Employees with Bipolar Disorder: Great One Day, Nightmare the Next

We have no accurate statistics regarding the prevalence of bipolar disorders in the workplace, especially because it is often hidden due to stigma, says Wootton. However, we do see a prevalence in creative departments, sales, legal, and management.

Frustratingly, he adds, it’s often a tough call whether the employee with bipolar is an asset or 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 in 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 women.
• Prevalence of about 2.6% of 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 hard to identify.
• Accommodations are more difficult.
• The irregular nature of the illness results in inconsistent performance.
• The 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 the symptoms of bipolar disorder:

Mania 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

Depression Symptoms:

• 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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Bipolar Cycling

• 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 predisposition 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 four or more illness episodes in a year are known as rapid cyclers.

In tomorrow’s Advisor, more on bipolar, plus an introduction to the all-things-compensation-in-one website, Compensation.BLR.com®.