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MANILA, Philippines – As the term “bipolar disorder” became attached to big names like Catherine Zeta-Jones, Bill Clinton, Britney Spears, Jim Carrey, Robin Williams, Mel Gibson, Robert Downey Jr., Abraham Lincoln, Winston Churchill, and Theodore Roosevelt, it has crept up in our vocabulary as a byword for sadness or depression.
Many people use the term loosely, sometimes making their own diagnosis as they talk to friends about their woes: “I feel so depressed. I think I’m bipolar.”
However, it is a lot more complex than that.
“At the heart of bipolar disorder is an oscillation in mood,” said Dr. Terence Ketter. “People struggle with depression; sometimes they have the opposite.”
Dr. Ketter is a professor of Psychiatry and Behavioral Sciences and the chief of the Bipolar Disorder Clinic at the Stanford School of Medicine in California, USA. He was in Manila last February to talk about mental wellness in the workplace. The event was organized by PMAP (People Management Association of the Philippines) and NGF (Natasha Goulbourn Foundation).
Dr. Ketter singled out depression as the hallmark symptom in people with bipolar disorder. “When you see a depressed person, there is a ¼ chance that he is bipolar.” Although depression is the most common manifestation, the disorder can present itself in many ways, making diagnosis more complicated.
For his Manila talks, Dr. Ketter zeroed in on the implications of bipolar disorder in the workplace, specifically on the employee with the disorder, as well as his co-workers, family, and employers.
“Artist kasi siya, kaya ganyan siya.” (He’s an artist that’s why he’s like that.)
In the workplace, it’s difficult to say if someone is bipolar or not. Dr Ketter said that there are people with bipolar disorder who are unable to function, yet there are others who are functional and whose co-workers don’t suspect that they have a problem.
“There are people who are able to cover up and they’re able to do it well enough to maintain their employment,” said Dr Ketter. “They look okay on the surface a little bit more than half the time.” Most of these people don’t tell officemates or employers about their problem because they are worried about losing their jobs or getting demoted.
They also struggle with how they are going to disclose the information, as well as the implications of this admission.
They have every reason to clam up because there is a very real stigma against persons with mental problems, especially here in the Philippines. Dr. Ketter himself mentioned that there is indeed “a lack of sensitivity to the problem.”
In fact, a UK (United Kingdom) survey conducted among people in the workplace reveals that:
- Almost 40% of those surveyed said that they would disapprove of a close relative marrying a person who has mental health problems, including bipolar disorder;
- Over half of the survey population said that these people shouldn’t teach in schools;
- Over 90% said that those who are mentally ill should not divulge their condition because it might harm their career; and
- Over half of those surveyed said that employers should not hire people who are mentally ill.
How do you recognize the symptoms of bipolar disorder? Watch this video (But NEVER self-diagnose. If you think you need help, see a doctor ASAP!):
What should employers do?
From the point of view of business, employers need to address the problem because mental illness in the workplace entails chronic unproduction and economic costs. It is, in fact, the second most common reason of lost time due to sickness, based on UK data presented by Dr Ketter. He encouraged employers, therefore, to find the problem and remedy it.
“If you treat it, it’s going to cost you some money,” he explained. “But if you don’t, it’s going to cost you 3 or 4 times as much.” And a company’s biggest cost, as far as this issue is concerned, is lost productivity. Leading up to the year 2030, mental illness is going to be “the number one cause of loss of function” among people worldwide.
“This is a big deal,” said Dr Ketter.
From the individual’s perspective, treatment should be the only option. Some people delay treatment by as much as a decade which is really not a good idea, said Dr. Ketter. He emphasized that bipolar disorder needs to be treated because “as episodes become more frequent, they also become more severe and ultimately more resistant to treatment.”
It is also a fact that “people with mood disorders are 20 times more likely to die from suicide than the general population.”
Here are specific guidelines for companies and their human resource department:
- Start by making the workplace a safe place for disclosure and for seeking help. Think of ways to get people to disclose or overcome the stigma.
- Create a mental health policy and craft an approach to address this challenge.
- Build workplace awareness and train staff about the issue.
- Figure out who needs help and get them into treatment. Do not isolate people once you have identified them. The idea is to provide treatment.
As far as bipolar disorder is concerned, there can be control rather than cure. “A lot of individuals are able to find non-intrusive treatments like psychotherapy — with no side-effects — and which allow them to function normally and have a full life,” said Dr Ketter.
He made it clear, however, that these people really need to do some work and not stop doing so. “You can’t let down your guard,” he said. Gaining control over it requires sustained effort.
Non-pharmaceuticals (alternative treatments) may also get the job done with fewer or no side-effects, said Dr Ketter. Psychotherapy, for instance, works well for adolescent depression. Anti-depressants are not recommended for people below 25 years old.
Those who are trying out non-pharmaceuticals and are not getting good results should keep going, keep looking for treatment that will work for them, advised Dr Ketter. – Rappler.com
NGF (Natasha Goulbourn Foundation), a partner organizer of Dr. Terence Ketter’s Manila talks, was set up to bring depression to light through lectures, confidential crisis lines, and referral to partner psychologists. NGF has a suicide counseling hotline called HOPELINE. Call 804-HOPE or 0917-558HOPE(4673).
Ime Morales is a freelance writer and the founder of the Freelance Writers’ Guild of the Philippines and Isang Bata, an independent organization that helps underprivileged Filipino children. She is also the Vice President of Kuwentista ng mga Tsikiting (KUTING).
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