Scott Reeves, 05.03.06, 6:00 AM ET
Under the Americans with Disabilities Act, a person with a disability is not required to disclose it unless seeking an accommodation at work.
The downside is that you may be passed over for a promotion or demoted. The ADA makes it illegal to discriminate against a person with a disability as long as the person can perform the essential functions of the job. However, defining those functions and demonstrating your ability to perform them despite your disorder can be a long and expensive legal wrangle.
"The stigma is real," says David J. Miklowitz, a professor of psychology at the University of Colorado-Boulder and author of The Bipolar Disorder Survival Guide: What You and Your Family Need To Know. "It can be as subtle as fellow workers attributing justifiable reactions to situations to your illness, or as blatant as not getting a job or a promotion."
People with bipolar disorder can experience mood swings from overly happy and excited to overly irritable and angry. The highs may last from several days to a month or more, but the lows often last longer and can be harrowingly deep. Some experts say this psychiatric condition affects about one in every 25 Americans.
Miklowitz, who earned a doctorate in clinical psychology from the University of California at Los Angeles, says people with bipolar disorder usually adopt one of four disclosure tactics:
--Tell everyone at work about the condition, including the boss and co-workers.
--Tell one or more trusted co-workers who don't hold positions of authority.
--Don't tell anyone, but admit to having bipolar disorder on work-sponsored health insurance claims, opening the possibility that the employer may find out.
--Don't tell anyone at work, and don't use employer-provided health insurance to cover the costs of treatment for the condition.
"The advantage of telling your boss is that you can ask for reasonable accommodations at the office," Miklowitz says. "If you have a tough time in the morning, you might be able to arrange to start later in the day. Some people don't do well in dark offices and work better in a well-lit room or near a window. Others find it better to take several short breaks rather than one long break. If there is some reasonable accommodation the employer can make, it makes sense to disclose."
If a co-worker struggles with bipolar disorder, be supportive, but don't try to become an amateur therapist; your actions likely will be viewed as intrusive and demeaning.
If you're a boss and one of your workers discloses that he has bipolar disorder, think what can be done to help. A separate office might be appropriate if the employee has trouble with the clatter and chatter of an office. If a good employee becomes depressed during winter, it might be possible to arrange a leave of absence during the dark months if extra lights don't help.
"The worst thing for a boss to say is, 'You can't handle this job because you're mentally ill,'" Miklowitz says. "Some people with bipolar disorder feel they're not allowed to have the same reactions as others because it will be attributed to their illness--not because they're justifiably upset."
Miklowitz stresses that having bipolar disorder doesn't necessarily limit your career. A survey conducted by the Center for Psychiatric Rehabilitation at Boston University found that 73% of 500 professionals previously diagnosed with a psychiatric illness were able to maintain full-time employment in their chosen fields, including executives, lawyers, professors, nurses and newspaper reporters.
But bipolar disorder is a chronic condition and requires a watchful eye.
People in the manic stage of the illness often feel they can do things no one else can do. They may sleep less than usual--or not at all--and may have great energy, talk faster and express unrealistic ideas. Some may be easily distracted and act impulsively by spending money unwisely or driving recklessly, Miklowitz says.
In the depressive stage, those with bipolar disorder may feel extremely sad, irritable or anxious. They may lose interest in people or activities, sleep too much or be unable to sleep. Energy levels may be low. Some may feel bad or guilty. A few may talk about committing suicide--and some attempt it.
The illness can be treated with mood stabilizing drugs, such as lithium; Depakote, a product of Abbott Laboratories (nyse: ABT - news - people ); Zyprexa, a product of Eli Lilly (nyse: LLY - news - people ); or Lamictal, a product of GlaxoSmithKline (nyse: GSK - news - people ).
Taking such medication requires the attention of a psychiatrist to be sure that any side effects don't get out of hand. Many patients find that therapy helps them learn how to prevent relapses, manage stress, monitor moods and regulate sleep cycles. If alcohol or drugs are part of the mix, many find that mutual support organizations, such as Alcoholics Anonymous, are helpful.
If bipolar disorder can't be controlled, it may be necessary to apply for disability payments. This should be a last resort, and, with luck, you'll be able to return to work eventually. For many, work helps steady the mood swings.
"Work keeps you on a consistent schedule--when you go to sleep, when you get up," Miklowitz says. "People who work are less likely to use alcohol or drugs that make a bipolar condition worse."
Most employers are good people who want their offices filled with happy, productive workers. Most have no intention of stigmatizing anyone with a mental illness, and missteps rarely are malicious, but stem from thoughtlessness or ignorance.
Disclosing your condition can be risky, but if you believe your boss has your best interests at heart, talking openly about your condition is a shot worth taking.
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