To Disclose or Not to Disclose: Public Perceptions of Bipolar Disorder in the Workplace

Background and Purpose: Bipolar disorder (BD) is one of the leading disabilities worldwide with estimates of unemployment as high as 65% and high rates of reduced work performance. Unemployed individuals with BD are more likely to live below the poverty level, experience a worse course of illness, and have lower life satisfaction. Disclosing BD at work may ensure appropriate work accommodations. However, research indicates that stigma towards employees with BD undermines their efforts to get hired, meet work requirements, and maintain employment. Consequently, people with BD are less likely to disclose their illness at work if they believe their symptoms can go undetected. No known studies have examined public attitudes towards working alongside someone with BD. A clearer understanding would help to further clarify the risks of disclosing one’s illness and aid in the development of strategies to better address these risks.

Methods: This cross-sectional, deception survey was completed by 628 working adults (18 or over) recruited through Qualtrics. Participants were randomized to read one of twelve vignettes describing behaviors of a hypothetical coworker that varied by: 1) coworker gender, 2) coworker’s present mood (depression versus hypomania), 3) reason for the mood symptoms (relationship status change, bipolar disorder diagnosis, no reason given). Following the vignette, participants completed 17 survey questions, assessing attitudes in five areas (social acceptability, competency, reliability, advancement, and job demotion or loss). Additional areas of assessment included demographics, work history, disability status, and degree of experience with BD. Five hierarchical linear regressions were conducted for the five dependent variables (social acceptability, competency, reliability, advancement, and job demotion or loss). Regressions included four levels of predictors: level 1 (vignette characteristics - present mood, mood reason, gender match); level 2 (age, income); level 3 (disability status of the participant (yes/no)); level 4 (participant’s degree of experience with BD (none - quite a lot)).

Results: Demographics represented the general US population by age, race, and gender. All five final regression models were significant: social acceptability, F(10, 605) = 3.817, p< .000, R² = .059; competency, F(10, 605) = 3.700, p< .000, R² = .058; reliability, F(10, 605) = 3.900, p< .000, R² = .061; advancement, F(10, 605) = 9.095, p< .000, R² = .131; job demotion/loss, F(10, 605) = 20.656, p< .000, R² = .255. Statistically significant (p < .05) predictors included mood reason, present mood, participant gender by coworker gender, age, income, disability status and experience with BD.

Conclusions and Implications: Positive work attitudes were greater towards “coworkers” who demonstrated hypomanic symptoms (versus depression), and those who disclosed their BD diagnosis. Participants who had a disability and/or had greater experience with BD, also reported more positive attitudes. Efforts to overcome the stigma of mental illness have increased over recent years. Implications from our work suggest potential progress towards public perceptions of mental illness and decreased negative stereotypes towards BD within the workplace. Strategies aimed at providing greater awareness and understanding of, and empathy toward BD in work settings may reduce stigma and, ultimately, the impact of disclosing one’s illness.