Tag Archives: disability

Support Needed for Mental Illness in the Workplace

Happy Monday! Today I want to share a recent article from USA Today that seems to address some issues I’ve been seeing (and living, let’s face it) about a lack of support around people with mental illness in the workplace.

I’ve been hitting a lot of big roadblocks when it comes to applying for SSDI, and I’ve honestly had some big questions about how our disability system works (or doesn’t work) here in the US. I’ve come across countless people who are against the whole idea of SSDI because it doesn’t support people who are disabled and want to work part time, and the current system seems to only support an “all” or “nothing” style of support. There have been so many situations I’ve found myself in where I know I could mentally benefit from working a few hours a week (giving my life a better sense of structure and a bigger sense of accomplishment and purpose) but the way the system is set up, trying to help myself this way is extremely frowned upon.

The article I’m sharing today addresses the idea of a “supported employment program” that potentially allows employers to do a better job of bridging the gap between the needs of their companies and realistic employment abilities of those with mental illness (which, let’s be honest, can widely vary for any given person over time). Personally, I consider this to be a stellar idea… I am just not sure how well this could realistically be executed. If companies aren’t currently willing to make the necessary accommodations for exceptionally well qualified applicants with mental illness as it is (something I have experienced several times), what would encourage them to use a program like this one?

At any rate, you can check out the article here. Give it a read and let me know what you think!

Can’t Stop a Moving Train

About a year and a half ago a bipolar mixed episode with psychosis and delusions wreaked havoc on my career in the fashion industry. My paranoia spread through the company until it got a grasp on the HR department and sent everyone reeling and investigating one another. It wasn’t until I pulled myself from work (for fear of hurting myself or someone else) and spent over a month in depression before I could see the delusions for what they had really been.

At the time I was extremely frustrated. This sort of thing has happened to me fairly regularly while working, I’ve never been able to hold a job for much longer than a year. My entire healthcare team (my psychiatrist, therapist, etc.) suggested I stop working because the stress of it was potentially triggering episodes far worse than I would normally experience.

I remember falling into this daydream-like state, wondering if I could eliminate all stress from my life (and primarily stress due to working) if things would quiet down. If the episodes would minimize, and I could have a stable-ish (albeit slightly boring) life by simply doing nothing at all.

Seems like a simple enough theory, doesn’t it? Remove all triggers and there is no reason for an episode to happen. I don’t know why I believed a move like this would work; I had seen plenty of people on SSDI at support groups who seemed totally out of control all the time (and they weren’t working either!).

My therapist at the time seemed to believe this would “work” (lessen my general episodes) because she, unlike me, believed all episodes had to be triggered by something. I tried to explain to her that wasn’t how it worked, and that episodes of bipolar disorder often seem to come and go as they please, but we were both too hopeful to pay much mind.

A few months ago I was sitting with her, now over a year since we put this plan into action. It was right around the time after my hearing (February) where I was significantly depressed. After all of the time I had put into applying and waiting for an SSDI decision I sat down in front of her and she said to me,

“You know what I think would help you? Working.”

Completely exasperated, I slapped my hand to my forehead and sighed. We had come full circle. Needless to say, my desire to get a new therapist (I start with someone new tomorrow) had been growing for quite some time.

As it turns out, you can’t just wave your hands and expect to stop a moving train. True, going without working is generally one of the things I attribute to not having been hospitalized lately, but it has honestly (at times) been just as stressful as working would be (with a much lower income).

Last week I managed two or three days of stability in a row, and I found myself thinking how great it would be to start working again, to meet new people, to have a task, and to have a little (as opposed to no) money. I’ve been here before though, I know this charade. I know that when I feel stable I generally feel like I can take on the world without any problems, and the truth of what happens when I do gets pushed to the background.

To top it off, even if I wanted to work (I say “work” but realistically mean roughly 10 hours a week) right now, there are some significant roadblocks. Some, like my social security disability application, I put there myself. I still haven’t received an answer after my hearing in front of the judge in February. My attorney has suggested that working (even 5 hours a week) will often return a negative reply from the government, because working 5 hours a week (and I kid you not) somehow suggests I could potentially work 40.

You can believe that if I could work 40 hours a week without becoming totally delusional, homicidal, and suicidal I would be doing it. I have always been an overachiever, and I’ve had several good positions at some very noteworthy companies (making sometimes incredible amounts of money). Why would I ever stop if I could handle it? Why would I ever give that up to sit in the dark alone, teaching myself to make a proper cream sauce for lack of anything better to do?

