Managing Bipolar Illness in College and in Graduate School

Graduate school from 1992 to 1994 was a time when my bipolar illness appeared to be getting more manageable.  Again, this was before the time of becoming a Project Management Professional or PMP-certified in 2002.  The mini-breaks began to subside in or around 1994, though I was still managing bipolar symptoms.  During this time my awareness of the importance of the sleep cycle developed.  If I had two nights of really bad sleep in a row, there were warning signs that instability was around the corner.  This two-night sleep rule continues with me today.  Now I can generally manage a one-night sleep deprivation but not two.  In addition to the new sleep hygiene, I gave up caffeine and alcohol at this time (though later resumed my use of caffeine only).

When I was enrolled in my master’s program, I was taking a Finance class and was having difficulty with bipolar symptoms.  The date for dropping or adding a course had already passed.  But I knew that I was not going to pass this Finance course.  I simply could not get the concepts the way the professor was teaching them.  So I reached out to the professor and asked if he could make an exception for the drop/add rule due to the fact that I was experiencing bipolar symptoms.  He reluctantly agreed but agreed nevertheless.

Later that summer I took a finance class from a different professor whose method of teaching “I got.”  I had no problems taking the course and passing it with this new professor.

This experience in academia also harkens back to a time during my undergraduate career.  I was able to drop a course associated with writing my thesis around the time I had my first break.  The college was accommodating in this regard, but did not provide any disciplinary action for the professor associated with that thesis who was engaged in trying to get me to come with him on a trip to New York.  My experience is that he was engaging in very inappropriate behavior – trying to get me to go to New York with him as well as providing cocaine to a group of undergrad students.  I have written several blogposts surrounding this experience as an undergrad so I will not go into detail about it at this time.

All in all, academia has been pretty tolerant of special needs associated with school requirements and my bipolar symptoms.  I would say though that there is still a long way to go in clarifying what type of behavior is appropriate for a college professor towards his or her students.  At the time in 1984 and 1985 there was absolutely no guidance from academia and academic ethics in this regard.

A Second Story of Bipolar Tolerance in the Workplace

This is the story of my second employer – an arts and cultural council in New England and state / public organization.  This was a difficult time for me as I was just getting acclimated to the fact that I would need meds for the bipolar indefinitely.  In addition, it was the time that my Dad and Step-mother died of cancer in 1989 and 1988 respectively.  In the post below, I make some comparisons about leadership roles with the state organization versus later leadership roles in project management. 

My opinion is that it made a great deal of difference to be employed by a state organization.  The rules seemed a good bit more relaxed and allowed me to take extra time off when my Dad died.  It was during this time – 1988 to 1992 – that I experienced my bipolar in what I call mini-breaks every six months or so.  During this time, I moved in with my big sister and she helped administer Haldol and Mellaril during the 3 to 5 days of the mini break-through’s twice a year.

Without my sister and her help, I would have needed to be have been hospitalized during this time.  I am still indebted to her for her love and kindness to me during this time and literally opening her doors to me at a time when I could not find my way on my own.

In any case, this job with the state never questioned my need for sick leave.  Again, I cannot remember if I was put on short-term disability but I don’t think so.  Basically, I was allowed to take as much sick time or leave time as needed.

In terms of a support role or a leadership role, my position started off as support and migrated more toward leadership.  I had a very close relationship (professionally) with my boss, so there was no need to go over the bipolar situation with her.  We never directly talked about it and she was the one who elevated me from a support role to a more senior oriented position.  I became an Information Officer and began a career which would one day be in the Information Technology or IT space. 

One aspect of the leadership nature of the role with this cultural organization is that I was not really managing a large team of people in a typical project management type atmosphere.  I was responsible for the relationship with the computer programmer who was contracted by the organization and for the relationship with the elderly gentleman who volunteered at the agency in a computer programming capacity.  So, it was important that I be able to communicate with contracted and volunteer computer programmers as my “team.”  On the flip side, I was not leading a large team of seven to ten Business Analysts and Computer Programmers in the software development process.  The leadership consisted of managing the software development process with these two computer programmers only.

