Supporting your valued employees living with bipolar at work means having a good grasp on the effects of the condition and a support plan in place.
Cazz Redding is a successful town planner who was on track to become a CEO before being diagnosed with bipolar disorder 15 years ago.
While Redding has since been able to manage her condition well, she encountered similar issues in the last five organisations she worked for. Being a high performer, Redding continuously put her hand up for more work, which led to exhaustion and depression, and the need for extended periods of leave.
But because she’s highly functional, the organisations she worked for either didn’t believe her or couldn’t accept it.
After striking out for the fifth time, Redding decided organisational life was not for her, so she opened her own business. While working for herself has turned out to be a better fit, adequate support could have ensured that she, a skilled and valuable employee, was able to continue performing in the workplace.
Bipolar disorder, a chronic mental health condition characterised by elevated moods and periods of depression, affects about one in 50 Australians. While it can be challenging for employees to manage alongside their workloads, Dr Phillip Mitchell AM, Director of Bipolar Australia, says it’s a condition that generally responds well to treatment.
However, Mitchell has observed that things can go south for his professional patients with bipolar when they disclose their condition, with many eased out of the workplace or heavily monitored. If employers had a better understanding of the condition, it could go a long way in supporting the retention of employees living with bipolar at work, he says.
Understanding bipolar at work
People with bipolar disorder bring as much value to the workplace as the next person.
“The first point for managers to know is that for the vast bulk of the time, people with bipolar are excellent employees who perform well,” he says. “Managers need to be able to pick up early signs of change that might indicate a swing into depression or an elevated mood, and reach an agreement about what approach to take to support the employee.”
While manic episodes distinguish bipolar disorder from unipolar depression, employers are far more likely to encounter an employee experiencing a depressed episode than an elevated mood, he says.
To give an idea of what symptoms managers should look out for, Mitchell provides a breakdown of the two types of the condition, bipolar one and bipolar two, and how they may present in the workplace.
In bipolar two, the elevated episodes are classified as ‘hypomania’. A person may be more energetic, talkative or active than usual. For people with bipolar one, elevated episodes are more marked and impairing.
“An employee who is normally careful about due diligence might be confident they can see options that others can’t,” says Mitchell. “And they may make major decisions without going through the normal checks and balances.
“Some people may become more creative at the beginning of elevated episodes, but it’s usually only for short periods of time before the illness becomes counterproductive.”
“Some days I won’t be able to get out of bed and I’ll be late to work. And that’s not because I’m being lazy. It’s because I’m unwell and need extra sleep.” Cazz Redding, Business Owner.
Thoughts might run through the person’s mind very quickly, making it difficult to complete tasks or make it to meetings on time.
Early warning signs that an employee may be entering a manic episode include talking faster, moving around the workplace more than usual, flitting from task to task, or appearing unusually adamant and overconfident.
In both bipolar one and two, depressive episodes are common and long-lasting. These episodes are sometimes characterised by exhaustion and the need to eat or sleep more.
“In a workplace setting, the employee may be more withdrawn, and people who are normally socially engaging may isolate themselves,” says Mitchell.
Depressive episodes can also affect people’s ability to concentrate and focus, so they may make more mistakes or take longer to carry out tasks.
Identify workplace triggers
Dr Simone Ryan, CEO and founder of TOTIUM, which designs corporate health strategies, says major changes to a role could cause an employee with bipolar undue stress.
For instance, a departmental move due to redundancy could lead to unease and uncertainty, particularly if the person needs to upskill quickly. While this is a challenging situation for anyone to find themselves in, it could trigger an episode for someone living with bipolar.
A movement from regular hours to shift work can play havoc with people’s sleep and the times they take their medication, knocking them off-balance.
Triggers that cause Redding stress include deadlines, unmanageable workloads and the pressure of managing teams.
Organisations shouldn’t put unreasonable demands on their employees with bipolar and should tread carefully during busy periods, says Mitchell. While this doesn’t mean people with bipolar should be put in less demanding roles, it’s important to consider pulling back if they’re not coping.
For the most part, people with bipolar function as their normal selves, says Mitchell, so it’s important to learn about an individual’s triggers and not to misinterpret appropriate assertiveness as mania.
“Like anyone else, people with bipolar can have reasonable opinions and commentary about what’s going on and it doesn’t necessarily mean their mood is elevated. Sometimes this is used to dismiss the opinions of people with bipolar, which can be patronising,” he says.