Honestly, I also found it a bit of a slap in the face when I met with my social security judge and the “vocational expert” for my hearing suggested I become a hotel maid, or a bottle-capper, or a mail-room clerk (because those jobs couldn’t possibly exacerbate bipolar disorder!). It felt rather humiliating that these “experts” were so quick to throw out the degree that I earned (and am still paying for) and my intelligence or goals or interests, simply because I have a mental illness. My attorney assured them that no matter what job, I am not capable of maintaining it (in my current, still unstable state) which I appreciated, though I still left feeling sour.

The other roadblock is the train itself. I am still looking for ways to help reduce my symptoms of bipolar disorder, and without some kind of useful treatment I am likely to become very volatile very quickly in the workplace. I like to believe (especially when I am feeling good or stable) that I am in control. After 10+ years under that delusion, I understand that there is a lot more to it. It appears that the more stress I experience, the less control I seem to have over myself. While I have been working hard to combat this truth with practically anything I can find, I am still doing so in an environment with the least amount of stress possible.

I’ve had a lot running through my mind. Frankly, I don’t know exactly where I am going to go next, and there are still many things up in the air (my SSDI decision, what my attorney will suggest to do next if it is a “no”, etc.). Right now I am putting all my attention on moving, because if there is one thing I want to get right… that one is it.

Still Waiting for an SSDI Decision

After the SSDI hearing in February (but pre post-hearing mental breakdown) my attorney told me to expect a letter in the mail with a decision in 3-5 weeks.

In the midst of the intensely depressed meltdown that followed, I checked the mail each day (some days twice) in hopes of hearing something. Every day since February 13th I have put my mail key in the mailbox and experienced a panic attack being triggered. The faster I put the key in and open it before closing it again, the more quickly the panic attack ends.

This has been the routine every day (except Sundays, and as I mentioned, some days twice because the mail didn’t come on time) for nine weeks now.

The intense depression dissipated. The notion that my life would end if I wasn’t awarded SSDI has passed. I’ve formulated a new future in my mind, a future where I don’t have the things that I wanted… and that is ok with me now. I know that leaving my home and having to find a new one farther away from the city is part of that future, but in the last couple weeks (without the depression) it doesn’t feel like the burden it felt like before.

I am no stranger to a sense of paranoia, of distrust, and I admit I was beginning to become suspicious of my mailman. After all, he works so inconsistently… what if he lost my decision letter? What if he was sitting in his little white hatch-back eating fried chicken reading it? I know. But that is where my mind goes!

Two weeks ago someone (Corey? A friend? My sister? I don’t recall) suggested I call my attorney’s office to see if they had any news. I agreed this was a great idea, but was so hypomanic all this time the days kept slipping past, faster and faster, and I forgot (several times).

When I made up my mind to call the office, I couldn’t remember the name of my case worker. Once I remembered it, I couldn’t remember if I was remembering it correctly, and my fear of phone calls was compounded by the thought that I would call the office and ask for someone that didn’t exist.

I finally made the call on Wednesday. The name I remembered was the right name, but the case worker said it isn’t uncommon for the decision to take this long, if not longer. 

The words she said rung in my ears:

“They haven’t made a decision yet.”

As much as I want to know the conclusion of all this fun I can’t help but feel pleased with the fact that there is still some element of mystery. Mystery in the sense that if they want to approve my claim, take your time! On the other hand, if you want to deny it, do it as soon as humanly possible.

At any rate, I’ve been waiting to go into more detail about the hearing until I received my decision letter… which of course I thought would be sooner rather than later. At this point, if the deep contemplation going on over there has things leaning in any way in my favor, take nine more weeks. I really don’t mind.

The Initial Aftermath

Yesterday was the SSDI hearing. Turns out I was dealt the most difficult judge, and despite my intense anxiety I went in feeling more confident than I expected to be going in (which is slightly laughable, considering I was on the verge of a panic attack at any given moment).

I couldn’t tell for certain, as the man was straight-faced and tight-lipped, but I’m about 98% certain he didn’t like what I had to say. I laid everything bare, even things I haven’t told my therapist at this point… all of these horrible questions making me say things I didn’t want to say (but needed to). I answered the questions as best as I could, and despite the anxiety felt a stillness of emotion for the hour I was engaged.

I’d be lying if I said it was anything less than traumatizing. The sense of relief I felt when I walked out the door (feeling as if I’d done and said everything I possibly could have) lasted about an hour. As soon as Corey and I got on the bus, it began. My mind started replaying every little detail, every moment that made me cringe. Every instant I have suddenly began second-guessing. All of this has made up some horrible loop in my mind, giving me only a 15-60 second window of being able to think about anything before my thoughts automatically cycle back to the hearing. The hearing. The hearing. The hearing.

