Bipolar Beat

Q&A: Managing a Job with Bipolar Disorder

By Candida Fink MD
January 6, 2009

Syndicated from the Bipolar Blog with a couple minor edits

Q: I am a job coach. I help get jobs for disabled people and help train them. I have had several clients who have bipolar disorder. They do not seem to be able to keep jobs no matter what field we put them in. Many of them are great workers but getting them to come on time (if at all) is a big deal. Is there a way to work with people who have bipolar that would make them more successful? It is frustrating to know that they can do the job and they love the job and the people they work with, but they cannot keep the job because of not showing up on time or not calling in when they’re going to miss work. Please let me know if you have any ideas that can help us help them.
MaryAnn Cheney, Job Coach

A: In terms of working with clients on these types of problems, the task is to break it down into more specific concerns. While we can say broadly that individuals with bipolar disorder have trouble with time management—that doesn’t help us solve the problem for any one individual. Sitting with the client and identifying the more exact nature of the problem is the first step, so you can develop an individualized plan for addressing specific issues.

Start with the assumption that the client is not getting there on time because they can’t, rather than because they won’t. Next, try to break down the problem into much smaller issues so you can address the skill set deficits and solve the problems from a smaller, more manageable standpoint.

For example, does the person have trouble remembering to set the alarm, hearing the alarm when it rings, or getting up upon hearing the alarm? Does the person run into delays when showering and getting dressed? Is transportation a major issue? Does the person have other demands in the morning or conflict with another person prior to work? Is there a problem with medications—either not taking them or perhaps a side effect that makes the person less able to wake up in the morning?

Once you can break it down, you can start to address one issue at a time—with your client actively involved in developing possible solutions. If you try to tackle too many issues at once it won’t work, so focus on one issue at a time.

Remember: Changes, when they come, will be incremental—small changes at first. You and your client are working to solve problems that are occurring because of skill set deficits, so always consider skill set deficits when formulating your solutions to the problem.

For example if we’re talking about waking up when the alarm rings, what may be getting in the way might include medication hangover, general fatigue, and lack of mental and/or physical energy. One solution could be to work toward a very gradual process of waking up. Your client could try to set the alarm earlier and hit the Snooze button one or two times before waking up. If your client’s medications were suspected of causing some morning fatigue, your client may consider consulting with his or her doctor to determine if the times that the medications are taken could be adjusted.

It is also important to remember that as long as you are talking and working on solving the problem, you are still in the game with the client. The first solutions you develop may not work or may be effective only to a certain degree. Achieving an effective solution is a dynamic process and may require a good deal of tweaking along the way. Remain persistent and provide your client with plenty of encouragement.


Related Posts

You can leave a response, or trackback from your own site.

15 Comments to
“Q&A: Managing a Job with Bipolar Disorder”

This is quite a timely article for me. My primary mental diagnoses is Bipolar II Disorder. I am a visual artist, so my jobs have been quite varied.

I am going back to school, at 43 to become an animal trainer. My mother worries about my illness affecting any business I might start.

Happily my best friend who is signing for the school loan doesn’t see it that way. She says we cannot avoid life in fear of our illness.

I couldn’t say it better myself.

A life lived in fear is a life half lived.

I am bipolar I have no car and live in a small town without few jobs and I need to work at home line

When the issue is waking up, a “dawn simulator” might be helpful to some folks. It lights up very gradually over a long period of time, cueing your brain that morning is coming. It works even while you’re asleep because we all perceive light through our eyelids which then sends a message to a gland in our brain that sets things in motion to wake up. People w/ bipolar disorder are often very sensitive to light issues including seasonal changes so light boxes and/or dawn simulators can help with our circadian rhythms. http://cet.org/ for more info on this.

With reference to the above article about those with bipolar illness receiving and maintaing employment…I have issues with this article to a certain extent. I do like the idea that each problem a bipolar patient has anxiety about with reference to gainful employment needs to be indvidually and appropriately addressed. However, I have a relative with this illness and it has been my experience that this list can seem to grow as time passes and correctly problems becomes basically an impossible task. It’s as if the employee needs a full time assistant to get to work, stay at work and do an appropriate job consistently. Therefore, I am of the opinion, that those with this illness (particularly Bipolar I) can only successfullyy work consistently part time. Even on a part time basis, they will likely need support services. However, working approxiamtely 20 hours a week would give these individuals more ability to process and rest and recover from their workdays.
Nomad

I am 36 and bipolar. I was diagnosed back in 2005. I have NEVER been able to keep a job. I would be lucky if I could maintain a job for 9 months. My husband doesn’t understand and blames me for all of our financial difficulties. I have applied for social security disability three times and have been denied all three times. I am depressed, sad and tired of being blamed by my husband. I’ve been on the INTERNET to see if their were other bipolar’s like myself who have had trouble keeping a job, because I was curious to see if this was a characteristic of being bipolar. Does anyone on here have the same issue as I do? I just don’t understand why I can’t keep a job.

