Nurse with bipolar disorder or adhd?

litbitblack, ASN, RN · May 13, 2008

I have ADHD and the only way it affects my job is in organization. It is so hard to try and keep everything I have to know and do and actually get it done. As for the bipolar I know in texas on the board applications it asks if you have been diagnosed with a psychiatric illness in the last 5 yrs so you might want to talk to the board before you start school to see if there will be a problem when you graduate. The school probably doesn't care but in the end it will be the BON.

queenjean · May 13, 2008

We have a couple of nurses who are openly bipolar (lol that's a funny phrase...). I can tell you we have a couple who SHOULD be on meds. People talk about an aerosolized form of ativan--man, I'd like to spray in Strattera through our ventilation system! Strattera and Prozac for EVERYONE!

Nurses are just like the rest of society--we've got the ADDs, the OCDs, the addicts, the goody-two-shoes, the religious freaks, the trustafarians, the athiests, the hippies, the soccer moms, the baseball coach dads, the democrats, the republicans, the socialists, the libertarians--every freaky little group and subgroup is represented. We've got those with mental illness and those with physical illness and those with spiritual conditions. An interesting cross section.

Don't worry about it. ANY medical condition you have should not be an issue if you are well managed on your meds. If you can get through nursing schoool, I'd bet that you are well managed.

carnationpixie · Nov 5, 2008

It shouldn't matter and the ADA may say you can't be discriminated against but you can't always prove that's why you were fired. I have bipolar, PTSD, schizoid personality disorder. I had to mark that I have been treated for mental illness on my application to the Florida BON and I am monitored by a program through the state of Florida for it. I am not allowed to work in home health care, substance abuse, or for a staffing agency. I also am required to notify my employer of my participation in this program, so my employer knows I have a mental illness, so no way to hide it...or I could let them think I have a substance abuse problem instead since that is the same program. My coworkers have complete confidence in me and come to me with questions often. I am completely stable on my medications and have not been hospitalized in 11 years and I have been on medications and in therapy for 17 years. I don't consider myself unsuccessful at all but I do often see nurses at work unfairly catagorize patients with bipolar and schizophrenia as "problem patients" merely because of their diagnosis even before they have met the patient. This annoys me becuase I would hate to be judged like that based solely on my diagnosis and not have been given a chance, but this is the stigma of mental illness unfortunately. I have also seen doctors medicate patients with bipolar less for pain than other patients. Has anyone else seen this?

lesleyg · Feb 4, 2009

I have a mood disorder (I am somewhere on the spectrum but have really only had major depressive episodes as well as some hypomania.......I think If you had to pinpoint my diagnoses it would be a combination of PTSD, Cyclothymic mood disorder, ADD (not ADHD), and major depressive disorder.)

I've been followed by a psychiatrist since I was 15 and diagnosed with depression. I am now almost 28 and have been an R.N for five years. I have to say that school was actually easier for me than being a nurse in the "real world". I actually have very good study skills and excellent reading comprehension so I was able to graduate from Northeastern University with a 3.5 GPA. My nursing class voted me "Most likely to be Late for the Boards" because of my reputation for either skipping lectures that I found boring or always showing up late for class and clinicals. A lot of times if they didn't take attendance in class I found it more beneficial to read the text and study on my own because I could not tolerate sitting still........I am a huge daydreamer but could at times super-focus and absorb large amounts of info in a sitting (especially if I was involved in class dialogue).

Anyways, I got through school with the help of my roomates waking me up for class, following classmates to class and having friends who always reminded me of deadlines, schedules, etc. It was like my nursing school friends acted as personal assistants- they accepted me for who I am and I actually had a friend in school who also had ADD- he is an AWESOME nurse and has done well in the nursing world.

Me, on the other hand, have gone from job to job trying to "find my niche". It's like I'm a job Who** and am always looking for the next best thing. I started in Labor and Delivery and that was very intense as a new grad.....I then left the hospital after a year and did travel nursing. Went to Hawaii and N.H (LOVE TO TRAVEL!). I had a back injury in N.H and was out of work for five months d/t an assaultive patient.

After that, I decided travel nursing was not safe and my confidence as a nurse was shaken to say the least. I was diagnosed with PTSD from the assault and fell into a major depression. I was in physical therapy for five months until I could break the pain cycle from my neck injury. I also had back surgery at age 22 right after I took my boards (on Time!- first person in my class to pass with flying colors....), so getting injured again really took it's toll.

