Accommodating Bipolar Disorder in the Workplace, Part I: Disclosure and Stigma
This is part one of a series. Part two, which is on scheduling, can be found here. Part three, which is on emotional support, can be found here.
Bipolar disorder, as well as being a mental illness, is also a disability. It is protected in the United States under the Americans With Disabilities Act, while in Canada it is protected under provincial Human Rights Acts. Employers are not only obliged to ignore bipolar disorder when considering hiring decisions, but they are obliged to provide what are called “reasonable accommodations” for people with bipolar disorder. In other words, they are obliged to take up to moderately difficult, active steps in order to ensure that people with bipolar disorder are able to perform their jobs.
Getting Accommodations in the First PlaceCurrently, many people who have bipolar disorder do not disclose their illness to their employers. An Australian study recently showed that four in ten bipolar workers do not disclose. This is too high. It shows that too many bipolar workers are not comfortable revealing their condition. One obvious side effect of this is that employees who do not disclose cannot be accommodated.
Several things need to change in order to improve this situation. First, workers need to have it be known that their jobs are not in jeopardy if they disclose their disorder. There are general workplace accommodations that need to be put in place in order to ensure that people with bipolar disorder feel comfortable disclosing so as to get the accommodations they might need.
Second, many bipolar workers do not even know what accommodations to request. For many physical disabilities, accommodations are (relatively) obvious, and years of accommodating those disabilities have put in place laws that are just as specific in the kinds of accommodations required as they are general in saying that such accommodations are necessary. In order for bipolar workers to get the accommodations we need, we need to have some sense of the accommodations to ask for when we disclose our condition.
As a result, I will be putting together a series of articles on accommodations for workers with bipolar disorder. It is written both for employers and for employees. For employers, it provides ideas on steps that can be taken in order to proactively comply with the law and the requirements of social justice. For employees, it provides ideas on the kind of accommodations to request in the face of well-meaning employers who might not otherwise know what it is that we need.
Dealing With StigmaIn today’s discussion, I will deal with something that is not exactly an accommodation at all, but a prerequisite for accommodation. However, it is something that must be dealt with before any positive accommodations can be made. After all, if people don’t disclose or don’t feel comfortable just being bipolar at work, then there is no foundation on which to build bipolar accommodations or any foundation will be especially weak. This first discussion, then, will deal with the problem of stigma and how it affects bipolar people at work.
I have discussed the subject of stigma before. Stigma constitutes social disapproval of mentally ill people simply for the fact of being mentally ill. This is why stigma is overtly discriminatory; further accommodations will go beyond simply fighting stigma. It is analogous to the kind of discrimination that people might face for being of a certain race or a certain religion at work.
I think it is difficult for people to underestimate the amount of fear that many people with mental illnesses feel that we will rejected if people knew that we had a mental illness. Many mentally ill people hide their mental illnesses even from their close friends and family. In a workplace environment this is not only a fear of social rejection but fear of harming their careers and even of losing their jobs.
What is needed then is for employers to proactively make it clear that people who have mental illnesses, including bipolar disorder, feel safe revealing their mental disorders. Further, they need to be willing to ignore signs of mental illness that do not themselves impact performance (I will discuss cases where performance is impacted in future installments).
Proactively Easing Disclosure
I think many employers believe that they are only required to protect disabled workers who actively disclose their disabilities. However, this undermines the principles of accommodating mental illnesses. As the social goal of accommodation is for the mentally ill to be able to participate in society in the form of work and the mentally ill are legitimately worried about what will happen if they disclose, disclosure should be made as easy as possible.Almost by definition, though, employers don’t know which employees have undisclosed mental illnesses. As a result, they need to find ways of letting all of their workers know that the work environment does not discriminate against those with mental illnesses and that accommodations are available.
I know from my own experience that I haven’t known what will happen when I disclose, and so for the most part I haven’t. After all, if my employer doesn’t tell me that they are open to mental illnesses at work, I have no way of knowing that they are. I have no way of asking, either. “Would you discriminate against me if you knew that I have bipolar disorder?”, kind of lets the cat out of the bag.
So, employers should let their employees know proactively that they will not discriminate against the mentally ill and that accommodations are available. This can be done in a number of ways, such as by putting together a memo that is sent out annually, by putting up a sign on a prominent bulletin board, by sending out a letter or by simply announcing it at a staff meeting.
The more proactive the provision of this information is, the better. The goal here shouldn’t be just to meet some legal requirement; the goal should also be to have us believe you. A page buried somewhere on the HR website that was obviously written by lawyers makes it look like our employers are just trying not to get in trouble, not that they want to integrate us into the work environment. A memo is better than a bulletin board posting, and a letter is even better. Mentioning it verbally at a staff meeting is best (don’t do it individually, because that starts to look like you suspect something). The more it looks like our employers are actively trying to make us feel comfortable, the more it looks like our employers are actively committed to avoiding discrimination and accommodation and the more likely we are to disclose.