I am 38 and though I have not been officially diagnosed with Bipolar, I strongly suspect that I am. I was hospitalized at 21 for suicidal depression and alcoholism - and received very little follow-up treatment from therapy in the next years. No regular doctor, not very supportive family, and frequent falling off the wagon and into trouble. Having been fired from yet another job last halloweeen - I am now unemployed and have almost run out of options. I have had 26 jobs in the 20 years since high school. That can’t be normal. I have problems with coworkers, with supervisors…and these are relatively easy and good-paying jobs if i could just sit and keep my mouth shut. Now enterting into middle age 10k in debt and no job skills, no references and a horrendous resume. Been looking at joining the national guard as i have so few options. Or teach english overseas if they will have me. but that is no way to get rich. but now i’m just worrying about ending up homeless someday. So TAI, yes there are others having trouble keeping a job. Aren’t financially responsible. And so on. Just wanted to share - i am very frustrated and depressed these days. and to top it all off, i have isolated over the past several years (after a series of pointless breakups with great girls) and to go on something like facebook and see everyone chatting and living itup, is really humiliating for me. really hating my life right now. i hope you all are doing well…

I am 42 years of age and have bipolar I disorder. I have had years of job instability many due to my severe mood swings. For years I never knew it was bipolar disorder. After seeing many psychiatrists and psychologists and finding one psychiatrist and psychologist I can trust, working through vocational rehabilitation, I am able to work part-time while collecting social security disability. I work between 16 to 24 hours a week and it sometimes it can be overwhelming. I have a job coach to help me along the way and can call him at anytime. My boss knows I am disabilied and allows me to have great flexibility in my schedule provided I tell him in advance I need a day off or that I can work only on certain days. To avoid being late, I prepare my lunch and dinner the night before. The day that I have to go to work I tell myself that my starting time is one half hour earlier than I need to report to work. It works all the time. I do have difficulties but keep my symptoms to myself. It is not easy. My boss in my review said that I have a lot of skills and great potential but have to work on my temperment with other employees and have to work on not acting on impulse when making decisions with others. I believe because I know myself, that those with this illness can only successfully work consistently part time. I have worked for one year and three months now at the same job and for me that is an accomplishment.

This is an excellent subject to bring up!
Work is many things to us, such as: A means to support ourselves, builds self-esteem, helps to think of something else other than ourselves and our situation, we socialize, challenge ourselves, submit meaningful actions towards others, and make a difference.

It actually has given me meaning in my own life, it has given me self-worth, with productivity, something to look forward to.

Unfortunately, my past is the same as all the others, in the fact that I am consistantly inconsistant, I can be disorganized, ruled by my feelings and emotions, talk to much, give out way too much information, have focus problems, and become easily distracted, and this affects my overall performance, causing insecurity, blame, and a downward spiral of yet another lost job! My mania along with extreme underlying fatigue, makes everything seem so difficult to maintain. I can do well for awhile, and then ahh, I have destroyed everything I have work hard for. I’m 45, a registered nurse, I didn’t get to be a nurse without intelligence, motivation and planning, but, I have had 37 jobs in 30 years. I’ve moved just as many times, and the older I get, the harder it is to bounce back. As soon as I get home from work I have to lay down and sleep about about 12 hours and I still don’t feel rested. I used to be able to hide behind fast-paced-multitasking
nurse jobs, but I can barely be able to hand out headache meds and do simple dressings and support stressed-out workers at a federal facility. This is just another terrible issue of our disease that we must accept, deal with and try to find a solution before we lose another battle. I might have 5 good days out of a month, and those are precious to me.

i did not go to work today. i missed 2 days last week..i have always been unreliable because of fatigue and crashes. my hypomania has saved me many times by overcompensating and working like a madwoman. i have several university degrees, acheived because of hypomania. i took entire semesters off at uni because of crashes. it is demoralising because i think that i am lazy and get really hard on myself which worsens the depression…a viscious cycle.

V–

I COMPLETELY understand what you are going through. I was once an over-achiever…then I lost 4 jobs in a year because I was “undependable” because I would go from mania/hypomania to severe depression where I couldn’t even get out of bed. THANK GOD I’m now on SS disability. I don’t know if I could ever go back to work because I don’t feel that I could commit to anything without letting people down. I feel useless now that I’m not working, but I’m using the time to write my memoir on growing up bipolar and not being diagnosed until age 28. Even though I’ve been on meds since 2001, I still struggle daily.

You are NOT ALONE.

