Bipolar Disorder Overview

Bipolar disorder is a mental health condition which causes extremes of mood. People with the condition experience periods of low mood and mania – periods during which their mood is elevated and they are full of energy. Bipolar disorder affects 3 million people in the UK.

What are the signs and symptoms of bipolar disorder?

Symptoms of bipolar disorder depend on whether the person is experiencing a manic or a depressive episode. Symptoms of depressive episodes include:

  • Restlessness
  • Feeling worthless or guilty
  • No longer enjoying doing things that you used to enjoy
  • Trouble concentrating
  • Avoiding friends and family
  • Difficulty sleeping
  • Dizziness
  • Delusions, hallucinations or illogical thought patterns
  • Physical symptoms, like aches and pains
  • Fatigue
  • Under/overeating
  • Irritability
  • Bad memory
  • Suicidal thoughts

Symptoms of a manic episode include:

  • Feeling overjoyed
  • Feeling self-important
  • Taking risks and indulging in dangerous behaviours
  • Feeling very energetic
  • Becoming easily distracted
  • Becoming easily agitated or irritated

How often a person with bipolar disorder experiences the different types of episodes can vary. Some people may experience periods of ‘normal’ mood in between their bipolar episodes and some people may experience being in a ‘mixed state’ – symptoms of depression and mania at the same time.

How does bipolar disorder get diagnosed and treated?

GPs can assess symptoms in conversation with the person to determine a need to access treatment. They will ask about family history of the condition (as there can be a genetic component) and the nature of the different types of episodes. Treatment can then be tailored to the person’s individual experience of bipolar disorder.

Treatment is key as without it a person with the condition can experience episodes lasting for months at a time.

Medication can be used to prevent episodes – called mood stabilisers – and it can also be taken after the onset of a manic or depressive episode to alleviate some of the symptoms. Lithium is the most commonly prescribed medicine for bipolar disorder in the UK.

Someone with bipolar disorder will commonly access some form of psychotherapy alongside their medication, to help them deal with the symptoms and the effects on their daily life.

Lifestyle changes such as regularly exercising, cutting down on alcohol and caffeine consumption and using apps for mindfulness can also help alleviate bipolar disorder.

Most people will not require hospital admissions in order to treat or manage their bipolar disorder, although this may happen if an episode causes someone to become a danger to themselves, such as by self-harming.

There are a few ways to determine whether an employee with bipolar disorder might require reasonable adjustments:

The employee may or may not wish to disclose their bipolar disorder, as many people feel shame regarding their bipolar disorder. Regardless, questions regarding the nature of any additional needs and what extra support may be required can be broached sensitively. For example:

  • Have they required adjustments in the past? It is important that an employer does not jump to conclusions or assumptions based on their existing understanding of bipolar disorder, but instead keep up a dialogue with the employee, in order to empower them in spite of their condition.

What reasonable adjustments are possible for employees with bipolar disorder?

Employers have a legal duty to make reasonable adjustments for employees with bipolar disorder if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has bipolar disorder. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of bipolar disorder:

  • Extra time to complete tasks to accommodate difficulties the person may have juggling work tasks and depressive thoughts, for example.
  • A structured working day to allow the employee to concentrate more easily.
  • Adjustment to duties such as during an employee’s manic episodes where they may not be in sound enough mind to operate potentially dangerous machinery.
  • Time off to attend appointments, so that the person can work on recovery while staying in work.
  • Flexibility regarding working from home if the employee is having a particularly difficult episode and they would find it easier to work without the added commute, for example.
  • Raising awareness so that colleagues understand the employee’s bipolar disorder and can help ensure the employee feels comfortable at work. This might involve learning more about the condition to gain a better understanding of what the employee might be facing day-to-day.

Bipolar disorder Signposting

Bipolar UK – charity supporting people with bipolar disorder and their families through peer support groups and online forums, as well as through online resources, and working to change public attitude towards the condition.

Mind – mental health charity with resources and advice to support someone with bipolar disorder and the impact this may have on their wellbeing (0300 123 3393).

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