During all this, My dad was diagnosed with Bipolar I and anyone who has lived with someone with that diagnoses knows how painful it can be for a family member. I was able to get him treatment and he has been stable for four years on his meds. At one point (again, while I was studying for those boards that I was determined to be on time for!), he was so suicidal that we decided to go ahead with ECT and I carried the brunt of caring for him as an outpatient.

So you can see why I ran away to Hawaii after all that I went through....after less than a year I had to take a short leave of abscence from my job and fought my nurse manager with the help of my union rep (and Won!) for discrimination. She was bullying me and giving me a hard time about taking the time off I needed to get my depression under control, despite the fact that I had a valid letter from my MD ordering a reduction in hours and no night shifts until further notice. The letter also stated I was competent and safe to work part-time.

My advice would be NEVER to disclose to an employer the reason you are taking an Leave of Absence. Having to defend myself and fight with administration for my right to stay healthy was a nightmare. And legally they have no right to know any of your health information. The only time I would ever disclose that I have depression or ADD is if I was well-established in a job. I was very naive to think that this particular management would be understanding about any illness, never mind a mental one!

Anyways, back to my career path.....after getting assaulted by a patient on a travel assignment I was reluctant to work in a hospital setting so I got a job working as an IV infusion nurse in an outpatient facility. I started per diem working with a world-renowned physician who specializes in occular immunology. However, I found the job repetative and boring and always wanted to go back to working in maternal child health. So I refused a permenent position because it simply wasn't "my passion". It is like I need instant gratification at work....and was either overwhelmed or bored- never inbetween.

I still work per diem for this company, which is great.......they were always very understanding about my chronic lateness because I did a great job when I was there and connected well with the doctor, who has written 50 textbooks and is a pioneer in his field. (I find that ironic because I feel so dumb sometimes.....)

Last fall I decided to move and start a new job- continued to work per diem at the infusion site and then took a 16 week position in Maternity at a local hospital. I couldn't juggle the change, was late for several shifts and did not learn the charting fast enough since I was only there once or twice a week. I was also on Lamictal at the time, which made me very foggy. Turns out I couldn't tolerate even the tiniest dose and am now considered allergic to it. Too bad because it really helped my moods. However, I am now more stable without it....I've done better mood-wise the past year or so and worse with the ADD. So I was fired for the first time in my life.

On to the next job.....pedi home care and MCH home visits. The driving was a nightmare because I have no sense of direction and the pay was terrible. The little boy I took care of was constantly in and out of the hospital so I had no job security. I made the painful decision to "break up" with my little patient and do what I thought was best for me....get back on the horse and go back to my first love- Labor and Delivery.

Well, I got some confidence back because I ended up picking it up quickly this time since I was full time. My preceptor also had ADD and seemed to understand the way I thought. Not to mention I am great one-on-one and L&D is usually 1:1 ratio. Unfortunately, I called in sick twice and overslept for my shift twice. It was slow in Dec. so my manager made the decision to let me go. She said it had nothing to do with my nursing ability or how I was doing in my job. I know there were also budget cuts and we were overstaffed, but if I hadn't given them a reason they probably would have kept me on staff. The staff members were shocked and all said they would recommend me and that this never would have happened if it wasn't slow on the unit; that I was being made an example out of, and that I was a great nurse. Still didn't help the devestation and failure that I felt when I was let go from a place where I finally felt like I belonged.

Reliability, getting to work on time, and keeping my schedule strait is a HUGE challenge for me. I do not have any substance abuse issues (Thank the LORD!), it is just how I've always been. Early mornings are very tough for me....it's like my brain and body sometimes don't wake up until around 1pm. I can sleep through three or four alarms when I am in a deep sleep and "normal" people don't understand this. I've been this way since I was a little kid and my dad is the same way. It doesn't help that I live alone and don't have a husband or roomates to help wake me up (it's not an easy job to get me out of bed in the morning).

Anyways, I am not a quitter.....I did consider getting my teaching certificate as I am very good with children. I may take the MTELS but I feel that there has got to be some way that I can manage my ADD and time management issue and be successful in my career for now. I have an interview at McLean hospital tomorrow (a harvard-affiliated psych hospital) and think this would be a good job since I am very knowledgable in psych. Not to mention the job market is TERRIBLE right now. I also have had the depression under control for quite a while now so I feel I am okay to help others.

