Bipolar and the Workplace

I often get asked the question “your kids are all at school now, why don’t you go back to work full time?” and it always leaves me floundering a bit for a socially acceptable explanation. It's hard to tell people that I struggle with a mental illness and while I haven’t had a major hospital requiring episode for nearly 2 years, the truth is I am scared to work full time, scared I will over commit and become unwell again. 

Every single time I have worked ‘full time’ hours, as in 9am-5pm  5 days per week, I have had an episode resulting in having to cut down hours. One or two full days a week seems to fit well for me, it gives me something productive to do and a social outlet but it doesn’t cause the stress build up that can trigger my illness.

“But lots of people with chronic depression work full time jobs.” 

Yes, yes they do. My hat goes off to them because I honestly don’t know how they do it. I have tried to work while depressed and had mixed results. If the depression at the time is relatively mild and not accompanied by anxiety, then I am able to plaster on a fake smile and make small talk in all the right places for 8 hours and then collapse into a heap afterwards. It exhausts me and gives me no energy reserves. My children and husband suffer because they have to deal with a wife and mother who can’t participate in family life, cries uncontrollably, yells too much and stays in bed all weekend.

When I am severely depressed most of my journey to work is spent convincing myself not to drive into oncoming traffic, work itself becomes pointless as I am unable to remember anything, concentrate or communicate effectively with colleagues, my inner dialogue chastises every thought and every thought’s, thought. I am useless, hopeless and I think about my pre constructed suicide plans at least 30 times per hour.

My anxiety spikes because I am aware of how completely awful my work performance has become and I become paranoid that I will be fired at any moment. The anxiety causes my hands and legs shake until I can no longer use a keyboard or construct a basic sentence, I am terrified somebody will realise I am not ‘ok’ and if someone actually asks how I am I am likely to burst into tears.

I literally attempted suicide in the car park outside an office building I worked in once because I couldn’t face going up there again.

“But what about hypomania, that makes you super productive, right?”

Ha! Yes, and no. Mild hypomania can be wonderful, everything seems crystal clear as though you have cleaned a dirty window or put on glasses for the first time. Your energy levels are up, you are exercising more, dressing for success, getting involved in more social events, and not needing as much sleep as usual to wake up refreshed. Work has suddenly become much easier, words and ideas flow in conversations and meetings, you enthusiastically take on more and more projects, everybody notices your excellent work ethic and bubbly attitude and are a sure thing for that next promotion.

The trouble with hypomania is it usually either fizzles out before you have finished all those new project submissions, or it increases in intensity. Intense hypomania is where everything becomes very, very fast. All those wonderful ideas are still coming only they are happening so quickly that the part of your brain that filters out the plausible from the outlandish takes a little holiday.

You are energetic and excited and EVERYONE needs to hear your AMAZING ideas so that they can be implemented as soon as possible! You are talking fast, really fast; your bosses boss whom you have approached directly to save valuable time and company resources, is having to get you to repeat yourself two or three times so she can understand your words.

To prove to your employer how your brilliant idea will best suit the company you have spent the last three nights at home awake until 5am on the computer researching patents, emailing CEOs in China and creating business plans, brochures and designing logo’s and buying websites.

Despite you feeling like a million dollars, at this point your family has probably realised that something isn’t right and are hopefully enacting some sort of pre organised action plan, if you are in therapy your therapist will have advised you not to go to work and sent you to a psychiatrist for a med review.

If you ignore this advice and carry on in your quest for glory, one of two things will happen. Either the intense hypomania stops dead in its tracks leaving you fatigued and in way over your head paving the way for a depressive episode or it escalates further into full blown mania.

Full blown mania at work isn’t fun anymore, you stop looking like a brilliant all be it slightly eccentric up and comer and start to look just plain crazy. You can’t remember the last time you had more than two hours sleep or ate something that wasn’t put directly into your hand. Your hair and make-up aren’t quite right anymore, you accidently wore your sneakers with your dress because you were too busy that morning writing long lists of famous people to pitch your life changing ideas to and got distracted.

Your mind is whirling so quickly that it can’t keep up with itself, ideas don’t even make sense to you anymore because they have all moshed together, hallucinations begin. You need to tell your boss that you have to go home, he says that’s fine so you head out to the car. Why are you still sitting at your desk? Didn’t you leave? Did you imagine that? Oh you are in your car. No its your desk? You can’t even tell what is real anymore.

You half come to your senses and realise you are in the sick room, your manager and team leader are both with you discussing whether or not to call an ambulance, the room is spinning. You try to talk, to explain, but the words come out too fast and too jumbled to make any sense. Someone comes to pick you up and all your colleagues stare at you in disbelief as you are escorted out of the office.

“But now that you are on a medication regime, you should be able to work full time like everyone else, shouldn’t you?”

Unfortunately, it’s not that cut and dry. Medications certainly save many people’s lives but they can often feel like a deal with the devil, you get to keep your sanity but not without serious side effects. Insomnia, fatigue, weight gain, tremors, cognitive and memory issues just to name a few; these can be quite disabling. Many people spend years trying to find a medication where the challenges of the side effects don’t outweigh the issues caused by the bipolar in the first place. 

“So how can we support people with bipolar in the work place?”

That plaster cast on your broken leg is a visible reminder that you are unable to run at the moment. Mental illness is invisible, it is understandably hard for people to remember that someone may be struggling when they don’t have a visual representation of illness to remind them all the time.

Having bipolar disorder does not make you a bad or lazy person, it doesn’t mean people need to tiptoe around you or fuss over you constantly either. While we don’t want to be singled out from our peers and colleagues we ask that you understand that living with this illness can be extremely challenging and working full time hours is simply not a viable option for many of us. 

What we do ask for:

• Increased awareness of our challenges and some of your time to listen and learn a little bit about our condition.

• Be willing to express concern if you feel our moods are intensifying but don’t assume every scowl or sad expression means we are about to have an episode. People with bipolar have normal feelings of happiness, frustration and sadness each day just like you do.

• Flexibility, we have doctor appointments, therapy appointments, specialist appointments that we must attend and these are often only available during work hours. We can become unwell suddenly and may require time off without warning at inopportune moments. We don’t mean to be difficult, but having one or two days off now can prevent several months off and severe productivity losses later on.

• Respect our privacy, if we want to tell colleagues about our condition or give you details about our recent visit to the psych ward we will, but otherwise we would appreciate you keeping these things on the down low.

• Patience, some of us might be taking several different medications that make us unable to function very well before 10am or after 3pm. Our memories might also be affected and we may require a little more prompting than other staff do.

So please understand, while you can’t see my mental illness, it is something that affects my life every single day. I enjoy working part time and challenging myself with new projects and my decision not to work full time has not been made because I am lazy or out for a free ride in life, but because it is the best one for myself and my family.