Back to Work with Bipolar Disorder: Part II

By Candida Fink MD

In Part I of this series, I highlighted the challenge of returning to work with bipolar disorder and provided some practical advice on how to smooth the transition back to work after experiencing a major mood episode. In this second part of the series, I provide some more in-depth information and recommendations on obtaining additional assistance with your back-to-work efforts:

• Bipolar can get worse or better: Don’t add even more stress to your situation by assuming your condition is progressive and will get worse – this isn’t universally the case. With the right treatment and some good fortune, situations can and often do improve.
• Brains change: We sometimes have the idea that adult brains have stopped developing and changing – but that is not true. The brain changes throughout life – with or without Bipolar Disorder. But this of course means that medication needs and symptoms can all change over time as well.
• Stay in touch with your doctor: Returning to work can expose you to additional stressors and triggers, which can lead to more frequent or severe episodes, but medication can make a big difference. During the transition, your doctor may need to monitor the situation more closely and be prepared to make necessary adjustments to your meds. If the doc isn’t willing to consider changes, consider getting another opinion.
• Stay in touch with your therapist: If you have a therapist on your treatment team, he or she will be an important resource for you right now. Digging through the problems that are going on related to work and generating some solutions to those problems – running the gamut from things you can change to changing work situations and if so to what kind of alternative work – is an important part of the ongoing management of bipolar disorder.
• Consult a vocational therapist: Even if you already have a general therapist working for you, consult a vocational therapist who specializes in helping people deal with work-related issues and accommodations. Most states have some form of vocational training and rehabilitation services. You may need to be receiving services from your state Department of Mental Health or through Social Security Disability to qualify. Disability income, health care, and other supports should be available to people with mental illness in all states, but it is managed differently in different places.If you prefer private resources, you could consider working with a private vocational counselor. Vocational counselors may be accessible through a local or community college. For more information, check out theAmerican Occupational Therapy Association.

Tip: As an added bonus, obtaining vocational therapy can actually make it easier to obtain disability benefits later if you are unable to work. It proves that you’ve “tried everything,” and may even provide you with an additional advocate (your vocational therapist) who can testify that yes, you have tried everything.

• Get more help from NAMI: The National Alliance on Mental Illness is an advocacy organization and they may have a local chapter in your area; you can search for local chapters at http://www.nami.org/Template.cfm?Section=Your_Local_NAMI&Template=/CustomSource/AffiliateFinder.cfm. Connecting with people there may help you to access services in your local area.

Remember to try to tackle this in small pieces – one task at a time – it won’t all get fixed at once – but as long as you are talking to people and reaching out, you are still in the game.

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