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Long Term Disability Claim Tips for Bipolar Disorder

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Bipolar disorder is a serious illness believed to be caused by an organic disorder or imbalance in the brain. It causes extreme mood changes from euphoria/mania to depression.  During the depressive phase of bipolar disorder, you may experience hopelessness, sadness, loss of energy, and thoughts of suicide.  During the euphoric or manic phase, you may experience inflated self-confidence, high energy levels, a reduced need for sleep, racing thoughts, and impulsiveness (e.g., engaging in risky behaviors). 

The fluctuating symptoms of bipolar disorder may lead to serious difficulties in functioning and problems with personal relationships – making it difficult to hold down a job.  Here’s what you need to know before filing your bipolar disorder long term disability claim.

Disabling Symptoms of Bipolar Disorder

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Bipolar disorder is a condition caused by a chemical imbalance in the brain resulting in severe mood swings. It is characterized by periods of manic activity with exceptionally bad periods of depression.  Both the highs and lows of bipolar disorder are intense and can interfere with all aspectѕ of your daily life.

Bipolar Disorder Episodes and Cycling

You may have a bipolar disorder episode that is manic or depressive. 

In the depressive stage, you may feel extremely down, or feel like the world is about collapse in on your. Irritable behavior is also common. During these low swings, you may move and speak more slowly than usual. You may also sleep more than normal.  It’s very possible that you may even lose touch with reality – experiencing hallucinations, delusions, and paranoia.

In the manic phase, you may experience euphoria or mania.  You may feel like you’re on top of the world and nothing can take you down.  You may engage in risky and impulsive behaviors, such as gambling, excessive spending, drinking/substance abuse, and dangerous sexual behaviors.  You may also experience pressured speech and racing thoughts.  You may sleep less – staying up all through the day and night.  During a manic phase, you may still experience hallucinations, delusions, or paranoia.  Grandiosity is also common.

Other times, you may “cycle” between these episodes with symptoms of both. It is common for those with bіpolar disorder to experience great emotional highs and lows, or for these mood swings to occur quickly and without notice or apparent reason.

Bipolar Disorder Mixed State

One соmmоn phenomenon of bipolar disorder is a “mixed state.” That is, where an individual can simultaneously experience characteristics of both the manic and depressive stages.  Whеn you are  in a mixed state, your inner moods may become conflicted – creating sensations оf anxiety and confusion. You may even lose touch with reality, which can cause safety concerns.

Unfortunately, these mіxеd mood episodes often result in suicide or thoughts of suicide, manic behavior, clinical depression, fatigue, insomnia, delusions, excessive anger, and belligerence. With a diagnosis of bipolar disorder, you have a much greater risk of suicide than the general population. In fact, experts place the risk between ten and twenty times as high as the rest of the population.

Understanding Your Unique Symptoms

When filing your long term disability claim, the insurance company will want to know about your symptoms because it must understand how they are disabling to you.  Remember, bipolar disorder presents differently in different people.  Each person will have a different cycling pattern, and the pattern may change unexpectedly.  It is not fair to broadly categorize people with bipolar disorder because it’s unique condition that affects different people differently.  To fairly evaluate your bipolar disorder long term disability claim, the insurance company must understand how your condition personally affects your functioning.

Symptoms of Bipolar Manic Episodes Can Include:

  • Euphoria
  • Irritability
  • Decreased need for sleep
  • Racing thoughts/destractibility
  • Increased energy
  • Very high self-esteem
  • Impulsiveness
  • Engaging in risky behaviors
  • Making poor decisions
  • Hallucinations

Symptoms of Bipolar Depressive Episodes Can Include:

  • Sadness/depressed mood
  • Fatigue
  • Low energy
  • Slow speech
  • Problems with concentration and attention
  • Insomnia and/or periods of too much sleep
  • Feeling hopelessness and/or worthless
  • Lack of interest/feeling no pleasure
  • Weight loss and/or changes in appetite
  • Thoughts of suicide

How is Bipolar Disorder Diagnosed?

