If your bipolar disorder symptoms threaten your job security, it’s time to educate yourself about disability protections and whether you want to disclose your diagnosis.
Jon B. has been in the workforce since he was 21—almost as long as he’s had a bipolar I diagnosis. Call his story a best-case scenario of bipolar on the job.
Jon, now 33, has been employed on the facilities staff at a Midwestern campus for the past couple of years. The others on his team of four know he has bipolar, something he cautiously shared in one-on-one conversations after he’d been on the job for six months or so and began to feel that they were friends.
“My co-workers had no negative reactions,” he says. “They simply listened to me and my story. I didn’t feel judged in the slightest.”
If he needs to leave work a little early for a therapist’s appointment, he says, “it’s just not a big deal.”
He hasn’t had any big issues due to bipolar symptoms, either.
“I try to be a happy and level-headed person, on my best behavior, who takes good care of myself and takes my medication regularly,” he says.
Of course, the employment picture isn’t so rosy for everyone. For one thing, research suggests that from 20 to 50 percent of people with bipolar don’t have paid employment. Among those who do, some find that mood symptoms lead to trouble on the job or stigma fosters a hostile environment.
“My co-workers had no negative reactions. They simply listened to me and my story. I didn’t feel judged in the slightest.”
When Greg S., a registered nurse, was employed at a hospital in the South three years ago, he took time off to deal with an untenable combination of family problems and his bipolar. On his return, his diagnosis somehow became common knowledge. He perceived a shift in how co-workers treated him, including how his actions and reactions were interpreted.
In his experience, he explains, “Once you are ‘labeled,’ sometimes you’re not allowed to get mad anymore, or stand up for yourself when you need to. Maybe I’m given too many patients to take care of during my shift, and when I bring it up, what might have been a simple disagreement … turns into, ‘There he goes again.’ ”
In his view, people with substance use issues get more leniency and understanding when they return after rehab than he did after his leave.
“I feel it’s more culturally acceptable to be a drug addict than to have a mental illness,” he says.
In some cases, the demands of a particular work situation just don’t mix well with managing bipolar. When Bijal D. had a full-time job at a construction company under a difficult boss, she had trouble staying stable—even with accommodations like getting a half- or whole day off when necessary.
After a year and a half in that position, she made the difficult decision to resign.
“I needed money, but my mental health was more important,” the 48-year-old says.
Law on your side
Bijal lived off her savings for a year, taking a couple of temporary jobs to tide her over. One was a part-time position with a mental health professional—and getting that position meant explaining the long gap in her resume.
“I said I had family health problems—and in fact, my father had just passed away,” she says.
Explaining that you were dealing with bipolar mood episodes—or any other medical condition—likely won’t endear you to a future boss. Indeed, experience has taught Jon that radical honesty may not be the best idea when you’re trying to get work.
Looking to get hired at a bookstore one summer, he listed “bipolar disorder” on a job application line that asked about having a disability. In hindsight, he says, “I really didn’t have to answer that.”
Whether or not that was the reason, he didn’t get the job.
“I would have been the friendliest, best bookseller ever, but I didn’t hear back,” he says.
According to experts at the Job Accommodation Network, a U.S. government program that offers free advice on the American with Disabilities Act (ADA), you have no obligation to discuss your diagnosis with an employer during the hiring process.
“Under the ADA, generally speaking, you don’t have to disclose a disability until you need accommodation,” says Melanie Whetzel, a consultant with the Job Accommodation Network.
“If you’ve taken time off, you can say, ‘I’m just dealing with stress and some personal issues’ and that’s enough.”
(Just to clear up any confusion: In mental health circles, the term “disclosure” generally refers to telling someone your diagnosis. That’s not the same as “disclosure of disability” under the ADA and another U.S. law known as the Rehabilitation Act of 1973.)
The ADA prohibits discrimination against people with disabilities in a variety of arenas, including employment. Under human rights legislation in Canada, everyone has the right to equal treatment in employment and no one may be discriminated against on the basis of actual or perceived disability. (For clarification, “equal treatment” does not mean being treated the same; generally speaking, employers have a duty to provide the necessary support to perform essential job duties.)