It's a risk doing this but life is all about risk taking. My parents are not happy with me considering psych nursing since it was a psych patient that I was assaulted by, but I told them that is in the past and that this can happen in any area of nursing, especially ER. I feel it would be a shame to waste my talent and interest in psychiatric nursing just because I am afraid of having a repeat of what happened to me before. I don't want to go through life afraid, and feel that I have learned so much from my experiences and can only consider myself a work in progress.

Thanks to everyone for reading.....comments and/or advice are welcome. Especially regarding being on time. It is easier said than done for me, and I think that is a common trait for people with ADD. I am also anticipating having trouble multitasking since I am used to having a lower nurse/patient ratio. Then again, I can run 7 IV infusions in the infusion suite at once......It's just a matter of having a routine.

Has anyone else had similar experiences? I would love to hear from you.

P.S My current meds are Effexor XR, Klonopin PRN at bedtime, and Adderall XR. I only take the Adderall on a very limited basis because of my family history of BPD. It can cause mania and where I am on the mood disorder spectrum I am very careful about taking anything that could cause an extreme mood of any kind. Every "episode" of depression or hypomania can alter the brain in such a way that future episodes are harder to avoid. The Adderall XR works great but makes me a little anxious and then when it wears off I am EXHAUSTED and irritable.

ritarunningfeet · Feb 4, 2009

I am not dx with anything but often say "this isn't good for my ADD" (25% joking and 75% really feeling like I have some sort of ADD). One day I said it and a doctor told me that something like 90% of ER nurses have ADD/ADHD. And I have to say I think I beleive him with all the multitasking and constant changing that goes on in the ER.

WalkieTalkie, RN · Feb 4, 2009

I have AD/HD and I work without issues.

lesleyg · Feb 4, 2009

Are you taking medication for it? Do you have any particular techniques for dealing with it? I've met nurses who have ADHD and they seem to do okay, especially if they have the hyperactivity componant. My type is more the "inattentive" type, so I have to really pull report out of people, write everything down, and develop systems to get around it. My biggest downfall is being on time for my shift; it seems like at times I have no concept of time. Like right now I'm on the internet and ignoring my loud alarm clock....and I have a job interview to get ready for!

nursebritts LPN · Feb 11, 2010

I was recently diagnosed with bipolar two and I was worried about the effects on my career. I am so glad that you brought this up and to everyone that answered. I have just started my treatment and I really hope that it helps!

mustlovepoodles, RN · Feb 12, 2010

Its pretty amazing how many of us have bipolar disorder. I have had at least 13-15 bouts of depression over the last 38 years, including two hospitalizations. The board has never been notified and I have not self-reported. After the last hosptialization, which ended up being 8 weeks, I took about a year off to recover. Now that I am in a good recovery program, have good coping skills, good insight, good support system, and a backup plan, I'm doing well. I just started working again, part-time in a non-hospital setting. Less money, but less stress and i love the job. Its a perfect fit!

mustlovepoodles, RN · Feb 12, 2010

I was recently diagnosed with bipolar two and I was worried about the effects on my career. I am so glad that you brought this up and to everyone that answered. I have just started my treatment and I really hope that it helps!

Good luck to you. February 13 will be my one year anniversary of seeking appropriate treatment and I'm doing so much better now. Last year I wouldn't have believed that I could ever be happy again. It has been a hard uphill climb, but so worth it. I haven't entertained thoughts of killing myself in about the last 10 months--I have had suicidal thoughts since I was 15! I'm happy, energetic, and fun now. I hope you have a similar experience. Hang in there with it. You've got nothing to lose!

lamazeteacher · Feb 12, 2010

I can't tell you how much validation this thread gives me! Bravo! Those of you who have contributed are so brave, self disciplined (especially those who are late a lot). I appreciate all that you've gone through.....

In 1957 I brought the P&H form to my doctor and I had filled in "mnother had Chronic depression" by the question about mental illness Hx. He stared at that as if something leapt off the page , stinging his eyes, and said, "Do you want to get into nursing school or not?" And he erased the comment. That was the first I knew about phobic reaction to mental illness. Of course that was in the "snakepit days" (that still exist in many places).

While in nursing school, I remember keeping it together unless I was around a particularly kind neurologist, working in his clinic. I burst into tears every time I saw him! Then, no one realized that mental illness could be inherited. The only med for depression was tofranil. Somehow, I thought he held a key tro relief from my mental state (always depressed). When on the psychiatric affiliation, the dx bipolar didn't exist, and no one there had a diagnosis of depression. Suicide wasn't discussed, yet it was termed the result of mental illness.