Michelle…thankyou..i think we all feel alone..and the funny thing is I am alone most of the time…i thought yesterday that one of my biggest strengths is “i can be alone”.unlike most people who fear it. depression teaches you that in a big way. i agree that it is a daily battle…i tell myself obsessively all day “”ït is just a bad day”" tomorrow will be better…like the buddhist saying: “this too shall pass”. writing a memoir (i am too) is a great healing process and being ok with aloneness is a great help for writing. there is the silver lining ..i always try to look for it..some days it just ain’t there..and “this too passes”

V-

I thought I could be alone too…but last summer I suffered from severe agoraphobia. I couldn’t leave the house, stores and grocery stores made me irritated and freaked me out. I like Winston Churchill’s quote (who was bipolar) “If you are going through hell, keep going…”

Glad you are writing a memoir. The more the public understands this disease the better and those suffering from BP will have an outlet to read and understand that they are not alone.

Would love to hear how far along your book is. I’m 80% done, but it’s hard to write about without getting depressed. I just have to take it one day at a time.

BEST WISHES and hang in there.

Michelle. i think noise and any external over-stimulation such as crowds etc..triggers the nervous system which in BP is already highly sensitive. there is always an element of anxiety also. i detest crowds and high pitched noise..children screaming, loud music etc..also i have become a recluse..social interactions and making new friends have completely deminished the last few years…

as far as the book..wow you are doing really well to be at 80%. write an excerpt on this website so we can critique it or give you good feedback to encourage you …that may help ease the depression that comes along with it…you may find it beneficial..as long as you dont take some of the comments in a bad way.

i am only at beginning stage. i am writing an auto-bio which of course must include my BP as it is part of why my life has evolved the way it has…

maybe i will write on the site also…follow my own advice..
keep going…only 20% to go..that’s is an admirable accomplishment.

I’ve just been diagnosed with Bipolar II. I’ve always been anxious, and one of the things that sets me off is missing or being late for appointments. I’m usually 15-20minutes early for everything. It doesn’t matter how depressed or awful (or sick) I am; the idea of being late is just awful.

Now, if only I could figure out where to get a job coach, muster up the gumption to see them, and get help finding one of these mystical jobs that I could actually love. I’d fight tooth and nail to stay once I got one. I’d just need to *get* one.

The only jobs I can get on my own are the high-turnover stuff where they pretty much say they’ve hired you before your pen hits the application. The sorts of jobs everyone hates. I just eventually break down doing something so utterly unfulfilling.

I guess I have my anxiety and perfectionism to thank for getting me through college as an honors student. But once I was off that boat, I had nowhere to go.

I agree 1000000% with what Nomad said about full time vs part time work.

I am bipolar, don’t know whether it’s type I or II. my dad is type two and he is a truck driver, and he has been doing it for a long time now so that’s a good job for him. I’ve never taken meds before but i made an appointment with mhmr, but i can’t be seen until february. that’s like four months from now. i need some medication for anxiety and mood swings. i have a job right now but i don’t go sometimes because i just get freaked out. I love this job and while i was in training i couldn’t quit thinking how this is the best job in the world. now that im done training and i go out on my own, i get really nervous and sccared feeling. it may be because my job entails up-selling the crap out of carpet cleaning services, but everyone else does it at my job, and they make really good money. I think my thoughts aren’t organized enough to be a salesman, but i love this job. I talked to my boss and he told me to get my stuff fixed and come back, so i think i need medicine for the anxiety feelings i get like 4 times a day. I also sometimes wonder whether i should take medicine. I know why i’m depressed all the time, it’s because the world just keeps getting worse and there’s nothing i can do about it. I feel that if i take medication I’m just ignoring my feelings. using drugs to force myself not to be sad that humanity is being forced apart by greed. I don’t even know why i posted this i just want to talk to people about this because, i want to go back to work and feel like i did during training…nothing has changed since training except my attitude…

Ask a Question or Post a Comment:

*
To prove you're a person (not a spam script), type the security word shown in the picture. Click on the picture to hear an audio file of the word.
Click to hear an audio file of the anti-spam word

 


Candida Fink, M.D. and Joe Kraynak are authors of Bipolar Disorder for Dummies. Pick up the book today!
Best of the Web - Blog 2008

Recent Comments
  • Sarah: I have been on tegretol for the less extreme bipolar variant for about 15 years, and it has been a life saver....
  • Chrisa Hickey: There is a lot of positive and useful information out there about bipolar disorder. My family was...
  • Bobbi J: My doc just told me that he classified me as BiPolar II, that I only reach hypomania so I have dealt well...
  • Joe: Hi, Amazon– You said… “Maybe I shouldn’t even be posting because my manias aren’t very...
  • Bill: cymbalta + lamactil + trazadone has been a life saver for me. Cymbalta and Lamactil alone did not fully treat...
Article Tools
Bookmark
Print
Email Friend


Stumble It!


Subscribe to Our Weekly Newsletter


Users Online: 1503
Join Us Now!