Bipolar Beat

Back to Work with Bipolar Disorder: Part I

By Candida Fink MD
September 16, 2008

Syndicated from the Bipolar Blog

Many people with bipolar disorder are able to successfully return to work once they’re on an effective treatment regimen, which typically includes one or more medications. In Bipolar Disorder For Dummies, however, we recommend that you avoid stressors and mood triggers – and returning to work, especially a demanding job, can be loaded with stressors and triggers. In this post, we offer some suggestions on how to ease the transition back to work.

Every individual and every situation is different. Some people have no option but to return to work full-time and really have very little support from loved ones. Others may have a tremendous support network, an understanding supervisor, and very accommodating co-workers. Some people may even find that returning to work is less stressful than staying home, and they embrace the opportunity to return to work.

Following are some suggestions that can help ease the transition back to work:

  • Meet with your doctor first. You may need a doctor’s release to return to work. In addition, your doctor may offer helpful suggestions concerning how to handle your medications in the workplace.
  • Set up a doctor’s appointment for the end of your first work week. By setting up an appointment in advance, you can return to work knowing that if anything goes wrong, you can get in to see your doctor soon.
  • Consider any workplace accommodations that can help you function more effectively at work. Under the ADA (Americans with Disabilities Act), you have a right to reasonable accommodations, but you can’t hold your employer accountable unless you disclose the reasons why you need special accommodations. If you are dead set against disclosing that you have bipolar disorder, you can always request accommodations anyway, simply stating that these accommodations will make you happier and more productive, but to gain some legal leverage, disclosure is necessary. Remember, your employer can’t fire you for having bipolar disorder. (In Chapter 13 of Bipolar Disorder For Dummies, we recommend some types of workplace accommodations that you can request.)
  • Discuss your return with your supervisor. You’re not required by law to disclose your diagnosis or treatment, but if you feel comfortable disclosing this information, it may make your supervisor a little more understanding and flexible.Tip: You can often predict how your supervisor may react to your diagnosis by thinking back to actions she performed or words she uttered in the past. How accommodating has your supervisor been regarding other illnesses and absences from work? Has she ever made unkind remarks about people who were “nutjobs” or “headcases?” Past behaviors are the best predictors of future behaviors.
  • Discuss your return with one or more coworkers you trust. Again, you have no obligation whatsoever to disclose your diagnosis or treatment. In fact, a disclosure may not always be the best idea. But if you have coworkers you trust, a support person on the job can help you watch for early warning signs and avoid potential conflicts.
  • Lighten the load at home. If you have a partner or other loved one who can relieve some of your burden at home, ask him or her to take on some additional responsibilities or chores or hire help (if you can afford it). If someone else can chip in by paying the bills, picking up the house, cooking, and making sure the kids (if any) are taken care of, at least temporarily, you may feel less stress at work.

Note: You may need to submit medical forms and other paperwork to receive sick pay or other benefits, but keeping up on all the paperwork can be quite stressful and difficult when you’re feeling depressed or overwhelmed. Get help from a family member or friend, a union representative, or your employer’s human resource department. Union representatives and HR workers are typically very knowledgeable about your rights and dedicated to making sure that your employer follows the proper legal procedures.

From Joe: When my wife, Cecie, was experiencing her worst mood episodes early on, when we really had no understanding of bipolar disorder, her doctor would simply prescribe medications and send Cecie back to work. Looking back, it reminds me of a boxer who’s getting pummeled in the ring being patched up in his corner and then sent back into the ring to get pounded some more.

Cecie wasn’t well enough to return to work. The major breakdown made her weak and confused. When she did return to work, her mind was in such a fog that she couldn’t perform her job duties, which understandably increased the stress she was feeling and ultimately led to another mental breakdown and all the fallout that resulted from it. Now, not only did she feel stress, but she also felt like a failure.

I think a lot of times people have no choice but to get patched up with a few meds and try to return to work before they’re fully healthy. But if you have enough sick time and a support network in place, I would strongly advise that you avoid returning to work prematurely. Wait until you feel healthy and ready. It will help ensure that your return to work is successful.

Tune in on Thursday for Part II of “Returning to Work with Bipolar Disorder.” In the meantime, please share any return-to-work strategies and tips that you’ve discovered or developed on your own. Also, feel free to share what you feel are the major challenges to returning to work with bipolar disorder and your own experiences.


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Links to This Article

From Psych Central's Dr. Candida Fink & Joe Kraynak:
» Back to Work with Bipolar Disorder: Part II - Bipolar Beat (September 19, 2008)

3 Comments to
“Back to Work with Bipolar Disorder: Part I”

As a bipolar, both before diagnosis and after, I was always able to excel at my career. It was the self-medicating that took me down. Once properly medicated, I not only succeeded in reclaiming my place but excelling above many in the industry in which I work. Mania has only been beneficial to my career and education, believe it or not. It has been the most difficult to remain on my medication every once in a while when the job becomes stressful and I would love to be able to work all night like I used to…but I know that if I did that…eventually the pendulum would swing the other direction and I would not be able to get myself out without resorting back to old habits or going through that month long hell to get my medications back into my system. It is hard to return to work…but it is hard to live in a society that can not even comprehend what our thought life would be like if we are refused the right to return to a productive status. In Texas, if you mark on your driver’s license application that you have been diagnosed with a mental disorder…they will not grant you your license. No license, no decent job…thanks Texas. Bipolars must return to work. We must feel productive. We can not feel like we are defeated by our disorder, or we will succumb to our depression and never find our way out.

I was a professor and went on leave for 1.5 semesters. When I came back, they required me to sign a statement that I would not disclose or discuss my bipolar disability with faculty, staff, or students. You know they wouldn’t do that to someone returning from a heart attack. I was okay the first semester back when I was half time and didn’t teach. The next semester I returned to full time and teaching…and I collapsed. I am on disability now but I hope to work again in the future. I have been determined totally disabled by my work place so I can’t go back there. I’ll have to find something new.

Let me add to what I just wrote. Before I returned to work, I set up accommodations with the dean of the college and HR. They were that I would not have an early class (nothing before 9am), at least one online class, not teaching out of town. The semester I returned to full time, I had an 8am class, no online classes and was assigned a class 75 miles away. They weren’t interested in making accommodations so I could succeed, they were interested in making me leaving.

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Candida Fink, M.D. and Joe Kraynak are authors of Bipolar Disorder for Dummies. Pick up the book today!
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