In the long run, this seemed to have made a difference – I excelled at maintaining the relationship with the two programmers but did not have to command a team of IT professionals (other than these two) in the development of software programs used to process applications at and to this cultural council.

At this organization, I started off as an Administrative Assistant and moved toward a Program Associate role and eventually landed as Information Officer.  This movement within the organization meant my colleagues and my supervisors knew my ability to function (or not) when I was in various positions within the organization.  I did not automatically land in a leadership position and have to “prove” myself as capable of that role.  Instead, I was employed for two years as an Administrative Assistant during the time of intense illness and death in the family. After those two years I was elevated to Program Associate and showed an affinity for database design and database development.  This work was eventually what proved to my boss that I would make a good Information Officer.

So this is the role in which I first began to show signs of information management capabilities.  These capabilities would continue with me after I graduated from Business School and received my MBA.  My first job out of graduate school was as a Business Analyst for a local engineering and environmental firm.  I will visit the story of my employment there coming up next. 

Story of Bipolar Tolerance in the Workplace

These next several posts will be dedicated to stories about how my mental illness was accepted or not by my various employers over the years.  This first story is about my first job out of college as a paralegal for a law office in a major New England city.  In the post below, I compare paralegal work and project management work.

When I started working as a paralegal, the Americans with Disabilities Act had not yet been passed.  This was 1986.  When I signed up to work for this law firm, I was asked to fill out a questionnaire.  As memory serves, one of the questions asked about whether I had a mental illness.  This was before it was illegal to ask this question.  The ADA did not get passed until 1990.

At the time in 1986, I opted not to be truthful in the questionnaire.  I felt it was my right and my knowledge that the employer could not or should not access.  This created the start of the process of always wondering whether it was good to declare my bipolar illness or not with an employer. 

During the two years that I was a paralegal at this law firm, I exhausted my sick leave due to the bipolar diagnosis.  I was still in process of getting the right combination of lithium and Tegretol together.  I was also adjusting to taking meds on a regular basis.  As many may know often it takes a year or two before you can accept your illness and that you will need to stay on meds likely indefinitely. 

I don’t recall whether I was put on short-term disability during this time or not.  But there was never talk of letting me go or firing me because of the bipolar illness or because of exceeding the allotted sick time for my station at that law firm.

In general, the lack of a negative reaction to my being out ill was a positive outcome in the long-run.  Today I consider this “tolerance” of my mental health needs to be a very positive outcome with an employer.  I had not yet been certified as a project manager – that would come later in 2002.  All in all and in retrospect, I found that working as a paralegal and having a mental illness were a combination that was somewhat manageable for me and for the employer. 

Years later in the 2000s I found that working as a project manager and having a mental illness was not a manageable combination at all.  The stigma associated with the mental illness particularly in the project management workspace was just too great.  This stigma has been discussed at various of my former blogposts.

What appears to be a deciding factor between “tolerance” and “intolerance” of the mental health condition is whether the specific job is in a supporting role rather than in a leadership role.  As long as I was a paralegal and providing support to a team of attorneys, the idea of having some sort of mental health complications was “acceptable.”  However, a project management role is/was a leadership role and therefore creates/created less “accepted” or “acceptable” responses proffered by the project management organization in the project/program management workplace.  I wonder if I had been an attorney at the same law firm whether the same level of “tolerance” would have been extended to me.  Or, if as an attorney I would have been in a leadership role and, therefore, the complications of mental illness would have also been less “accepted” and “acceptable.”

Being a Project Manager with a Mental Illness

Being a project manager by definition means you are in a position of leadership.  Your job is basically to lead the assigned team to project fruition from a time, scope and financial perspective.  This reputation of being a leader means you are expert in resolving issues and risks and in motivating people on your team to supply their best work even if you only have influence and not direct control over these resources.

