Wednesday, November 25, 2020

Bipolar Disorder and Unemployment

The unemployment rate for people with bipolar disorder is over 60%. This rate persists even in people with bipolar disorder who have achieved functional recovery.

This high unemployment is not the result of an inability to perform sustained, meaningful work. 82% of people with bipolar disorder have either graduated from college or have some college study. This is significantly higher than the population without a mood disorder.

It’s not a function of persistent symptoms of depression or mania, either. Whereas a large majority of patients were symptom free or had only mild symptoms 1 year after an episode of depression or mania, only 46% of the patients were employed, and as few as 12% worked at their expected level of employment.

This is tragic because those engaged in competitive, paid employment report greater improvement in symptoms, self-esteem, and satisfaction with vocational services, leisure, and finances compared with patients in the minimal- work and no-work groups.

This is a difficult time to be advocating for work for people with bipolar disorder. Despite such high levels of education, most people with bipolar disorder find themselves in low paying unskilled work. 91% of those who are employed earn less than $37,000 per year.

These are precisely the jobs that have been lost during the coronavirus pandemic. Early in the crisis there was a broad focus on unemployment assistance and business stimulus in an effort to preserve jobs and keep people in the workforce. Now political priorities have blurred in partisan bickering and talk of further stimulus has stalled.

Work has been instrumental in my own recovery.  While my career was derailed by a series of hospitalizations and I earn less money now than I did when I was younger, I couldn’t have recovered, lived independently and had a family without always returning to work.

Any sort of success takes incredible self-discipline, and many days are rocked by mood swings that make work difficult, but I’ve been able to get up and work nearly every day. Absenteeism is high in people with bipolar disorder who do work, yet it’s crucial to go in even on difficult days in order to hold a job.

While this may not be within reach of those people who have not entered symptomatic recovery, those still severely disabled by moods that inhibit daily life, I believe most people in functional recovery, as are most people with bipolar disorder, can and must work in order to heal and live successfully.

Yet the study that followed a group of patients post-hospitalization and found only 46% employed reports that 80% were symptom free or mildly symptomatic. Obviously, more people could have been working.

It is on society and business to create a market where work is possible and in demand, yet it is on each of us with bipolar disorder to do whatever it takes to find employment and achieve independence. Training programs and other assistance exist. Too few people with bipolar disorder take advantage of them.

The greater risk of the economic crisis caused by COVID-19 is that some of these programs may be cut. This will likely factor into the conversation about what responsibility society has toward those who suffer from bipolar disorder. But those of us with bipolar disorder must equally accept our own responsibility to society and, when at all possible, get out and work.

Source: https://www.ajmc.com/view/jun05-2073ps91-s94

This post appeared in the October 18th edition of the Practicing Mental Illness newsletter. Subscribe here for the most up-to-date posts and information.

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