Bipolar Beat

Nobody can tell you whether you will be able to return to work. The answer hinges on several variables, including the severity of the illness, the effectiveness of the treatment you receive, how much support you have at work and home, the stress level (and your capacity for handling it), and how eager you are to return to work.

You might be better off rephrasing the question. Instead of asking “Will I be able to return to work?” Ask yourself what returning to work means for you:

  • Full return: Some people with bipolar take a few weeks or months off work, obtain the medications or other treatments they need, and then return to work as though nothing had happened.
  • Partial return: Instead of returning to your standard 40- to 50-hour workweek, you scale back, perhaps working only 3 or 4 days a week if your situation allows for it. Some people who take this approach find that they can, over time, build back up to working a full week.
  • Return with accommodations: The ADA (Americans with Disabilities Act) covers mental illness, so whether you return full-time or part-time, you may qualify for reasonable workplace accommodations. We cover this in detail in Part IV of this series, “Requesting Workplace Accommodations.”
  • Job change: Instead of returning to the same job, you may be able to secure a less demanding position with the same employer, seek employment elsewhere, or change careers.

Experiencing a major mood episode is often likened to being in a serious car accident. You may not look bruised and battered on the outside, but your brain has suffered serious trauma and needs rest to fully recover. In addition, you’re probably taking some new medications, which often require at least a few weeks to become effective and perhaps even more time for your body to adapt to them. In short, try not to be in too much of a hurry to get back to work.

You are much more likely to have a successful return to work by taking all the time you need to fully recover and get your moods on an even keel. A premature return increases your chances of experiencing another crash, which may make returning to work even more difficult next time.

Also ask yourself whether you can afford not to work. I am not talking just about money and benefits. Work offers a host of perks, including the following:

  • Structure: Bipolar often responds better in a structured environment, particularly in terms of schedule, and a workday can provide this structure.
  • Positive self esteem: Being productive naturally provides you with a sense of self-worth.
  • Camaraderie: For many people, work is the place where they socialize the most, and having an active social life (not too active), can level out your moods and provide support as you set work-related recovery goals and develop adaptive habits.

Don’t underestimate the value of these benefits when making your decision. But if bipolar prevents you from returning to work, don’t assume that you’re losing out on all this great stuff, either. You can structure your day, establish a healthy social life, and build self-esteem without a job – it just may be a little more challenging. These activities may take the form of volunteerism, new roles within your family, adult education, or avocational pursuits, such as gardening, book clubs, and art, or music.

We would like to know what you think. Please share your experiences and insights of returning to work with bipolar disorder. If you’ve been able to manage bipolar at work, how have you done so? Did you return to the same job under the same conditions or with changes? Did you change jobs or careers? If bipolar has prevented you from returning to work, what specifically kept you from going back to work? What are you doing, if anything, to keep yourself busy, structure your days, and maintain a social life?

Join us next week for Part II of this series: “To Tell or Not to Tell?” when we discuss the pros and cons of disclosing bipolar to supervisors and coworkers.


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Links to This Article

From Psych Central's Dr. Candida Fink & Joe Kraynak:
Bipolar Disorder on the Job | Bipolar Disorder and Work | Bipolar Beat | Bipolar Beat (December 8, 2009)

From Psych Central's Dr. Candida Fink & Joe Kraynak:
PsychCentral (December 8, 2009)

Take the stress off work! « Asianetindia.com Blog (December 8, 2009)

From Psych Central's Dr. Candida Fink & Joe Kraynak:
Bipolar on the Job Part II: To Tell or Not to Tell? | Bipolar Beat (December 15, 2009)

Five-Part Series on Returning to Work with Bipolar Disorder | Bipolar Blog | Candida Fink, MD (December 15, 2009)

From Psych Central's Dr. Candida Fink & Joe Kraynak:
Bipolar Disorder on the Job | Bipolar Beat | Bipolar Beat (December 22, 2009)

From Psych Central's Dr. Candida Fink & Joe Kraynak:
Bipolar Disorder Reasonable Workplace Accommondations | Bipolar Beat | Bipolar Beat (December 29, 2009)

From Psych Central's Dr. Candida Fink & Joe Kraynak:
Bipolar Disorder on the Job | Protecting Your Rights at Work | Bipolar Beat | Bipolar Beat (January 5, 2010)

12 Comments to
“Bipolar Disorder on the Job Part I: Will I Be Able to Return to Work?”

I’m currently trying to return to work, which I do from home. I’m finding it nigh on impossible as just the smallest amount of stress sends me spiralling downwards. I’m being forced back into work too soon as we don’t have the money for me to take more time off.

