Accommodating Bipolar Disorder in the Workplace, Part II: Scheduling
This is part two of a series. Part one, which discusses disclosure and stigma can be found here. Part three, which is on emotional support, can be found here.
Bipolar disorder is different from many other disabilities in that it affects many bipolar people periodically. In other words, bipolar people are sometimes quite functional, while at other times, their functionality is impaired. However, this provides quite an opportunity for accommodation. If scheduling can be done in such a way as to work around the less functional periods, people with bipolar disorder can have their functionality effectively maximized if not completely restored.In this article, I will discuss a number of ideas for providing accommodations that relate to scheduling. Not all bipolar people will need all of these accommodations; in fact, some bipolar workers may need no accommodations of this type at all. Bipolar disorder is a mental illness that affects people quite differently, and is ultimately a spectrum. Moreover, how function is best maximized will be different from workplace to workplace and from position to position. This article provides a series of ideas to consider in accommodating individuals in individual positions.
Accommodating Therapeutic Needs
One problem that a lot of full-time bipolar people face is that it is difficult to get therapeutic and psychiatric appointments outside of work hours. For many of us, it is even impossible, especially in jurisdictions in which care is state sponsored, and therefore we have little control over the schedule. Therefore, one very important accommodation is allowing for time for bipolar employees to see their physicians and their therapists.Many bipolar employees will see a therapist or a psychiatrist up to weekly or biweekly. Adding travel time, this means that we can effectively miss a couple of hours per week of work. Without these visits, we will be even less able to function than if we didn’t have that therapy or medical supervision (and it can, in fact, be dangerous). It is very important, then, that we have some time to seek appropriate care for our bipolar disorder. There is really no difference in practice between this and other medical conditions that require supervision, and many workplaces already have accommodations in place for monitored health conditions into which bipolar workers can be fairly easily integrated.
Another part of accommodating therapeutic needs is allowing bipolar employees to use the telephone to set up or change appointment times. It is surprisingly difficult in some workplaces to use the telephone in a private manner, but without the ability to do so, we cannot both take care of our therapeutic needs and maintain our privacy. Having a way or place for bipolar employees to both make and take private phone calls is very important and usually very easy to accommodate.
Something else that many bipolar people can benefit from is the ability to contact people outside of work when they are under emotional strain. Many of us use nonprofessional resources such as spouses, family members and friends to get through a rough work day. Within reason, then, we may need access to private telephone use in order to get through a rough patch during the day.
Flexibility in Work Schedules
Perhaps the most important accommodation for most bipolar people is flexibility in work schedules. Because bipolar is effectively a periodic disability in most cases, there will be times when we can work at full effectiveness (and sometimes more-than-full effectiveness, thanks to hypomania) and there may be other times when our work will be impaired or it is impossible to work entirely.As a result, many bipolar employees work best when they have flexible work schedules. In other words, if we can move our work from times when we are less efficient to times when we are more efficient, we will get more done.
How to make this work will depend heavily on the position. It is in many ways easiest when we work on projects that are done over a period of time. We can move the heaviest parts of the work to points in time when we are most effective and get the most done. If a job can be more easily broken into smaller projects that can be distributed according to our efficiency, then that can really improve our effectiveness.
For jobs where there are tasks that must be done at a fixed time, one possible way to handle the situation is to create the ability to trade off tasks with other people on the team or at the workplace. For instance, if everyone on a team needs to give a presentation, but the order of the presentations isn’t especially important, then it may be possible to trade days with someone else on the team.
Schedules can also be made more flexible if we have the ability to work earlier or later or work from home. In these cases, the goal is to find ways to make up lost work when possible. This can be a bit of a slippery slope, if it leads to the situation in which we are working all of the time, but the ability to move some work around to nonstandard hours can be helpful in some situations. If this becomes unwieldy, though, it might be better to move to part-time work, which I will discuss below.
Many bipolar people will have periods of time where they are simply unable to work at all. For some people this will be an afternoon here and there, and for others it might include weeks while they seek more intensive psychiatric treatment. Depending on the severity of the condition and needs, there are different ways to handle this complete inability to work.If it is only occasional, then the need for time off could even be handled under normal sick days. It would be a lot like other chronic health conditions in which the person periodically requires time away from work for treatment or because they are especially symptomatic. It some cases, it may be necessary to increase the number of sick days available to someone with bipolar disorder.
As with most situations with illness, it is often best to make sure that the workload is somehow shifted around during the time that the person is ill, rather than have the person have exactly the same amount of work when they get back as they would have had if they had never been ill at all. That creates the problem of work “piling up”, which can be especially problematic for someone coming back from a few days off for psychiatric reasons.
If bipolar people need more extensive time off, it can be handled under existing leave of absence provisions, though the number of leaves of absence may ultimately need to be increased, depending on the severity of the condition. Some people can have serious episodes every few years, in which case it can be treated like an occasional serious illness. Others may have a few per year, in which case, more leaves may need to be added to what is standardly available.
A Move to Part Time?
