Mental Illness Unemployment Statistics Were High Before COVID-19 Hit
The truth is that up to 80% of adults with a serious mental health condition are unemployed in the U.S. Unemployment rates among people with a brain disorder are significantly higher when compared to a neurotypical person. According to a report from the National Alliance on Mental Illness, unemployment rates continue to decline despite the national employment rate rising.
The shocking truth of unemployment & how it relates to mental illness
What do you do for a living? It astounds me how often people ask that question. It’s one of the first questions that comes up when meeting someone new. Maybe I just notice it more now because I dread having to answer. I’ve become so self conscious about the answer to that question. I can no longer respond with an impressive corporate role that people regard as prestigious. I no longer work for a fortune 500 company that everyone recognizes. Now, i’m just – unemployed.
Approximately 60 percent of the 7.1 million people receiving public mental health services nationwide want to work, but less than 2 percent receive supported employment opportunities provided by states.
National Alliance of Mental Illness (NAMI)
Mental Illness & Unemployment
I can see the look of shock and disdain on people’s faces when I tell them. The interrogation that follows is brutal and I feel the need to explain when they ask; really? why not? what do you do for money? what do you do all day? I can feel the judgement radiating from them as I sheepishly try to explain myself. Then comes “the help” as they offer suggestions on job types, companies, and solutions that I should try to help get me back into the workforce.
People can be so focused on the job we each hold, as if our job defines who we are and our worth in society. They also tend to judge those of us who are unemployed, as if we are all just lazy and don’t want to work. Which just isn’t true. I desperately wish I was able to go back to work, to another job with benefits, to another corporate role, to not waste my degree i’m still paying for. But I can’t, you see. I’ll tell you why:
10 Reasons Mental Illness Unemployment Rates are High
1. My illness is unpredictable.
Some days, I can function just as well as neurotypical brains . Other days, not so much and some days, not at all. I never know what type of day it will be when I wake up each morning, and that’s unsettling to me. How can I plan ahead or consistently show up every day?
2. Inability to maintain stability for long enough to work contributes to unemployment.
The longest I have maintained stability between episodes is < 3 weeks which is followed by 2 weeks of hypomania/depression/mixed moods. The mixed moods are the hardest for me. I’m both depressed and manic at the same time. My mind is racing with things I want/need to do, but my body refuses to cooperate. It’s a battle between my physical and mental being. It’s agonizing to have a hyperactive brain at the same time as being depressed. When the hopes/wants of mania are stunted by a weak body the racing thoughts turn from LET’S DO ALL THE THINGS to you’re a piece of shit that doesn’t do anything. My mind turns on me and irritability turns into aggression towards myself and sometimes others caught in the crosshairs.
3. Stress and lack of a consistent sleep schedule make my illness worse.
Stress & lack of treatment/selfcare are what led to my career ending mental breakdown. I can feel the way stress is impacting my health as my brain starts to deteriorate often leading to weeks or even months recovering. After the breakdown it took 2 years of pain, sickness, unemployment and stress for me to return to a healthy brain.
4. I am sometimes unreliable due to my illness.
I can’t consistency maintain future commitments because of how often my moods fluctuate. This is one of the hardest challenges I face with having a chronic illness. On hypomanic days i’m the bell of the ball. My brain floods me with endorphins, high energy levels and confidence as I strut around thinking of how great I am. I’ll talk to anyone, over sharing with them at a rapid pace until they just look at me, speechless. I answer the phone when my friends call, I make it to our brunch date.
But when i’m depressed, everything changes…
I’m exhausted, living in a body no better than a shell as I wait out the darkness – alone, in solitude. I’ll cancel plans, not return calls, and go days into isolation from the world only to emerge from the shadows having to clean up all the messes my hypomanic episode made. I go through the list of people i’ve disappointed or upset and try to make amends, but after awhile – it can be too much for people. Which I get. But just can’t help.
