Embracing the Mentally Ill in the Workplace: My Work Wish List!

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I am currently appealing the initial denial of my SSDI claim for being unable to work due to my Bipolar I disorder, ADHD, and PTSD. I fought going on SSDI for nearly a decade which led to multiple failures and a disruption of my medical care and housing, resulting in an exacerbation of my illness. In my last employment experience, a state agency separated me from my probationary period, stating that I was disqualified due to my disability.  They fired me after a medical leave for my illness, at my very first accommodations meeting.  They were not interested in accommodating me and I lost a great job as a result.  This inevitably caused a relapse and after a year of decompensation, I am just now resurfacing.

And so, I am appealing the SSDI decision as a result of being unsuccessful for the past several years. I am trying to become more stable and acquire better coping techniques prior to ever returning to work. One of my greatest problems arising from my mania and ADHD is my inability to “self pace”. I can accomplish an amazing amount of work in a short time and I learn more quickly than others. But, on the flip side, my mania causes inconsistency that stems from insomnia that eventually leads to crashing in exhaustion, often suffering with severe migraines and IBS. As a result, I miss work and to those who do not understand my illness, they are baffled by my inconsistency.  They will often attribute it to my character which upsets me. I perform remarkably well for a time and receive praise, and then inevitably begin missing work. The lack of sleep and mania often will cause me to be more sensitive and short fused. I become drained by having to “hold back” the mania and come across as short and easily agitated.  This results in conflicts with colleagues and supervisors.  I have tried very hard to prevent this from occurring, but it always occurs in the same predictable fashion: performing well with praise, becoming increasing obsessed and driven, de-compensating both mentally and physically, and eventually collapsing to include conflicts, absences, and termination. It has been a major heartache in my life to not reach my full potential in the workplace due to living with a mental illness.

Sadly, most people attribute my failures to my personality and character, instead of my illness which presents itself in a variety of ways while working. It is soul destroying to disclose an illness and be raw and vulnerable only to be continually misunderstood and devalued.  The stigma surrounding the illness and the lack of sensitivity is traumatizing and I have had multiple nightmares with the theme of working with my illness. I have had therapist stop me when discussing my work experiences because I was getting too anxious and visibly upset. It has been that difficult for me.

I feel the workplace and community needs to embrace the mentally ill working. It truly has to be a compromise of sorts for it to be successful. The benefits far outweigh the risks on either side. I acknowledge that there are some workplaces that are truly sensitive and inclusive, it just has not been my experience, yet. I hope one day once I am recovered, I will be able to be myself, open and honest, about my struggle and I will be valued for my skills, education, and experience and my illness will fade into the background. I recognize the importance of a business running efficiently, I also feel that retaining employees, even those with mental illnesses, will benefit employers in the end. Often employers do not want to take the time to accommodate a person with an illness because they feel it will be time consuming and yet, hiring and training a new employee is more involved and costly. The accommodations process might take time initially, but once accommodations are in place they are often effective, benefitting both employee and the employer.

Here is my wish list should I choose to brave the work world again once I have recovered.

  1. I want to find a place that truly exemplifies a culture of diversity and inclusivity. I want to work for an agency that sees the value in employing people of diverse backgrounds.  A place that longs to hear the voice that often isn’t represented in an organization, the voice of one who is disabled.  I want them to see that it makes their organization stronger, not weaker.
  2. I want to work for an organization that is aware that I have a disability, but also is aware of my strengths and values them.  A workplace that gets that I am often more productive than most, but I do have the risk of decompensation due to my illness. I want an employer that accepts both and works with me to minimize the risk of decompensation so that I can continue benefitting the organization and remain successfully employed.
  3. I want to work for a place that acknowledges my struggle and sees that my intention is to do a good job always.  I don’t want to work for an employer that feels my accommodations request is to get special treatment or have an excuse to do less work. I am a conscientious worker and my intentions have come into question when I was trying to get accommodations in place. My only intention was to remain successfully employed benefitting the organization.
  4. I want to work for an organization that is versed in the Americans with Disabilities Act where they enjoy and value helping those with disabilities remain employed.

On a personal note, it is important for me to find an employment opportunity that will compliment my illness. I have been working primarily in healthcare and that is already a busy, stressful environment. If I am able to work again, it has to be flexible to accommodate my issues in self pacing. I am either lighting speed fast or at home nursing a migraine. My goal will be to explore opportunities that make sense with the illness I live with every day.

