HELP: taking medical leave for Bipolar Mania, what to tell boss?

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I have a history of rapid cycling bipolar d/o (dx'd 1999). Went off my meds (AMA) in 2002 and was fine until now, which led me to claim I was misdiagnosed. Flash forward to now: Just finishing up my first year at a job as a brand new nurse. Besides the new job, I've had many other problems this year. I have also been self-medicating w/ Ambien, Benzos, Opiates, Pot, Alcohol (anything to help me sleep). I have a Rx for medical MJ and Marinol. I had a breakdown the other day at work and seem to have slipped into a manic episode. I have stopped all meds/drugs/ETOH and got started on Zyprexa and Depakote. I should test clean no problem in a couple weeks. In the past I responded well to Depakote/Risperdal when I have this acute mania. I get extremely irritable, agitated, suicidal ideation. My last day at work, I realized I was too sick too work anymore.

I did all my paperwork and took a medical leave, but my boss wants to talk to me. The leave will be for a month, and I can extend it if I'm not ready to work by that time. I know it is my legal right not to tell her why I need the med leave, but I don't want rumors and speculation. I was going to tell her its been a hard year, alude to problems in my family, and tell her I wasn't able to focus d/t stress. I'm afraid if I tell her too much, she'll report me to the boards for psych diversion. I don't want to go down that road. I'm very high functioning for my dx. I don't want to downplay it too much for fear she'll think I'm working the system for a vacation. I'm so scared and anxious. How is the best way to approach this? Any and all advice appreciated. Thanks!

Specializes in Maternal - Child Health.

Ask Human Resources to fax or mail you a copy of the hospital's policy and procedure regarding FMLA. Read it to be sure that you have complied with all of its provisions. To my knowledge, you have no obligation to meet or speak with your boss and I know for certain that you are not obligated to reveal your diagnosis. Your health care provider's certification is all the proof they need that you are not taking a vacation.

Your employer does have the right to request periodic written updates from your health care provider and to require you to notify them in advance of your anticipated return to work.

Please seek guidance from your health care provider and attorney on whether it is in your best interests to meet with your boss.

Be well.

More information: http://www.dol.gov/esa/whd/fmla/

Thanks for responding. I did speak w/ my boss briefly over the phone. I didn't have to say much, she already had the paperwork and she just told me I had to take care of myself before I could take care of anyone else and to let her know as far in advance as I could if I need an extension. I am starting to feel better, just defeated that this problem is kicking my butt. I complain about my job, but I love it and feel a sense of purpose. I am worried about going back to the 12hr shifts and/or night shifts. I know it would be healthier for me to work 8hr shifts or something less stress. I work in neuro/trauma and its hard work. Has anyone ever switched depts in the same hospital? I don't even know if its an option for me, but would like something less stress like pre-op or something.

Specializes in Maternal - Child Health.

I know it's not easy to find 8 or 10 hour shifts in the hospital setting. Maybe you could check your hospital's internal job postings to see if any are available, or ask HR to notify you if any become available.

One of the features of FMLA is that you can use it in increments to take regularly scheduled time off if needed. Many people do that to keep medical appointments or to lessen their work hours when they first return to work. Managers aren't crazy about this option because it does make scheduling tricky, but if your doctor recommends it, your manager will have to comply. If this interests you, please ask your doctor to recommend a maximum number of hours per day or maximum number of days in a row, or maximum number of hours per week. Then contact your manager as far in advance as posible to try to work out a schedule. If you use this option to shorten your work week, the hours you take off count towards your maximum allowed FMLA time per year, which with most employers is 12 weeks.

Take care.

My heart goes out to you. I am kinda the same but I cant take meds. I am manic and am the same but have never been diagnosed. Meds made me suicidal I took Zanax and Prozac and saw bugs all ove me had to jump in the lake to get them off of me. I have nothing. I am trying to et on disability but no one believes me.

you have the right not to disclose your diagnosis under the ada law & the hippa act. your employer also has to accomodate you according to your illness; which means, if an 8 hr shift is better for your condition that they have to accomodate you accordingly. if your md thinks taking fmla for an extended amount of time is necessary for your well being, your employer has to comply. check out the americans disabilitiy act and know your rights as an employee with a disability; but whatever you do never disclose everything regarding your condition to your employer; its like shooting yourself in the foot.

best wishes to you & good luck!

Dear jnks,

hope all worked out. I just joined this post. I was concerned that you are rapid cycling but went off meds, any reason? I am also BPD II, a NP, and also in a doctoral program, I understand stress. I also suffered the stress of my son's suicide 3 years ago; he was BPD I, he refused to take medications.

bipolar disorder is close to my heart. I am currently doing research on BPD for my dissertation. 40-50% of people with BPD stop taking medications, and yet this is what will keep us stable.

I took a variety of medications before I tolerated my current regimen - and I resisted with all my strength. I suffered through a topamax 'stun' and was zombie like for about a week before I tolerated it. When taking mood stabilizers without an antidepressant, I felt suicidal, with the addition of an antidepressant, I felt 'normal' again, and functional, and my racing thoughts and anxiety went away. I just take 2 Ativan to sleep at night.

Bipolar disease is now being classified as a spectrum - and every person is unique along that spectrum. It is so important to find a psychiatrist who is willing to work with you and not just slot you into a certain diagnosis code and treat you accordingly. You also need to be your own best advocate.

As a nurse, you have the intelligence and power to be your own best advocate on bipolar disorder, research the disease, the meds, the legal implications, and your rights. I currently advocate for my son who is bipolar ( I had two sons with BPD) and has no insurance, I fill out all of his paperwork to apply for medications, medical assistance, etc, as he has no insurance because he is 33 years old. It is time consuming, but worth it.

In my case, I know the implications of not advocating, as I lost someone to BPD.

I know that you can get through this, please don't give up,

take care,

AnnMarie

I have a history of rapid cycling bipolar d/o (dx'd 1999). Went off my meds (AMA) in 2002 and was fine until now, which led me to claim I was misdiagnosed. Flash forward to now: Just finishing up my first year at a job as a brand new nurse. Besides the new job, I've had many other problems this year. I have also been self-medicating w/ Ambien, Benzos, Opiates, Pot, Alcohol (anything to help me sleep). I have a Rx for medical MJ and Marinol. I had a breakdown the other day at work and seem to have slipped into a manic episode. I have stopped all meds/drugs/ETOH and got started on Zyprexa and Depakote. I should test clean no problem in a couple weeks. In the past I responded well to Depakote/Risperdal when I have this acute mania. I get extremely irritable, agitated, suicidal ideation. My last day at work, I realized I was too sick too work anymore.

I did all my paperwork and took a medical leave, but my boss wants to talk to me. The leave will be for a month, and I can extend it if I'm not ready to work by that time. I know it is my legal right not to tell her why I need the med leave, but I don't want rumors and speculation. I was going to tell her its been a hard year, alude to problems in my family, and tell her I wasn't able to focus d/t stress. I'm afraid if I tell her too much, she'll report me to the boards for psych diversion. I don't want to go down that road. I'm very high functioning for my dx. I don't want to downplay it too much for fear she'll think I'm working the system for a vacation. I'm so scared and anxious. How is the best way to approach this? Any and all advice appreciated. Thanks!

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