5. I have anxiety and panic disorders.
Sometimes (often weeks) I don’t leave my house. Anxiety controls all my thought patterns, and I immediately assume the worst in people, or doing an activity. Consistent and public panic attacks would hit me at work, including in front of Managers & Supervisors. Which led them to the assumption that I was a child unfit for my position, crying as an excuse for working untraditionally when I was just too sick & too depressed to even brush my teeth that day. Stress, bipolar, & anxiety feed into my panic attacks making them worse, and last longer.
6. My energy levels fluctuate from day to day.
Imagine you’re trading a spoon for each task you need to do that day, you have unlimited spoons, unless you’re sick. Maybe those days you get 2,000. Tasks: Get out of bed. Pick out an outfit. Get dressed. Brush your teeth. Shower. Blow Dry hair. Let the dogs out. That would be 7 spoons, 1 for each action.
Each morning I wake up, I get a different amount of spoons ranging from 10 – 2000 depending on my mood (hypomanic / depressed / stable). Now imagine waking up one morning with 10 spoons – you have work, and can’t call off work, what do you use them on? To conserve my energy I’ll skip things such as showering (3 spoons. Yes, the value of my spoons is different than the value of your spoons) not drive to the grocery store (yes, driving counts as a spoon) not go to work (which requires 400+ spoons). Could you work full time on 10 spoons a day for a week each month? Me either. That’s why 80% of individuals with a mental illness are unemployed.
Bipolar disorder is associated with high rates of unemployment and job-related difficulties. A survey by the National Depressive and Manic-Depressive Association showed that approximately 60% of individuals with bipolar disorder were unemployed, even among patients with college degrees. Additionally, 88% of the respondents reported occupational difficulties. Data from a large registry of patients with bipolar disorder also demonstrated an unemployment rate of about 60%.
bowden md, l, c., (2005). Supplements and Featured Publications, Understanding Bipolar Disorder: Impact on Patients, Providers, and Employers, Volume 11, Issue 3 Suppl
7. I have an eating disorder
I don’t eat unless it’s something easy like a granola bar, fresh fruit, or a bowl of cereal for breakfast. Most days I skip lunch, starving myself during the day because I don’t have the energy or will to make food for myself. My medication also has the side effect of suppressing hunger, so often times I just forget i’m supposed to eat. Logan prepares dinner when I’m low on spoons, which is most days. Since I haven’t eaten all day I binge eat my dinner. while also cutting up the entire plate of food into tiny bite size pieces, usually leaving a few bites or more left on the plate.
8. My medication has bad side effects, including a tremor and gastrointestinal problems.
The most disabling side effect I have are gastrointestinal issues. Some medications give me constipation, severe stomach cramps, nausea, amplifying my GERD (gastroesophageal reflux disease). These symptoms often prevent me from completing tasks that day, or doing fun activities which is very restrictive. On average I spend at least 1-3 hours throughout the day sick with nausea. I get headaches and migraines (which I also have medication for). Then there’s the dry mouth where my lips stick together when I talk and you can literally hear the dry mouth in my speech. Try giving a speech or leading a meeting with cotton in your mouth, you’ll get it. I developed a tremor in my hands from one of the medications which made it extremely difficult to maintain my photography hobby, so I was prescribed ANOTHER pill to help with the tremors.
Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues.
BMC Psychol 8, 36 (2020). https://doi.org/10.1186/s40359-020-00399-0
9. I have regular appointments with my mental health professionals.
In order to maintain stability and keep my disorder from further deterioration it is crucial to keep and show up for my appointments. A missed appointment with my Psychiatrist can cause medication delays, worsening side effects, and a hit to my progress in getting well. We meet once a month to do a med check, or more if my medication treatment plan has changed.
My Therapist is literally a lifesaver. I didn’t start seeking help until I was suicidal, even though the signs of suicide showed for months prior. My session times vary from week to week depending on my mood. In the beginning when I first started seeing my therapist I was on a 2x/week appointment schedule that lasted almost 1.5 years. Today I see her on an as needed basis.
