Bipolar disorder presents one of the trickiest challenges in accommodation. It’s doubly ticklish because it often combines your greatest star with your biggest problem—all in one person, says expert Tom Wootton.
We have no accurate statistics regarding the prevalence of bipolar disorder in the workplace, especially because it is often hidden due to stigma, says Wootton. However, we do see a prevalence of it in creative departments, in sales and legal departments, and in management.
Frustratingly, he adds, it’s often a tough call whether the employee with bipolar disorder is an asset or a liability. It’s often your top producer, your biggest star, who has bipolar disorder. You’ll find all of the issues of depression plus manic episodes, says Wootton, and you’ll also find that the inconsistency of the disorder makes it even more frustrating.
Wootton, CEO of Bipolar Advantage, was joined by Maureen Duffy, PhD, a practicing family therapist, consultant, educator, and author; and Susan G. Fentin, Esq., a partner at Skoler, Abbott & Presser, P.C. in a recent BLR®-sponsored webinar.
What Is Bipolar Disorder?
Duffy describes bipolar disorder as follows:
- Brain‐based condition leading to episodes of mania and depression.
- Causes changes in mood, energy, and activity levels.
- Also called manic‐depressive disorder.
- Equally common in men and in women.
- Prevalence of it in about 2.6% of the adult population.
- Only 55% of those with bipolar disorder receive treatment in any given year (National Institute of Mental Health).
- Peak age of onset is late teens/early adulthood.
- High risk for substance abuse and anxiety disorders.
Why Bipolar Disorder Is Such a Challenge
Wootton cites several reasons why dealing with employees with bipolar disorder is challenging:
- Employees are reluctant to ask for help and may try to mask their symptoms (and nondisclosure adds more stress).
- Symptoms are difficult to identify.
- Accommodations are more difficult.
- Irregular nature of the illness results in inconsistent performance.
- Side effects of medication must also be accommodated.
- Malingering and exaggeration are more difficult to prove.
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Signs and Symptoms of Bipolar Disorder
Duffy offers the following summary of bipolar disorder symptoms:
- Elevated mood (euphoria and/or agitation)
- Flight of ideas
- Pressured speech
- Increased energy
- Decreased need for sleep
What the symptoms look like at work:
- Feeling high or “weller” than well
- Feeling agitated, jumpy, edgy, or wired
- Acting irritated, even rageful
- Talking fast, jumping from idea to idea, racing thoughts
- Easily distracted
- Grandiosity and unrealistic beliefs about one’s abilities
- Impulsivity and high-risk behavior—spending sprees, hypersexuality, questionable business investments and/or plans
- Sad, discontented, or hopeless mood
- Sleep and appetite disturbances
- Loss of interest in previously pleasurable activities
- Reduced energy, increased apathy
- Poor concentration
- Psychomotor retardation or agitation
- Suicidal thoughts
What the symptoms look like at work:
- Feeling sad and hopeless, crying a lot
- Feeling pessimistic, guilty, having low self‐esteem
- Feeling slowed down or exhausted; staring vacantly; pained look on face
- Sitting in a chair or lying in bed for long periods of time
- Difficulty concentrating, remembering things, or making decisions
- Thinking of death and dying, attempting suicide (10% to 20% commit suicide)
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- The patterning of illness (mania or depression) episodes varies considerably from person to person—there is no cookie-cutter template.
- Period between illness episodes (the “euthymic” or normal period) can last days, weeks, months, years, or decades.
- Not everyone has a “euthymic” or normal period between episodes.
- Most with bipolar disorder have a preponderance for either depression or mania rather than regularly alternating mania/depression.
- Median duration for a manic or depressive episode is 13 weeks.
- Some have seasonal cycling—depression in fall and winter; mania in spring and summer.
- Those with 4 or more illness episodes in a year are known as rapid cyclers.
In tomorrow’s Advisor, more on bipolar disorder, plus an introduction to BLR’s ADA Compliance 2013, the practical guide to reasonable accommodation and all the other ADA challenges.