Why work may be important to your quality of life
Having a job can give people a sense of purpose and identity, a sense of their own ability to succeed or feel competent at what they do, the chance to make friends and meet people, a feeling of being involved with others in shared work and the financial resources to reach their personal goals. It provides a structure for daily life, a reason for getting up in the morning and a place to go. This is as true for people with bipolar disorder as for anyone else; maybe more so. After all, chronic health conditions like bipolar disorder can make it hard to feel competent and to maintain an orderly structure to your life. A stable job is a source of structure and grounding that can be invaluable when living with bipolar disorder.
But there is an important thing to remember. Although having a job is an important part of life for many people, it is also clear that not everyone needs or wants one. Some people with bipolar disorder may prefer to be involved in meaningful volunteer work, some will make a conscious decision to focus on activities that they feel are more important (like caregiving or parenting) or that are less stressful. When it comes to jobs, there is no one-size-fits-all prescription.
What do we know about work and bipolar disorder? Well, the research is mixed. On one hand, some research has shown that unemployment rates in people with bipolar disorder are a lot higher than in the general population with around 40-60% of people with bipolar disorder being unemployed, often because they didn’t do as well as expected at their jobs (this is called workplace under-performance1). The number may actually be smaller than this, however, because it’s possible that it doesn’t include everyone with bipolar disorder who is working. Some people working with bipolar disorder who are doing well at work may not have told their co-workers that they live with the condition due to fear of stigma in the workplace.
There are a number of things that are linked with doing better in the workplace when you live with bipolar disorder, such as: having good cognition (the ability to think clearly, reason things out, and understand what’s happening or needs to be done), having more years of education under your belt, not having been hospitalized too much, not being depressed and not having a personality disorder as well as bipolar disorder2. Research also points to the importance of learning how to find your way around bipolar disorder-related stigma in the workplace3 as well as effectively dealing with problems between yourself and your co-workers and using self-management practices at work. Successfully getting back into work settings after a bipolar episode can be helped by having a good fit between the person with bipolar disorder, the job they’re going to do, and their support system; as well as by being in recovery from their mood episode.4
How you can take action
There are a number of ways that a person living with bipolar disorder can deal with it at work.
You have certain rights in the workplace as a person dealing with a serious health condition. Disability and anti-discrimination laws protect the work rights of people living with bipolar disorder. Some laws may require a person living with bipolar disorder to tell (or disclose) the condition to their employer. Disclosure5,6 of bipolar disorder is a difficult decision, given the reasonable concern that employers will discriminate against the person disclosing his or her condition, and the possibility of negative attitudes from co-workers. But on the brighter side, supervisors and coworkers can be excellent sources of support, where the workplace culture itself is a supportive one.
Using both psychosocial treatments and medication can prevent depressive or manic episodes from turning your life upside down. It’s possible that using medication only may not be enough to help people flourish in their work life. While medication is the accepted first-line treatment for people with bipolar disorder, for the best results, medications should be used along with other treatments like psychological and rehabilitative efforts. For example, there are psychosocial treatments that help people with bipolar disorder to improve how well they function socially and at work, and research has shown that supported employment is one way for people to deal with mental health challenges in the workplace.7,8,9,10 (Supported employment services for people with severe mental illnesses are usually delivered by teams in community mental health agencies who can provide people with support finding work as well as support in their jobs.)
There are a number of nonprofit organizations that provide support to people with bipolar disorder (or other mental health issues) in finding a job. Using your Employee Assistance Program, if your employer provides one, can really help in keeping a job once you find it. And remember, employers are required to provide appropriate changes to the job or the work environment for individuals with health barriers, unless these changes create "undue hardship" on the employer or other employees. In other words, if you ask for job duties that shrink enormously when you're depressed and expand enormously when your mood is elevated, that might be considered undue hardship to the employer – but if you request reasonable changes for specific job related issues, that should be provided.
A few recent research studies have found that individuals recovering from psychotic episodes link job success to three strategies: "self-assessing their mental health regularly, actively working to maintain and improve their mental health, and striving to feel connected to others at work."11 That last strategy is especially worth noting – having good relationships with your manager or co-workers is an extremely valuable source of support in dealing with bipolar disorder. It's a great idea to connect with an occupational therapist to develop a work or career plan as they’re trained to help people get back to doing their daily activities and work.