“Alan Tudyk will be at comic con this year… what about when you said you’d only posted your blog once last week? It looks suspiciously like three posts. But I did technically only post once! One was a re-blog and the other two I wrote at once and scheduled to be posted on the same day. That’s one day’s work, it just looks like three!”

Gahhhhhhhhhhhhhhhhhhh.

I got in bed early last night and took an Ambien to silence this obsessive inner monologue. I felt sneaky, like maybe I had beaten it, when it started up again at 4 o’clock this morning.

I’ve been trying very hard to look at this hearing like I might look at a job interview. The way I feel about most jobs is that I am not particularly interested at first, I’ve even been wary about the amount of stress the job would put on me. Then, after thinking about it a little, I become interested. As time begins to pass, my enthusiasm begins to grow, and I move from being interested, to wanting the job, to passionately wanting the job, to feeling like I need the job and ultimately feeling like I can’t live without it.

In the last year, my mind has moved from a place where “it would be nice” to have SSDI benefits to, “there is no point in living if you don’t have them,” (which I understand is untrue, just the way my brain tends to exaggerate sometimes). Undoing this thought is difficult, and doesn’t really lend itself well to helping me not frantically obsess over this for eons.

The truth is that I’ve been obsessing over this for a year. I am ready, really ready, to obsess over something else. Wrestling with this situation has been extremely difficult, so please refrain from calling/texting me right now in an attempt to find out more detail about how things went. That’s why I’m writing this post.

Luck was not on my side. I will find out “for certain” in a few weeks, but I can say with some assurance I really don’t believe I won.

SSDI Prep – Listing Former Job Duties

Each week I’ve been trying to mark something off the list my lawyer gave me to help me prepare for my SSDI hearing. My hearing is (gasp) is next week, so I’ve been running around trying to make sure I have things covered.

If you’ve been following along, the list so far looks a little something like this:

1. Keep a diary
2. Make a list of things you used to do but can no longer do
3. Make a list of medications
4. Write out a description of your job duties of your former jobs
5. Meet with your lawyer

Next week I’ll be meeting with my lawyer, which means this week is all about former job duties. Hooray. (Not.)

Many people who apply for SSDI benefits have been working at one job for a number of years. That, unfortunately, is not me. In the last five years I’ve had thirteen fourteen jobs, probably evidence enough to the average citizen that I have had a lot of trouble trying to work.

It isn’t that I am cavalier about working, on the contrary I’ve been in several positions where my employer wanted to promote me. I work hard, and I like working hard. The trouble is that working hard doesn’t like me. I become fixated with working harder and harder until not only is there no way I can keep up with myself, but my mood destabilizes and I am lucky if I can perform any task at all.

For a long time I thought maybe if I found the right job, this derailment wouldn’t happen. That’s part of the reason I’ve had so many… I’ve tried working a lot of different jobs, attempting to find both a position that I enjoy but also one that doesn’t leave me stark raving mad at the end of the day. What I found is that it doesn’t exist (or, at least, it wasn’t readily available in Seattle when I needed it).

The task of listing my former job duties is something of a feat, considering the number of jobs I’ve had and how different some of them were from one another. I must admit, I’ve been working on this step for three weeks because I knew it was going to be the most difficult… and what I have now is a spreadsheet (several pages) with a lot of bullet points and words on it. Things like (taken from several jobs, not just one):

  • Operate a POS cash register
  • Unload and process replenishment merchandise from trucks
  • Communicate with factories in India for product development
  • Work as part of a team to come up with ideas for product development
  • Measure incoming samples and convey technical details to factories
  • Dress and stylize mannequins
  • Perform friendly and upbeat customer service
  • Safely operate a stone saw
  • Safely utilize caulk, scissors, razor-blades, to create samples

You get the idea.

What it comes down to is creating a list like this can come from several sources. Here are a few I found to be the most helpful:

1. Look back through employee paperwork

I’ve kept a few of my “employee handbooks” and paperwork from when I started my new job(s). I realize this isn’t something that many people keep, but when I looked through the paperwork I found a list of job duties printed right on the paperwork. This was nice and easy, because there were a lot of things listed I would have normally forgotten.

2. Visit your employer website and search for job opportunities

If the handbook thing doesn’t work out, you can go to the website for your employer (given you were employed by a large corporation) and do a search for job openings like that one you were employed in. Job opportunities usually have duties listed right in the description, which is a great place to get details you may have missed.

