Bipolar Disorder is characterized by the presence of mood swings. These mood swings cause two main episodes which are depressive and manic episodes. It is a disorder caused by a disfunction of some neurotransmitters in the brain.
There are some notable works on workplace accommodations and job success of people with bipolar disorder. A quantitative study that shows us that bipolar patients expect more autonomy, more help from their supervisors for adaptation and flexible schedules to be more productive.
Considering the absenteeism rates related with the bipolar disorder and the long working hours in USA, the experiences of people diagnosed with this illness must be studied separately. This research examines their work-related experiences but precisely focuses on their self-perceptions, challenges and support issues after their breaks off their careers after they are first diagnosed or have major episodes.
Definition Of Bipolar Disorder I and II
There are two common types of Bipolar Disorder Type I and Type II. Research has shown that these types have major differences in characteristics. Bipolar Disorder Type I is typically recognized by the presence of one or more manic and mixed episodes along with depression. Bipolar Disorder Type II, on the other hand, has a long period of depression and a hypomanic episode that lasts less than a manic episode.
The definitions of Bipolar Disorder type I and type II are currently being reviewed by the World Health Organization and American Psychological Association. Bipolar Disorder I, which is also known as manic-depression or manic-depressive disorder is a condition characterized by the presence of at least one manic and/or mixed episode, which can be explained as two episodes alternating the same day or day after day. BP-I patients, compared to BP-II patients are found to have higher rates of genetic proneness to mania/ hypomania, have more episodes in their lifetime, higher illness progression, clearer seasonality of episodes and mixed episodes.
In 1994 bipolar disorder-II was officially recognized by American Psychiatric Association and was included to DSM-IV.
Bipolar disorder-II can be perceived very similar to BP-I in its nature, however, in this type of the disorder, the patients never reach full mania; their state is described as hypomania.
Prevalence of Bipolar Disorder
Among many disorders classified by DSM V, bipolar disorder could be considered one of the most prevalent ones. It is the 4th most common mental disorder, after depression, anxiety and schizophrenia. About 2.4% of the world population is diagnosed with bipolar disorder.
The disorder is also very common in USA. About 0,92% of American population is diagnosed with Bipolar Disorder Type I. This also coincides with the global statistics which state that the prevalence of the diagnosis is about 1% in the whole world. According to Hirsfield, Calabrese, Weissman, Reed, Davies & Frye, in 39% of cases with bipolar disorder, the disease shows itself after the age of 20, which very often coincides with the period of higher education or the period of early work after high school. Studies done to understand the demographics of people diagnosed with the bipolar disorder in USA show that this illness starts between the ages of 23.8 and 27.7.
The term Functioning historically has been described as the ability to perform operations appropriate for the task in the required time frame. The definitions such as excellent communication required for duties or for organizational psychologists, satisfaction that comes with understanding various roles for measurement of psychological function in the occupational setting.
In short, occupational functioning can be described as having all characteristics to be fit for the duty. Although several definitions can be found for this term, this word is seen to be described in many different ways depending on the occupational concept where it is used. In other words, the definition of occupational functioning depends on the executed job, making its definition inconsistent for different occupations.
Schedule & Flexibility
Schedule is the timeframe in which the task should be completed. The mental and physical health of workers depend not only on the characteristics of their occupations but also on the timeframes and working hours of their jobs. Knowing that there are always more people that do not want to follow 9 to 5, Monday to Friday working arrangements, it is important to understand schedule’s nature and its implications. The term flexibility is often described as the ability to work from anywhere at anytime as long as the task is completed on time, regardless of the schedule.
Full or part-time employees may skip on work for various reasons such as work-related, organizational or individual, reported a study done with a group of health workers. It represents a big problem both for public and private sectors. A qualitative research focusing on work functioning of people diagnosed with BD has shown that absenteeism is an important subject for people with the disorder. They tend to have higher rates of absenteeism.
