Objective: Highly educated Dutch women experience more work related mental health disability than their male counterparts, and yet little is known regarding the process. Using the theory of symbolic interactionism, we examined how women interpret their roles at work, during sick leave, and upon their return to work. Methods: Semi-structured interviews focusing on role perceptions and interactions with other actors were conducted with 13 women (aged 29-41 years) on sick leave or off work for periods ranging from half a year to 8 years. Results: The women worked overtime because of workaholism, or to meet supervisors' expectations. This led to mental health problems and social isolation. Taking sick leave aided recovery, but further isolated the women. Insufficient support from the workplace and social insurance professionals intensified negative feelings. Psychological counselling provided alternatives whereby work and private roles could become more balanced. However, their reintegration into the workplace failed because the women could not implement these strategies when the organizational culture failed to change. Conclusions: A long lead-up time preceded sickness absence and sick leave allowed for recovery and value adjustment. However, a variety of interpretations reinforced the women's individualized focus, thereby hampering their successful reintegration. Practice implications: Given the importance of implementing effective sick leave prevention measures in the workplace, psychological treatment should focus on women's interactions with their work environment.