One thing to seriously consider is whether an employee might want to move to permanent, part-time work. So many bipolar people I have spoken to have made the same comment. They wish that they could find part-time work that was permanent, so that they could work flexibly without work always piling up. Many would be quite willing and even happy to take a proportional pay cut if it would allow them to hold down a job that they could handle effectively given the condition.In order to understand where this is coming from, it is important to understand how many government systems of disability work. Most systems basically behave as though people are either completely unable to work or they can hold down a five-day, nine-to-five job. As a result, many bipolar people who can work three-or-four-day work week find themselves stuck on disability. Ironically, many of these people actually do things like charity work three or four days per week, and handle those positions quite effectively.
As a result, one option is for bipolar employees to reduce their workload and move to part-time, half-time or eight-tenths time work, depending on the severity of their illness and the type of positions (these are only examples; there is no reason why any fraction could not be used). This would need to be done by mutual consent between the employer and employee, as to simply insist that a bipolar employee move to part time with less pay would be discriminatory.
One thing to note here is that part-time doesn’t mean contract or temporary work. A lot of the time, we conflate these two. People can work on salary and not work from nine to five daily. This provides employees with job security and peace of mind, and provides employers with a stable work force. What the pay would be in such a situation would need to be worked out (especially if there are benefits that are fixed for any salaried employee). However, one of the most important changes to the workplace that would accommodate chronically ill employees of all types is to end the confusion between part time and temporary employment.
Because bipolar disorder is often a periodic disability, flexibility in schedules is one of the most important accommodations that we can have. There are a number of possible accommodations that might be appropriate, depending on the situation:
- Bipolar employees may need time for medical and therapeutic appointments.
- Bipolar employees may need access to a telephone that can be used privately.
- Bipolar employees may need more flexible schedules, including ways of trading off work with others and making up for missed work (to a point).
- Bipolar employees may need increased sick leaves.
- Many bipolar employees may appreciate the ability to move to part-time work that suits the severity of their condition. This should not be done unilaterally and should not imply losing their status as salaried or permanent employees.
Part one, which discusses disclosure and stigma can be found here. Part three, which is on emotional support, can be found here.
I work for a large multinational company that had provided me with an alternate work schedule for 2 years. When I was given a new boss and was frank about my illness and what I needed for accommodations my boss, and her boss, did everything in their power to undermine my mental health through schedule changes. This was not limited to me, which I can only assume was to protect the discrimination lawsuit they anticipated, but I was the one most seriously affected. Because the company is so large they have outside sources handle their disability requests. This saved my job. The independent insurance company worked with my amazing medical team and decided the alternate schedule was not only a reasonable request, but a necessary request. I heard this week after being on disability for 4 months last year that my job will not make the accommodations requested. Again, the independent insurance came to my rescue. Because my restrictions are medically necessary I can remain on disability for up to 4 years. It is so important to know the leave laws for your state, and the way your company handles disability claims. Without that information I would have been fired, lost my insurance, and would have had to take on a multinational company alone.
That’s really great to hear that it worked out. Disability laws can be very complicated, vary from state to state and even change over time, and if we don’t know our rights, people can often take advantage of us. At some point, I’d love to get a lawyer to do a guest post about the law specifically. (Hint: if you’re a lawyer and you’re reading this, please e-mail me!)
i work for the schol for 7 years and i am soferin with bipolar disorer i some times ia very hard to go work
Thank you for sharing this, Aj.
Thank you for this. I had been diagnosed with clinical depression at 19 and recently diagnosed as Bipolar II. I have been in a stressful, demanding workplace for the past seven years. During this time I have had three different Managers. Some have been better than others. I decided, about year 3 to make it known that I have been suffering with depression. I had missed a lot of work and was worried I would lose my job if I didn’t make it known what was going on with me. I would exhaust my paid sick leave and then require unpaid leave. I am great at my job when I can be there but when the depressive episodes hit, I am down and out for a week or more. I would love to have a work atmosphere that was supportive of me and make accommodations like the ones you’ve mentioned. I would also like to know exactly what is available to me, in clear language, in terms of supports in the work place. I feel that there should be something written clearly that states what the employer is expected to accommodate with if the employee would like to avail of these supports or accommodations then that is something that should be up to the employee. Maybe I’m asking too much. Maybe Canada is working on something and I just don’t know about it but there are so many days where I wish to be at work but honestly just feel like I can not be there. I would love to be able to work consistently and now have the Earth swallow me whole when the depression hits. I would love to be able to take care of myself, financially, emotionally and work at this job and not worry that every time a depression flares up that I will lose my livelihood and job that I really enjoy.
You’re welcome, and thank you for the comment. Unfortunately, accommodation for mental illness is still in its infancy, if one can even call it that. In principle, employers are obliged to make reasonable accommodations for any disability, mental illness included. In practice, most employers have very little idea of what to do, would consider most accommodations unreasonable, and have very little incentive to do so in the first place. As our employment environment becomes increasingly inequitable, employers have less and less incentive to accommodate us.
I think one day, it will get better, but it’s ultimately tied into general workers’ rights. However, that doesn’t mean that there isn’t the odd employer out there who genuinely does want to accommodate employees, which is why I wrote this article. As the culture changes, what appears reasonable will change.