I've struggled with mental health issues at various points in my life, and for the most part I've been able to maintain a reasonable level of productivity when

I've struggled with mental health issues at various points in my life, and for the most part I've been able to maintain a reasonable level of productivity when dealing with those issues, but there are times where it's just been too much and I need a break. I don't normally talk about it with employers unless I am going through a particularly bad episode which is materially affecting my situation, which if I understand correctly is the case for you. On the relatively rare occasions where this has happened, I've basically said that 1) I'm not handling this well at all, and - most importantly - 2) unless I'm able to take some time off or reduce my workload significantly, I'm going end up in hospital again and/or having to resign, and that having me keep working while ill is going to work out badly for both parties. It's strange and unfortunate that mental health issues aren't always understood to the same extent as physical ones. I hesitate to give concrete advice on exactly what your best option is as I don't know enough about your relationship with your employer or how critical your involvement is to the company, but if they're understanding people you have a good rapport with I'd be inclined to go ahead and talk about it. The most important thing above all else is your health. I cannot stress this highly enough; the alternatives aren't pretty. Even in the (probably very unlikely) event it costs you your job, you should put your wellbeing first - you can always find another job later.