Job Satisfaction and Bipolar Disorder
Job satisfaction is the degree of how much people like doing their jobs. It can be related to their professions, environments, organizational climate and many other factors. It is a very important concept because organizations that have high levels of job satisfaction in their employees have lower turnover levels. People diagnosed with bipolar disorder report having lower levels of job satisfaction. At least 31% of participants in a study find their jobs uninteresting and 52% have thought at least once that their jobs are boring, which can be cause lower job satisfaction levels.
Occupational health is responsible for employees’ psychological and physical safety and health. In other words, the mental and physical state of an employee related to his occupation could be characterized by his level of occupational health. Most governments have occupational health policies both for public and private sector workers. (Fingret & Smith, 1995).
Occupational health and Occupational satisfaction cannot exist in a dimension where these variables are not interdependent. Evidence supports that such conditions’ quality may depend on contextual factors. The term can be defined as “the shared meaning organizational members attach to the events, policies, practices, and procedures they experience and the behaviors they see being rewarded, supported, and expected”.
Bipolar Disorder and Occupational Functioning
Bipolar disorder causes impairment in social, family and work life. A very significant and recent study with a large number of participants showed that depression has a big, negative impact on work performance. Since factors such as psychological demands, work schedule, and job insecurity have positive correlation with depression, they contribute to lower self-efficiency and performance at work. Since this disorder is identified by the presence of mood swings in an individual, a patient continuously goes through depressive and manic or hypomanic episodes. The depressive episode is more disabling compared to the manic stage. Also, it is seen to last longer than the manic one.
According to findings of a study, the disorder is closely related to unemployment. About 60% of US residents with bipolar disorder experience long periods of unemployment during their lifetime.
The WHO report suggested that, bipolar disorder is a greater burden than any kind of cancer, epilepsy and many other physical and psychological diseases. One of the largest costs is hospitalization according to some studies done in the US, stating that, 49% of the costs are direct medical costs for a bipolar disorder patient. Productivity loss costs due to unemployment arrive to 69%. Studies conducted in different regions also supported the previous ones. The annual cost for treating patients diagnosed with bipolar disorder is about 2 billion £ at 1999-2000 prices. 10% for direct hospital prices, 4% for residential care, and the rest for indirect costs.
All mental disorders are a big factor in sick leaves, aka. absenteeism and Bipolar Disorder is no exception. People with Bipolar Disorder diagnosis may experience some difficulties at workplace due to manic episodes, depression, history of psychiatric hospitalization, personality disorders and substance abuse.
Individuals who suffer from bipolar disorder report having periods of depression that affect their life in general. Patients stated that that their perceived life quality was low because of their lack of functioning during depressive episodes.
Although occupational functioning has not been researched extensively in terms of people diagnosed with bipolar disorder, there are some works showing that people with this illness tend to have lower functioning levels with some exceptions; in other words, people with the diagnosis usually have lower occupational functioning levels, but about 16 percent of them are highly functioning. A research conducted to evaluate the occupational functioning has concluded that about 30% of individuals diagnosed with bipolar disorder are unemployed and 18% do not reside independently.
Especially patients with higher prevalence of depressive episodes were found to have more difficulties at work, therefore, lower levels of occupational functioning, since depression can be very disabling in organizational environment. Other than that, some factors that lead to lower levels of occupational functioning is stigmatization experiences of the individuals who disclose their disorder at work. The exclusion that comes with it disturbs communication, therefore, decreases functioning.
A very recent research conducted in USA and analyzed with IPA focused on general working life experiences of individuals with bipolar disorder. The research showed that support and communications are key factors in increasing the quality of working life for individuals diagnosed with bipolar disorder.
Another qualitative research done in Canada and the US has focused on the work functioning of individual with bipolar disorder. This study had a relatively large number of participants (n=52), therefore, is a very important study to consider. The interviews were done both with individuals diagnosed with the disorder (n=35), healthcare professionals (n=12) and their caregivers (n=5).
The study has concluded that, there is still a lot to do for the companies and policy makers in terms of creating more precise measures in order to increase the work functioning levels of their employees with BD. Stigmatization and Disclosure experiences, as well as absenteeism, interpersonal problems and their importance and illness management strategies were key factors.