his treatment in deciding whether his mental health problem has a substantial adverse effect on his day-to-day activities and so he has a disability.
What if I had a disability in the past?
You are still protected from discrimination if you had a disability in the past. That means that if your past mental health problem had a substantial, long-term and adverse effect, you will get the protection of the Equality Act.
Four years ago, Mary had depression that lasted 2 years and had a substantial effect on her ability to carry out normal day-to-day activities. She has not experienced depression since then.
If Mary is treated worse by her employer because of her past mental health problem, she will be protected by the Equality Act.
Checklist: Is my mental health problem a disability?
You can ask yourself these questions:
Do I have a mental or physical health impairment?
Is it long-term (meaning lasting more than 12 months or likely to do so)?
Does it have a more than minor adverse effect on my day-to-day living, if I discount my treatment or medication?
If you answered “yes” to all three questions, then your mental health problem could get the protection of the Equality Act.
If you want to get the protection of the Equality Act, you may find it helpful to get some evidence from your GP, or another medical professional. You can ask them to write a letter saying whether they think you have a disability under the Equality Act. It would be particularly useful if they can give their opinion on the answer to each of these three questions.
Esra doesn’t consider herself disabled because she doesn’t receive disability benefits and she is physically healthy.
Esra has been living with an anxiety disorder for the past 3 years. Because of this, it takes her a longer time to do things like get up in the morning, dress herself for the day and do the shopping. She takes medication to control the symptoms.
Esra would be protected by the Equality Act because she has:
a mental impairment – an anxiety disorder
it is long term – she has had it for the past 3 years
it has a substantial effect on her daily life – her mental health has a major effect on her daily life when you ignore the effect of her medication
it has an adverse effect – her mental health problem makes things more difficult for her.
A disability is any continuing condition that restricts everyday activities. The Disability Services Act (1993) defines ‘disability’ as meaning a disability:
which is attributable to an intellectual, psychiatric, cognitive, neurological, sensory or physical impairment or a combination of those impairments
which is permanent or likely to be permanent
which may or may not be of a chronic or episodic nature
which results in substantially reduced capacity of the person for communication, social interaction, learning or mobility and a need for continuing support services.
With the assistance of appropriate aids and services, the restrictions experienced by many people with a disability may be overcome.
Types of disability
The main categories of disability are physical, sensory, psychiatric, neurological, cognitive and intellectual. Many people with disability have multiple disabilities.
A physical disability is the most common type of disability, followed by intellectual and sensory disability. Physical disability generally relates to disorders of the musculoskeletal, circulatory, respiratory and nervous systems.
Sensory disability involves impairments in hearing and vision.
Neurological and cognitive disability includes acquired disability such as multiple sclerosis or traumatic brain injury. Intellectual disability includes intellectual and developmental disability which relate to difficulties with thought processes, learning, communicating, remembering information and using it appropriately, making judgments and problem solving. Intellectual disability is the result of interaction between developmentally attributable cognitive impairment, attitudinal and environmental barriers.
Psychiatric disorders resulting in disability may include anxiety disorders, phobias or depression.
Stress can be defined as the degree to which you feel overwhelmed or unable to cope as a result of pressures that are unmanageable.
What is stress?
At the most basic level, stress is our body’s response to pressures from a situation or life event. What contributes to stress can vary hugely from person to person and differs according to our social and economic circumstances, the environment we live in and our genetic makeup. Some common features of things that can make us feel stress include experiencing something new or unexpected, something that threatens your feeling of self, or feeling you have little control over a situation.1
When we encounter stress, our body is stimulated to produce stress hormones that trigger a ‘flight or fight’ response and activate our immune system 2. This response helps us to respond quickly to dangerous situations.
Sometimes, this stress response can be an appropriate, or even beneficial reaction. The resulting feeling of ‘pressure’ can help us to push through situations that can be nerve-wracking or intense, like running a marathon, or giving a speech to a large crowd. We can quickly return to a resting state without any negative effects on our health if what is stressing us is short-lived 3, and many people are able to deal with a certain level of stress without any lasting effects.
However, there can be times when stress becomes excessive and too much to deal with. If our stress response is activated repeatedly, or it persists over time, the effects can result in wear and tear on the body and can cause us to feel permanently in a state of ‘fight or flight’ . Rather than helping us push through, this pressure can make us feel overwhelmed or unable to cope.
Feeling this overwhelming stress for a long period of time is often called chronic, or long-term stress, and it can impact on both physical and mental health.
Stress is a response to a threat in a situation, whereas anxiety is a reaction to the stress.
What makes us stressed?
There are many things that can lead to stress. The death of a loved one, divorce/separation, losing a job and unexpected money problems are among the top ten causes of stress according to one recent survey 5. But not all life events are negative and even positive life changes, such as moving to a bigger house, gaining a job promotion or going on holiday can be sources of stress.
What are the signs of stress?
When you are stressed you may experience many different feelings, including anxiety, fear, anger, sadness, or frustration. These feelings can sometimes feed on each other and produce physical symptoms, making you feel even worse. For some people, stressful life events can contribute to symptoms of depression.6 7
Work-related stress can also have negative impacts on mental health 8. Work-related stress accounts for an average of 23.9 days of work lost for every person affected 9.
When you are stressed you may behave differently. For example, you may become withdrawn, indecisive or inflexible. You may not be able to sleep properly 10. You may be irritable or tearful. There may be a change in your sexual habits 11.Some people may resort to smoking, consuming more alcohol, or taking drugs 12. Stress can make you feel angrier or more aggressive than normal 13. Stress may also affect the way we interact with our close family and friends.
