Bipolar disorder is a lifelong ordeal, even with treatment. Medications need to be adjusted. Therapy may be needed at some times and not others, and bipolar disorder can get worse over time. Meanwhile, life goes on. Patients’ lives are not just their bipolar disorder. They have relationships, jobs, hobbies and dreams. Unlike neurotypical people, however, all of these situations become more complicated when bipolar disorder is present, especially during mood episodes. People with bipolar disorder have to consider their illness when making major life choices.
When monitoring bipolar disorder, even small decisions require extra thought. Small events like losing sleep, drinking alcohol and not taking a dose of medication can trigger symptoms, if not full manic or depressive episodes. Life’s big decisions carry even more weight. Here are two areas in which having bipolar disorder becomes a huge factor.
Excessive spending is one of the primary examples of risky behavior during manic episodes, but can also happen during depression. It’s impulsive. People spend too much at the grocery store and buy hundreds of dollars worth of art supplies because of a sudden desire to become an artist. They buy cars they can’t afford or a last-minute plane ticket to vacation on a whim.
Because the risk of overspending exists, people with bipolar disorder need to take precautions. The consequences of these spending sprees are not always immediate. High debt leads to bad credit. Lenders can charge higher interest rates if a loan is granted at all. Retirement may have to be put off and emergency spending cushions disappear.
Several options exist to help keep savings intact. All parties involved should speak with a financial planner, CPA and an attorney to determine the best scenario.
- Money can be put into trust accounts where a trustee oversees the account for the beneficiary (in this case, the person with bipolar disorder) based on rules agreed upon and set up by a lawyer.
- Set up an annuity. This takes larger sums of money and doles them out in smaller payments. The patient would receive a check each month without being able to withdraw more from that account.
- If a person is deemed legally incompetent, a conservator can be appointed to manage money for them.
Only 60% of people with bipolar disorder are regularly employed and less than 30% work full-time. Problems with cognitive functioning (memory, language, attention, critical thinking and social functioning) can make work difficult. Absenteeism is also a problem. Patients are seven times more likely to miss work due to mental illness than other groups. They cost more to employ because of health insurance costs. People with bipolar disorder are also more likely to quit one job without having another lined up.
It’s important to consider personal limitations when choosing a job or career.
- Is there too much stimulation (noise, light, etc.)?
- Does the job allow flexibility in case of emergencies or sick time?
- Does the job follow a regular, daytime schedule?
- Is the job too high-stress?
- Is it possible to maintain interest in the job for a long period of time?
Employers have to make reasonable accommodations for employees with mental illness under the Americans with Disabilities Act. This includes schedule changing, sick leave, providing an alternative environment (less noisy, working away from others, etc.) and modifying job duties. However, this does require the person to inform their employer of their mental illness, which may invite further scrutiny and stigma.
If someone with bipolar disorder is not able to work, filing for disability benefits is an option. It’s a difficult process that can take years to get through. Basic requirements include two years of documented periods of unemployment due to symptoms as well as a limited ability to maintain social and occupational activity. Benefits include Social Security Disability Insurance (Medicare) as well as supplementary security income that is based on the person’s need.
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