Practical question, and please skip the "mental health is health" line — I believe it, it doesn't help me.

How do I tell my employer I need FMLA for a mental health reason?

My situation, concretely. I'm thirty-six, I've been at this company six years, software, mid-size, about four hundred people. I'm a team lead with five people under me. I've had two good reviews in a row.

What's going on: I've had a diagnosed anxiety disorder since 2017, managed, medicated, fine for years. Since roughly February it has not been managed. I'm sleeping about four hours. I had something in June I'd call a panic attack but I was alone in my car so nobody saw it.

Last month I missed a deadline for the first time in six years and I lied about why — I said a dependency broke. That lie is the thing that made me realize I'm past the point of managing it.

My psychiatrist says I should take eight to twelve weeks. She'll write whatever's needed. I have the paperwork sitting in a folder on my desktop since September.

What I've looked into: we're over fifty employees so I qualify, I've got the tenure, my state has a paid leave program so it's not unpaid. HR has a portal and the medical certification form doesn't actually require a diagnosis — just the provider's statement that I have a serious health condition.

I know I don't legally have to tell my manager the reason.

So on paper this is solved. That's why I'm asking a different question.

What I don't know how to do is the twenty-second conversation with my manager, who is a good person, who promoted me, and who will ask — not because she's allowed to, but because people ask. "Everything okay?" And then I have to either lie, or say "it's a medical thing" in a tone that makes it obvious, or tell her.

And the part I actually can't get past: I lead five people. Three of them are under thirty. If I vanish for ten weeks and the reason circulates — and reasons circulate — I'm the team lead who couldn't handle it, forever, in a company where I want to be in ten years.

So: who's actually done this?

Did you tell your manager the real reason or keep it at "medical"? If you kept it vague, did the vagueness cause more talk than the truth would have? Did anything change when you came back — the role, the reports, the way people talked in meetings? And if you'd do it differently, what would you do?

I'll take blunt. I've had enough encouragement.