Medications for Treating Bipolar Disorder
It is often challenging to find the right combination of medications and the right dosages, says expert Tom Wootton. Typical medications include:
- Mood stabilizers
- Antipsychotics
- Combination of both
Wootton, CEO of Bipolar Advantage, whose remarks came in a recent BLR-sponsored webinar, 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.
Medication Side Effects
Unfortunately, most of the effective medications have significant side effects, Wootton says:
Lithium
- Loss of coordination
- Excessive thirst
- Frequent urination
- Blackouts
- Seizures
- Slurred speech
- Fast, slow, irregular, or pounding heartbeat
- Hallucinations (seeing things or hearing voices that do not exist)
- Changes in vision
- Itching, rash
- Swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
- Need regular kidney and thyroid blood levels
(National Institute of Mental Health)
Anti‐Convulsants
- Changes in weight
- Nausea
- Stomach pain
- Vomiting
- Anorexia
- Loss of appetite
- Rash, some that can be extremely serious
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Anti‐Psychotics
- Weight gain
- Drowsiness
- Dizziness when changing positions
- Blurred vision
- Rapid heartbeat
- Sensitivity to the sun
- Skin rashes
- Menstrual problems for women
- Changes related to physical movement that can become permanent after long- term use (rigidity, tremors, spasms, restlessness)
(National Institute of Mental Health)
If the medication brings about these symptoms, you have to consider accommodation, says Fentin.
Psychoeducation
- Learning about bipolar disorder and its effects
- Learning to recognize the early warning signs of mania and depression in oneself
Psychotherapy
- Understanding one’s feelings, emotions, and thinking
- Learning to manage frustration and setbacks
- Setting goals, including work and career goals
- Developing personal life plans and monitoring them
Peer Coaching
Wootton’s Bipolar Advantage Program is one such offering.
What Laws Apply to Managing Employees with Bipolar Disorder?
Fentin note the following laws that may come into play when dealing with people suffering from bipolar disorder.
- ADAAA—Americans with Disabilities Act as Amended Act of 2008
- Applicable EEOC regulations
- Family and Medical Leave Act (FMLA), if eligible
- State and local laws against disability discrimination
Bipolar Disorder Clearly Is a Disability
Bipolar disorder is clearly a disability, says Fentin. Remember that it is evaluated without considering the effects of any medications. Your obligations to the employee include:
- No discrimination or harassment
- Reasonable accommodation, including an interactive dialogue to determine what accommodations might be possible
Distinguishing Bipolar Disorder from Nondisabling Conditions
Bipolar is not:
- Short‐term sadness brought on by an event (death, breakup) that is expected to lift with time
- Temporary anxiety over a change in circumstances (car accident, new supervisor)
Bipolar is far more serious and longer lasting than these. Unfortunately, bipolar is typical of compensation challenges. “Maintain internal equity and external competitiveness and control turnover, but still meet management’s demands for lowered costs.” Heard that one before?
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