Effective strategies to trial
Routine is key to keeping people with bipolar centred, says Ryan. This often means they prefer to work regular hours, for instance.
“When people with bipolar start to get a bit unwell or panicked, it’s often the variability in routine that can make them feel unwell,” she says.
Creating a checklist can prevent the person from missing anything, which can save their performance from being criticised should they become unwell. Having an open dialogue with employees about managing episodes allows for early intervention, which Mitchell says is key to preventing full-blown symptoms.
It’s essential an agreement about managing episodic periods is reached when the employee is well, to avoid any misinterpretation during high or low periods, says Mitchell. For example, this might be an understanding that the employee will take leave quickly to give them a chance to seek professional help and recover.
It’s important that managers understand what happens when the employee is unwell and how to proceed when certain warning signs have been identified.
“An open conversation with your manager could look like, ‘This is how I am when I’m really good. This is what my family and friends tell me happens when I’m not so good, and these are the things I want you to know can happen when I’m unwell.’”
For people living with bipolar, moods can change rapidly and they may not have the clarity of mind to self-identify the warning signs. However, to contact the employee’s doctor or next of kin, you need to obtain informed and written consent, unless they are a risk to themselves or others.
“There could be an agreement that when the person’s behaviour starts to escalate, you can call a nominated contact,” says Ryan.
These plans should be tailored to the individual, she says. They could be developed into personal situation plans (PSPs). These are established in collaboration with the employee at any time during their employment. They are not only for those living with mental health challenges – a PSP can be helpful for those with caring responsibilities, for example.
This formal document is designed to lessen any impact to the individual, their team or the organisation. Along with who to call should the employee display signs of a bipolar episode, it could include what not to do, such as contacting the police or an ambulance if a family member is preferred and the situation isn’t an emergency.
It could incorporate any temporary agreed upon changes to the person’s role or tasks, as well as detailing the employee’s strengths and the best way for the organisation to utilise these.
For example, it might include information that outlines an individual’s preference to stay at work when they’re feeling mentally unwell, as this can be anchoring for them, but perhaps they take on lighter duties, or focus on rote tasks.
“People with bipolar can have reasonable opinions… it doesn’t necessarily mean their mood is elevated. Sometimes this is used to dismiss the opinions of people with bipolar, which can be patronising.” – Dr Phillip Mitchell AM, Director of Bipolar Australia
Little adjustments can go a long way in terms of supporting employees living with bipolar.
“Some days I won’t be able to get out of bed and I’ll be late to work,” says Redding. “And that’s not because I’m being lazy. It’s because I’m unwell and need extra sleep.”
Rather than having to take leave, an employee can negotiate making up the work in their own time, says Redding.
At one organisation, Redding was under a 48/52 agreement which meant she had a day off every fortnight and a couple of weeks of leave per year to spare.
Ryan suggests encouraging employees to communicate adjustments that would help them manage their stress levels.
“It might be a 10-minute break after long calls,” she says. “It doesn’t have to be formalised, but just an understanding that it’s okay to take a walk around the block after a big Zoom call.”
Compassionate leadership makes a difference
Employers want to keep their high-performers – especially now during such a tight labour market – and helping them manage their life-long mental health challenges ensures they can continue adding value.
In Redding’s experience, support evaporated in her past workplaces at a time when she needed it the most.
At her peak, she was praised. But when she asked to reduce her workload, one employer told her she could only do so if she went down a pay grade.
“I was very upset,” she says. “It made me feel really undervalued.”
She did have one supportive mentor in the organisation, and while he wasn’t her director, he advocated for her to HR and the CEO.
The employer informed Redding that it would no longer support her when she was unwell, and she was advised to go to WorkCover.
When she told her mentor she felt pushed into resigning, he helped her see it was the organisation that wasn’t coping, not her.
“I think if I’d been in his directorate, there would have been a completely different outcome,” she says. “It really came down to the skills of the people in the management positions.”
This shows that you can have all the company-wide policies/programs in place that you like, and leadership can have the best intentions, but it’s often the skills and actions of an employee’s direct manager that will determine if they feel their mental health will be cared for.
A longer version of this article first appeared in the November 2021 edition of HRM magazine.
Learn how to assist those experiencing mental health problems through AHRI’s new Mental Health First Aid course.