My husband was diagnosed yesterday as BP. He has commenced EPILIM and is also taking LUVOX. He has his 1st appointment with a Psychiatrist in 2 Weeks. His biggest concern is that he will be unable to work whilst on the  medication. He is a police officer who does carry a gun. If his gun was taken from him and he had to work station shifts or go off sick would devastate him as his career would be over and  i worry about the repercussions. Are the drugs 'forever' or will he eventually be weaned off tehm? 2 weeks seems such a long time to wait to get answers.

Dear Anna -- 
Sorry that my reply here also took nearly two weeks.  I hope perhaps by now things are seeming a little closer to some sort of resolution of these concerns. However, in the "big picture" the concern about his ability to work is very similar to what many people face with bipolar disorder: can they work? What if a mood episode occurs -- how will that affect their job performance, and perhaps ultimately their employ-ability?  Unfortunately there are no easy answers to these concerns. On the other hand, I think the starting place should be just what you appear to be doing in your note here: start by assuming that despite the illness, striving for a "normal" life is still appropriate.  It may be more complicated than for other people, but one should begin by assuming that it is possible, anyway. 

Keep records of episodes of mood symptoms (There is a new program for this record keeping, if one of you is on a computer every day, that might be wise to begin early, so as to have a near-perfect record of how things are going: check out www.chronorecord.org. You won't see a perfect example there, but take my word for it, for now: it creates a daily record of mood and sleep and medications used that would be the perfect record in any legal proceedings or employment problems, far better than a doctor's record--as long as you use it regularly). 

Since several bipolar-specific psychotherapies have now been shown to help get good outcomes (better than treatment as usual), it would be good to get that part of treatment going early too. This might be a setting in which your husband can get some help dealing with his worries about what could happen to his job, and his sense of self as defined by his job, before there is any problem -- and afterward, if there did turn out to be such a problem. I hope that turns out not to be the case. Good luck to you both. 

Dr. Phelps

Published July, 2005