Q:  Bipolar Disorder & Careers

What types of careers might you suggest for the college graduate that has bipolar condition that are better suited to consistent lifestyle rythym management?  Is there a career advice service or registry that specializes in matching bipolar patients with suitable careers or jobs depending on the state of their respective bipolar condition?
 

Dear Mike --
Interesting question.  There really are no limits, except for two broad constraints:

1.  A career that requires repeated sleep deprivation is not such a hot idea.  On the other hand, there are plenty of doctors with bipolar disorder.  I was just referred another one recently.  These folks are operating at a very high level (sometimes literally).  If they can do it, should we conclude before a young person even gets under way, but she should not risk such a profession?  I don't think we can say that.

2. A career that requires exposure to severe stress is probably also not such idea either.  What is severe stress?  Well, front line warfare probably counts.  By comparison with that, I think most other jobs would be regarded as fairly mellow.  So, perhaps we might be able to go so far as to say that someone with a known bipolar disorder had best not enroll for infantry duty in the military?  Yet even that is probably too much of a constraint.  There are other factors, so-called "resiliency" factors, that might make some people with bipolar disorder are able to tolerate even getting shot at.

In the past I joked that if I was running the military, I would do a genetic analysis and disallow anyone with two short versions of the serotonin transporter gene from active duty.  This gene is indirectly associated with bipolar disorder, but millions of people with no mood problems have the "two shorts" genetic risk for stress.  The entire story of that particular gene is available and 10th-grade English here: Yellow People and Blue People http://www.psycheducation.org/mechanism/1MoralityorGenes.htm.

The point is, bipolar disorder as a diagnosis is probably not the way to decide about careers.  Or rather, a person with really well-controlled bipolar disorder should not feel very constrained.  It may take some work, but she could do nearly anything.  On the other hand, if the history of the disorder has been complex, and poorly controlled, then indeed some consideration of sleep deprivation and stress exposure is probably warranted.

To my knowledge, no one has ever thought of establishing a career advice service for this.  Again, as reflected above, I think that might be overstating what we know.  Nevertheless, as you probably have read, a lifestyle in which regular patterns of activity are the norm -- a regular routine, that is -- has clearly been shown to help maintain mood stability.  Yet there are many people who have violated this rule and yet done well. As in so many things, it's a tough balance to maintain: wise forethought versus taking what life offers, or what one seeks from it.

Dr. Phelps