It would also be a good idea to have everyone who supervises other workers do the same with those under them. After all, discrimination from an immediate supervisor can be just as bad as discrimination from an employer, and most of us don’t want to get into HR battles because only our employer but not our supervisor are committed to accommodating us. If we fear discrimination from anyone, we are less likely to disclose.
Proactively telling people in job selection processes would also be a good idea. Applicants need to know whether or not they will be welcomed at work, as they are making an important decision about their futures, too. Bipolar people may not disclose during the job interview process (and they are in no way required to do so), but it will make them much more likely to disclose once hired if they were told at some point in the selection process. After all, it is impossible to get more proactive than that.
Employers committed to accommodation need to consider how to ease the process of disclosure. After all, accommodation is impossible unless employees feel comfortable disclosing.
StrangenessBehavior of bipolar people can be roughly divided up into two categories: those that affect functioning that those that are merely a little strange. I will talk about those that affect functioning in future installments, but here I would like to discuss those that just come across as kind of weird. I consider our strange behaviors to be just like skin color. It’s a sign that we have a legally-protected difference, but are nothing more than a sign and shouldn’t be something we need to either hide or be ashamed of.
A good example of this is the speed and enthusiasm with which we talk. When we are a little hypomanic, we tend to talk fast. We might also talk more loudly and with great enthusiasm about things that don’t exactly warrant it. However, none of these things actually affect our functioning at all. Unless we are having a severe hypomanic episode or a manic episode, we will usually be perfectly intelligible while doing this. We’ll just be a little strange.
There are others, too. We might like to pace, sit awkwardly, or, when depressed, read with our head in our hands. These aren’t ways that people normally behave, but they aren’t functionally relevant either. They’re just “tics”, so to speak. They “mark” us as bipolar (the Greek meaning of “stigma”), but don’t do anything more.
I think something people without mental illnesses don’t quite appreciate is just how much work it takes to hide these ticks. They also don’t appreciate just how much anxiety arises from the worry that they may not have been successful in hiding these ticks. In fact, the constant anxiety of trying to hide my bipolar ticks was a large part of my decision to go public three months ago. Expecting us to hide these ticks places an undue burden on us.
I think one of the things that an employer could ever say to me is something like, “And don’t worry at all. If you’re speaking a little fast that day or want to read with your head in your hands, that’s absolutely fine. If you’re having difficulty, please let us know, but don’t feel you need to hide your moods. We want to welcome you as a part of our diverse work environment.” (I will discuss ways of monitoring employee moods in future installments, but one thing not to do is to ask bipolar people if they are okay every time they are at all symptomatic).
I need to make a quick note here about confidentiality. If another employee complains that a bipolar worker is acting strangely, but the bipolar person has not disclosed to that employee, then employers should not disclose on the bipolar person’s behalf. Employers can provide general non-discrimination training for employees so that they are aware of what does and doesn’t constitute legally protected differences.
Before working on accommodation, a workplace first needs to create an environment in which people who are bipolar are comfortable disclosing their mental illnesses. There are a few easy steps to take when doing this:
- Be as proactive as possible in letting all employees know that the workplace is welcoming of mental illnesses and that accommodations are available.
- Provide this information at all levels, including supervisors and during the hiring process.
- Recognize that bipolar people have strange behaviors that do not affect functioning when subclinical, and be accepting of those behaviors.
By following these steps, it is easier to create a work environment in which bipolar people feel comfortable.
This is part one of a series. Part two, which is on scheduling, can be found here. Part three, which is on emotional support, can be found here.
What about the states that rule with the iron fist of “at-will employment”? You can be fired without an explanation. After I was called a psychotic b-itch by one ex-employer, who KNEW of my condition (a lawyer, no less) I was fired for the sole reason I was “a liability”. I contacted employment lawyers who all told me that I couldn’t prove they fired me out of discrimination, when in fact, it clearly was. Thoughts?
I’m very sorry this happened to you. At-will employment doesn’t, in principle, allow people to fire others for discriminatory reasons, such as religion, race or disability. The main problem is that the burden of proof is on us that discrimination was the cause, and it can be difficult to prove. In addition, many judges and, as you point out, even jurisdictions can be hostile to the law (partly because the laws are federal in the United States). So, we end up stuck between what the law says can happen and what the system allows people to get away with.
I don’t know what the timing of your case might be, but the U.S. rules changed last year and are retroactive for claims dating back to January 1st, 2009. Before that, whether bipolar Americans were protected was dicey at best. There’s some discussion of the changes on this page on the EEOC website.