I hope this post helps some of you still working and struggling. Maybe you can share in the comments section your experience and what has helped you. I still feel our world has a long way to appropriately accommodating those who are struggling. It takes education and awareness to cultivate sensitivity in the workplace. Mental illness is highly stigmatized and many myths must be debunked for progress to truly occur. I’ve always wanted to work in advocacy and education regarding these issues. I believe everyone who wants to work should have the right to do so, with the support provided to ensure success. Working is such a part of one’s identity and I support anyone who is doing their best to work while living with a mental illness. It is an arena that has immense potential to help restore and remediate one’s health if the process is supported.

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Bipolar I: The Suffering, The Stigma, and The Shame

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That’s me above and my pup, Gracie.  This was about 2 years ago while I was still working.  I was living in Seattle, WA.  And, trust me, was severely anxious even in this picture!  I’m currently waiting to be approved for SSDI and hope to one day make a full recovery.  If I do not, I hope to live gracefully with my illnesses of: Bipolar I, PTSD, ADHD, and PMDD.  Just trying to accept each day as it comes and continue learning!

The suffering we endure related to our mental illness is amplified by the stigma and shame surrounding it.  Let us tease out each of these concepts and acknowledge the impact each has on our lives.

The Suffering: Those who struggle with a mental illness do so due to biological changes in the brain that are often difficult to manage and control.  No one chooses to be mentally ill, not for a certain time period, or even for a day!  Most of those who suffer were active and involved prior to the onset of their mental illness.  The illness more than likely crept along, gaining momentum, until one day it was painfully obvious to others that something was “not right”.  That something presented itself as a combination of symptoms to possibly include: obsessive & intrusive thoughts, hallucinations and/or delusions, anxiety, panic attacks, depression, disassociation, etc.  The sufferer is often aware, on some level, that his or her thought processes are not correct and may seek help due to the uncomfortable and debilitating symptoms of anxiety or depression.  Some people who suffer with a severe mental illness lack the insight needed to seek treatment.  In both cases, the person suffering has not done anything to invite the “illness” into their lives, no one intentionally wants to have their ability to control their emotions and perceptions altered or compromised in any way.  Sure, there are individuals who use recreational drugs that alter their minds, but even so, no one would want to remain on a “trip” indefinitely with their perceptions altered.

I’ve often compared my illness to someone having unwanted side effects of a drug.  Except, those struggling have never ingested a substance, nor do they have the ability to control or ceases the symptoms by removing a substance from their life.  The symptoms also differ from the following examples of “side effects” in that they are often more severe and the onset and duration of symptoms can be unpredictable and uncertain.

For example, a person having way too much caffeine may experience some symptoms comparable to mild mania in that they may be: edgy, anxious irritable, energetic, etc.  Their mind might race and they may feel overly optimistic about what they can accomplish.  Another example I give is that depression can feel somewhat like taking too much Benadryl for an allergy attack: one can feel foggy, exhausted, excessively sleepy, and withdrawn.  In drawing these comparisons, I am trying to help a person who doesn’t suffer understand that the symptoms are not only biological, like side effects that must wear off, but they are also difficult to “snap out off”.  Unfortunately, for the sufferer, it is not as easy as discontinuing a medication to stop the unwanted side effects.  Imagine, living life and all is going relatively well and then one day you get trapped in a cycle of “side effects” in which there is no escape.  Sounds like a personal hell, right?  It is.  I have lived years in the cycle of severe anxiety desperately trying any and everything to get relief.  Often it is years of trial and error, until relief arrives very slowly over months to years.  It is something one has to learn to cope and manage with and it takes time, persistence, and commitment.  This is the suffering that most people do not understand, while others do not even acknowledge.  The latter leads to another type of suffering, compounding the already difficult task of managing a mental illness.

The Stigma: Those who live with a mental illness also have to “suffer” in a world that stigmatizes and shames those struggling.  There are many people that question the validity of mental illness and have unfair and unrealistic expectations of those struggling.  Often people who have a mental illness feel that they must hide their struggle from the workplace, for fear of retaliation.  They also may not get treatment and suffer needlessly for many years because of the shame that is associated with asking for help and admitting that they are sick.  I personally have lost jobs and experienced discrimination in the workplace when I requested help in the form of accommodations.  My struggle was not viewed as credible and I was seen as a “troublemaker”.  Even though we have certain rights through the American Disabilities Act, the laws are not always enforceable and the EEOC (Equal Employment Opportunity Commission) is very slow to act.  The reality is that the stigma surrounding the mentally ill discourages people from getting help and it prevents people from disclosing their disability in order to get help in the workplace.  The effects of stigma can be devastating and can mean job losses and inadequate care.  Many of the failures stemming from those suffering are not the fault of the individual struggling, but of the inadequate and unjust system that perpetuates stigma and negative stereotypes.  The shame must be placed on a system that is inefficient when taking down barriers that would lead to progress for those struggling.