In both countries, disability is generally defined as an impairment that substantially limits an individual’s ability to carry out one or more major life activities—and that umbrella covers mental health conditions.
Accommodations are reasonable modifications that help you remain a productive employee, such as flexible work hours, adjusting how work gets done, or tweaking the work environment. For example, if you have trouble staying focused because of fuzzy thinking during bipolar depression or when you’re overly distracted during mania, you might ask to wear earbuds to mute distracting noise or request a cubicle with higher walls.
The law provides recourse against discrimination, but doesn’t guarantee you’ll have an ideal outcome in every situation. Nor does it provide blanket protection for problematic behavior: A recent court ruling in Cincinnati found for the employer when a factory worker with bipolar was dismissed for a pattern of angry outbursts.
In requesting accommodations, you likely will need to provide your employer with a doctor’s note or other documentation confirming that you have an impairment—but “ in most situations, you do not have to share your actual diagnosis,” says Donna Hardaker, a specialist in workplace mental health.
Hardaker was director of Mental Health America of California’s Wellness Works program before taking her expertise to the Sutter Health system in Sacramento earlier this year.
She recommends educating yourself about your employer’s accommodation policies before you take any action, including whether to approach an immediate supervisor, the human resources department, or your union rep, if applicable.
It’s best to conduct conversations in a planned, calm manner, she notes. Consider bringing an ally into discussions if you need the support.
“If possible, minimize sharing of information and requesting of help when in a highly emotional state,” says Hardaker. “Request a meeting and come prepared with information and possible strategies for accommodation.”
Although employers have a legal duty no matter what, it’s good diplomacy to frame any discussions about accommodations—or medical leave—around how this will help you be a better, more productive employee.
That holds true for the dreaded resume gap, too.
“If you had a gap in your work history, you would want to tell the employer if you were helping a family member, did volunteer work, or received training,” Whetzel says. “Then focus on how those experiences helped and prepared you for the next steps in your career and how ready you are to move forward.”
No matter what you decide to tell your boss, the human resources department, or a prospective employer, personal medical information must be kept confidential, Whetzel says. It’s your decision how much you wish to share with co-workers.
“If you’ve taken time off, you can say, ‘I’m just dealing with stress and some personal issues’ and that’s enough,” she says.
Choosing to be more explicit may give co-workers more context for symptoms like increased irritability or taking longer to get things done. Still, there’s no predicting how others will take the news.
Bijal says that when her mood revved up, she would get hyper at work, joke, and talk very loudly—the kind of behaviors that people around her would be apt to notice. When she did share with a co-worker that she has bipolar, though, she felt the person began to treat her differently, “with caution.”
And after his experiences at the hospital, Greg says, “My gut instinct is it say, ‘Don’t tell anybody.’”
“It’s completely false if someone says you must share your diagnosis [to get accommodations].”
The decision to “come out” depends on many factors, including the nature of your job, the climate in your workplace, and whether you consider the people you work with to be good friends.
If you feel you’re ready to have “the talk” with co-workers, Hardaker recommends timing it to when you’ve been doing well. Ideally, she says, you’ll be adding “new information to their already positive perception”—but she warns there’s no guarantee of a good outcome.
“Be prepared for possible backlash by having your own networks of support, just in case your message can’t be heard right now,” she says.
Tom (not his real name), a 30-year veteran in the human resources field, made his big reveal during a not-so-positive period.
At a former job, Tom’s boss told him he was “disruptive, dysfunctional, and that I’d hurt some people with my behavior,” he recalls. In the back-and-forth over addressing the problem, his supervisor suggested that Tom write an email to the staff explaining what was behind his actions and attitude.
“It completely backfired on me—these were health care workers and even they didn’t get it,” he says.
Coping on the job
Tom, 52, is now a human resources director at a hospital in the Northeast. Only two people on staff there know about his diagnosis—and one is his wife. The other is a nutritionist who has a son with bipolar, and who has become part of his on-site support network.
To maintain privacy, Tom keeps his explanations vague when he has an appointment with someone on his treatment team.