I remember the head of OB/GYN (from the hospital where the 3 year nursing program I attended, was) had a teenaged son there at the psych hospital, who was labelled "simple schitzophrenic", and if he wasn't tied down, he'd severely bite any part of his body he could reach. He was kept in a basement alone, with his male personal attendants, who were usually pretty punative and fierce. He was restrained at all times. Only sedatives were occasionally given him. How pathetic psychiatric care was, then! I believe now, that he may have had a severe form of autism.

Much later in my life, I was crying (my usual state) when I saw my doctor about a URI, as she looked sympathetically at me and asked, "Would you like to take something for your depression?". I'd had psychotherapy for decades at a time, and no one ever asked me that! One psychiatrist thought his "affection" would help me, and held me on his lap during our sessions, hugging and fondling me. In those early days, I thought he knew best! At the time I finally got medicated, the psychologist who saw me weekly for the past 2 years apologised, as she'd thought I was already on "something".

The Effexor XL I was prescribed made a dividing line in my life, into pre Effexor days and post Effexor days. No longer do I have to exert great effort to rein in my tears. I was like the unsmiling drama mask, yet I'd become quite a comedienne before Effexor. Once a sadistic pharmacist refused to order it anew when the generic form became available (insurance would no longer pay for the trade named one), and due to the change in formula a new Rx was required. I had I moved out of state and my new generalist refused to prescribe it for me. I had crossed out the generic name and wrote in "venlafaxine", which may have been most unwise, as the pharmacist got suspicious and since he knew I was a R.N., he threatened to report me to the BON.

I actually called the head office in Washington state for that chain of pharmacies and the head of pharmacy for all of them, ordered the newer product to be sent to the pharmacy near me (across the country). When they were delivered, the pharmacist became balistic! Finally I got the scrip a week later, was "in withdrawal", a puddle on the floor. My new pharmacist makes sure that she keeps venlafaxine in stock, at all times now and warns me when the time is near to refill it. I get the prescription from the doctor I had before my move, and go back to see him (an oncologist/haematologist) occasionally, even though he said I'd "graduated" from his care (34 and 38 years post breast cancer). Not one doctor I've seen in my new community - and I saw plenty, will prescribe it for me, as I seem "normal" while I'm on my med....... The one time I became so desperate for my med, when I came to his office for the new Rx, he said I'd screamed at his "nurse", which I hadn't, and said I would no longer be seen at his office.

Incidently the new white tablet of venlafaxine XL 225 mgm does work better than the 3, 75mgm capsules I had been taking daily.

An aside: the Effexor XL was $10./capsule and for a year I was without health insurance and had to pay for it myself (@$1000/month) in addition to the same unit amount for Prevacid, but I took only 1 cap daily of that...... All my meds cost $1500/month during that down period of my life, while I changed jobs 3 times, due to the increased cost of insuring employees who are over 55 years

old ($1,000/month over the other employees' premium). When I finally got Medicare, there was no drug coverage, for 2 more years....... so a lot of my salary went to my meds. If that doesn't convince you that Health Care Reform is essential, I don't know what will........

When it does, President Obama has made the coverage for Mental and Physical illness the same! About time, I say.

NurseEmma2010 · Jul 11, 2010

I hope you all are still reading these posts...I'm going to give it a shot anyway. I'm a RN working in Critical Care/ICU nursing. I've been in my position for over two years, and I have no issues with my bipolar disorder affecting my work. No one in my current hospital (other than employee health) knows of my condition. I have been on medications for 15 years, and have been stable on the current group for over five. My biggest issue is that not all states are so accepting of those of us with mental illness. If I were to go to Texas, I would have to participate in a program that monitored my work. I'd have a preceptor and my manager scrutinizing my work and then reporting back to the board. I would also have to report to the board as would my therapist and psychiatrist. This seems like such a circus, when I have to do nothing special in the state I'm in. I'm a perfectly healthy individual when I take my medications. I'm hurt by the need to pull me out of the crowd and make my flaws obvious to my co-workers. Any thoughts on this? It doesn't seem legal, although I can understand where they are coming from. However, someone who is unstable would never be able to pass off as being stable all through nursing school and nearly three years as a nurse. Certainly that has to count for something?