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What It Means for Employers
Life can be full of ups and downs, but for people with bipolar disorder, the ups and downs are often severe. Bipolar disorder causes extreme shifts in mood, sleep, energy and ability to function . The level and severity of bipolar disorder can vary significantly, based on the type of condition that a person experiences.
Bipolar Disorder by the Numbers
- Affects nearly 3% of the U.S. population aged 18 years or older
- Affects men & women equally
- 82% of people with bipolar disorder have serious impairment
- 17% of people with bipolar disorder have moderate impairment
- Impacts all aspects of life, including work
What is Bipolar
People can experience three types of bipolar disorder: bipolar I, bipolar II and cyclothymic disorder.1
Bipolar I disorder causes dramatic mood swings between depression and manic episodes. During a manic episode, a person often feels high and on top of the world or uncomfortably “revved up.” Whereas, during a depressive episode, a person feels very sad, empty or hopeless. A person is likely to experience periods of normal moods in between mania and depression.
Bipolar II disorder exists when people have at least one major depressive episode and at least one less serious manic episode. People with bipolar II disorder often seek treatment because of depressive symptoms, which can be serious, and return to normal function between the depressive and milder manic episode. People with bipolar II disorder often have other co-occurring mental health conditions like anxiety or substance use disorder.
Cyclothymic disorder is the mildest form of bipolar disorder with people experiencing frequent mood swings with regular less serious bouts of mania and depression.
Treatment and Management
Although bipolar disorder can significantly impact productivity and performance, with access to effective treatment, people can do quite well. An effective treatment plan usually consists of a combination of medication and talk therapy. Medication stabilizes the extreme mood swings between highs and lows. People with bipolar disorder may need to try different medications and therapy before finding what works best for them1. When untreated, suicide is a serious risk for people with bipolar disorder, making access to care extremely important.
How Bipolar Disorder Impacts the Workplace
Direct health care costs for employees with bipolar disorder can be high2. These costs are largely driven by psychiatric inpatient and outpatient care, along with pharmacy costs2. Yet, access to care is essential to ensure people with bipolar disorder have the chance to reach their full potential and lead productive lives.
Indirect costs related to absenteeism and lost productivity are also key factors. The absentee rate for employees with bipolar disorder is 18.9 workdays per year, while those without miss 7.4 workdays. Many employees with bipolar disorder end up on short-term disability because the number of missed work days is high3.
There can also be challenges with functioning well at work for those with bipolar disorder. Stigma and discrimination remain major concerns in the workplace yet working is helpful to people with mental health conditions achieving and sustaining recovery.
Employers also incur lost productivity costs associated with employees serving as caregivers for a person with bipolar disorder.
Learn more about caring for working caregivers.
Despite cost concerns, bipolar disorder is also associated with high levels of creativity and productivity. Many high performing and successful people have experienced bipolar disorder, including Ernest Hemingway, Carrie Fisher, Ted Turner, just to name a few. What matters most is ensuring that people connect with effective care, find the right treatment provider and remain fully engaged in their overall health and wellness.
Tips for Employers
- Provide and encourage a culture that tackles stigma and makes employee mental health a high priority, while keeping stress levels in check.
- Ensure mental wellbeing policies and procedures are in place and implemented. Aim to maintain a good work/life balance so employees have time for work, leisure and relationships.
- Provide training to managers and employees on mental health awareness to normalize mental health in the workplace while ensuring everyone is comfortable responding to a person in need of support.
- Be flexible with work hours, schedules and tele-work for employees with bipolar disorder, allowing longer or more frequent breaks and time off for therapy and related appointments.
- Offer added time management skills training for interested employees.
- Implement recommendations for improving access to mental health and substance use care created by the Center for Workplace Mental Health -APA Foundation and the APA.
About the Author
By Ewuria Darley, M.S., former associate director of the Center for Workplace Mental Health
Last Updated: November 2018
- American Psychiatric Association: What Are Bipolar Disorders?
- Williams, M., Shah, N., Wagie, A., Wood, D., Frye, M. Direct Costs of Bipolar Disorder Versus Other Chronic Conditions: An Employer-Based Health Plan Analysis. Psychiatric Services. September 2011. Vol. 62. No. 9.
- Laxman, K., Lovibond, K., Hassan, M. Impact of Bipolar Disorder in Employed Populations. The American Journal of Managed Care, November 2008.
- National Institute of Mental Health: Bipolar Disorder
- Center for Workplace Mental Health