Together at the Poles

Accommodating Bipolar Disorder in the Workplace, Part III: Emotional Support


This is the third part of a series. Part one, which discusses disclosure and stigma can be found here. The second part, on scheduling can be found here.

At first, it might look like emotional needs may not be a part of an employer’s responsibility. After all, employers don’t seem to concern themselves with the emotional needs of their employees; a certain set of emotional predispositions is required of anyone in a work environment.

Red Person

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However, this is an inaccurate representation of what goes on in workplaces. Employers do take care of their employee’s emotional needs, but because people without mental illnesses tend to respond to many of the same types of feedback, we tend not to notice what is going this dynamic. Feedback on work, the setting up of the work environment, the treating of employees with certain types of respect and so forth take care that the average person is able to maximize efficiency in a workplace. Often this is worked into what is called a “retention strategy”, which is the way in which employers ensure that they can hold onto their quality employees.

Many bipolar employees require a slightly different retention strategy. However, because the different retention strategies are required to make bipolar employees comfortable at work and even able to work at their maximum efficiency, they actually become a part of reasonable accommodation. Which parts of a retention strategy would need to change will vary from employee to employee and position to position.

Work Environment

People with bipolar disorder often don’t thrive without certain accommodations in terms of the physical work environment. As I mentioned in the second part of this series, bipolar disorder is often a cyclical disability, meaning that it affects employees only at certain times when they are having episodes. However, even when employees are not having their strongest episodes, that does not imply that they are necessarily asymptomatic.

Light

Full-Spectrum Desk Lamp

Source: Fat Wallet - Fair Use Rationale: to illustrate the person(s), product, event, or subject in question.

One important issue for many bipolar people is light. In fact, for many bipolar people, if not most, their moods tend to fluctuate in certain seasonal patterns. For the most part, this takes a simple form: light equals good. Working in a dark environment can produce depression in employees, who effectively have moods that work like seasonal affective disorder.

So, one important accommodation can be ensuring that bipolar employees have good lighting in their workspace. Bipolar employees may require that their cubicle be especially well lit. This can mean moving the cubicle to a better-lit part of a shared office or simply using more light sources.

Sunlight is much better than artificial light. This doesn’t necessarily mean that they should have a windowed office. However, bipolar employees who are especially sensitive to light may require artificial solar lighting, which provides light on a wider spectrum than typical lighting. Many people with seasonal affective disorder already use this sort of lighting and it is widely available.

Breaks

For bipolar people who do work through some of their less serious episodes, they may be suffering from what is called “psychomotor retardation”. This is a symptom of the depressive periods of bipolar disorder that makes everything seem like more work than it would otherwise be. At its most serious, people with psychomotor retardation find it hard to even get out of bed, but people with bipolar disorder can often work through less severe forms.

However, when suffering from psychomotor retardation, everything feels like it is taking twice or more the normal amount of effort. As a result, people with bipolar disorder may need more frequent breaks in order to recuperate than other people might. That one hour between normal breaks feels like two or three. When in a state of psychomotor retardation, bipolar people burn out faster and will actually accomplish more if they can take more frequent breaks (consider why breaks are good for efficiency in the first place).

In addition, the breaks may need to be a little longer. After all, the work feels more intense. By balancing frequency and lengths of breaks, bipolar employees will be able to accomplish more through periods of psychomotor agitation.

Employee Expectations

Employee Feedback

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People with bipolar disorder often find it hard to read both how well their are doing and how much other people approve of their work. In general, if bipolar people have a low mood, they may have a tendency to think that their work is subpar and that everyone dislikes it, no matter how good it is. Conversely, if bipolar people have a high mood, they may have a tendency to think their work is incredible no matter its flaws and assume that everyone thinks their work is excellent.

Frequent Feedback

As a result, many bipolar employees require more direct feedback on their work than other employees, so that they can replace these mood-based assumptions with a more objective assessment. Unless the employee is actually in a serious episode, they won’t just ignore the feedback, assuming they get it. However, without such feedback, they may simply invent their own.