10. I have to sometimes go to the hospital.
If you’ve ever had a panic attack, you understand what I am about to explain. Panic attacks can happen anytime, anywhere, and without warning. They can be triggered by unexplainable events, making the panic attack that much scarier. Once you’ve had one, it’s very possible you may live in fear of having another. My panic disorder has gone as far as avoiding places or people where previous attacks have occurred.
Panic attacks feel like you’re dying. When they happen during a bipolar episode, the consequences are complete loss of control of body and mind. Mine are so severe that they have put me in the hospital 3+ times in the past few years.
Annual prevalence among U.S. adults, by condition:
Major Depressive Episode: 7.8% (19.4 million people)
Schizophrenia: <1% (estimated 1.5 million people)
Bipolar Disorder: 2.8% (estimated 7 million people)
Anxiety Disorders: 19.1% (estimated 48 million people)
Posttraumatic Stress Disorder: 3.6% (estimated 9 million people)
Obsessive Compulsive Disorder: 1.2% (estimated 3 million people)
Borderline Personality Disorder: 1.4% (estimated 3.5 million people)
NATIONAL ASSOCIATION OF MENTAL ILLNESS (NAMI)
Unemployed mentally ill are not lazy – they’re warriors
Most of us very desperately WANT to work, but fighting for our lives everyday is a full time job in itself, and can prevent that. I wrote this article in hope that I can explain some of the reasons I and many others are unemployed.
It’s upsetting when people judge me and assume I just don’t try. Because that’s simply not true. I have been employed since I was 13 years old. Babysitting, ice cream parlor, pet shop, retail worker, cashier, receptionist, restaurant host, server, cook. From 14 – 31 years old I have been either part or full time employed. In highschool I worked 2 afterschool jobs – going right from school to one then the next 5-7 days a week. In college I was enrolled in 4+ classes each semester while working 2 jobs 5-7 days a week and still graduated with honors holding a Bachelors in Science with a concentration in Occupational Health & Safety, I held on to each of these jobs until I was ready to move on – never getting fired.
Unemployed does not equal unqualified
Senior year of college I was an intern with a fortune 500 company. After graduation I was offered a full time position where my career took off. Every couple years I was getting promoted to a higher position with a larger salary. My free time was spent traveling the world with my friends, visiting a new place 1-3x a month. I had a 6 figure salary, and could afford to travel anywhere I wanted in the world with no concern of being able to pay my bills that month. In my final year of my career I was promoted again.
Can Stigma Prevent Employment?
The short answer is yes—stigma does prevent people with mental illness from getting a job. But why?Well, people with mental health conditions are typically held responsible and blamed for their behavior and symptoms. Simultaneously, they are perceived as unable to make decisions for themselves. This causes people with mental health conditions to be perceived as “unsuitable” for the workforce.
Greenstein, L. (2017, october 16). Can stigma prevent employment. nami
My mental state was fragile and teetering towards collapse before the promotion and added stress. At the same time I was learning my new role & managing a team for the first time – I was diagnosed with bipolar disorder II, panic disorder, anxiety disorder, ADHD, & lingering PTSD. A few months later, between therapy 2x/week, finding a psychiatrist (it is NOT EASY) experimenting with medications, testing, and regular doctor appointments – I had 3 mental breakdowns in less than a month. Ending my career at 31 years old.
Tomorrow is a new day
I won’t stop trying to do what I can when i’m able. Trust me – I wish I could work full time again and go back to my life before becoming unemployed. But when my doctors are telling me I have to choose between my job and my mental health – I’ll choose my health every time. After almost 2 years of recovery I know now what I need to succeed in my chosen profession, but unfortunately the U.S is decades behind understanding how to make accommodations in the workforce for the mentally ill.
So the next time you hear that someone is unemployed and hasn’t worked for awhile – please don’t be so quick to judge them. Help us break the stigma of what “unemployment” means. It doesn’t mean someone is lazy or just doesn’t want to work (I understand this may not be true for EVERY case). Because there is a great possibility they simply can’t, not won’t.
I hope you enjoyed this article and it providing you with an awareness about how having a mental illness may affect jobs & unemployment. Drop a comment below and share your thoughts with me and other readers!
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