Returning to Work

Returning to work after a period of increased symptoms of depression or bipolar can seem daunting. And, indeed, there are major challenges to be dealt with.

If you are returning to work, you are in a happy minority of people with bipolar or recurrent depression. Congratulate yourself!

Or at least that is what the, admittedly incomplete, evidence suggests.

Trying to answer the question about how many people are working, how many want to work, and how many are unable to work, is surprisingly difficult and consumed a couple of afternoons for the authors of this post (Deborahmichelle Sanders and Peter Forster).

There are layers upon layers of complexity. For one thing, who has bipolar? For those with bipolar 1 the estimates of prevalence are pretty good, but for other types of bipolar estimates are quite variable. More recent studies finding a higher prevalence, presumably reflecting increased awareness of, and acceptance of, the bipolar spectrum… and probably indicating that more people with bipolar who are not severely functionally impaired are being identified in community surveys.

For another thing, what questions do employment surveys ask related to mental health? In the past some federally funded studies looked at something called “Serious and Persistent Mental Illness,” now the term more often used is “Serious Mental Illness.” These two terms cover different types of people with mood symptoms.

The Center for Studying Disability Policy of the statistical contractor Mathematica Policy Research (in a personal communication to one of the authors of this blog on January 22, 2018) stated that figures from the US Substance Abuse and Mental Health Services Administration can be understood as follows:

  • Only 50.1% (or, is it only 24.5%?) of consumers with serious mental illness are either employed or looking for work. The 24.5% figure (which apparently came from a different assessment at SAMHSA) refers to consumers with serious mental illness who are no longer in the work force, as well as those either employed or looking for work.
  • These two figures are of course mutually exclusive, which demonstrates the paucity of our knowledge of how many people with mental health conditions are working in the USA.

The Department of Labor tracks something called “disability” in its monthly labor statistics. It looks at who with disability is “in the workforce” (which means not on disability payments and “available for work” or looking for work) as well as who is employed.

  • In December, 2017, of all disabled people—for any reason, not just mental health–only about 21% were employed, compared to about 68% of those “not impaired.” See below for the definitions.
  • Of those who with disability who were “available to work” (not on disability and seeking work – excluding those who have given up or don’t want to work), 8.4% were unemployed, compared to 3.7% of those without disabilities.

Since 1990, the USA has had a law that provides employment and other rights to persons with disabilities. (Only companies with fifteen or more employees are regulated by the law.) It is the Americans with Disabilities Act (known as the ADA.) See the EEOC website for a simple guide to ADA rights.

The law is one thing. But stigma prejudices many employers, supervisors, and co-workers when you assert your rights, because you have divulged the fact of having mental health symptoms.

Certain conditions, such as PTSD, Bipolar and Major Depressive Disorders, OCD, and Schizophrenia are categorically protected, but many other mental health symptoms are granted protection with appropriate clinical back-up. People with mental health symptoms file more than 10% of all discrimination claims with the agency in charge of complaints, the US Equal Employment Opportunity Commission. The linchpin of the law is that a protected employee needs to be able to perform the essential functions of the job, with or without reasonable accommodation.

I believe that you should not disclose your situation to co-workers. I believe that you should disclose your mental health symptoms:

  • To the Human Resources Department only, and that
  • Only after your arrangements for a date to return to work, your department, and your job description are relatively clear.You may need or request a change in your job description as a “reasonable accommodation,” such as the ability to work at home, a changed schedule so that you can make doctor’s appointments, or having work instructions given to you in writing rather than orally.
  • If you try to make these arrangements directly with your supervisor, you might open a Pandora’s box of prejudice.

Most people with mental health symptoms who work full-time are self-employed. Finding a niche for yourself as your own boss, an entrepreneur, is probably the fail-safe for reducing stress. However, self employment is generally not nearly as financially rewarding as employment in a corporation.

All of this means for you that you will be one of the pioneers in your workplace, even 27-1/2 years into the life of the ADA, should you return to your prior corporate employment after an interval of mental health symptoms.


Department of Labor Disability Information. 

Your Legal Rights

Author Information

Deborahmichelle Sanders, JD, chaired or co-chaired the Disability Rights Committee of the Bar Association of San Francisco, CA, for a decade. See her for complete coverage of how to heal optimally by planning the essentials. The site provides cognitive recovery tools for the “brain fog” that can come with mental health symptoms, as well as assistance for living on a low income.

Peter Forster, MD. Wrote small sections, and raised some questions about the statistics, in order to make the post fit into the usual format of moodsurfing blog posts.


These are the questions that the US Government asks to identify people with disability.

  • Is anyone deaf or does anyone have serious difficulty hearing?
  • Is anyone blind or does anyone have serious difficulty seeing even when wearing glasses?
  • Because of a physical, mental, or emotional condition, does anyone have serious difficulty concentrating, remembering, or making decisions?
  • Does anyone have serious difficulty walking or climbing stairs?
  • Does anyone have difficulty dressing or bathing?
  • Because of a physical, mental, or emotional condition, does anyone have difficulty doing errands alone such as visiting a doctor’s office or shopping?