3. If all else fails, consider what you did on a day to day basis

What did you do when you were at work? I would consider both your day to day responsibilities but also special responsibilities you may have had when something big happened. Were you asked to help prepare the store for a big event? Did you meet with the Chinese fabric vendors? Consider those responsibilities within your job duties.

Like the medication list I mentioned, I have found it is a pretty good idea to keep a record of jobs I’ve had, with information such as how much I earned at each job, the address of the business, the phone number of the business, who my manager was, and the dates I began and ended each job. With the encouragement of this new step (listing job duties) I’ve gone a step further and added a list of job duties for each job I’ve had to the “Master Job List” as well.

This list is more useful than just applying for SSDI, I’ve used it when applying for food stamps and certainly when applying for jobs (they always ask for the addresses of my former employers which I can never remember). Keeping a list like this could be extremely helpful if, heaven forbid, your symptoms require you to apply for SSDI down the road.

Don’t let me fool you. I’m not as organized as one might have you think… I just really obsess over making lists.

Anyway, finishing this task has helped alleviate a touch of my anxiety. All that is really left now before meeting with my lawyer is figuring out what to wear, which (as a woman with anxiety who worked primarily in the fashion industry -a fashion horror trifecta) might take a full week to figure out, which is why I’m giving myself as much time as possible. I’m a firm believer that our clothes say things that aren’t said out loud, and I want to make sure I am saying the right thing with what I’m wearing.

Physical Symptoms of Anxiety

Most people consider anxiety to be something of internal stress and struggle, constant worrying or over-thinking, but there is really much more to it. Anxiety has many physical symptoms that can pop up without warning or seem to eat away at us over a period of time.

This topic has been on my mind the last week or so because the closer I get to my SSDI hearing, the more of these physical symptoms of anxiety begin to manifest for me. My mind can only worry so much, but when it hits something of a peak, that is never the end, is it? For anxiety to blatantly “get worse” it often means other parts of my body being subjected to something akin to torture.

Maybe you’ve never considered the ways anxiety can physically obstruct someone from being at their best, so here is a list of a few of the ways anxiety can effect us physically.

  • Difficulty breathing (feeling out of breath all the time or having trouble catching one’s breath)
  • Breathing too quickly (hyperventilation)
  • Racing or pounding heartbeat
  • Trembling or shaking (generally in hands or feet)
  • Stomach pain (like an acidic feeling or a scraping pain)
  • Stomach cramps
  • Vomiting
  • Diarrhea
  • Tense muscles causing general body pain potentially in neck, back, or abdomen
  • Tension headaches (from tense head muscles)
  • Sweating
  • Blacking out/fainting

Of course, one might also include the ever-dreaded panic attack which often includes many of these symptoms at once as well as the overwhelming sensation one is about to kick the bucket.

Understanding that anxiety manifests physical symptoms can help us better gauge 1. how anxious we are, and 2. what we can do about it.

For example, noticing that my body has been in a position where I have been sitting rigidly and very tense for several hours gives me some insight about my anxiety level. At the same time, combatting this particular symptom with a hot bath or a hot tub or even a massage from someone will not only make the symptom lessen, but will also help lessen my anxiety.

When it feels like I have been trying to digest a handful of gravel for a week I don’t usually run out and consume a bottle of tequila and the spiciest Indian curry I can find. I generally stick to, you know… yogurt and macaroni and cheese.

If I feel like I can’t breathe, I try to avoid situations that might exacerbate it. Trying to do very physical things (running, even walking at times) can make me begin to panic if I feel like I can’t breathe, which can ultimately trigger a panic attack. Taking it easy, breathing deep, and moving slowly for a bit tends to help me in that arena.

Ultimately, recognizing physical symptoms of anxiety (as well as the mental symptoms) can help us gain a better understanding of what we’re dealing with as well as give us some clues as to what we can do to help ourselves feel a little better.

SSDI Prep – My Medications

I’ve been working my way down the list of objectives given to me by my attorney for my SSDI hearing. Here’s where we’re at:

1. Keep a diary
2. Make a list of things you used to do but can no longer do
3. Make a list of medications
4. Write out a description of your job duties of your former jobs
5. Meet with your lawyer

Next up is to prepare a list of my medications.

Keeping track of my medications has been fairly difficult. My diagnosis is bipolar type 1, but recently my psychiatrist has moved me into the category of “treatment resistant” bipolar disorder since I have tried numerous medications that haven’t had any (positive) effect on my symptoms.

Basically what this means is that I have been trying every new medication my psychiatrist throws my way, usually every couple months. I’m constantly ramping up on a dosage or ramping down, so even trying to predict what I’ll be taking in three weeks (at my hearing) is sketchy at best.

