To disclose or not to disclose, that is the question.

Anonymous — Mon, 24 Mar 2008 18:24:43 -0800

Need advice on disclosing bi-polar disorder to employer. BACKGROUND (question(s) in bold if you want to skip my long ramble):

Obviously, according to the title, I have been diagnosed with BP II (or possibly cyclothymic disorder). After a horrible experience with Wellbutrin in fall 2006-spring 2007 that almost pushed me over the edge, I went to see a shrink and was properly diagnosed after 20+ years being treated off and on for major depression. For those not in the know, anti-depressants are often a very bad thing to give someone with BP. At first they help the depression but can eventually push you into a manic (or hypomanic) state. I’m not speaking for everyone but that has been my experience and the research (and my doctor) seems to back me up. In late summer 2007 my doctor started me on Lamictal (lamotrigine) and has been slowly ramping up my dosage since then. It's a slow process due to a dangerous (although rare) rash that is usually avoided if you take it slow.

Every time my dosage increases I get better for a few weeks and then get worse until he increases it again. My doctor has treated thousands of bi-polar patients and said this is expected until I reach my proper therapeutic dose. BP symptoms vary depending on the person but my worst problem is paranoia as well as a general lack of control when thoughts pop into my head. My doctor told me Lamictal is also great for this problem and has given his other patients a few second delay before speaking their minds. In addition, I have the usual problems associated with BP: insomnia, racing thoughts, suicidal ideation, etc.

My department head really sucks (generally acknowledged by the entire department) and I haven't gotten along with him since before my Wellbutrin episode. Things have gotten progressively worse since I began the up and down process of starting Lamictal and I have done some things that were out of line, regardless of my boss' poor performance. The exact incidents aren’t that important to my question but, if you were on the outside looking in, you’d be amazed I hadn’t been fired several times over by now. As a testament to my value to the organization (if I do say so myself) and to my boss’ pathetic performance, there were two serious incidents and I wasn’t even written up for either of them. The second one, more serious than the first, didn’t even get me a verbal warning.

Due to my intense paranoia, after the second incident I sent the president an email resigning because I was positive I was going to terminated (despite the complete absence of discipline mentioned above). Within minutes, he called me to his office and told me I was being paranoid (Captain Obvious to the rescue!). He then told me my position was "mission critical", I had a very promising future with the organization and then criticized my boss' performance.

Upon realizing my totally distorted view of the situation I told him about my disorder to try to explain my actions. It might not have been a great idea but what's done is done. He was very relieved to hear there was a valid reason for my actions and offered to work with me in any way necessary to ensure my continued success. I have a fantastic relationship with him and he has a mentally retarded brother so I wasn't concerned that he would pass judgment on me. He told me he would keep this info completely confidential, to the point of not even telling his wife (who I know loosely).

He suggested I also tell the HR Director so she could be able to assist me if I need any accommodations to do my job or if I need help with anything in general. I'll admit this sounds great in theory. However, my boss is really good friends with her so I have some obvious concerns about confidentiality. I used to have a great relationship with her (dated her best friend for 6 months) but it has slipped a little over the past year or so due my weird actions. I still do things with her occasionally like going to her Super Bowl party, but it's not the same as it used to be. Another concern would be that she would tell my boss because she thinks he has a "right to know" because I report to him.

Here's my question(s): Have you told you boss (or co-workers I suppose) about a mental illness? If so, how did it go afterwards? Did the news spread and, if so, how did it effect your reputation and\or working conditions?

It might be my paranoia again, but I have concerns in general with sharing personal info with too many people. While one or two key people in an organization "should" be able to keep a secret, I think the expectation for confidentiality drops significantly with each additional person that gets the information. BP II or cyclothymia shouldn't be nearly as alarming to an employer as BP I, but most people don't know the difference. Once my meds get to the right dosage it will hopefully be a non-issue.

To play devil's advocate, should I tell the HR Director to protect myself from possibly getting fired for actions related to my BP? I've read that, in some cases, BP Disorder is protected under the ADA. But I've also read that, to get full protection (assuming you're covered by the ADA), you need to disclose it before you get to the point of being fired. Otherwise, it looks like you're making it up just to save your job.

FYI, I checked my company policies and, while there is mention of confidentiality regarding results from physicals used during the hiring process, there is no mention of exactly how other medical info must be handled. It states that it must be kept in a separate file from your personal file but not that it can't be discussed with your supervisor.

Lamictal for depression?

Anonymous — Tue, 02 Oct 2007 19:14:18 -0800

Is Lamictal effective for treating depression? I have a life-long history of depression with a 20 year history of SSRI use. They are effective. Recently I was diagnosed with bi-polar disorder and a new doctor, after one meeting has taken me off Zoloft saying it would make the mania aspect of bi-polar worse and Lamictal is the only treatment needed for depression. She actually said it was an anti-depressant. I know my depression is worse, getting even more so and, because of my HMO am having trouble finding a second opinion. Does anyone have experience with Lamictal as an effective anti-depressent?

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To disclose or not to disclose, that is the question.

Lamictal for depression?