Last updated: October 2026
You can be signed off work with stress in the UK. For the first 7 days you self-certify. After that, a GP or other healthcare professional can issue a fit note if stress or anxiety affects your ability to work. You may get Statutory Sick Pay from your first full day off. Be honest with your GP.
Below: fit notes, what to tell your GP, sick pay, your rights, recovery and going back. This is general information, not legal or medical advice.
If you’re struggling right now: you don’t have to wait for a GP appointment. Call NHS 111 and choose the mental health option, or call Samaritans free on 116 123, any time. If your life is at risk or you can’t keep yourself safe, call 999 or go to A&E.
Can you be signed off work with stress?
Yes. Mental health is health, and time off for stress, anxiety or low mood is as valid as time off for a physical illness. ACAS, the workplace advice service, says time off for work-related stress “might give someone the space and time to recover”.
What matters is the effect on you, not the label: poor sleep, constant worry, trouble concentrating or feeling overwhelmed. See stress symptoms and anxiety symptoms for the full lists. If you’ve been running on empty for months, it may also be burnout.
Fit notes are only for health problems: government guidance says they can’t be given for non-medical problems, such as relationship trouble at work. If a work problem is affecting your health, it’s your health they assess. And being signed off isn’t a failure. Taking time to recover is a sensible step, and far better than pushing on until you hit a wall (see signs of a nervous breakdown).
Signed off with stress: week 1, after 7 days and long-term
| Stage | What you need | Who provides it | Pay |
|---|---|---|---|
| Days 1 to 7 | Tell your employer you’re off sick by their deadline (or within 7 days if they haven’t set one). Self-certify when you go back. | You | Statutory Sick Pay from your first full working day off, or company sick pay if your contract offers more |
| More than 7 days in a row (weekends count) | A fit note, printed or digital | GP, hospital doctor, registered nurse, occupational therapist, pharmacist or physiotherapist | SSP or company sick pay carries on |
| Long-term (weeks to months) | Updated fit notes, agreed keep-in-touch contact, a return-to-work plan | Your healthcare professional and your employer | SSP for up to 28 weeks. When it ends, your employer sends form SSP1, which supports a Universal Credit or ESA claim |
The 7 days are calendar days, including weekends and bank holidays. A fit note is free once you’ve been ill for more than 7 days.
How fit notes work
A fit note (officially the Statement of Fitness for Work, still often called a sick note) is advice to you and your employer about how your health affects your ability to work. Since 2022, nurses, occupational therapists, pharmacists and physiotherapists can issue them as well as doctors, and they can be sent to you digitally.
The assessment can be in person, by phone or by video. You’ll be assessed as:
- Not fit for work: you’re signed off for a set period.
- May be fit for work: you could work with some support. They can tick one or more options: a phased return (gradually building up hours or duties), altered hours, amended duties or workplace adaptations, such as working from home.
“May be fit” advice isn’t binding. Your employer should talk to you about whether they can make those changes. If you can’t agree on them, you’re treated as not fit for work, and you don’t need to go back to your GP for a new note.
For stress, fewer hours or a lighter workload can sometimes suit you better than a full stop. Ask your GP which they’d suggest.
What to say to your GP
There’s no magic phrase and you don’t need a script. Honest detail helps your GP help you. Jot a few notes on your phone first:
- How you feel in your own words: overwhelmed, on edge, low or numb.
- How long it’s been going on and whether it’s getting worse.
- What it’s doing to daily life: sleep, appetite, concentration, mistakes at work. See low mood vs depression if your mood has dipped too.
- What’s causing it, if you know: workload, a manager, money or a bereavement.
- What you’ve tried and what you’d like: time off, a “may be fit” note, talking therapy or simply advice.
Government guidance says that if your healthcare professional doesn’t ask how your health affects what you can do at work, you should raise it yourself. It’s fine to say “I don’t think I can cope with work at the moment” if that’s true. If you have any thoughts of harming yourself, tell them. That’s exactly what they’re there for.
Your GP may also suggest treatment, such as talking therapy. In England you don’t need a GP to refer you: adults registered with a GP can refer themselves to NHS Talking Therapies for anxiety and depression.
How long can you be signed off with stress?
There’s no fixed limit. It depends on your health and the clinical judgement of whoever issues the note. In the first six months of a health condition, a single fit note can last up to three months, and a review date can be set so your GP can check how you’re doing.
You can go back to work before the note runs out if you feel able to and your employer agrees, without seeing your GP again.
Sick pay while you’re signed off with stress
Statutory Sick Pay (SSP) is the legal minimum. According to gov.uk it is £123.25 a week or 80% of your normal weekly earnings, whichever is lower, for up to 28 weeks, paid by your employer with tax and National Insurance deducted.
The rules changed on 6 April 2026. ACAS confirms SSP is now payable from the first day of sickness (the old three waiting days have gone) and the lower earnings threshold has been removed, so lower-paid and part-time staff now qualify too. To get SSP you must:
- be classed as an employee and have done some work for your employer
- have been ill for at least one full working day
- tell your employer by their deadline (or within 7 days if there isn’t one), or you could lose some SSP
Company sick pay (also called contractual or occupational sick pay) can be more generous. Check your contract or staff handbook. Your employer can’t pay less than SSP. If you think you’re being paid the wrong amount, talk to your employer first, then HMRC’s Statutory Payment Disputes Team.
You keep building up statutory holiday while you’re off sick.
Your rights when you’re off work with stress
Can my employer contact me?