I’m so glad to see that the law has changed last year and they made it retroactive. Unfortunately it didn’t change in time to help me. I also however have a number of physical disabilities, (walk with a cane, COPD, and major depression as well as Bi-polar. When I was ousted I contacted the EEOC but was told they were not taking cases of white women over 40. Talk about discrimination. I felt abandoned without any recourse. So I took on the social security system. Only to be told my husband makes too much money for me to apply. Recently he moved out and I have been approved after 3 attempts and 6 years. I had not disclosed as I felt like I would be targetted for dismissal. I worked at a major chain drug store and even would not fill my prescriptions there because as an employee there were no secrets. Sad story as I still feel as though I might be worth something in the right position. Oh well until I find that position I’m just going on with my SSI. Just wanted to vent my story thanks so much for this site and it’s wealth of info.
You’re welcome, Christina, and I’m glad to hear that your situation with social security did work out in the end. Your situation with the EEOC sounds really awful; I hadn’t even heard of anything like that before, though I’m not surprised.
Isn’t it tic, not tick?
Oops. Fixed. /blush
I realise disclosing is anxiety generating in itself, but i found that following disclosure not an awful lot changed apart from i felt a lot better every time i told someone i was bi-polar! The onus is on me to mange being bi-polar whilst staying in employment and although accomodations can (and should) be made by my employers, they have shown themselves to be fairly ignorant as to what bi-polar is and have shown very little interest in learning anymore about it. It would appear that as long as i am doing my job competently, then it is not an issue as far as they are concerned. The interesting times may be when it does start to affect my work performance and how much consideration will be given to the fact i am bi-polar. It is without doubt a huge step to take and i am sure people will have a variety of experiences (both positive and negative) and should always consider carefully whether it is something they are able to do. All i can say for myself is that once i accepted i am bi-polar i felt i should treat it positively rather than hiding it from people and take each day as a challenge to move onwards and upwards!
Thank you for the very positive comment, Dan. In cases where we’re functional, there’s always the option of showing that we could be even more functional, I suppose, but I’ve found most employers simply have no idea how to help, unfortunately.
I want to thank you for another very insightful blog. I have bipolar 1 and was diagnosed in 2009. I worked for the state of michigan for 22 years. After reading your blog and becoming aware of the laws and protocols I may have disclosed my disorder with my employer. Instead when I was in a deep depressive cycle I essentially gathered all of my personal belongings and went to my supervisor and (not intially) told Him that I,m bipolar, I started crying after I told him (Im crying now) I was bipolar he was understanding. I then pursued my state pension and social security based on disability. Had I know of these laws in effect I feel I may have pursued staying with my employer. I must say It’s still very difficult not working even though i’m collecting both disability payments, yes I can comfortably live on them, but it tears me up at times during my depression cycles that I’m not a productive person actively contributing and helping society. I hope for volunteer work, or a part time job withing the limits of social security disability. I need to find a bipolar support group and get back into seeing a therapist and not just my psychiatrist.
Thank you for the comment, Paul. I’m lucky enough to be able to work part time, without needing to go on disability, but there’s not a lot of support for part-time workers. In Ontario, where I live, you’re either fully disabled, or you’re not, which is a completely inaccurate representation of how it really works.
I didn’t realize that sitting awkwardly or reading with my head in my hand were strange behaviors associated with Bipolar Disorder. I don’t know how many people have come up to me at my desk while I was reading and asked me if I was okay. I didn’t realize it was odd, I just thought I was reading… That’s just how I read. That’s so interesting! People laugh (with me, not at me) when I get hypomanic and start talking a mile a minute about something that doesn’t remotely interest anyone else. I think they like it because I’m showing enthusiasm as opposed to being my “Debbie downer” personality.
A few friends at work know that I have Bipolar Disorder and my current supervisor and my manager in my old department.
I am very lucky at work because we directly support the CMHA (Canadian Mental Health Association), and as part of our health benefits we get an allowance for Psychology and/or Couselling. Lucky for me my Psychiatrist does cognitive therapy and does not just dispense meds – psychiatry is covered by my Provincial Health plan so there is no charge.
Thanks for starting and maintaining this page. It even has great info for us Bipolar II’s – who are really confused about what’s “normal” and what’s Hypomania. (Being that if we’re hypomanic, we think (thought) that’s how “normal” people are when it’s not really the case.). Anyways, clearly I’m in that state now as I ramble on and on and on.
Thanks for the comment, Lindsay. Yep, the reading with head-in-hands is something most people don’t do (I do it, too!). I didn’t realize it either, until I did some reading on the subject, then realized, “Oh!” I’ve also been lucky to have a psychiatrist who is covered by the province. It’s so helpful.