Mental Illness and Employment
We know our mental health will affect our performance at work, but it works both ways. In full-time employment we spend more of our life at work than anywhere else. If our environment isn’t something we are comfortable in or manageable for our illness, the consequences can be very serious.
What Is the Impact?
Stress is the biggest factor to consider. According to the American Institute of Stress, one million people in the United States miss work every day due to workplace stress?
We have stress at work and we have stress at home, and it is impossible to just leave it at the door. The impact of this is huge. There is often an expectation, particularly at work, to just forget about our outside problems and simply focus on the tasks ahead. While some are capable of doing this, home stress can affect performance, attitude and efficiency.
I know when I have had problems I have lacked concentration, felt low in mood, been irritable with other colleagues, and wanted desperately to be left alone. I remember a member of my team saying in their appraisal that my mood could affect the whole office. As a manager I had to accept the feedback, but it was incredibly difficult to digest. I didn’t want to intentionally affect anyone, but it was evident I was.
When you take stress to work, it affects relationships at the office. On the other hand, taking stress home affects personal relationships.
Sometimes we just need to rant and this can put stress on other people who want to relax and forget their day’s troubles. With long-term stress, relationships can potentially be destroyed. Family and friends often develop a level of understanding for loved ones with diagnosed bipolar disorder, but many people live with their illness unrecognized, leaving all parties unable to cope with the variable changes in behavior.
My Past Employment
I haven’t worked full-time for seven years due to my bipolar disorder, which resulted in medical retirement. Now, most of my work is voluntary. I watch friends, family and old colleagues surpass the senior positioning I once held and often wonder how the career path I envisioned for my life stopped so abruptly.
I studied hard at college and graduated with a high degree in marketing. Afterwards, I worked hard and proved to be a dedicated, ambitious woman, receiving a number of promotions as a result.
My last full-time job was a senior account manager role for a branding and design agency, but my ultimate vision was to be on the board of directors. I welcomed the heavy workload and stress to push myself further and demonstrate my ability.
Work was my life. I strived for recognition and to feel successful. I now realize those feelings are impossible to achieve if you do not have a true understanding and acceptance of yourself. In fact, I should have been aiming for contentment on a daily basis instead of thinking only of tomorrow.
Bang — Everything Stopped
There is no other way to explain it. The stress of work combined with a relationship breakdown, family problems, and escapism through an eating disorder ended my chosen career. I remember my moods changing; I was irritable, forgetful, couldn’t concentrate and became overemotional. I carried around a sad knot of fear but had no clue what was wrong.
After a prolonged period of starving myself and bingeing, I gorged on desserts at work one day. I drove the five minutes home and purged until I couldn’t recognize my red, swollen face.
Bang — Everything Stopped
I phoned a friend and told her I was going mad. I can’t remember anything apart from a web of confused feelings I couldn’t vocalize properly. My friends took me back to work the next day and I lied and said I needed time off for a family emergency. I had no idea what was ahead.
After receiving depression and eating disorder diagnoses, going through medication trials, rare anti-depressant reactions, and severe manic and depressive symptoms, the sick notes were endless. I was finally diagnosed with rapid cycling bipolar.
It took a year of inpatient admissions before I could start my first stage of recovery. Unfortunately, after 18 months I had no choice but to accept medical retirement. I had a letter from my psychiatrist stating it would be highly unlikely I could ever return to a senior position like that again.
Needing a Purpose
Unfortunately, careers tend to define people in our society.
I would sit with friends, having completed only the most basic of tasks that day and the conversation would be a whirlwind of work stress, long hours, responsibility and predicaments. It used to scare me. However, there was also a pang of jealousy. They sounded important. They sounded like someone.
As my recovery progressed there was a need to have a purpose, too.
My therapy helped me to find things I enjoyed. We all know that a love for activities and completing tasks lifts moods and breaks through the seemingly invincible depressive bubble.
In creative writing I spent hours scribbling poetry. I never expected it to change my life. It encouraged me to write a book about my journey, which led to wanting to raise mental health awareness. It’s interesting how once a seed is planted, a tree grows and branches sprout unexpectedly.
Five years ago, I approached the mental health charity MIND in the United Kingdom. They gave me a volunteer opportunity to talk to different businesses to help people understand what it’s really like to live with a long-term mental illness. It built my confidence and I now lecture at universities in addition to writing for online magazines.
Changing Moods
However, in depression I can hardly lift a finger to write, let alone shower and dress to smartly lecture to a group of students. It can be heart-breaking to agree to work but then pull out due to poor health, but I have learned that it’s normal and I have always received understanding and empathy from those I have had to say no to.
At the same time, it is invigorating to enter the early onset of mania when opportunities are vast. All the poetry, volunteering, writing and lecturing is suddenly possible and my creative ideas literally fly from my head.
I am studious, motivated, fearless and highly productive. Unfortunately, I have previously made the mistake of pushing myself to the point of crashing and then sat with a mess of commitments, spiralling into depression with all my ability robbed.
Managing Workload
I have been educated about managing my workload when I am feeling slightly high or low. My therapist told me to be consistent and to keep to a few objectives a day. Pulling myself back in my manic moments has been the hardest thing to do due to my ambitious nature.
After seven years I no longer want to contribute to the trigger of another episode. The brutality of a crisis and my inpatient stays have been so traumatic that the short manic periods no longer feel worth it. Stability comes from routine and consistency, and we should all remember this in managing our mental health.
It’s important to note that my work structure is built on flexibility and has collapsed in periods of ill health. The positive thing is I have a purpose to come back to when I begin my recovery.
Early Intervention Is Key
I now use mood charts and mark my highest and lowest mood points throughout each day so I can keep an eye on how “normal" my moods are. They are fantastic for spotting any signs and symptoms so I can put a plan in place to prevent exacerbation.