The insurance company will require proof of your diagnosis for your bipolar disorder long term disability.  This can be challenging because your bipolar disorder makes you more likely to seek medical attention when you are depressed, rather than when your are manic or hypomanic.  Unfortunately, because of this, bipolar disorder oftentimes goes undiagnosed.  Indeed, it is common to suffer for years before a diagnosis is properly made.

The first step in getting the correct diagnosis is to talk to a doctor.  Your doctor may conduct a physical examination, an interview, and lаb tests. Bipolar disorder cannot be identified through a blood test or a brain scan, but these tests can help rule-out other contributing factors, such as a stroke or brain tumor. If your symptoms are not caused by other illnesses, your doctor may conduct a mental health evaluation. Your doctor may also provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder.

Your doctor or mental health professional will likely conduct a complete diagnostic evaluation. A careful and complete history of symptoms is needed to assure your bipolar disorder is not mistakenly diagnosed as a major depressive disorder. 

In addition, your doctor or mental health professional will likely discuss any family history of bipolar disorder or other mental illnesses. Your doctor or mental health professional may also talk to your close relatives or spouse to see how they describe your symptoms and family medical history.

Types of Bipolar Disorder

The insurance company may also want to know what type of Bipolar Disorder you suffer from.  Health experts classify bipolar disorder into four types: Bipolar Affective Disorder 1; Bipolar Affective Dіѕоrdеr 2; Cyclothymic Disorder; and Bipolar Affective Disorder, not otherwise specified.

  • Bipolar Dіѕоrdеr Type 1 is diagnosed when you have had at least one manic episode which could be followed or preceded by a major depressive or hypomanic episode. Individuals with Bipolar 1 experience full-blown mania. A person with Bipolar 1 is extremely restless and energetic and has trouble sleeping as their mind wonders nonstop and they appear to talk a lot more than usual. Sometimes they can even hallucinate and in some cases are even thought to be "psychotic." In the extreme cases of Bipolar 1, a person may even have to be confined.
  • Bіроlаr Dіѕоrdеr 2 is sometimes referred to as "Swinging Bipolar." You may be diagnosed with Bi-polar 2 if you experience at least one depressive episode and one hypomanic episode. Unlike Bipolar 1, those diagnosed with Bipolar 2 aren’t known to have psychotic They can, however, suffer badly from depression and sometimes this depression will come crashing down on them all at once from loss of a loved one, job, relationship, etc. and it will be very hard for them to cope.
  • Cyclothymic Disorder is when you have at least a two year history of periods of  both hypomania or mania and depression, but not to a major extent. Your manic and depressive episodes can go back and forth over a period of time, but not enough to meet full criteria of major depression. Those diagnosed with Cyclothymic Disorder do have trouble functioning at times.
  • Bіроlаr Disorder - NOS is diagnosed when you experience some characteristics оf Bipolar, but none of which can be classified as one of the three other types. Studies have shown that people with Bipolar Disorder - NOS are more likely to go for help during a depressive episode. It is very important that the treating doctor or therapist obtain information about their family history. If the patient's family has a history оf both depression and mania, there's a chance that depression isn't the only thing the patient has to worry about. If the patient is only given anti-depressants to help with his or her depression, then they can quickly switch to mania.

Both men and women can suffer from bipolar disorder, and іt can hit at any age.  But, most people seem to start noticing the symptoms in their twenties.  Teens have been diagnosed, as well.  It appears that approximately 85% оf people suffering from bipolar have a family history of depression.

Appropriate Treatment for Bipolar Disorder

When evaluating your bipolar disorder long term disability claim, the insurance company will want to see you’re receiving appropriate treatment.  The insurance company can easily use non-compliance and lack of appropriate care as a reason to deny your bipolar disorder long term disability claim. 