Being in a position of leadership means your supervisors put complete trust in you for your management techniques and your perceptions on what needs to be managed by the team and what may need to be escalated up the chain for management to handle.

In short, being a project management professional means your superiors trust your ability to cognitively manage the project or projects in front of you.  This puts a person with a behavioral health diagnosis in a difficult spot.  By definition of having a behavioral health diagnosis there will be times when that person’s cognitive ability is impaired for a period of seconds or hours, best case scenario, to a period of months or longer, worst case scenario.  

When there is a break-down of this “trust” when a behavioral health event is exposed either voluntarily or involuntarily, all trust in the project manager diminishes to nothing.  There is no in-between in that as a project manager when you have a break-through event, you are trusted a great deal less or not at all.  It is all or nothing with no in between.  As a project manager you are riding on your good reputation at handling people, handling scope, handling time and handling money.  If any of these is less than perfect, the project manager loses face at being a project manager for that employer.  A behavioral health event – exposed – at any time in my experience means the trust in the impacted project manager is reduced to nil.

This is difficult and complicating and may lead that project manager not to be open about his or her behavioral health diagnosis in the long-run.  This compartmentalization is something I have experienced and sadly found to be much more effective than being honest about my bipolar illness to my employer.  During the times that I have been able to compartmentalize my illness, I have had much more success in the workplace.  Sadly though, this success in the workplace is not matched at home with good management of my bipolar illness and its ups and downs (quite literally). 

Rare but not unheard of is reassignment of a project manager to a position that is no so dependent upon constant team leadership.  I have not experienced this transfer of responsibilities but I have seen it happen once while in employment with a big corporation.  The person in question was experiencing panic attacks and was treated somewhat more fairly than myself by being transferred to a new position that was intended to help relieve the panic attacks.

Do you feel your behavioral health diagnosis was or has been accepted without stigma in your workplace? If so, what do you think the important factors were? If not, what would you have liked to have gone differently?

PMP Risk Management as Applied to Behavioral Health

This is a blogpost detailing the use of PMP risk management techniques to help manage mental health disease symptoms:

During the last 20 years or so, I have been applying risk management techniques learned as a Project Management Professional to help manage risks associated with my mental health and mental illness characteristics.  What I learned as a technical skill as a project manager to manage risks can be applied to illness management as a person with bipolar illness.  Typically in risk management, the project manager identifies with the team all the risks associated with the particular project in hand.  After recounting the risks, the team goes through the process of assigning probability of occurrence and level of impact associated with each risk to the project.  After the severity and likelihood of the risk is captured, the team then works to develop mitigation strategies for each risk and to indicate whether mitigation strategies are sufficient to address each risk recorded. 

How can this be helpful to a person with mental illness?  The idea of risk management is characterizing the probability and impact of the risk and then creating risk mitigation strategies.  This same scenario can be applied to managing risks associated with bipolar illness.  This risk management may take place with the patient’s care team including the prescribing doctor and the therapist.  For example, say I have extreme anxiety about leaving my home and have an Obsessive Compulsive Disorder-type set of checking routines I do to mitigate this anxiety.  The risk would be the anxiety condition and the mitigation would be the checking routine.  This is a largely effective strategy for managing this form of anxiety unless the OCD ritual becomes ever-present and ever-pervasive.  In this instance with the OCD mitigation it might be said that the risk mitigation strategy is becoming non-mitigating.  It may be time to revisit that risk or anxiety and re-evaluate what an effective new mitigation strategy might look like.  This might include self-talk about the probability of the risk occurring based on the prior number of years the risk has been managed and self-talk about the impact if ever the risk or anxiety has manifested itself in an actual real event during the course of tracking the risk.

All in all, assigning probability and impact to behavioral health management risks helps set priorities for what is a big risk to manage versus what is a smaller risk to manage.  Key is the development of effective risk-management mitigation strategies to use to address the risks.  Also key is the reassessment of risk mitigation strategies when the risk mitigation is no longer effective.  At that time, new measures of risk mitigation need to be developed and put into place.