The easiest way to do this is to simply schedule weekly feedback meetings with a supervisor. These need not take more than fifteen minutes, and the goal is simply for the supervisor to go through some of the things that the employee is doing that are both higher and lower quality. With this feedback in place, the employee can focus on continuing to do what he or she is doing right while correcting what he or she is not doing as well. A few extra minutes once per week can greatly improve a bipolar employees work by avoiding the tendency to constantly apply shifting standards to himself or herself.

Dividing Up of Projects

Because bipolar employees can often be unsure of where their moods will go, larger projects that are not divided into parts can often be overwhelming. Many bipolar people have learned to divide up projects into smaller parts to compensate for this, but in some cases, employees are given large projects that can’t be divided up except by a supervisor, and the employee ends up working on several aspects simultaneously.

One way to overcome this is to divide up projects into a series of parts, each of which can be done in succession. This allows people with bipolar disorder to focus on smaller projects that are less anxiety provoking, while at the same time allowing them to better slot in those parts as their moods fluctuate.

General Support

By far one of the most common comorbid disorders with bipolar disorder is anxiety and, when coupled with irritability, this can lead to one of the most common ways that bipolar people leave their positions. They may believe that people dislike them or their work, and start to genuinely believe that other people are out to get them or dislike them. This usually isn’t true, and except in serious episodes, is actually fairly easy to accommodate.

One of the most important things that a bipolar person may need is an open channel of communication. Some bipolar people are especially good at “presenting well”, meaning that it is especially hard to read how they are feeling, especially if they are subclinical. Sometimes, an employee may feel so terrible that they need to go home, but it won’t be immediately obvious. The more open the channels of communication, the more likely they are to come to you.

Positive Reinforcement

The easiest way to avoid conflict is to provide positive reinforcement to bipolar employees. Just like shifting standards, worries about a work environment are usually not especially entrenched, and just need to be dispelled by something real like compliments on work. Positive reinforcement is important in the workplace anyway, but for people with bipolar disorder, it can easily make the difference between a bipolar employee staying in the position and leaving.

For people without bipolar disorder, the need for high levels of positive reinforcement might seem like a kind of narcissism, but for bipolar people it is a way of compensating for the effects of the illness. There is not really a correct level of positive reinforcement, just a correct level for each individual.

Crisis Management

It is quite possible that a person with bipolar disorder may have an episode while at work. This can be disruptive and it can be quite damaging to relationships between the bipolar employee and other employees. In this case, an employer and an employee should have a plan in place to deal with an episode as it arises, so that damage can be kept to a minimum. This plan should be worked out in advance, as it will be difficult if not impossible to generate during an episode.

There are a few steps that one should take during a crisis:

  • Put together a list of symptoms with the employee in advance to determine what symptoms would constitute a crisis.
  • Be calm in any discussions with an employee thought to be in crisis. Try to convince the employee not to leave.
  • If possible, try to isolate an employee thought to be in crisis from other employees. This can prevent disruption and future embarrassment for the employee.
  • Have a list of phone numbers to call in case of a crisis. This can include family members or a physician. If no one else is available, consider calling 911, or taking the employee to the hospital.

An episode itself should not be a disciplinary issue. At the end of the day, it is a symptom of a medical illness. Medical issues can be disruptive, but that doesn’t necessarily mean that the person has done anything wrong (consider George H. W. Bush throwing up at that banquet in Japan).

Conclusion

Employees with bipolar disorder may have special emotional needs. These do not represent cries for attention or excessive praise, but simply ways of compensating for the way that emotional episodes, even subclinical ones, can make it difficult to appropriate evaluate their own work and their relationships. By putting together an appropriate work environment, providing certain types of feedback and putting together a crisis plan, bipolar employees are often able to become even more effective in the workplace.

This is the third part of a series. Part one, which discusses disclosure and stigma can be found here. The second part, on scheduling can be found here.

