Employees with 

Bipolar Disorder 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

2 

Preface 

The Job Accommodation Network (JAN) is a service of the Office of Disability 

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Updated 03/22/10.
Practical Solutions • Workplace Success 

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JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction

JAN’s Accommodation and Compliance Series is designed to help employers determine 

effective accommodations and comply with Title I of the Americans with Disabilities Act 

(ADA). Each publication in the series addresses a specific medical condition and 

provides information about the condition, ADA information, accommodation ideas, and 

resources for additional information. 

The Accommodation and Compliance Series is a starting point in the accommodation 

process and may not address every situation. Accommodations should be made on a 

case by case basis, considering each employee’s individual limitations and 

accommodation needs. Employers are encouraged to contact JAN to discuss specific 

situations in more detail. 

For information on assistive technology and other accommodation ideas, visit JAN's 

Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar. 

Information about Bipolar Disorder 

How prevalent is bipolar disorder? 

According to National Institute of Mental Health, “more than 2 million American adults, 

or about 1 percent of the population age 18 and older in any given year, have bipolar 

disorder” (NIMH, 2002). 

What is bipolar disorder? 

Bipolar disorder, also known as manic-depressive illness, is a mental illness involving 

episodes of serious mania and depression (American Psychiatric Association, 1994). 

Bipolar disorder tends to run in families and is believed to be inherited in many cases. A 

person's mood can swing from overly "high" and irritable (mania) to sad and hopeless 

(depressed), and then back again, with periods of normal mood in between. Signs and 

symptoms of mania include discrete periods of: 

• Increased energy, activity, restlessness, racing thoughts, and rapid talking; 

• Excessive "high" or euphoric feelings; 

• Extreme irritability and distractibility; 

• Decreased need for sleep; 

• Unrealistic beliefs in one's abilities and powers; 

• Uncharacteristically poor judgment; 

• A sustained period of behavior that is different from usual; 

• Increased sexual drive; 

• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications; 

• Provocative, intrusive, or aggressive behavior; and 
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• Denial that anything is wrong (American Psychiatric Association, 1994). 

Signs and symptoms of depression include discrete periods of: 

• Persistent sad, anxious, or empty mood; 

• Feelings of hopelessness or pessimism; 

• Feelings of guilt, worthlessness, or helplessness; 

• Loss of interest or pleasure in ordinary activities, including sex; 

• Decreased energy, a feeling of being "slowed down” or fatigued; 

• Difficulty concentrating, remembering, making decisions; 

• Restlessness or irritability; 

• Sleep disturbances; 

• Loss of appetite and weight or weight gain; 

• Chronic pain or other persistent bodily symptoms; and 

• Thoughts of death or suicide, including suicide attempts (American Psychiatric 

Association, 1994). 

What causes bipolar disorder? 

Most scientists now agree that there is no single cause for bipolar disorder, but research 

is ongoing as to what can lead to the diagnosis (NIMH, 2002). 

How is bipolar disorder treated?

Because bipolar disorder is a recurrent illness, long-term preventive treatment is usually 

recommended, and a strategy that combines medication and psychosocial treatment is 

often considered the optimal way to manage the disorder (NIMH, 2002). 

Bipolar Disorder and the Americans with Disabilities Act

Is bipolar disorder a disability under the ADA? 

The ADA does not contain a list of medical conditions that constitute disabilities. 

Instead, the ADA has a general definition of disability that each person must meet 

(EEOC, 1992). Therefore, some people with bipolar disorder will have a disability under 

the ADA and some will not. 

A person has a disability if he/she has a physical or mental impairment that substantially 

limits one or more major life activities, a record of such an impairment, or is regarded as 

having such an impairment (EEOC, 1992). For more information about how to 

determine whether a person has a disability under the ADA, visit 

http://askjan.org/corner/vol02iss04.htm. 

Where can employers get additional information about psychiatric impairments 

and the ADA? 

