Is Bipolar a Disability?Updated October 26, 2020 Social Security Disability
Bipolar disorder was once called “manic depressive disorder” when this mental illness was first identified in the 1950s. Today, bipolar disorder is the most common mood disorder in the US after depression and anxiety. People with bipolar disorder typically take medications to smooth out the ups and downs that are the hallmark of this condition.
14 Symptoms of Bipolar Disorder
- Unusual talkativeness (manic phase)
- Need for too much or very little sleep
- Withdrawal from social activities
- Increased libido (manic phase)
- Spending sprees (manic phase)
- Depressed mood
- Inability to concentrate
- Suicidal thoughts or actions
- Anhedonia (depressive phase)
- Weight loss when not dieting
- Rapid change or shift in moods
- Restless (manic) or slowed (depressive) behavior
Bipolar can be difficult to diagnose in children and especially in teenagers, but in adults, the diagnosis can come after either a manic or depressive episode. Manic symptoms may not be noticeable to the person suffering from bipolar disorder but are obvious to friends, family, and even acquaintances. Mania includes rapid speech, hyperactivity, risky behaviors, and spending sprees. For people with bipolar disorder, the manic phase can be enjoyable, especially in the early stages, and they may resist treatment or medications for this reason.
As mania intensifies, those with bipolar I or bipolar II may experience a psychotic break. This shows up as rambling, nonsensical speech, audio and/or visual hallucinations, and bizarre behaviors.
The depressive phase is usually more obvious to the person with bipolar disorder because it makes everyday activities difficult. People who have bipolar disorder are much more likely to seek treatment when depressed. Loss of energy, irritability, and fatigue are common symptoms of depressive syndrome. But even with proper treatment, depression is dangerous because it can lead to suicidal thoughts or gestures.
Symptoms of Bipolar Disorder
Unusual talkativeness (manic phase)
Being unusually talkative is a symptom when it happens over several days or weeks, especially for a person who is usually quiet.
Need for too much or very little sleep
Sleep changes are one of the best ways to recognize this disorder in yourself or others. A change in sleep pattern can have a physical cause but is sometimes a sign of mental illness.
Withdrawal from social activities
Social isolation goes hand in hand with depression, especially in a person who is usually socially active or someone in their teens or early adulthood.
Increased libido (manic phase)
The manic phase will result in a greater sex drive, which can also lead to promiscuity.
Spending sprees (manic phase)
The manic phase may cause some people with bipolar to go one shopping sprees, gamble, or otherwise spend money (whether they have it to spend or not).
Irritability can be caused by many things, including conditions like low thyroid and PMS. If physical causes are ruled out, however, there may be a mental disorder behind it.
An extended depressed mood is associated with a bleak, empty feeling. It is different from grief, which is the result of loss. A depressed mood can overtake someone even when life is going well.
Inability to concentrate
Bipolar disorder diminishes concentration. People who suffer from bipolar have a hard time sticking with tasks, may perform poorly on tests, and may not be able to complete work projects.
Suicidal thoughts or actions
Bipolar disorder is one of the leading causes of suicide. Going from feeling great (manic) to major depression makes it very difficult to have hope for the future.
Anhedonia (depressive phase)
Anhedonia is the loss of pleasure. An example is doing something normally fun, like the weekly bowling league, and getting little satisfaction. People who suffer from depression or bipolar disorder may have to force themselves to show up for “fun” events.
Weight loss when not dieting
Weight loss may accompany either depressive or manic phases. This signifies preoccupation and distraction, or loss of enjoyment in eating, both of which lead to eating less.
Rapid change or shift in moods
Rapid mood changes are more than being moody or “emo” and are sometimes called cyclothymia. These shifts can happen over hours, days, or weeks.
Restless (manic) or slowed (depressive) behavior
Restlessness is being fidgety, distracted, or unable to stay still. It is associated with the manic phase. Slowed behavior can result from fatigue, anhedonia, or other feelings that come with depression.
Psychosis refers to being out of touch with reality. Symptoms include making bizarre statements, revealing strange beliefs, describing visions, or hearing voices.
Is Bipolar Disorder a Disability?
Bipolar can be managed with medication, but many people with this mood disorder resist taking meds. Untreated, it can wreak havoc in families and at the workplace. People with bipolar who refuse meds or stop taking them are unlikely to be approved for disability benefits because many medications do work to alleviate most symptoms.
If you are bipolar and have decided to apply for disability, consider your medication status. You may want to first ask yourself:
- Do I sometimes forget to take my medications as prescribed?
- Do I avoid taking meds because of side effects?
- Have I only tried taking one type of medication?
- Do I avoid taking meds due to the expense?
If you answered YES to one or more of these questions, you may not be a good candidate for disability.
On the other hand, if you have tried medications for several months, have had bad side effects, such as headaches, fatigue, worsening symptoms, suicidal thoughts. If you have tried multiple medications with no relief, then you have a better shot at winning disability.
Another factor for people who have bipolar disorder is hospitalization. Have you ever been hospitalized for any reason related to bipolar disorder? Common reasons are psychosis and suicide attempts. If you have had several visits to the hospital as an inpatient, your disability claim is much more likely to be approved.