8 Responses to Accommodating Bipolar Disorder in the Workplace, Part III: Emotional Support

  • I definitely agree with the frequent feedback and dividing up of projects points you made. Both are especially helpful when you are in a manic phase and are easily distracted. Once a task is broken down, I find that each part of it becomes a small detail and then you just focus on them in order, and when manic thats where I shine.

    If I had a more accommodating supervisor as a mid-level manager, I might very well still be there instead of having to step down to a less stressful position…of course, as a manager its hard to help the employees under you when you need such help from your manager. Kind of a Catch 22, ce’st la vie ^.^

    • I hadn’t really thought of how small tasks are something that we really excel at when manic or hypomanic, but now that you mention it, it makes sense. When my mood is elevated, I find I’m often able to do a lot of little things very fast and often very well. Thanks for the insight.

  • I would like to thank for the information and suggestions in this blog. As a supervisor of a bipolar person, I find it very useful, especially “emotional support”.
    I would like to add here that the person under my supervision has absolutely no visible symptoms of the disorder. However, we both were struggling before I knew about his medical condition. As I can see (and I might be wrong since he is not open about the condition), most of the problems he has are not a result of depression or hypomania but are side effects of a treatment (and I fully understand how important it is). The main issues are problems with the memory (like forgetting to fulfil a task), confusion (between two small tasks for instance) and similar stuff. Since I know about the problem I ask him to write down information he needs to remember and divide for him bigger tasks into small pieces.
    There are also other small issues that I believe are side effects of drugs, such as not noticing a hostile behaviour of one of the colleagues.
    Right now I am learning what the problems are and how to solve them. It would be very helpful to get some more information about these side effects and how to deal with them in a most professional and helpful way.

    Thank you

    • Hi Joan,

      Thank you for the comment. You are definitely right that the medications and treatment themselves can cause issues that themselves need to be accommodated. I had chosen to stay away from the side effects of medications, simply because there are so many different medications with so many different side effects that it would be a huge project to discuss accommodations for each one of them. However, now that you’ve brought it up, there are definitely some side effects that are more common than others (the memory problems are especially common; I’ve even had them myself on previous medications). Thank you for the suggestion, and I’ll put some thought into how to discuss some of the side effects.

      Best,
      Daniel

  • I am not bipolar, but BPD, and I agree with all this too. What I could never do though, is to ask for this kind of accommodation. I’ve been fired multiple times because I can’t control my emotions enough, and I know, that even if discrimination against the mentally ill isn’t supposed to exist – it does. I think they would very carefully find some way to fire me while making it seem like it was me, and not at all health-related. Also, can you imagine someone in a conservative company (where I usually work) who would promote someone who admitted to dealing with mental illness? It’s almost impossible to imagine. Maybe your experiences are different than mine, but that’s how I see it. It’d be nice, but… if I want to have the same fair chance at doing well in a company as someone without mental illness, it’s better for me to keep my mouth shut.

    • We’re at an awkward point historically, where discrimination is illegal but it still readily exists. So, it’s really a matter of judgment whether or not to disclose, and it will vary from position to position. One thing I think anyone with a mental illness could benefit from is retaining a lawyer. Since discrimination is illegal, it’s good to have legal protection. It’s amazing what a single scary letter from an attorney can accomplish.

  • Hi Daniel,
    Thank you so much for your post here I find it very valuable that you are speaking out about accommodating bipolar disorder in the workplace. I’ve been doing some research on bipolar disorder and the link to creativity and your post here sparked a blog post on my own website.

    http://ideatetowin.com/2012/08/06/clinically-creative-part-3/

    Keep going!
    Krysta

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Psychotherapy from Daniel

Daniel Bader, Ph.D., RP (Qualifying), CCC

Daniel Bader, Ph.D., is a Registered Psychotherapist (Qualifying) and Canadian Certified Counsellor specializing in bipolar disorder, offering in-person psychotherapy in Kitchener, Ontario, and online and telephone psychotherapy within Canada.

To book an appointment with Daniel, please visit his Psychology Today profile.