All in all, risk management learned through the Project Management Professional lens can prove helpful in the management of unwanted behaviors associated with bipolar illness.  Different risks can be catalogued and associated with different mitigation strategies.  When these mitigation strategies no longer are viable, new mitigation techniques are developed and applied.   

What tools – either from your professional life or not – do you use to help mitigate your illness symptoms?

Stigma Resistance and Existence in the Project Management Workplace:

I have found in my 35-year career mostly doing project management work that the company you work for is only as accepting as the people who make it up.  When I have experienced a supporting atmosphere for my bipolar illness (which is extremely rare), my mentor or my boss has come from a place where mental illness was in their family.  One a husband, one an aunt.  This was volunteered information to me from them.  I find the ability of the workplace to be supportive is in direct correlation to the boss or mentor having first-hand experience with mental illness.  For all intents and purposes, the individual and not the company is the determinant of a supportive environment for working with a mental health condition.

It should not be this way.  The company as a unit in and of itself should be able to show understanding and support for mental health challenges particularly with such advances as the Americans with Disabilities Act. 

In my experience, the company is more prone to act out of fear or out of ignorance and assume someone with a mental health condition is dangerous to themselves and to others around them.  There is a tendency to criminalize people with mental health diagnoses in the workplace when that mental health diagnosis is exposed. 

Not uncommon is the ushering out of the office by building security when the mental illness surfaces.  Is this ever done when you have diabetes?  Or a brain tumor?  Or cancer?  No, you are not humiliated and meant to feel you are criminal just for being ill.  These other illnesses are accepted as part of the risk profile for managing employees.  People are given support for their illness by co-workers and by management for these other non-mental illness profiles, while for mental illness profiles the employee is considered an immediate and unsurmountable threat and treated as a criminal.

Again, I would hope in the US the Americans with Disabilities Act would change this criminalization of people with mental health diagnoses in the workplace, but in my experience it has not.  That sounds out as a sad state of affairs for employment for people with mental health diagnoses.

Have you ever been treated poorly at the office because of a mental health diagnosis or break-through event? Have you ever been treated well for the same? What causes some employers to act in a way that is supportive and others not?

My Experience with CBD Oil

Caution: this post involves the use of CBD oil. The post in no way suggests that CBD oil should be used for mental illness. Rather, the post suggests that the lack of prescription amount and dosage is a real problem that makes CBD oil unsafe or unreliable to use for most people.

About two years ago I started using CBD oil with buy-in from my therapist and my psyche doctor. It was very effective at reducing anxiety — my biggest problem remaining from the bipolar I have had since college. When I bought the CBD oil from a New Age Health Vitamin Store, they failed to tell me to shake the bottle with each dosage. So when I got to the last several doses particularly the last one, the CBD was so concentrated it did me in for a day.

After that episode I became somewhat suspicious of the process of selling and administering CBD oil. I later bought another bottle but I found myself to be too circumspect about the proper dosages for my condition. Even though the CBD oil had helped me there was no place to go for getting the right levels and the right amounts in my daily routine. While my therapist and MD said I could try CBD oil, they never prescribed a certain amount for my condition. This was not their purview.

Even though CBD was somewhat beneficial for me, my lack of trust with the process of buying and administering CBD won out. I have not used the new bottle – I am not even sure how that dosage compares to the dosage I took with that first bottle. There is concentrate information that varies from brand to brand and from bottle to bottle. For me, I need to be working with a professional to get the right dosages on a daily basis. Experimenting with the use of CBD oil is not something I am happy to do. Right now I don’t have that person in my life who could prescribe dosages.

Have you ever used CBD oil? Did the lack of information on dosages and strengths leave you feeling suspect about the process of using CBD oil? Do you wish there was more data about CBD oil including dosage information for people seeking its medicinal qualities? How do you think that additional dosage information might come about?

Thou Shalt Not

Compare thyself to others…..

