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How does bipolar affect ability to work?


Bipolar disorder, formerly known as manic-depressive illness, is a mental health condition characterized by extreme shifts in mood and energy levels. Individuals with bipolar disorder experience episodes of mania (elevated moods and energy) and depression (lowered moods and energy). These episodes can significantly impact a person’s ability to function in daily life, including their capacity to maintain employment.

Bipolar disorder affects approximately 2.8% of American adults each year. It typically emerges in young adulthood, often in a person’s late teens or early 20s. This is a critical time when many young people are pursuing higher education or entering the workforce. As a result, bipolar disorder symptoms frequently disrupt academic and professional goals.

While many people with bipolar disorder can gain control over their symptoms and live productive working lives, bipolar does substantially affect occupational functioning for others. Issues with employment are common, and many studies suggest the majority of individuals with bipolar disorder struggle to maintain stable employment.

Let’s take a closer look at how the symptoms of bipolar disorder can impact a person’s capacity to work. We’ll also discuss treatment options and strategies that can improve occupational functioning.

The Impact of Manic Episodes

The manic phase of bipolar disorder is characterized by feelings of euphoria, racing thoughts, increased energy, impulsivity, and other symptoms. Manic episodes vary in severity and duration but typically last for at least one week. Some symptoms of mania that can negatively impact work performance include:

– Impaired judgement – During mania, people may take greater risks or make reckless decisions that negatively impact their jobs. This could include going on spending sprees, engaging in inappropriate behaviors, or taking on more tasks and projects than one can reasonably handle.

– Decreased focus – It’s common to have racing thoughts and difficulty concentrating during mania. This impaired focus makes it tough to complete tasks and think through decisions.

– Irritability – Many people experience increased irritability during manic episodes, which can strain relationships with bosses and co-workers. Outbursts of anger are more likely.

– Reduced sleep – Mania often involves sleeping less without feeling tired. Fatigue from too little sleep can reduce productivity and focus at work.

– Grandiose beliefs – inflated self-esteem and confidence are common in mania and may undermine willingness to take direction from supervisors.

Case Study 1: Mania Disrupting Employment

John began his first job out of college at an advertising firm. After a few weeks, his coworkers noticed increasingly erratic behavior. John began launching ambitious new projects without consulting his team. He worked late into the night, firing off emails at all hours with new taglines and ad campaign ideas.

While many of John’s ideas showed creativity, they weren’t grounded in reality. He became irritated when colleagues tried to get him to slow down or run ideas by their supervisor first. John’s manic symptoms caused him to alienate coworkers and undermine his actual job duties. After an angry outburst at a team meeting, John was let go from the position.

The Impact of Depressive Episodes

While mania represents the “highs” of bipolar disorder, depression reflects the corresponding “lows”. A depressive episode is characterized by an extremely low, melancholy mood along with other possible symptoms like:

– Loss of energy – Daily tasks require substantial effort. Individuals may call out of work frequently because they are too exhausted to get out of bed.

– Impaired concentration – Depression interferes with focus and attention span, reducing work performance.

– Changes in sleep – Sleep patterns are disrupted, involving either insomnia or sleeping too much. Both make it difficult to maintain a regular work schedule.

– Feelings of worthlessness – Low self-esteem contributes to decreased motivation. Individuals experiencing depression often see themselves as incapable in their jobs.

– Suicidal thoughts – In severe cases, depression may lead to suicidal ideation. Co-workers should take any expression of suicidal intent very seriously.

Case Study 2: Depression Disrupting Employment

Maria’s depression symptoms emerged in her late 30s. She began to have more difficulty waking up in the morning to go to her job as an accountant. Small tasks seemed to take substantial mental effort. Maria no longer socialized with colleagues and ate lunch alone at her desk with the lights off.

At home, Maria spent increasing amounts of time in bed. She called out of work frequently, and when she went to the office she struggled to concentrate. Maria’s supervisor noticed the change in her work performance and tried to give her words of encouragement, but there was little improvement. After months of support with no lasting changes, the company ultimately terminated Maria for too many absences.