The Shame:  Many people who live with a mental illness feel ashamed of their struggle and this leads to additional struggling and depression.  I used to do a fair amount of self-loathing due to the multiple times I would start a job and then “fail” due to the increased symptoms relating to my illness.  I realized over time that I wasn’t actually failing, but was suffering under a system that would shame me to the point that I would “give up”. My work was always praised, but my attempt to work with a mental illness was harshly criticized.  I was even told at my last job that I was disqualified due to my disability.  This caused a relapse and I spent several months stewing over my life and my lack of success due to my illness.  It took a lot of soul searching to separate my illness from my identity.  In time, I could see clearly that my illness has robbed me of my potential, not my talent, motivation, experience, or passion.  It was how I decompensated during times of stress due to my illness that wrecked me.  This has prompted me to respect my illness for what it truly is, a devastating biological illness that affects my mood and perceptions and is often outwardly presented in behaviors.  I began to see the distinction between myself when I am suffering and myself when I am not.  I challenge those suffering to let go of the shame you have relating to your behavior when you are sick.  Focusing on the negative behavior that arises during an episode often will only serve to keep you hooked in a cycle of shame and regret.  Instead, give the illness the respect it deserves and spend time finding ways to aggressively fight it and keep it at bay.  If you are like me, if will more than likely rear its ugly head again, but this time I will forgive myself and instead of lamenting the mistakes made when I was chained against my will and suffering, I will get busy working to get ahead of the next episode.  I honestly want to be like a hunter and become skilled at tracking it down, intercepting it before it begins!!!

I hope this was helpful.  It is a struggle, and you deserve to know that someone out there sees your struggle, believes it, and is right there with you.  Thanks for reading!

Embracing the Mentally Ill in the Workplace: We Work Too!

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Love and work are the cornerstones of our humanness.

Sigmund Freud 

I’ve struggled the last 20 years while working and am in a period of regrouping at the moment.  I have been accommodated at work, have negotiated severances and settlements due to discriminatory practices, and have spent time becoming aware of the resources available to me.  I also have been a recipient of vocational rehabilitation services where I was able to have my tuition paid for to complete my MS degree in Recreation Therapy.  I’m not certain what my next work endeavor will be as right now I am currently recovering.  I’m an advocate for embracing the mentally ill in the workplace and am writing to hopefully help those who are also struggling. 

Living with a mental illness often, at one time or another, will impact work performance and perhaps, threaten viability.  Life is full of ups and downs, and sometimes a stressful event or situation, will cause decompensation even with medication and treatment compliance.  During these times, work relations and performance can be compromised in various ways, discussed below.  Each person struggling is unique with the challenges they face, and often will have ways they adapt and cope.  Some individuals may need to request accommodations from their employer.  In most cases, an individual with a disability has rights through the Americans with Disabilities Act (ADA) to receive accommodations while working, absent undue hardship on the employer.  Many people struggling are unaware of their rights and the responsibilities of the employer regarding workplace accommodations.  For example, the employer has the responsibility to approach and offer assistance with the accommodations process if they can visibly see a person struggling or the employee mentions that they are struggling due to their disability.  Also, if an individual with a disability requests accommodations the workplace is obligated to engage in an interactive dialogue regarding the implementation of accommodations in order to help the person remain employed and successful in their job.  The person with a disability must be qualified for their position and able to perform the job with or without accommodations in order to be eligible to receive accommodations and they will more than likely need documentation from a medical provider.

Being aware of the various ways people struggle, will hopefully cultivate sensitivity.  A mental illness is often revealed through one’s behavior, and co-workers & supervisors may mistakenly attribute symptoms as personality traits.  This is not only invalidating, but can increase symptoms by placing unrealistic demands on an individual suffering due to no fault of their own.  Remember, that each person who struggles is unique and is doing the best they can with an illness that they would rather not have.