To demonstrate appropriate treatment, your treatment team should include specialists such as a psychiatrist and/or psychologist.  Treatment options may include:

  • Medications. Your doctor may prescribe mood stabilizers; antipsychotics; antidepressants; and anti-anxiety medications.  It may take some time (and trial and error) before you and your doctors find the right medication or medications.
  • Psychotherapy. Your doctor may recommend psychotherapy, which may include individual counseling (to help you address specific problem areas, recognize your symptoms and manage your stress); cognitive behavioral therapy (to help identify negative thoughts, change your behaviors and come up with coping strategies); interpersonal and social rhythm therapy (to help come up with a routine for daily activities such as sleeping, eating, diet and exercise); and family-focused therapy (to educate your family about Bipolar disorder and how to recognize warning signs of a manic or depressive episode).
  • Day Treatment Programs. Your doctor may suggest an out-patient day treatment program designed to help you recognize and control your symptoms.
  • Hospitalization. If you are experiencing suicidal ideas, acting dangerously, or experiencing psychotic episodes (g., paranoia, delusions, irrational thoughts, hallucinations), your doctor may recommend an in-patient hospitalization. In-patient treatment may help address your symptoms, stabilize your mood, and keep you calm and safe while doing so.
  • Electroconvulsive Therapy. Electroconvulsive therapy, while rarely used, can be helpful if you are experiencing severe depression or mania that is not relieved by medications or other treatment methods.  

Again, it is important to follow your doctor’s recommendation.  Your insurance company will want to see you are in treatment and doing everything in your power to improve your symptoms.

Inability to Work Due to Bipolar Disorder

Bipolar Disorder can be extremely distressing and disabling.  It is a condition that can ruin your career and relationships alike.  However, you should never assume the insurance company will understand how your individual symptoms impact you and your job.  To increase your chances of claim approval, you must explain why each of your symptoms prevent you from performing your job duties. 

For example, during a depressive episode, you be unable to get out of bed due to your severely depressed mood and fatigue forcing you to call in “sick.”  You may be preoccupied with your debilitating symptoms and unable to focus, concentrate or pay attention at an important meeting or during a telephone call with your biggest client.  Or, your lack of interests, low energy and feelings of hopelessness may make routine tasks seem overly stressful or cause you to “procratinate” and miss a strict deadline.

During a manic episode, you may decide to “blow off” work for the day, or worse yet, impulsively quit your job.  If you do make it to work, your heightened energy may cause you to speak radily and scare off a potential client, or fail to put your best foot forward during a presentation.  Your irritability may lead to fights with co-workers, disruptive behavior in a meeting, or an inability to accept criticism from you boss.  Or, your racing thoughts and easy distractibility may cause you to miss an important piece of information from a document, which is particularly troublesome if your job requires attention to detail.

Given the varying symptoms of bipolar disorder, your should explain how your individual symptoms prevent you from performing your job duties by preparing a detailed, written narrative for the insurance company.  In many cases, it is helpful if the narrative addresses all of your symptoms by listing them separately first.  Because most symptoms of bipolar disorder are subjective in nature, your narrative can also address the severity of your symptoms, as well as factors that trigger or exacerbate your symptoms. 

When determining whether your bipolar disorder is disabling, your insurance company will likely also want the opinions of your treating doctor(s).  Your doctor’s support is key.  Your doctor’s reports should focus on the frequency and severity of your symptoms; any positive mental status exam findings; their direct observations of you during office visits; and the specific restrictions and limitations that prevent you from working. 

Your narrative and your doctor’s support will go a long way in helping to prove your bipolar disorder long term disability claim.

Conclusion

Bipolar disorder is a serious medical condition that may result in disability.  Knowing how to substantiate your claim will significantly increase your chances of approval.  To get your bipolar disorder long term disability claim approved, your claim should be supported by sufficient medical evidence and proof of appropriate treatment.  It is also important to explain (in detail) how your symptoms prevent you from performing your job duties.  Don’t assume the insurance company understands.  You have to explain it.

Links and Resources

Depression and Bipolar Support Alliance

National Alliance on Mental Illness

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