Mental Health Awareness


Bipolar Disorder at work

Bipolar Disorder Exacts Twice Depression’s Toll in Workplace

Productivity Lags Even After Mood Lifts

Bipolar disorder costs twice as much in lost productivity as major depressive disorder, a study funded by the National Institutes of Health’s (NIH) National Institute of Mental Health (NIMH) has found. Each U.S. worker with bipolar disorder averaged 65.5 lost workdays in a year, compared to 27.2 for major depression. Even though major depression is more than six times as prevalent, bipolar disorder costs the U.S. workplace nearly half as much — a disproportionately high $14.1 billion annually. Researchers traced the higher toll mostly to bipolar disorder’s more severe depressive episodes rather than to its agitated manic periods. The study by Drs. Ronald Kessler, Philip Wang, Harvard University, and colleagues, is among two on mood disorders in the workplace published in the September 2006 issue of the American Journal of Psychiatry.

Their study is the first to distinguish the impact of depressive episodes due to bipolar disorder from those due to major depressive disorder on the workplace. It is based on one-year data from 3378 employed respondents to the National Co-morbidity Survey Replication, a nationally representative household survey of 9,282 U.S. adults, conducted in 2001-2003.

The researchers measured the persistence of the disorders by asking respondents how many days during the past year they experienced an episode of mood disorder. They judged the severity based on symptoms during a worst month. Lost work days due to absence or poor functioning on the job, combined with salary data, yielded an estimate of lost productivity due to the disorders.

Poor functioning while at work accounted for more lost days than absenteeism. Although only about 1 percent of workers have bipolar disorder in a year, compared to 6.4 percent with major depression, the researchers projected that bipolar disorder accounts for 96.2 million lost workdays and $14.1 billion in lost salary-equivalent productivity, compared to 225 million workdays and $36.6 billion for major depression annually in the United States.

About three-fourths of bipolar respondents had experienced depressive episodes over the past year, with about 63 percent also having agitated manic or hypomanic episodes. The bipolar-associated depressive episodes were much more persistent — affecting 134-164 days — compared to only 98 days for major depression. The bipolar-associated depressive episodes were also more severe. All measures of lost work performance were consistently higher among workers with bipolar disorder who had major depressive episodes than those who reported only manic or hypomanic episodes. The latter workers’ lost performance was on a par with workers who had major depressive disorder.

“Major depressive episodes due to bipolar disorder are sometimes incorrectly treated as major depressive disorder,” noted Wang. “Since antidepressants can trigger the onset of mania, workplace programs should first rule out the possibility that a depressive episode may be due to bipolar disorder.”

Future effectiveness trials could gauge the return on investment for employers offering coordinated evaluations and treatment for both mood disorders, he said.

Also participating in the study were: Dr. Kathleen Merikangas, NIMH; Dr. Minnie Ames and Robert Jin, Harvard University; Dr. Howard Birnbaum, Paul Greenberg, Analysis Group Inc.; Dr. Robert Hirschfeld, University of Texas; Dr. Hagop Akiskal, University of California San Diego.

The National Institute on Drug Abuse (NIDA), Substance Abuse and Mental Health Services Administration (SAMHSA), Robert Wood Johnson Foundation and John W. Alden Trust provided supplemental funding.

In a related NIMH-funded study in the same issue of the American Journal of Psychiatry, Drs. Debra Lerner, David Adler, and colleagues, Tufts University School of Medicine and Tufts-New England Medical Center, found that many aspects of job performance are impaired by depression and that the effects linger even after symptoms have improved.

The researchers tracked the job performance and productivity of 286 employed patients with depression and dysthymia, 93 with rheumatoid arthritis and 193 healthy controls recruited from primary care physician practices for 18 months. While job performance improved as depression symptoms waned, even “clinically improved” depressed patients performed worse than healthy controls on mental, interpersonal, time management, output and physical tasks. The arthritis patients showed greater impairment, compared to healthy controls, only for physical job demands.

Noting that 44 percent of the depressed patients were already taking antidepressants when they began the study and still met clinical criteria for depression — and that job performance continued to suffer despite some clinical improvement — the researchers recommended that the goal of depression treatment should be remission. They also suggest that health professionals pay more attention to recovery of work function and that workplace supports be developed, perhaps through employee assistance programs and worksite occupational health clinics, to help depressed patients better manage job demands.

