Saturday, December 23, 2006

Bipolar Disorder and Stigma

I was thinking about the whole "bipolar disorder and stigma" thing recently and thought I might blog about it, but never got around to it. Then I came across a post on the bipolarview blog. Here's a snippet from the post which made me think of the issue again:

"Even when you're doing well, you're still stigmatized. I wrote about my gallbladder surgery recently. Once the gastroenterologist reviewed my history and saw "lithium", his manner changed."

Twenty years ago I would also have agreed that stigma is attached to mental impairments. But this would have been in a general sense. Now I know a little more about how it can directly affect an individual.

Here's an example. My stepson has bipolar disorder. And, unfortunately, he also has OCD and ADHD. Very rough combination and just dealing with the meds is a constant battle (try this, try that, up this, lower that, substitute this for that). Well, recently, he ran into difficulty at a job he had only started two months prior. Neither his peers nor his supervisor were aware he had bipolar and he was at the low end of a cycle, the kind that caused him to retreat from the personality traits they had known him for. Rather than talkative, he was quiet. Rather than outgoing and upbeat, he was sullen, brooding, and irritable. At one point, my stepson's personal insight into his own condition motivated him to see his doctor and inquire about his meds. The result of this was that he was placed on lithium. And, for all appearances, lithium seems to have done him a world of good.

However...after all of this, something in the relationship between my stepson and his immediate supervisor and coworkers changed. Yes, he was back to the same person they had (up to that point) gotten to know. And, yes, his supervisor said he was glad to know that my stepson had bipolar as that "explained a few things". However, despite these acknowledgements, and despite my stepson improving on lithium, things continued to slide downhill. Could this downhill slide in work relations in the aftermath of a bad bipolar cycle and the admission of having bipolar be purely coincidental. Sure. However, a few weeks after this episode, the same supervisor denied him time off to go have his liver levels checked. Of course, when you're dealing with these kinds of medications, such things, from a patient's perspective, are hardly negotiable.

I'm also reminded of another incident that occurred within my "family grouping". My mother-in-law, who also has bipolar (ok, here's the roundup: my stepson, mother-in-law, and my brother-in-law all have bipolar. Tell there's not a genetic link here. My brother-in-law has been on outpatient shock therapy at the local VA hospital for two years) recently went back to work. She is in her mid sixties and had worked as a teacher's aide until her various health problems took her out for a while (back fusion, addision's disease, a heart attack, and a broken ankle, all adding up to whew!). Well, she had to reapply for another teacher's aide position and, apparently, someone in human resources advised the principal at the school my mother-in-law was seeking a position at not to hire her. The quote that was overheard was "Don't you know she's crazy?". Now, get this. My mother-in-law was only diagnosed with bipolar disorder a couple of years ago (late in life, but the signs were there) and had never told anyone at her school about this. Also, my mother-in-law had won awards for being an exemplary employee. Yet, because the bipolar diagnosis had become part of her personnel record (don't ask me why or how), the clerk in personnel had simply assumed that she would be a bad rehire.

Legal issues aside (let's put it this way, what the clerk said was a big no no---organizations can get their butts sued off for stupidity like that), what does a personnel clerk know about bipolar or any other mental impairment or disorder? Nothing I'm sure. But, it's another example of uneducated assumptions being made by individuals who can, unfortunately, have an impact on one's livelihood. Fortunately, in this case, everything went smoothly, though my mother-in-law would probably like to send the personnel clerk a fifty lb fruitcake.

These two examples, of course, are illustrative of this: stigma tends to arise and propagate among the ignorant.

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Blogger Earthreel said...

I recently encountered this feeling of stigma at a local hospital er. I have bipolar disorder in my medical history. However, it becomes hard for medical professionals to differentiate between a large brain cyst in your left frontal lobe and a mood disorder. Most aren't skilled enough to dicern between neurological symptoms and psychiatric ones. They are more apt to attribute them all to the latter. They left me in a room and when I went out to ask the nurse if my CT results were in, she threatened me with security if I did not go back to my room.

It does not matter that I am a US Coast Guard veteran with an honorable service record. Sailor of the Quarter at every unit in my four years of serving. Graduated from a University with honors.. I must never forget that I am first and foremost, a psych patient from the prospective of many professionals. Well, they have M.D.s and they are still fairly unintelligent so perhaps my point is defeated in that respect. You can imagine how effect my complaint with the hospital was. How fast the intertia set in once they learned I had bipolar disorder. Suddenly, it is not worth the prospect of tarnished reputations. It can be painful.

Thank you for your blog

10:40 AM  
Blogger Disability Blogger said...

As a disability examiner, I learned that physicians and other medical professionals carry quite a few biases regarding specific impairments. Sorry to hear you were treated this way. Thanks for your comments. BTW, I come from a military family and I've always held admiration for the Coast Guard. It's a fine service that's underappreciated.

11:25 AM  

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