Episode Cycling and Mixed Symptoms

One of the hallmarks of bipolar disorder is the cycling between manic and depressive states. These episodes follow an unpredictable course. After recovering from one severe manic episode, a person may quickly plunge into a depressive episode, then abruptly become manic again.

This cycling can happen over the course of weeks or even days. The fluctuating highs and lows make it incredibly difficult to maintain steady work performance. Additionally, some individuals experience “mixed episodes” where symptoms of mania and depression occur simultaneously. The competing symptoms leave the person feeling paralyzed, unable to function productively.

Cognitive Impacts

Research shows that in addition to mood disturbances, many individuals with bipolar disorder experience cognitive deficits. Even during periods of relative wellness between mood episodes, they may struggle with:

– Sustained attention
– Processing speed
– Learning and memory
– Executive functioning

These cognitive challenges can substantially undermine job performance. Difficulties with memory, attention span, and high-level functioning often persist regardless of how well a person’s mood symptoms are managed.

Psychosocial Impacts

Bipolar disorder affects much more than just mood. The psychosocial consequences of the illness also influence work capacity. These include:

– Damaged relationships – Frequent conflicts with spouses, family, friends, and coworkers strain an individual’s support system. This increases overall stress and makes employment more difficult.

– Social isolation – During depressive episodes especially, people withdraw from their social circles. Lack of social connection removes an important recovery resource.

– Substance abuse – There are high rates of alcohol and drug use disorders among people with bipolar, often as an unhealthy coping mechanism. Substance abuse undermines workplace performance.

– Financial stress – Frequent job losses, erratic spending during manic episodes, and medical costs can cause money issues that perpetuate employment challenges.

– Trauma – Some individuals experience traumatic events related to their bipolar symptoms. Past trauma interferes with focus and engagement at work.

Positive Coping Strategies and Treatment

While the symptoms of bipolar disorder undoubtedly cause major occupational challenges, there are treatment and self-care strategies that can improve functioning. These include:

– Medication – Mood stabilizing medications like lithium can reduce the severity and frequency of mood episodes. Antipsychotic medications may also be used as a bipolar treatment. Some medications have cognitive enhancing effects as well.

– Psychotherapy – Talk therapy and cognitive-behavioral techniques help individuals manage stress and develop healthy thought patterns. Therapy can provide practical employment strategies.

– Routine – Maintaining consistent sleep, exercise, and eating habits helps regulate mood. A predictable daily routine makes work engagement easier.

– Wellness strategies – Activities like meditation, journaling, and creative pursuits can be incorporated into a wellness plan to manage symptoms. Regular vacations and days off are important as well.

– Work accommodations – Adjustments like flexible scheduling, more frequent breaks, and working from home can support job retention. Coworker education helps build a supportive work environment.

– Support system – Having loved ones, friends, and professionals that can provide guidance and encouragement makes coping with the ups and downs of bipolar disorder much easier.

– Goal setting and tracking – Setting small, measurable goals for tasks and tracking progress provides a sense of control. Goals should be realistic based on current energy and mood.

Case Study 3: Effective Treatment and Coping

When Claire was diagnosed with bipolar II disorder in college, she began a treatment plan involving medication, therapy, and lifestyle changes. She kept her condition private for several years as she built her teaching career.

After a severe depressive episode, Claire’s psychiatrist recommended she request accommodations at her school. She began to openly discuss her bipolar disorder with the principal and close coworkers. With support at work and her outside treatment team, Claire excelled at her job and reduced the number of episodes she experienced.

Conclusion

Bipolar disorder significantly impacts occupational functioning in many cases. The mood and cognitive symptoms of the illness interfere with work performance and strain relationships. However, while bipolar poses inherent challenges, effective treatment and wellness strategies do allow many people to successfully manage their careers.

Supported employment programs, openness about the condition, workplace accommodations, and compassionate colleagues can make maintaining employment possible. Work provides an important sense of purpose and routine that aids in overall recovery. With proper care and treatment, people with bipolar disorder can absolutely overcome obstacles and achieve vocational goals.