I’ve talked a bit about this before, but the way I go about handling all of the information that comes with trying so many new medications is that I have a spreadsheet where I list:

  • the medication I tried
  • when I began taking it and when I stopped taking it
  • the maximum dosage achieved
  • the side effects that ultimately caused me to stop taking it

I keep a separate section for medications I am currently taking, with similar information.

I also keep a list of hospitalizations at the bottom of the spreadsheet for a very important reason.

Let’s say I am going to the emergency room, or entering an inpatient hospitalization, or even going to see a new psychiatrist – this sheet has my entire medication history on it. All I have to do is hand it to the nurse or doctor when I arrive instead of trying to prod a brain that is thoroughly out of whack for this information. And, hey, if you want to have your prescribing doctor’s information on the sheet, that never hurts either.

I keep all this information in a spreadsheet on a cloud (through gmail) so I can access it from any computer with internet in an emergency. So far, it has really helped me.

Ok, so side note, I am preparing my medication list to include all of the medications I’ve tried so that I can demonstrate (if it comes up) that my symptoms have been treatment resistant at my hearing. Again, it is always better to have more information than not, so I want to consider my entire history, as well as my current medications.

If you are compiling a list of your medications, it is perfectly reasonable to start with your current ones. Open up the medicine cabinet, grab your bottles, and start your list.

You want to list all medications, so consider things like herbal supplements you might take (I take fish oil), over the counter daily medications (I take pepcid AC daily for an abundance of stomach acid), or things like prescription face creams (which I use for acne). You also want to consider medications you take as needed. 

These things may not seem important, but they might be addressing issues that are side effects of the psychiatric medications you’re taking. I have stomach issues and acne from taking lithium, so I use two medications to address those side effects.

My current medication list looks like this:

  1. 1200 mg Lithium Carbonate (once daily)
  2. 20 mg Latuda (once daily)
  3. 50 mg Tegretol (once daily)
  4. 5 mg Risperidone (as needed)
  5. 10 mg Ambien (as needed)
  6. .01% Tretinoin Gel (once daily)
  7. 20 mg Pepcid AC (twice daily)
  8. 1000 mg Fish Oil (once daily)

From what I understand, this is all that is required for the social security hearing. I know from experience, however, that if asked to recall information about my previous medications I will have a bit of trouble, which is why I want to be ready with the full history list.

If you are interested in making a list of your full medication history, there are a few things you can do to help in the process.

  • You can ask your prescribing doctor to give you a list of what they’ve prescribed. Most doctors I’ve met are happy to share this information.
  • Look at old medication bottles. I have a bit of an OCD thing where I can’t throw mine away, so I have every psychiatric medication bottle I’ve been prescribed since 2003. This was extremely helpful in piecing together which medications I took and when.
  • Look through a blog or journal. You may have written something about trying a new medication, or stopping an old one.
  • Ask a family member or friend if they remember any details.

Having a history of your medications can be helpful, but it isn’t absolutely imperative. After all, you could always begin your list with what you’re taking currently, and if things change, update it. Realistically, I only really care about having a history list so I don’t wind up taking the same medication twice, when I’ve already had a bad reaction to it in the past.

Here’s a chopped down version of my list:

  • Latuda 40 mg (12/10/13-) – back and neck muscle agitation, mood destabilization
  • Geodon 120 mg (10/28/12-8/2/13) – developed muscle spasm in jaw, intense dizziness, fainting, no appetite
  • Lorazepam 1 mg (10/1/12-10/25/12) – worsened mood (hostility)
  • Trileptal 150 mg (6/12/12-6/21/12) – worsened mood swings
  • Zyprexa 5 mg (4/3/11-6/6/11) – 40lb weight gain in two months
  • Zoloft 100 mg (4/7/11-4/13/11) – triggered mania
  • Abilify 5 mg (4/13/11-4/20/11) – extreme nausea and dizziness
  • Clonazepam (4/3/11) – severe mood swings, panic attacks
  • Seroquel (4/2/11-4/3/11) – extreme dizziness, trouble focusing, intense drowsiness
  • Prednisone (2/04/11-2/6/11) – severe mood swings with uncontrolled crying spells, unprovoked panic attacks
  • Lamictal 25 mg (2/23/11-2/26/11) – rash, discontinued
  • Wellbutrin 150 mg – (no memory)
  • Neurontin 300 mg – (no memory)
  • Fluvoxamine 150 mg (12/02-2/03) – worsened depression, mania, psychosis, and homicidal/suicidal ideation
 There we have it!