How to Get Bipolar Disability
In addition to a history of poor response to medication and multiple hospitalizations, there are a few other factors that make it more likely you’ll receive disability benefits. These factors have to do with your age, how long you have been diagnosed with the disorder, and your work history. Keep in mind that getting SSDI (Social Security Disability Insurance) requires having a work history.
For SSI (Supplemental Security Income) you need to have low income and few financial resources. Some people who file a disability claim qualify for SSDI plus SSI. (Both SSI and SSDI benefits are, generally, called SSD: Social Security Disability benefits).
The following factors can help you get disability benefits:
- Difficulty maintaining employment, because of your bipolar disorder
- Difficulty with relationships
- A history of suicide attempts
- A history of inability to stay on medications
- Job loss directly due to a manic or depressive episode
- Psychological tests showing impaired cognitive function (trouble thinking)
- Diagnosis with bipolar I or bipolar II at a younger age
- Major life problems (loss of children, substance abuse) related to bipolar
Is Bipolar a Serious Mental Illness?
Bipolar disorder is considered a serious mental illness (SMI) although many people can find help through lifestyle changes combined with medications. A diagnosis of bipolar should be taken seriously. When left untreated, this impairment can be life threatening. This mental illness does not pick and choose: It affects men and women, rich and poor, young, and old. It is one of the leading causes of suicide in the US.
People with this mental health condition are dealing with both mania and depression, each of which is hard to manage. A manic episode can cause major upheaval, including overspending and broken relationships. Depressive episodes can take months of recovery. The painful consequences of being hyperactive or extremely fatigued don’t only affect the person who has bipolar disorder, either. Often, family members face consequences, too.
Additionally, rapid cycling between mania and depression can feel to the sufferer like torture. People who have bipolar disorder have little control over mood and behavior. In many cases, they may also lack insight which makes it difficult to accept treatments or maintain a medication schedule.
Why Is Bipolar a Disability?
The main reason bipolar illness (or any mental illness) is disabling has to do with maintaining employment. An adult who cannot keep a job is considered disabled under Social Security rules. People who get disability for depression or anxiety are approved for the same reason—an inability to stay employed relating to their impairment.
For a person who has bipolar disorder, social interactions can be challenging. Other people expect stability and consistency in relationships, but from someone who has bipolar disorder that is a tall order. Like ADHD and other affective disorders, bipolar disorder symptoms impair normal social behavior.
Most work also requires social interaction. It is difficult to find a job in which you can work entirely alone and even if that is possible, other bipolar disorder symptoms can interfere with basic job skills, like maintaining a routine or dealing with authority figures.
How Does Social Security Evaluate Bipolar Disorder?
SSD benefits are reserved for individuals who are unable to maintain employment or have a terminal medical condition. All disability claims are reviewed by doctors who determine if the impairment is severe enough to keep the applicant from working.
The first question is whether the medical evidence shows a mental impairment that could impact the ability to work. A psychologist or psychiatrist, called a Medical Consultant or MC, reviews the evidence and may order a psychological evaluation. This is to determine if the applicant has significant symptoms such as psychomotor agitation, extreme behaviors, or psychosis. Through doctor’s notes, test results, or hospital admissions, the medical evidence must show evidence of severe symptoms over time.
Other factors can affect how the MC views severity. For example, if the applicant has a substance abuse problem, that may be the cause of mood swings and behavior problems and could negatively affect a disability allowance. The psychologist may determine substance abuse, rather than bipolar disorder, as the causes of symptoms.
After review, the MC determines Mental Residual Functional Capacity (MRFC) by filling out a form that lists what the applicant can still do. Can he or she be expected to show up every day to a job? Is the applicant still capable of completing work without becoming distracted, or being a distraction to others?
The MRFC might determine, for example, whether the applicant can still perform past work as a hairdresser. Will he or she still be able to appropriately interact with co-workers and clients?
The medical documentation may show depressive symptoms or manic symptoms or both, but it must demonstrate severity.
The Disability Examiner also reviews the applicant’s work and earnings history to determine what type of past work he or she performed, then summarizes this information for review by the MC.
Should I Hire a Disability Attorney?
For individuals who have bipolar disorder, it is a good idea to consider hiring an attorney. Most people applying for SSI or SSDI can benefit from an attorney, but legal advice from a disability attorney is especially valuable when dealing with a mental health disorder. Applying for disability often requires skills that are impaired (like concentration and consistency) for someone who has bipolar disorder.
The attorney will help organize medical records. Make sure you keep any appointments to ensure the claim is moving forward on schedule. If you need to appeal the decision, the attorney will ensure that happens within SSD deadlines.
Disability Benefits for Bipolar Disorder
Filing a disability insurance claim is a big step and a necessary one if you are battling serious mental illness. For bipolar patients, getting disability benefits is possible whether depressive symptoms or manic behavior is present. Bipolar I and II are serious mental illnesses, and Social Security disability benefits can make a big difference in supporting people with these conditions.
If you are a person with bipolar disorder who has a hard time maintaining employment, with or without a long history of illness, consider getting a disability lawyer to help you file a claim. SSDI is a form of long-term disability benefit that can provide some economic stability, and it is possible to win benefits if you know how disability decisions are made.