Sometimes you have to suck it up and do it, no matter your mental health. Go to work and ease into it. It’ll mean less time to focus on your own problems, and solve some of the financial concerns you’ve got. Mental illness doesn’t give us the right to never have to work again.

In 2006 I hit a major road block and after severe emotional problems, quit my full-time job. This was after switching to a less demanding job and taking off numerous times for mental-health days. I simply cannot handle the stress (whether real or imagined) of interacting with more than a few people at a time. I attempted for about 1 1/2 yrs to work as a substitute teacher, as this was more accommodating to my moods, but I found even this level of interaction was too taxing. If I am outside of my house for more than an hour or so, my anxiety skyrockets and I begin to have difficulty functioning normally (ie, not crying hysterically the entire time I am gone from the house). Even attempting to go to the grocery store takes days of mental preparation for me to go. I have huge problems with paranoia and no matter where I am, if there are strangers, I am going to think the worst (mostly I just end up fearing everyone I see, as if they are going to harm me). With the teaching, I was gradually less able to accept jobs until the point that I had to remove myself from the list (I didn’t even actively do that, as I am so afraid of people, I just didn’t respond for long enough time that they dropped me).

I struggle with tremendous guilt for not working. Of course, my family would be far better off financially if I worked, but I simply cannot make myself do it. I feel like a completely useless person and I feel as though I am a burden to my husband, but no amount of guilt or self-hate can get me over the trauma required to return back to working.

I am currently on disability and have been for 3 years. At first it was very difficult to accept. My therapist worked with me on establishing a routine, helped me find volunteer work is is helping me to be able to deal with the question, “What do you do?” Considering the job market now, the loss of Medicare insurance and likelihood that the new job wouldn’t have medical insurance benefits, staying on disability seems to be my best option.

Hi, Suck It Up–

Would you consider any illness a reason not to ever have to work again? Just curious.

my mom was diagnosed with bipolar several years ago. She tried to go back to work but couldn’t, and so we ended up losing our house. It wasn’t her fault, but I know she still feels guilty. I just want her to get better and stay that way for at least awhile

In 1997 I was able to return to work as my recovery coincided with the end
of summer vacation, but then in Feb. ‘99, my treatment drug, Risperdal,
was so horribly depressing and slowed me down so much that I couldn’t return to a job that required very fine manual dexterity, speed and reading a conductor’s mind to stay one step ahead of him, all while managing four other parts besides my own. Leaving and just being on Risperdal made it one of my worst years. Only one or two other times were quite that bad.
I only had a couple of church jobs that summer and felt a loss of identity with the loss of work, but soon enough moved to another area of music.

I have been off work now for 3 months on short-term disability. Although I do occasionally feel pangs of guilt for not pulling down a full-time job I recognize that I am being productive in my own way through church service, etc. I am in the process of trying to become self-employed and structure much of my day around that.

One of the frustrating aspects of my treatment is that my medication knocks me out in the mornings (medication hangover as some call it). This makes it difficult to have a regular 9-to-5 job–I’ve been in corporate accounting. I am hoping that being able to set more of my own schedule will help. Right now, there are many questions yet unanswered.

I have been on disability for three years now, while the family budget would be helped greatly if I returned to work, I do not believe that would become a reality. I used to be an office manager for a medical office, to return to being a receptionist(less stress/possibly part-time), most offices wouldn’t hire me- they would feel that they couldn’t pay me enough, or that I would be working below where I was. I don’t know how to explain that I am no longer able to function in that capacity, ECT for the depression erased a lot of memory and I used to be quite effective in my hypomanic state. Now being more level I can’t keep track of things (multitasking) like I did- just dealing with the house is enough for now.

I have been off work since Sept and contemplating going back to work. I am scared and find I do much better in my own environment. Too much outside stimulation seems to totally put me in a state of great aggitation. My next step would be to be on SSI but I don’t know if I could live on that alone. I just don’t feel ready to multi-task anything other than what I do at home – guilt is HUGE! Some of my family members say things like, “Susan everyone has an off day”! Like NOT being able to even get out of bed??????? That’s not normal to everyone! I have doctor’s appointments this week and will discuss my fears and anxiety’s and get their help. It’s nice to know I’m not alone on this journey of recovery or life as it is.

hi I’ve not worked for 19 years because of depression and arthritis, the guilt of not working consumes me most of the days, i’ve tried so many thinks to try and return to work,each time it seems as though i am trying to walk through a brick wall, therapy, meds has not removed this guilt, i feel that it is something i have to live with and accept

After being out of work for two years, I was able to go back to work. I changed my career to less demanding and I am able to function well for the last decade.

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    Last reviewed: 5 Jan 2010

 


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


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