I often view managing the ups and downs of bipolar, mentally and physically, as a full-time job because it impacts life on a daily basis. For those of us who are employed it is similar to juggling two jobs, which is very hard.
If we focus on what we need to keep us well, monitor our moods, and speak up to everyone around us we are doing our best to manage ourselves, which in turn will have a positive impact on our work.
Why Is Employment so Important in Recovery?
In addition to finding a purpose, we need to build confidence, independence and feel empowered. One of the biggest things when dealing with mental illness is the loss of control.
When medical intervention is required, it can be even worse as we deal with the side effects of medication or even face hospitalization, which takes away any independence you had before. You give yourself up to the powers of the illness, but hope helps you find yourself again!
Employment can provide independence and empowerment through financial stability. When we can pay our bills and have disposable income, we can support ourselves and our families, which is a great responsibility. When I struggled with money it closed many doors for me and brought me back to that nagging feeling of failure.
Social inclusion is also extremely important. I remember being discharged from the hospital and finding myself alone in my home with weekly visits from my community psychiatric nurse. I was isolated with my thoughts and almost wished I was back with the other inpatients. At least I had people there who understood me.
Work offers you the chance to communicate, learn and laugh with others. We can’t always get along with other colleagues, but people change our attitudes on life and distract us from plaguing thoughts. It is also great to receive positive feedback. It makes us feel good and motivates us to continue working.
Are We Treated Fairly?
I desperately want to say yes, but careful research shows we are still very much battling stigma, which is a shame.
I volunteer with Mental Health First Aid England and many businesses are finally waking up to the fact that we need a happier working culture with open door policies and better understanding of mental health issues. There is also a growing awareness of the cost to businesses due to absenteeism and I believe this is driving them to make significant changes.
These U.K. statistics were taken from The Guardian) in 2007, so I predict the numbers have improved since then. However, they are both interesting and shocking:
- 40 percent of people said they were denied a job because of their history of psychiatric treatment and about 60 percent say they have been put off applying for a job as they expect to be dealt with unfairly.
- 38 percent of employers said they would not employ someone with a mental illness.
- Eight out of 10 of company directors said their company had no formal policy to deal with stress and mental ill health and only 14 percent of those that did felt it was effective
Do We Disclose Our Illnesses?
We don’t have to.
In America, the Disabilities Act forbids companies from firing people with mental health conditions as long as they can do the “essential" functions of the job and this is currently being strengthened with regards to the hiring and treatment of people with physical and mental disabilities. (New York Times, 2014)
The UK Equality Act 2010 banned discrimination against people with disabilities due to mental health problems. They state that it is not necessary to prove that a mental health problem affects your ability to do specific tasks. (Time to Change UK)
Do We Disclose Our Illnesses?
I would like to think times are changing where we can speak openly about any challenges we face in the workplace. Celebrities are publicizing their mental health struggles and helping to reduce stigma, however, this doesn’t always translate to those in what I would refer to as more everyday work. For example:
“In one recent study of six hundred people with disabilities, roughly half involving mental health, about a quarter of the respondents said they received negative responses to revealing their problems — such as not being promoted, being treated differently or being bullied." (Sarah von Schrader, New York Times, Nov 2014)
One inspiring and brave move was documented in the New York Times in 2014 about Patrick Ross, the deputy director of communications at the United States Patent and Trademark Office. After sending an angry email to his superior, combined with temper flare ups and uncontrollable irritability, he was endangering his job. He decided to write down his admittance to having bipolar disorder and give it to his supervisor before a scheduled meeting about his work-related problems. A weight was lifted off his shoulders.
Getting Back Into Work
In terms of finding employment, we are the experts of our illnesses. With support, we need to consider our skills, interests, emotional resilience and personal characteristics in order to find work that we can enjoy and find motivating.
We need to grow and develop. It may be that we start on a zero-hour contract before moving to part-time and possibly full-time. I understand, however, that this depends on our health and financial circumstances.
In getting back into current work, employers need to listen and accommodate our needs. We will need understanding, flexibility and possibly a phased return. It is important we speak up and not be afraid to say, “I need support." Employers need to respond to this and help us find solutions.
I believe mental health training should be mandatory in all businesses because more than a quarter of us will experience mental illness in our lives and we all need to have a positive attitude towards the subject. At the very least, we should be talking to friends, family or medical professionals to ensure we can offload and relieve stress in order to help us cope with work.
Let’s Stand up and Be Counted
We know we need a purpose in life and employment in whatever capacity can provide this. No one with mental health issues should be discriminated against and businesses should work closely with individuals to ensure the workplace accommodates personal needs. If anyone does receive poor treatment it is up to us to stand up for ourselves and fight back. We should report and take action to ensure that we continue to fight stigma in society to prove we are capable.
However, more and more businesses every day are adopting a culture of wellness, which will ultimately make those with mental illness feel more relaxed, comfortable and equal within their place of work.
Support Resources
- The Samaritans – UK helpline number
- Mind.org — excellent UK resource for all mental health issues with help resources
- MentalHealth.org.uk
- Rethink.org — Carers' guide for those supporting people with mental health problems
- Mind.org (Violence and Mental Health Factsheet)
- 1-800-334-HELP – 24-hour crisis hotline in the U.S.A.
- 1-800-273-TALK – 24-hour crisis hotline in the U.S.A.
- Fliss Baker Talks - My blog
- Madly Seeking Sanity by Lola Jane – my book
If ever you feel or you think someone you know is experiencing mental illness take immediate action by contacting a doctor, crisis team, calling 911 if you/they are in danger, talking to someone you trust or calling a support helpline.