29th March 2018
Chances are you’ve heard the term Bipolar Disorder, its usage having well and truly entered the mainstream over the past decade. Previously known as Manic Depression, despite general awareness of the diagnosis, the nature, signs and symptoms of Bipolar Disorder remain broadly misunderstood.
Could you identify the signs and symptoms that an employee may be experiencing Bipolar Disorder? If a colleague has received a diagnosis of Bipolar Disorder, what does that mean for you and your organisation? What can you do to help? In this article, we address what Bipolar Disorder really is, what it might look like, and what you can do to help.
What is Bipolar Disorder?
Bipolar Disorder is a term used to describe a group of mental health concerns (i.e. Bipolar I Disorder, Bipolar II Disorder, Cyclothymic Disorder). According to the DSM-5, Bipolar Disorder is associated with significant changes or “swings” in mood and energy levels, and each subtype differs in terms of its severity, frequency, and duration.
People living with Bipolar Disorder generally experience recurrent episodes of depression (low mood, feelings of hopelessness, extreme sadness, lack of interest and pleasure in usual activities) as well as episodes of mood elevation (also referred to as “mania” or, in its milder form, “hypomania”). Manic and hypomanic episodes are marked by a pervasive, extremely good mood, high activity and energy levels, agitation, racing thoughts, a reduced need for sleep, and the presence of rapid speech. It is the swing between these two extremes, or “poles”, that give the condition its name.
During manic episodes, individuals can engage in uncharacteristic and extreme risk-taking behaviours which can lead to damaging effects on career, finances, reputation, and relationships. Mood fluctuations for affected individuals can last a week or more, and are strongly associated with functional impairment across multiple domains (e.g., work, social, household, relationships). Severe episodes may also contain psychotic features (i.e. delusions and hallucinations).
What is NOT Bipolar Disorder?
Mood changes do not necessarily imply a diagnosis of Bipolar Disorder, as emotional highs and lows, as well as fluctuating energy levels are commonly experienced within the general population. More than just feeling good or feeling bad, a person experiencing Bipolar Disorder has sudden and extreme changes in mood, more so than having a “good day” or “bad day”.
Bipolar Disorder is a distinct phenomenon due to the intensity and severity of the moods experienced, and the level of disruption to the affected individual’s life resultant of the illness. Mood changes in Bipolar Disorder often occur out of context, and episodes can last for several days, weeks, or even months at a time. Bipolar Disorder is frequently misdiagnosed as depression, as depressive episodes occur more frequently for affected individuals in comparison to manic and hypomanic episodes, and accordingly depression can be more readily identified.
Bipolar Disorder in the Workplace
Mental health conditions reportedly cost Australian businesses between $11 to $12 Billion each year through staff absenteeism, reduced work performance and productivity, increased staff turnover rates, as well as compensation claims.
‘Every dollar spent on effective mental health action returns $2.30 in benefits to an organisation.’
(PWC, Beyond Blue National Mental Health Commission, 2014)
Approximately one in 50 (1.8%) adults in Australia experience Bipolar Disorder each year. Despite its comparatively lower prevalence, Bipolar Disorder imposes higher economic and non-economic costs to society than other mental disorders.
Research shows that the majority of mental illness seen in the workforce is treatable. Meaningful employment can also provide a supportive context through which recovery can take place. It is imperative that employers understand an employee’s subjective needs in a collaborative and supportive manner in order to then provide reasonable adjustments to the workplace conducive to an effective, productive, healthy and safe workplace for employees with Bipolar Disorder.
In a broad sense, flexible work practices (e.g., frequent breaks, working from home) are conducive to job success for employees with Bipolar Disorder. Access to water at workstations is another provision often cited in the literature, due to the side effects of medications such as Lithium (i.e. increased thirst and urination). Barriers between workspaces may be appropriate for employees with Bipolar Disorder as social withdrawal is often a feature of depression. This might also minimise distractibility, a symptom of hypomania, mania and depression.
It is also important for organisations to understand and accommodate the affected employee’s self-management strategies (e.g., absence from occupational settings when symptomatic, reducing the employee’s workload, changing work activities, enlisting emotional or practical support from trusted co-workers and/or professionals, seeking help from the employee’s healthcare team).
Workers who do not seek accommodations or disclose their illness may be those most anticipating employer bias. In order to address employees’ fears about disclosure, organisations may benefit from developing formal policies and clear guidelines addressing how employees will be protected from discrimination should they chose to disclose their mental illness.
Recovery from Bipolar Disorder
The use of medication is of primary importance to assist recovery from Bipolar Disorder, however in order to promote long-term recovery, a preventative plan will ideally combine physical, psychological and lifestyle approaches to manage the illness. People who function well despite a significant history of Bipolar Disorder cite the following key wellbeing strategies as critical to the recovery process:
managing sleep, diet, rest and exercise;
ongoing monitoring of changes to symptoms;
reflective and meditative practices;
understanding Bipolar Disorder and educating others;
connecting to others and;
enacting a management plan to stabilise symptoms.
Employees with Bipolar Disorder often bring valuable skills to the workforce, including creativity, high intelligence, energy, passion, and productivity. Supporting individuals affected by Bipolar Disorder with greater sensitivity and responsiveness will not only benefit employees and organisations, but also the broader systemic and social context in which mental illness exists.
World Bipolar Day will be celebrated on 30 March 2018 to increase awareness of the illness and to eliminate social stigma, and to improve sensitivity toward the illness.