“When I need to see my doctor or therapist, I can say I have an appointment ‘out of the office.’ I go first thing in the morning or last thing in the afternoon, and other people can think I went to the dentist,” Tom says. “Or I say I have an important personal matter to take care of.’ ”
When necessary, he takes a literal mental health day. A workplace policy called “earned time off” gives him some leeway.
“Anything more than a day and I’d need permission unless I was out sick. Some places require a doctor’s note, but I never got into a situation long enough that I was asked for one.”
“I go [to therapist appointments] first thing in the morning or last thing in the afternoon, and other people can think I went to the dentist.”
After giving himself that bit of breathing room, Tom says, “I force myself back into the office. Otherwise things will fester too much and get worse.”
His workplace behavior doesn’t make waves now that Tom is better managing his bipolar with help from his psychiatrist, therapist and a variety of coping strategies—including tai chi, hobbies like photography, and using a light therapy lamp from October through April.
In the mornings, he meditates in his rocking chair and forms an intention for the day. He writes that on an index card and places it in clear view on his desk.
To some degree, Tom is able to make his own workplace accommodations for milder mood fluctuations, which might cycle “from laughing to grouchy” in the course of a workday.
For example, the nature of his job often requires dealing with people even when he’s feeling unsociable. One of the perks of his senior position, he notes, is flexibility in scheduling what he needs to get done when.
“Yesterday I worked on projects all day in my office, not interacting and just lying low,” he explains. “Tomorrow I’ll make it up and be friendly and gracious, even if I have to play-act it out. You know what they say: ‘Fake it till you make it.’ ”
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Be Your Own Boss: Gain or Loss?
Carrie L. has bipolar disorder. A licensed professional clinical counselor, she chooses to have a private practice in Campbell, California—which “allows a lot of flexibility in terms of when, where, and how I work,” she says.
“With bipolar disorder, the biggest challenges I found with traditional employment were a lack of flexibility in terms of hours and a lack of control over my work environment. I was a competent and ethical professional, but in many jobs I wasn’t allowed to set my own hours or do some of my work at home.”
It’s true that working for herself, by herself, means she has to forego the companionship of co-workers and the comfort of a steady paycheck. Plus, she notes, working in a traditional job provides the kind of daily structure that can be very helpful in managing bipolar.
When you’re self-employed, she says, “you have to build structure and find social connections on your own.”
Running your own business isn’t for everyone, however. Another option: a “portfolio career” consisting of two or more occupations, related or not.
“You might have a part-time office job in the morning, tutor kids or college students in the afternoon, and walk dogs through a site like Rover.com on weekends,” Carrie explains.
Carrie highly recommends people use resources such as a career counselor, business coach, or vocational rehabilitation service. Another resource: “microenterprise” programs that offer guidance and financial support to start a business.
To tell the truth?
If bipolar symptoms affect your ability to perform your job, it may be worth considering “disclosure of disability” (which is different from disclosing your diagnosis) to your supervisor or human resources department. This is what triggers an employer’s duty to explore accommodations. Some expert advice:
There’s an advantage to taking action as soon as you start to have performance or conduct issues on the job. If you wait too long, “your employer doesn’t have to rescind discipline, low evaluations, or even a termination when they didn’t know a disability was a contributing factor,” says Melanie Whetzel, a consultant with the U.S. Job Accommodation Network.
You also want to act when you’re able to have conversations in a calm, planned manner. “If possible, minimize sharing of information and requesting of help when in a highly emotional state,” says California-based workplace mental health specialist Donna Hardaker. “Request a meeting and come prepared with possible strategies for accommodation.” Consider bringing an ally into discussions if you need the support.
Collaboration is key. “Ask your employer to work with you to develop a plan for your success,” says Mary Ann Baynton, program director for the Great-West Life Centre for Mental Health in the Workplace in Canada. Focus on solutions for how best to manage various work pressures, demands and conflicts.
Depending on your symptoms, your plan may have to address “what the employer can and should do if you become unwell,” Baynton says. For example, if you are at risk of a psychotic episode, your manager should have contact information for your doctor or another trusted person to support you.