When stressed, some people start to experience headaches, nausea and indigestion. You may breathe more quickly, perspire more, have palpitations or suffer from various aches and pains. You will quickly return to normal without any negative effects if what is stressing you is short-lived, and many people are able to deal with a certain level of stress without any lasting adverse effects.
If you experience stress repeatedly over a prolonged period, you may notice your sleep and memory are affected, your eating habits may change, or you may feel less inclined to exercise.
Some research has also linked long-term stress to gastrointestinal conditions like Irritable Bowel Syndrome (IBS), or stomach ulcers14 as well as conditions like cardiovascular disease15.
Who is affected by stress?
All of us can probably recognise at least some of the feelings described above and may have felt stressed and overwhelmed at some time or another. Some people seem to be more affected by stress than others. For some people, getting out of the door on time each morning can be a very stressful experience. Whereas others may be able to cope with a great deal of pressure.
Some groups of people may be more likely to experience stressful life events and situations than others. For example, people living with high levels of debt, or financial insecurity are more likely to experience stress related to money16, 17, people from minority ethnic groups or whose who are LGBT (lesbian, gay, bisexual and transgender) may be more likely to experience stress due to prejudice, or discrimination18,19,20, and people with pre-existing or ongoing health problems may be more likely to experience stress related to their health, or stress due to stigma associated with their condition.
How can you help yourself?
There are some actions that you can take as an individual to manage the immediate, sometimes unpleasant, signs of stress and identify, reduce, and remove stressful factors that may cause you to feel overwhelmed and unable to cope. If you feel comfortable, talking to a friend or close colleague at work about your feelings can help you manage your stress.
However, sometimes individual actions on their own are not enough to reduce long-term stress for everyone. We can often be affected by factors that are beyond our direct control. Communities, workplaces, societies, and governments all have a role to play in tackling these wider causes of stress.
1. Realise when it is causing a problem and identify the causes
An important step in tackling stress is to realise when it is a problem for you and make a connection between the physical and emotional signs you are experiencing and the pressures you are faced with. It is important not to ignore physical warning signs such as tense muscles, feeling over-tired, and experiencing headaches or migraines.
Once you have recognised you are experiencing stress, try to identify the underlying causes. Sort the possible reasons for your stress into those with a practical solution, those that will get better anyway given time, and those you can’t do anything about. Take control by taking small steps towards the things you can improve.
Think about a plan to address the things that you can. This might involve setting yourself realistic expectations and prioritising essential commitments. If you feel overwhelmed, ask people to help with the tasks you have to do and say no to things that you cannot take on.
2. Review your lifestyle
Are you taking on too much? Are there things you are doing which could be handed over to someone else? Can you do things in a more leisurely way? You may need to prioritise things you are trying to achieve and reorganise your life so that you are not trying to do everything at once.
3. Build supportive relationships
Finding close friends or family who can offer help and practical advice can support you in managing stress. Joining a club, enrolling on a course, or volunteering can all be good ways of expanding your social networks and encourage you to do something different. Equally, activities like volunteering can change your perspective and helping others can have a beneficial impact on your mood.
4. Eat Healthily
A healthy diet will reduce the risk of diet-related diseases. There is also a growing amount of evidence showing how food can affect our mood. Feelings of wellbeing can be protected by ensuring our diet provides adequate amounts of nutrients including essential vitamins and minerals, as well as water.
5. Be aware of your smoking and drinking
If possible, try to cut right down on smoking and drinking. They may seem to reduce tension, but in fact they can make problems worse. Alcohol and caffeine can increase feelings of anxiety.
Physical exercise can be an excellent initial approach to managing the effects of stress. Walking, and other physical activities can provide a natural ‘mood boost’ through the production of endorphins. Even a little bit of physical activity can make a difference, for example, walking for 15-20 minutes three times a week is a great start.21
7. Take Time Out
One of the ways you can reduce stress is by taking time to relax and practicing self-care, where you do positive things for yourself. Striking a balance between responsibility to others and responsibility to yourself is vital in reducing stress levels.
8. Be Mindful
Mindfulness meditation can be practiced anywhere at any time. Research has suggested it can be helpful for managing and reducing the effect of stress, anxiety, and other related problems in some people22. Our ‘Be Mindful’ website features a specifically-developed online course in mindfulness, and details of local courses in your area.
9. Get some restful sleep
Sleep problems are common when you’re experiencing stress. If you are having difficulty sleeping, you can try to reduce the amount of caffeine you consume23 and avoid too much screen time before bed24. Writing down your to do list for the next day can be useful in helping you prioritise but also put the plans aside before bed25. For more tips on getting a good night’s sleep read our guide ‘How to sleep better’.
10. Don’t be too hard on yourself
Try to keep things in perspective and don’t be too hard on yourself. Look for things in your life that are positive and write down things that make you feel grateful.
If you continue to feel overwhelmed by stress, seeking professional help can support you in managing effectively. Do not be afraid to seek professional help if you feel that you are no longer able to manage things on your own. Many people feel reluctant to seek help as they feel that it is an admission of failure. This is not the case and it is important to get help as soon as possible so you can begin to feel better.
The first person to approach is your family doctor. He or she should be able to advise about treatment and may refer you to another local professional. Cognitive Behavioural Therapy (CBT) has been shown to be helpful in reducing stress by changing the ways we think about stressful situations26, this might include focusing on more positive aspects of a situation and reassessing what their likely impact might be. Other psychosocial interventions that can be helpful include brief interpersonal counselling, which can give people the opportunity to discuss what causes them to feel stress and develop coping strategies; and mindfulness-based approaches27.