 

 

© 2001-2007 National Institute of Mental Health. All Rights Reserved

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Book Recomendation

hurrydownsunshine_adv

Hurry Down Sunshine

by Michael Greenberg (Other Press 2008. 238 pages.)

An excellent memoir—written by the father of a 15-year old daughter about her onset of bipolar disorder and its impact on their extended, blended family. His description of life on a psychiatric ward is exceptional: marked by critical insight and occasionally dark humor. He describes the uncertainty that marks the process of treatment and recovery, which will recur throughout his daughter’s life.



Mental health resources

Resources

The following organizations provide information and resources for mental illness:

Severe Anxiety
Overcoming Social Phobia One Step At A Time
A well-written site about Social Phobia, resources for help, advice for dealing with the illness, and links to many other sites. “Severe social anxiety is one of the most difficult disorders to overcome. It can literally destroy your life in a matter of months. People do no realize that their is no real treatment to rid yourself of social anxiety, sure there is medication that is available through your family doctor. But how on earth does someone with severe social anxiety get this medication when their number one fear is in social interaction?”
http://www.severe-social-anxiety.com/

Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
Phone: 301-443-8956
http://www.samhsa.gov/

Resource Center to Address Discrimination and Stigma
ADS Center
11420 Rockville Pike
Rockville, MD 20852
Toll Free Phone: 1-800-540-0320
Email: stopstigma@samhsa.gov
http://www.stopstigma.samhsa.gov/

Drug Abuse Information and Treatment Referral Line
(Sponsored by the Center for Substance Abuse Treatment)
TollFree: 800-622-HELP (4357)

Health Resources and Services Administration Information Center (HRSA)
TollFree: (888) 275-4772
Email: ask@hrsa.gov

National Institute of Mental Health
Office of Communications
Phone: 301-443-4513
Toll Free: 1-866-615-NIMH (6464)
TTY: 301-443-8431
Email: nimhinfo@nih.gov
http://www.nimh.nih.gov

American Foundation for Suicide Prevention
Phone: 212-363-3500
Fax: 212-363-6237
Toll Free: 888-333-AFSP
Email: inquiry@afsp.org
http://www.afsp.org/index-1.htm

American Psychiatric Association (APA)
Phone: 703-907-7300
http://www.psych.org/index.cfm

American Psychological Association
Phone: 202-336-5510
Toll Free: 1-800-374-2721
http://www.apa.org

Anxiety Disorders Association of America
Phone: 240-485-1001
http://www.adaa.org

Borderline Personality Disorder Research Foundation (BPDRF)
New York State Psychiatric Institute
Phone: 212-543-6247
Email: BPDRF.USA@VERIZON.NET
http://www.borderlineresearch.org

Child and Adolescent Bipolar Foundation
Phone: 847-256-8525
http://www.bpkids.org/

Depression and Bipolar Support Alliance (DBSA)
Phone: 312-642-0049
http://www.DBSAlliance.org

Depression and Related Affective Disorders Association (DRADA)
Phone: 410-583-2919
Email: drada@jhmi.edu
http://www.drada.org/

Freedom from Fear
Phone: 718-351-1717
http://www.freedomfromfear.com

National Alliance for Research on Schizophrenia and Depression (NARSAD)
Phone: 516-829-0091
Toll Free: 800-829-8289
Email: info@narsad.org
http://www.narsad.org

National Alliance for the Mentally Ill (NAMI)
Phone: 703-524-7600
Toll Free: 1-800-950-NAMI (6264)
http://www.nami.org

National Eating Disorders Association
Phone: 206-382-3587
Email: info@NationalEatingDisorders.org
http://www.nationaleatingdisorders.org

National Mental Health Association (NMHA)
Phone: 703-684-7722
Toll Free: 1-800-969-6642
TTY: 800-443-5959
http://www.nmha.org

Substance Abuse and Mental Health Services Administration
National Mental Health Information Center
Toll Free: 800-789-2647
TTY: 866-889-2647
Email: info@mentalhealth.org
http://www.mentalhealth.org

The Reach Institute

The Reach Insitiute

 This 501c3 non-profit has the CEO’s of many of the family advocacy organizations on its board. It’s mission is to ensure that the latest interventions are available in every community by ensuring that health care providers can get trained in the latest methods.

Peter S. Jensen, MD
President & CEO, The REACH Institute
REsource for Advancing Children’s Health
NY, NY