The following are some of the ways an individual with a mental illness may struggle while working.  These are only a handful of examples and the list is not an extensive one

  1. Work Attendance:  The symptoms of a mental illness alone are often severe enough to cause an individual suffering to remain at home, in bed all day.  These symptoms can range from extreme fatigue, tearfulness, anxiety, and even feelings of derealization.  It is difficult to be fully present, when unable to focus and feel a part of your surroundings.  Attendance can also be affected as an episode can often exacerbate other illnesses an individual struggles with, for instance, migraines and IBS.  Often, an episode can cause insomnia or excessive sleep both of which can impact immunity.  People who do not suffer often downplay the severity of an episode and the multitude of symptoms it can cause for an individual that may result in absenteeism.
  2. Work Productivity: Due to a diminished ability to concentrate and attend to appropriate stimuli, mistakes can be made or work may not get completed.
  3. Work Relations: Many symptoms can cause strained relationships in the workplace.  Mood disorders, Borderline Personality Disorder, and ADHD all can cause impulsivity that can result in someone blurting something out that is perhaps inappropriate, at times.  When someone is episodic their perceptions may not be as clear which may cause misunderstandings resulting in conflicts.  Often times, because co-worker are unaware of the disorder due lack of disclosure, these symptoms are mischaracterized as someone’s personality, instead of attributing them to an illness.  Even with people knowing about the illness, stigma is so prevalent and illnesses so vastly misunderstood that people develop a negative view of the person suffering. This only serves to further alienate the individual often causing relapse or a continuation of symptoms.  Individuals who are suffering are often aware that they struggle and the act of hiding their symptoms for fear of not being accepted and embraced is another reason why symptoms increase.  Interpersonal conflict at work or at home is a trigger for an episode and being in an unwelcoming, hostile work environment is truly unhealthy for the individual suffering from a mental illness.
  4. Disclosure of the Illness: Many people choose not to disclose that they are suffering with a mental illness to an employer due to the prevalence of stigma and lack of awareness.  Most applications now will ask if you are able to do the job with or without accommodations and if you are requesting them at the present time.  Many people who struggle continue to do so privately for fear they will not get offered the job, especially when the job has not been landed yet.  Their thinking might be that they feel they can manage and want to develop rapport and a relationship, learn the culture, before feeling safe enough to disclose.  Even so disclosing in certain environments can be challenging, once the private information is disclosed, there isn’t a way to retract the information and people often are not sensitive, nor aware of the struggle of mental illness.  All of this aside, there are many people out there, working, receiving accommodations with success and feeling comfortable with those around them.  Many more have disclosed and have felt discriminated against and have lost jobs.  There may be a time during a severe episode where in order to save your job, it is best to disclose and request accommodations.  At this point, with an accommodations request on the table, if an employer refuses to work with you, you do have leverage.  The Equal Employment Opportunity Commission is the entity that will accept charges of discrimination and will investigate and potentially mediate for a resolution or provide a “right to sue” letter in order for a lawyer to be obtained.
  5. Work Environment: Another consideration for a person with a mental illness is if their disability is compatible with the environment.  Environments that are dark with little to no sunlight during long winters in the Northwestern part of the country, for example, may truly drain a person with a depressive disorder.  A loud, noisy office, constructed of cubicles, allowing for multiple disruptions during the day may be difficult for someone who struggles with ADHD disorder.  If a person is having a difficult time performing well due to the environment, there might be an opportunity to receive the accommodation of having an office near sunlight or one that is away from distraction absent undue hardship for the employer.
  6. Benefits/Paid Time Off: Because episodes are often unpredictable in both frequency and duration, it may be a wise idea to become aware of the policies and benefits surrounding paid leave.  Finding a company where benefits are ample, even if pay is less, may be better than struggling along from job to job that is not sustainable when suffering with an illness.

There are two resources that are helpful when navigating the accommodations process.  The Equal Employment Opportunity Commission (EEOC) which can answer questions related to your rights and the workplace’s responsibilities related to receiving workplace accommodations. https://www.eeoc.gov//   And, The Job Accommodations Network (JAN), an excellent resource that gives specific examples of workplace accommodations for people who are struggling. https://askjan.org

Many people who have a mental illness are not affected in the workplace, or it is infrequent and not severe enough to request accommodations while working.  But for those who are struggling the two sources can be an invaluable tool in navigating the accommodations process.  One can also apply for Vocational Rehabilitation services, which is a state-funded service that helps those with disabilities to be successful at work.  Often they provide training, support through funding to attend school, and can help with the accommodations process.  There are many resources out there for those struggling with employment, the largest challenge is the stigma and lack of knowledge relating to mental health issues.   Using our voices and sharing our struggling will break that barrier in time.   Thanks for reading!  I wish you much success in the navigation of the work world!  #WeWorkToo