Sick note for anxiety or depression

Anxiety and depression are among the most common reasons people are signed off work in the UK, and they are treated in exactly the same way as a physical illness when it comes to fit notes, sick pay and your rights at work.

That is the law. Whether it always feels that way is another matter, which is why it is worth knowing precisely where you stand before you have the conversation.

Yes, you can be signed off for anxiety or depression

A doctor can issue a fit note for a mental health condition on the same basis as any other: they assess you, form a clinical view that you are not fit for work, and certify a period. There is no separate category, no higher bar, and no requirement to have been to a specialist first.

Your employer must treat that note the same as one for a broken leg. Sick pay works the same way, the 7-day self-certification rule works the same way, and the protections around dismissal work the same way.

The first week is yours

For the first 7 calendar days you self-certify. You tell your employer you are unwell and confirm the dates in writing when asked – no doctor, no appointment, and a general reason is enough. “Illness” or “medical reasons” is acceptable; you do not have to write anything about your mental health.

Those 7 days include weekends and bank holidays. Use them. A great many people scramble for a GP appointment on day one when they do not need a note until day 8, which adds pressure at exactly the wrong moment. Our free self-certification letter generator produces one in about a minute.

What the fit note will say

A fit note has to give a reason and cannot be left blank. What it will not do is set out your symptoms, your history or your treatment.

Depending on what the doctor has assessed, it might say “anxiety”, “depression”, “low mood”, “stress”, or something more specific. If the wording matters to you – and for a lot of people it does – raise it in the consultation. Doctors are asked this regularly and it is a reasonable question. The note only needs to say enough to explain why you are not fit for work.

What your employer receives is the note. Not your records, not the consultation, not a diagnosis history.

“May be fit for work” and why it matters here

The second option on a fit note says you may be fit for work if certain adjustments are made – reduced hours, amended duties, a phased return, or a change to the workplace.

For anxiety and depression this is often more useful than a straight “not fit for work”. The obstacle is sometimes a specific part of the job rather than the whole of it: client-facing work during an acute period, a commute at rush hour, a particular working pattern, an unmanageable volume. A note that names what would help gives your employer something to act on.

It is advice, not an instruction. If your employer cannot accommodate the suggestions, the note is treated as “not fit for work” and you stay off.

How much do you have to tell your employer?

Less than most people assume.

During self-certification, a general reason. After day 8, whatever the fit note says. Beyond that, you are not obliged to describe your symptoms, explain your treatment, or discuss your personal circumstances with your manager.

Your employer cannot approach your GP for more information without your consent, and you can refuse. If they want a fuller picture the proper route is an occupational health assessment – and even then they receive an opinion on your fitness for work and what adjustments would help, not your clinical details. You can ask to see that report first.

Health information is special category data under UK GDPR. Your employer should collect only what is genuinely needed, store it securely, and limit who can see it.

When a mental health condition is a disability

This is the part worth understanding properly, because it changes your employer’s obligations.

Under the Equality Act, a condition is a disability if it has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities. “Long-term” generally means it has lasted, or is likely to last, 12 months or more. “Substantial” means more than minor.

Anxiety and depression can meet that test, and frequently do. Three points people get wrong:

• You do not need a formal diagnosis label – what matters is the effect on your daily life, not the name of the condition.
• Fluctuating conditions still count – if the effect recurs, it is assessed on how it would be without treatment, so being well at the moment does not remove the protection.
• Nobody has to have used the word “disability” – the protection applies because the test is met, not because it has been declared.

Where it applies, your employer has a legal duty to make reasonable adjustments, and treating you unfavourably because of the condition can amount to discrimination.

What adjustments actually look like

Adjustments for mental health are often small, practical and cheap – which is worth knowing, because “reasonable” partly means proportionate to what it costs the employer.

• Hours and pattern – a later start to avoid rush hour, reduced hours for a period, or a compressed week.
• Where you work – working from home some days, or a quieter space in the office.
• Workload and duties – temporarily removing a particular task, reducing volume, or stepping back from client-facing work.
• How you are managed – clearer written instructions, more regular one-to-ones, advance notice of changes.
• Time for appointments – paid or unpaid time off for therapy or medical appointments.
• Absence triggers – raising or discounting trigger points so disability-related absence is not counted against you in the usual way.

Ask in writing and be specific about what would help. “I am struggling” is harder for an employer to act on than “a 10am start would let me avoid the commute at its worst”.

Going back to work

A phased return is the normal route back, and after a mental health absence it is worth taking seriously rather than rushing. Reduced hours building up over several weeks, with a review point, gives both you and your employer a way to adjust without it feeling like failure.

Build a phased return plan to propose, and get what is agreed written down with a review date. If something at work contributed to the absence, raise what will be different before you return rather than after.

If you cannot get an appointment in time

The practical problem is often timing. Self-certification runs out on day 8 and GP appointments can take longer than that, which adds pressure when you have least capacity for it.

Health Works issues fit notes the same day after a short video consultation with a GMC-registered doctor. Get a fit note online.

One honest caveat: if your mental health has been an ongoing issue and you are already under a GP or a mental health team for it, they are the right people to write your notes. They have the history, and continuity matters more than speed once a condition is established.

Getting support, not just a note

A fit note buys time, and time genuinely helps. But it is not treatment, and it is worth thinking about what else might.

In England you can self-refer to NHS talking therapies without going through your GP. Your GP can also discuss other options, and many employers have an Employee Assistance Programme offering free confidential counselling – worth checking, because people often have one and never use it.

If you are struggling to cope, Samaritans are free and available 24 hours a day on 116 123. For urgent medical help, call NHS 111.

Related reading

Signed off work with stress covers pay, employer contact and dismissal protections once you are already off. Sick note for stress covers getting the note itself.