Yes, within reason. ACAS says employers should keep a reasonable amount of contact with someone off with stress, and you should agree together how often so it isn’t overwhelming. Contact is a chance to check on your wellbeing and update you on changes that affect your job. If calls feel too much, ask for email, or for a family member to be the contact.
Reasonable adjustments and the Equality Act
Whether the Equality Act 2010 protects you depends on your situation. A mental health condition counts as a disability if it has a “substantial” (more than minor or trivial) and “long-term” (12 months or more) negative effect on your ability to do normal daily activities. If it does, your employer must make reasonable adjustments. ACAS examples include flexible hours, more breaks, working from home and an extended phased return.
Even if your stress doesn’t count as a disability, ACAS says employers should still offer support and explore whether adjustments can help. The Equality Act doesn’t apply in Northern Ireland, which has its own rules.
Can I be dismissed while I’m off sick?
Citizens Advice explains that after a lot of time off, dismissal might be reasonable if you can no longer do your job, but your employer should first look into your condition, warn you, show you any medical evidence and let you respond. If your condition counts as a disability, you may be protected from discrimination too.
Need advice on your situation? Talk to ACAS, Citizens Advice or your trade union rep. Get advice early if you’re worried your job is at risk.
Using the time to recover
Time off works best as real rest plus a little structure. Some ideas, drawn from NHS advice:
- Step away from work properly. Turn off work email notifications and agree contact through one channel.
- Get support started. Self-refer to NHS Talking Therapies if you’re in England, or ask your GP what’s available locally. Your employer may also have an Employee Assistance Programme.
- Rebuild your sleep. Keep regular wake times, even on bad nights, and wind down without screens. See sleep debt and our bedtime routine for adults.
- Keep a light routine. Get up, get dressed, eat proper meals, get outside and set small targets you can easily achieve.
- Calm your body. Slow breathing helps you switch off. Try box breathing or the techniques in how to relieve stress.
- Go easy on alcohol. The NHS advises against using alcohol, smoking or gambling to cope, as they can make your mental health worse.
- Talk to someone you trust. If worry is a big part of it, how to deal with anxiety has more ideas.
The NHS Every Mind Matters site also has a free “Mind Plan” with personalised tips for stress, anxiety and sleep.
Looking after yourself day to day
Small rituals can make evenings feel calmer. Our Magnesium Glycinate Sleep Complex is a warm berry drink with magnesium bisglycinate, L-theanine and chamomile that some people make part of their wind-down. Magnesium contributes to normal psychological function and to the reduction of tiredness and fatigue. Supplements are not a substitute for medical help, talking therapy or proper time to recover.
Going back to work after being signed off with stress
Plan your return before your note ends:
- Ask for a return-to-work meeting. ACAS suggests employers talk to you when you return after time off with work-related stress and agree a plan, for example a phased return.
- Agree a phased return. You build up hours or duties gradually. ACAS says how long it lasts depends on your circumstances, it should be agreed between you and reviewed regularly, and it may need extending.
- Check the pay. On reduced hours you may get full pay (if agreed or in policy) or company sick pay. ACAS notes SSP can only be paid for full days you don’t work.
- Ask about occupational health if your employer has it. They can recommend adjustments.
- Look at Access to Work. This government scheme offers mental health support for people in England, Scotland and Wales who are in work or returning within 12 weeks, including a tailored plan and one-to-one sessions with a mental health professional. You don’t need a diagnosis to apply, and the mental health support can only be used once. See Access to Work on gov.uk.
Expect some wobbly days, and keep up what helped while you were off. If you work from home, see working from home and mental health. If you’re someone who always looks fine on the outside, high-functioning anxiety may ring bells, and men can find our guide to stress in men useful too.
When to get urgent help
Get help the same day if you feel unable to cope or have thoughts of harming yourself or ending your life.
- NHS 111: call and choose the mental health option, or use 111 online.
- Samaritans: call free on 116 123, day or night.
- 999 or A&E: if someone’s life is at risk or you can’t keep yourself safe.
The NHS also lists where to get urgent help for mental health.
FAQs
Can I get signed off work with stress and anxiety?
Yes. If stress or anxiety affects your ability to work, a GP or other healthcare professional can give you a fit note once you’ve been off for more than 7 days. For the first 7 days you self-certify.
How long can you be signed off work with stress?
There’s no fixed limit. It depends on your health. In the first six months of a condition, one fit note can cover up to three months, often with a review date.
Do I get paid if I’m signed off with stress?
If you’re an employee you may get Statutory Sick Pay: £123.25 a week or 80% of your normal weekly earnings, whichever is lower, for up to 28 weeks. Since April 2026 it’s paid from the first day of sickness. Your contract may give you more.
Can my employer contact me when I’m off with stress?
Yes, within reason. ACAS says employers should keep a reasonable amount of contact and agree with you how often, so it isn’t overwhelming. Contact should be about your wellbeing and any changes that affect your job.
Is it bad to be signed off work with stress?
No. Time off for your mental health is as valid as time off for a physical illness. Use the time to rest, get support and plan a return that works.
Can I go back to work before my fit note ends?
Yes. You can go back whenever you feel able to and your employer agrees, even before the note runs out. You don’t need to see your GP again first.
Sources
- GOV.UK. The fit note: guidance for patients and employees.
- GOV.UK. Statutory Sick Pay (SSP).
- ACAS. Statutory sick pay changes 2026.
- ACAS. Phased returns to work and mental health adjustments.
- GOV.UK. Definition of disability under the Equality Act 2010.
- NHS. Stress.
This guide is general information, not medical or legal advice, and some rules differ in Northern Ireland. Evopure makes the Magnesium Glycinate Sleep Complex.