The EEOC (2000) has a publication called “Psychiatric Disabilities and the ADA,” which 

is available online at http://www.eeoc.gov/policy/docs/psych.html. 
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Accommodating Employees with Bipolar Disorder 

(Note: People with bipolar disorder may develop some of the limitations discussed 

below, but seldom develop all of them. Also, the degree of limitation will vary among 

individuals. Be aware that not all people with bipolar disorder will need accommodations 

to perform their jobs and many others may only need a few accommodations. The 

following is only a sample of the possibilities available. Numerous other accommodation 

solutions may exist.) 

Questions to Consider: 

1. What limitations is the employee with bipolar disorder experiencing? 

2. How do these limitations affect the employee and the employee’s job performance? 

3. What specific job tasks are problematic as a result of these limitations? 

4. What accommodations are available to reduce or eliminate these problems? Are all 

possible resources being used to determine possible accommodations? 

5. Has the employee with bipolar disorder been consulted regarding possible 

accommodations? 

6. Once accommodations are in place, would it be useful to meet with the employee 

with bipolar disorder to evaluate the effectiveness of the accommodations and to 

determine whether additional accommodations are needed? 

7. Do supervisory personnel and employees need training regarding bipolar disorder? 

Accommodation Ideas: 

Maintaining Stamina During the Workday: 

• Allow flexible scheduling 

• Allow longer or more frequent breaks 

• Provide additional time to learn new responsibilities 

• Provide self-paced work load 

• Provide backup coverage for when the employee needs to take breaks 

• Allow for time off for counseling 

• Allow work from home during part of the day or week 

• Allow part-time work schedules 

Maintaining Concentration: 

• Reduce distractions in the work area 

• Provide space enclosures or private office 
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• Allow for use of white noise or environmental sound machines 

• Increase natural lighting or provide full spectrum lighting 

• Allow work from home and provide necessary equipment 

• Plan for uninterrupted work time 

• Allow for frequent breaks 

• Divide large assignments into smaller tasks and goals 

• Restructure job to include only essential functions 

Difficulty Staying Organized and Meeting Deadlines: 

• Make daily TO-DO lists and check items off as they are completed 

• Use several calendars to mark meetings and deadlines 

• Remind employee of important deadlines 

• Use electronic organizers 

• Divide large assignments into smaller tasks and goals 

Working Effectively with Supervisors: 

• Provide positive praise and reinforcement 

• Provide written job instructions 

• Develop written work agreements including the agreed upon accommodations, 

clear expectations of responsibilities, and the consequences of not meeting 

performance standards 

• Allow for open communication with managers and supervisors 

• Establish written, long-term and short-term goals 

• Develop strategies to deal with problems as they arise 

• Develop a procedure to evaluate the effectiveness of the accommodation 

Difficulty Handling Stress and Emotions: 

• Provide praise and positive reinforcement 

• Refer to counseling and employee assistance programs 

• Allow telephone calls during work hours to doctors and others for needed support 

• Provide sensitivity training to coworkers and supervisors 

• Allow the presence of a support animal 

• Reinforce peer supports 

Attendance Issues: 

• Provide flexible leave for health problems 

• Provide a self-paced work load and flexible hours 

• Allow work from home 

• Provide part-time work schedule 

• Allow the employee to make up time missed 
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Issues of Change: 

• Recognize that a change in the office environment or of supervisors may be 

difficult for a person with bipolar disorder 

• Maintain open channels of communications between the employee and the new 

and old supervisor in order to ensure an effective transition 

• Provide weekly or monthly meetings with the employee to discuss workplace 

issues and production level 

Situations and Solutions: 

A supervisor of a printing company requested information on how to accommodate an 

employee who has reduced concentration and memory loss due to mental illness. His 

duties included operating copy machines, maintaining the paper supply, filling orders, 

and checking the orders for accuracy. He was having difficulty staying on task and 

remembering what tasks he had completed. A JAN consultant suggested laminating a 

copy of his daily job tasks and checking items off with an erasable marker. Another 

suggestion was to use a watch with an alarm set for every hour as a reminder to check 

on his other job responsibilities. 

A JAN consultant spoke with an employee with bipolar disorder who had difficulty with 

short-term memory and concentration. The employee worked as a secretary in a busy 

office. The JAN consultant discussed requesting additional training time, written job 

tasks instructions, daily checklists, and allowing one hour each day to be off the phones 

to complete job tasks. 