My sister and her husband were in town for the Holidays and stayed with us for three nights along with my aging and memory-impaired mother. It is always great to be around my sister. She is active, fun to be with, helps out whenever necessary. In short you could not ask for a better big sis.

Big difference between my sister and me? She did not get the bipolar. But she has always been very supportive of me and actually used to take me into her home every six months for what I call mini-breaks when I lived up north.

My problem with my relationship with my sister is I try to compare myself to her in terms of her successes in managing relationships, her accomplishments at work, her steadfastness with her faith and just her innate ability to have fun. My therapist suggests using her as a role model rather than comparing myself to her because I will likely always come up short. My therapist did not say “come up short” but that is how I feel when I make the comparison.

A word of caution – it’s not the type of nice that rubs your face in it. My sister is really just a very good person who has not had a mental health diagnosis to deal with. But if I remember things honestly and correctly, my sister has had her share of hardships. One of her sons had a chronic disease growing up and almost did not graduate high school. Her other son is an artist who is extremely talented but not necessarily financially prepared for family life with a spouse and kids. (I am not sure he even wants that….).

So why do I gloss over these facts when I think about my sister’s lot in life? She has definitely had her share of hardships. She is just expert in getting past these. I think her strong faith is main reason why.

So do any of you compare yourself to siblings or cousins when you know you “should” not? What do you tell yourself when you are comparing self with others? Does resolving the comparison or downplaying it involve faith in any way?

Living in the present moment – what can a puppy do for you??

A week and a day ago, we adopted a puppy whose name is Parsnip. Our old dog had cancer and we had to put him down a little under a year ago . We have had rescue dogs for twenty years so getting a puppy is a new phenomenon in our household.

True confession: I have never been that great at living in the present. I have tended to dwell in the past – would’ve, could’ve, should’ve territory. Or in the future – what on the horizon for next week should I worry about – did I get a holiday card out? What should I worry about next month – will schools go virtual again due to Omicron? What should I worry about about six to eight months from now when my daughter goes to college?

Having a puppy in the house again challenges that past/future orientation. I find myself in the present whether I am comfortable there or not. I am preoccupied with puppy pees and puppy poops and with learning to reward positive puppy behavior and ignore negative puppy behavior. I am also trying to redirect behaviors like nipping with playing with a toy. It is a constant lesson in cognitive behavioral therapy that has taken me by surprise – emphasis on behavioral – for me and the pup. Somewhat LOL and somewhat really true about CBT.

All in all puppies are a joy but a load of work. For me for now, that work keeps me focused on the present day maybe even the present hour. I am extremely exhausted by it but it does seem to keep me in the now.

To all of you who have beloved pups and other beloved pets, do you find the act of taking care of that pet helps keep you in the present? And avoid the terrible would’ve, could’ve, should’ves or that projected anxiety into and onto the future’s horizon?

Mental Health While Working in Project Management

This is a series of blogs which attempts to talk about stigma existence and stigma reduction in a particular field of work – project management.  Beginning in 2002, I became certified as a Project Management Professional.  This feat was subsequent to obtaining my college degree and my Masters in Business Administration.  In this series of blogposts, I will talk about several issues including: 1) being accepted (or not) for having a mental disorder while serving as a project manager, 2) addressing stigma associated with a mental health diagnosis while practicing as a project management professional, 3) learning to adopt risk management principles from project management principles to self-care and risk management with a mental health diagnosis,  4) detailing work places and individuals that seemed accepting of mental health diagnosis either before, during or after practicing as a project manager full-time,  5) balancing two or more projects versus one project while being diagnosed with a severe mental illness, 6) calculating the rewards and the challenges associated with compartmentalizing mental health issues while serving as a project management professional, 7) relaying the benefits of openly discussing the impacts of mental illness on my ability to serve as a project manager, and 8) detailing specific examples of prejudice in the workplace due to a mental health diagnosis.    

Some of the material may seem redundant as I have experienced repeatedly non-acceptance in the field of project management for mental health in general and for mental health diagnoses in particular.