The Boss Nobody Checks On : The American Centinel

She runs the Monday meeting, approves the budget and handles the hard conversations. Her team comes to her with problems, and she fixes them. At 51, she is the manager people describe as steady. What few of them know is that she has been sitting in her car in the parking lot every morning, trying to make herself walk in.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.

Leaders are often the last people anyone checks on. Their teams assume they are fine because they seem to be in control. Their own bosses may only see results. And many women in leadership roles feel they cannot show weakness, especially after working twice as hard to get where they are.

Why women leaders hide it

Women who reached senior roles in midlife often did so by being dependable under pressure. Admitting that they feel hopeless can feel like a risk to their credibility or their job. They may worry about being seen as emotional, or about what it would mean for the people who report to them.

At the same time, midlife often piles on private weight. A leader may be managing a parent's dementia, a teenager's struggles, a divorce or the physical changes of perimenopause, all while showing up composed at work. The gap between how she looks and how she feels can grow wide and lonely.

What to look for in a leader

Peers, direct reports and family members might notice:

A manager who used to be engaged becomes distant, irritable or unusually quiet
Working constantly, answering email at all hours and refusing any time off
Or the opposite: missing deadlines and seeming not to care
Comments about being tired of everything or about nobody needing her
Talk of feeling like a burden or wanting to disappear
Sudden decisions to step away, hand off everything or tie up loose ends

These signs matter even in someone who seems strong. Strength on the outside does not protect anyone from depression.

It is okay to check on the boss

Employees often feel it is not their place to ask a manager how she is really doing. But a sincere, private word can matter a great deal. You do not need to be her friend to say: I have noticed you seem worn down. Is everything okay? If something feels seriously wrong, a peer, partner or close friend can go further and ask directly: Are you thinking about suicide?

That question does not plant the idea. It often brings relief. If she says yes, stay with her, listen and help her reach 988 or a clinician. If she is in immediate danger, call 911. Families can also help during a hard stretch by keeping medications and firearms stored safely or out of the house, in a calm and general way.

If you are the leader

If this describes you, consider that taking care of yourself is part of leading well. Your team does better when you are well. Many workplaces offer confidential employee assistance programs that do not report back to the company. A primary care doctor or mental health clinician can help, and it is worth mentioning sleep and hormone changes. Talking with one trusted peer outside your chain of command can also ease the isolation.

Depression is treatable, and leaders recover just like everyone else. Getting help is not a weakness; it is the same good judgment you use every day at work.

A newer treatment a clinician may mention

For a leader whose depression has come with suicidal thoughts, a clinician may raise this newer option. Spravato (esketamine) is a nasal spray the FDA has approved, taken along with an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. It is also approved for treatment-resistant depression. It is not a crisis treatment: it does not replace emergency care or a hospital stay when one is needed, and it has not been shown to prevent suicide or to reduce suicidal thoughts or behavior. It is given only in a certified clinic under a safety program called the Spravato REMS. The patient takes it there under supervision, stays at least two hours to be monitored, and does not drive until the next day after a full night of sleep. It is never dispensed for home use. Whether it fits is a clinician's decision after an evaluation.

Many clinics that offer this treatment begin with a free first consultation, a private, low pressure conversation about whether an evaluation makes sense. She can bring her spouse or a trusted friend with her if that makes the first step easier.