Why Can't People with Bipolar Disorder Work? Or Is It Work That Fails Them?

Rashmika Majumdar

It was March 6, 2025. My last working day at my previous workplace. I felt a sense of relief mixed with guilt. Relief because I could focus on improving my mental health without deadlines and targets dangling over me, and guilt, because I would become dependent on my family. But after a while, that relief started to wear off. I was applying to hundreds of jobs, barely hearing back, and even when I did, I’d get rejected after a few rounds. It slowly started to get to me. I began to feel like something was wrong with me, like I wasn’t good enough anymore. And as my savings started to run low, that feeling turned into panic. I thought I would take a one-month break and be back to looking for work. But it’s been more than a year and I’ve been unable to hold a job longer than a month, my mania and depression getting in the way every time.

This is not just my experience as a person with bipolar disorder. Members from my bipolar peer support group have similar experiences, a resume gap stretching into years, the fear of interviews after months of isolation, loss of confidence, deeper depression after a rejection. Unemployment isn’t just a consequence of bipolar disorder, it becomes part of the illness.

“I was diagnosed with bipolar disorder at the age of 20. I’m 27 now. I had to start working at the age of 17 to support my family,” says Sundar*, a member in our Telegram group run by Bipolar India, a peer support group run by members with lived experience, an initiative of Mental Health Support Foundation. “I completed my BTech degree while being sick, facing several manic and depressive episodes. I was exhausted by the problems I faced at work. I was a bright kid with many dreams, but now I am just a useless piece of sh*t, unemployed and barely keeping things together.”

Bipolar disorder is characterized by manic and depressive episodes and can be a lifetime condition. In a 2025 systematic review, it was found to be associated with various types of disabilities, including low employment rate and high dependence on public aid. The onset of bipolar disorder typically occurs in the late teens or early adulthood, a period which is widely recognized as being key in the development of academic, occupational and social skills. Bipolar disorder has been found to be associated with various types of disabilities, including increased suicidal behavior, increased usage of healthcare resources (and the associated costs), higher unemployment, higher dependence on public assistance, lower annual income, increased work absenteeism directly attributable to illness, a reduction in work productivity, poorer overall functioning, lower quality of life and a general reduction in life expectancy.

In terms of the global burden of diseases, bipolar disorder is ranked as the 22nd highest, with the World Health Organization (WHO) identifying it as being among the top ten causes of years lost to disability. According to the same study, for people living with bipolar disorder, the ability to work is shaped by many different factors, ranging from their symptoms and medical history to personal circumstances like education and social support. One of the biggest challenges is cognitive difficulties, such as problems with memory, focus, and decision-making. These skills are essential for learning new tasks, staying organized, and making purposeful choices, which are all critical for success in most jobs.

Ashish Kejriwal, program lead for the ‘Let’s Walk Together’ initiative by Mental Health Support Foundation and member of my bipolar peer support group says, “Prolonged unemployment affects a person’s confidence, identity and relationships. In India or anywhere in the world, when we first meet a person, we ask “What’s your name? What do you do? And when an unemployed person with bipolar disorder doesn’t have an answer to the question, they tend to isolate themselves and avoid social connections. They lose their sense of identity and are afraid to disclose anything about themselves. This affects their social life and relationships, as without interaction, relations don’t last long. Their self-esteem is at an all-time low. You need to be positive and present yourself socially in workplace settings. But people who deal with prolonged unemployment don’t even know when they’ll land a decent job opportunity.”

People with bipolar disorder are less likely to have jobs compared to those without the condition. Unemployment is more common in those with type I bipolar disorder, younger people, and those who have lived with the illness for fewer years. Higher levels of depression, slower thinking speed, and poor overall health also make it harder to stay employed. Job instability is much greater, too.

According to an eight-year longitudinal study published in the Journal of Affective Disorders in 2023, 64% of people with bipolar disorder struggle to keep steady work compared to 37% of healthy individuals. Factors like a history of psychosis, memory problems, poor physical health, and major negative life events further increase the risk of losing jobs or facing unstable or even long-term unemployment.

Long-term unemployment not only affects financial stability but also directly increases suicide vulnerability in bipolar disorder. Given that suicide rates among people with bipolar disorder are 20–30 times higher than the general population as per a 2020 Springer article, workplace accommodations such as flexible schedules, supportive management, and vocational rehabilitation are critical suicide prevention measures.

“A person with bipolar disorder experiences turbulence. They are unable to socialize at work, unable to deliver or meet targets. And they don’t disclose their mental health status to their employers because of the stigma surrounding mental illness. They fear they will be terminated on grounds of behavioral issues or performance. Some quit their jobs out of impulse because they can’t handle the stressful or toxic work environment,” says Kejriwal. “Companies that really care about their employees do make accommodations for people dealing with mental health issues. Companies that talk about diversity, equity and inclusion are open to making accommodations for better gender equality, for instance. But people may not be as open about disclosing their mental illness as they are about their gender. Mental illnesses are no different, and there is a need for accommodations instead of labeling those with mental illnesses as unpredictable and unreliable.”

What works for people with bipolar disorder is a combination of support systems and flexible structures. This can include flexible or remote work arrangements that allow them to work during periods when they feel most stable, freelancing or project-based roles that reduce the pressure of long-term consistency, and understanding managers who are willing to accommodate fluctuations in performance. Gradual re-entry into work after an episode can make a significant difference, as opposed to being expected to immediately function at full capacity. Equally important is continued therapy and medication, along with strong support from friends, family, and colleagues, which together create a more sustainable path back to work.

The ‘Let’s Walk Together’ initiative works with people with bipolar disorder to address commonly experienced issues at the workplace, such as reframing negative thoughts, and managing stress and anxiety at work. Online webinars are conducted by psychologists who have experience working with people with bipolar disorder.

“We often measure people by their productivity, by how consistently they can show up, perform and deliver,” says a member of the support group. “But bipolar disorder doesn’t operate on consistency. When someone is unable to work for months or years, we call it a gap, a failure, or a lack of effort. We rarely ask what it takes for them to survive those months in the first place. Unemployment, for many people with bipolar disorder, is not a choice or a phase. It is part of the illness. And until workplaces, policies, and conversations begin to reflect that reality, the question isn’t why people with bipolar disorder can’t work; it’s why work refuses to make space for them.”

(The writer is a Chennai-based communications professional with lived experience of bipolar disorder)