An employee with major depression and bipolar disorder was having difficulties working 

in a busy central banking office. He needed to manage a large staff of workers, provide 

customer service, and oversee the daily office management. As an accommodation he 

requested and received a transfer to a smaller and less busy branch office. The 

employee maintained his salary and the responsibilities of his leadership role. 

Products: 

There are numerous products that can be used to accommodate people with limitations. 

JAN's Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar is 

designed to let users explore various accommodation options. Many product vendor 

lists are accessible through this system; however, upon request JAN provides these 

lists and many more that are not available on the Web site. Contact JAN directly if you 

have specific accommodation situations, are looking for products, need vendor 

information, or are seeking a referral. 
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Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@askjan.org 

http://askjan.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act (ADA), and 

the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase employment 

opportunities for adults and youth with disabilities while striving to eliminate barriers to 

employment. 

Center for Psychiatric Rehabilitation 

Boston University 

940 Commonwealth Avenue West 

2nd Floor 

Boston, MA 02215 

Direct: (617)353-3549 

Fax: (617)353-7700 

http://www.bu.edu/cpr 

Conducts research, develops educational materials, disseminates new knowledge, and 

provides training and program consultation in the area of psychiatric rehabilitation. 

Mental Health America 

2000 N Beauregard Street, 6th Floor 

Alexandria, VA 22311 

Toll Free: (800)969-6642 

Direct: (703)684-7722 
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TTY: (800)433-5959 

Fax: (703)684-5968 

infoctr@nmha.org 

http://www.nmha.org 

A charitable organization with more than 80 years of success in addressing the mental 

health needs of our communities, state, and nation. Founded in 1909 as the National 

Committee for Mental Hygiene by a former psychiatric patient named Clifford W. Beers, 

NMHA has always depended on volunteers to change the way Americans think about 

mental health and mental illness. NMHA volunteers all over the country work to meet 

the mental health needs of their communities through a wide array of services. 

National Alliance on Mental Illness 

Colonial Place Three 

2107 Wilson Blvd, Suite 300 

Arlington, VA 22201-3402 

Toll Free: (800)950-6264 

Direct: (703)524-7600 

Fax: (703)524-9094 

campaign@nami.org 

http://www.nami.org 

A self-help organization for mentally ill persons, their families, and friends. 

National Institute of Mental Health 

Science Writing, Press, and Dissemination Branch 

6001 Executive Blvd, Room 8184, MSC 9663 

Bethesda, MD 20892-9663 

Toll Free: (866)615-6464 

Direct: (301)443-4513 

TTY: (866)415-8051 

Fax: (301)443-4279 

nimhinfo@nih.gov 

http://www.nimh.nih.gov 

NIMH offers a variety of publications and other educational resources to help people 

with mental disorders, the general public, mental health and health care practitioners, 

and researchers gain a better understanding of mental illnesses and the research 

programs of the NIMH. All publications and educational materials are written by science 

writers, in collaboration with NIMH scientists and outside reviewers. 
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References 

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental 

disorders (4th ed. Text Revised). Washington, DC: Author.

Equal Employment Opportunity Commission. (2000). EEOC enforcement guidance on 

the Americans with Disabilities Act and Psychiatric disabilities. Retrieved 

September 4, 2008, from http://www.eeoc.gov/policy/docs/psych.html 

Equal Employment Opportunity Commission. (1992). A technical assistance manual on 

the employment provisions (title I) of the Americans with Disabilities Act. 

Retrieved September 4, 2008, from http://askjan.org/links/ADAtam1.html 

National Institute of Mental Health. (2002). Bipolar disorder. NIH Publication No. 3679. 

Retrieved September 4, 2008, from 

http://www.nimh.nih.gov/publicat/bipolar.cfm#readNow 
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This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability Employment 

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the 

position or policy of the U.S. Department of Labor. Nor does mention of trade names, 

commercial products, or organizations imply endorsement by the U.S. Department of 

Labor.