workWe’re big believers in the notion that work is often an extremely important part of the — of what can help stabilize moods and daily rhythms. For that reason, we work hard to try to help people who have had to go on disability, return to work.

We’ve been working with several people who had to take time off from work, due to mood episodes, and have recently begun to create a return to work program, as part of the clinic where we work.

There are some things about returning to work that may not be quite as straightforward as they seem. For one thing, many months after mood symptoms resolve, there are persistent cognitive deficits. We’ve taken to using a screening cognitive test, that can help to define how well a person’s brain function has recovered after a mood episode. On average, after a manic episode, full cognitive function doesn’t return for up to six months, once a person’s mood has stabilized. That doesn’t mean that you have to stay off of work for that long, but it does mean that you may want to talk to your employer about less challenging work assignments upon your return.

Another aspect of returning to work involves dealing with some of the upsets or negative feelings that may have developed as a result of the fact that most people don’t leave work on disability without some problems having been pretty apparent at work for a while. Here’s where a mental health professional can really help, by explaining — by helping to provide an explanation for what was going on, and helping you to explain to your boss about how your moods were affecting your performance.

A lot of the stress that comes out when you go back to work has to do with both of these misunderstandings about how moods relate to disability.

Finally, it’s often perplexing to us why it is that employers feel that there is a “on/off” switch, that distinguishes between a period of disability and a period of being able to work. As a psychiatrist, I am sometimes called upon to write a letter that says that a person is “medically cleared” to return to work. But this notion of recovery from an episode of depression or mania as something that happens all at once is foolish. People recover gradually, and returning to work, at least part time, is an important part of that recovery. For that reason, sensible employers will recognize that a part-time return to work, or a return to work with a change in responsibilities, is the best way of helping their employee.