People expect you to take time off work for things like surgery and recovery, as well as pregnancy. But if you have bipolar disorder and a period of acute sickness led you to take time off work, the process of returning to the workplace may feel daunting. What do you even say to your colleagues?

The added pressure of making yourself attractive to employers doesn’t help — regardless of whether you’re going back to a job or if you’re on the market for a new one. We’ll share hints and tips to help disguise the bipolar disorder in your background — and a few pitfalls to avoid.

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

He is also the host of Healthline Media’s Inside Mental Health podcast available on your favorite podcast player. To learn more about Gabe, or book him for your next event, please visit his website,

Dr. Nicole Washington
Dr. Nicole Washington

Dr. Nicole Washington is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions.

Find out more at

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.

Gabe Howard: Hey, everybody. My name is Gabe Howard and I live with bipolar disorder.

Dr. Nicole Washington: And I’m Dr. Nicole Washington, a board-certified psychiatrist.

Gabe Howard: Now, Dr. Nicole, before you were Dr. Nicole, you were just a young woman looking for a job, correct? I’m assuming that doctor was not your first job.

Dr. Nicole Washington: It was not my first job. No.

Gabe Howard: Were you given any advice when you were leaving your house to go interview for that job? Anybody give you any tips?

Dr. Nicole Washington: Yeah. I think people gave me the usual advice, right? Like, look, nice, iron your clothes, make sure you’re clean. All those kinds of good things that we tell our kids when they get ready to go out and do stuff in the world.

Gabe Howard: Right. Right. The firm handshake, look, people in the eyes, show up on time,

Dr. Nicole Washington: Yes.

Gabe Howard: Make sure that there’s no misspellings on your application or resume

Dr. Nicole Washington: Yes.

Gabe Howard: Just your standard run of the mill advice. The first thing that I want to say is all of that still applies, right? All of the advice that you can think about job hunting, applying for a job, that all applies. But if you live with bipolar disorder, and especially if you’ve been off work for a long time, there’s some extra. That’s what I’m going to go with. There is some extra things that you need to be aware of. And one of them is you might have been placed off work by a Dr. Nicole and you have to get un placed off work. Am I using the correct terminology here?

Dr. Nicole Washington: Un?

Gabe Howard: Unplaced off work?

Dr. Nicole Washington: How about we say return?

Gabe Howard: Return to work.

Dr. Nicole Washington: Return to work. Yeah.

Gabe Howard: Dr. Nicole, you use language like return to work and it creates this idea in people’s heads that they have a job to return to. Like they’ve been on FMLA or disability or just off work. And that could be the case. It could also be the case that you don’t have a job. But either way, my next question applies to both scenarios. What do you as a doctor look for to allow somebody to return to work, to medically clear them to go back to work?

Dr. Nicole Washington: If they have a job already, then we focus on the job duties. What is it that they are expected to do day in and day out as part of their work? We then take a peek at what were the things you were not able to do when you were acutely ill. So whether you were in a depressive episode or having some mania going on, like what things were you not able to do? And then we just go through them one by one and talk through, How do you feel now? Do you feel like you’re ready? And we try to use the interview, the exam, to see how we feel. But the reality is somebody being able to focus and concentrate during their 15 to 20 minute visit with the psychiatrist may not equate to being able to sit down and focus and concentrate for 8 hours a day. So it’s a little bit false, but we do talk about what is that person doing during the day? Are they reading or are they able to focus on puzzles or what are they doing during the day that would give me any indication that they’re actually able to fulfill those duties?

Gabe Howard: I imagine it is very difficult to determine if somebody is ready to go back to work, because the reality is, is if somebody goes back to work too soon, it could have consequences. It’s not good for us. Right? We could have an issue at work and then all of our coworkers will see it or the people around us will see it. This could lead to termination. It could lead to setbacks in our medical care. So it’s very important that we work with our medical providers to get this right. As much as we want to get back to work, we want to be ready to go back to work. Now, I like what you said about really breaking down what you do in a day and if you can handle it or not. I always tell people at this point, hey, go back part-time and see how you do. And if you have a job that you can do that, that is the advice that I highly recommend. Go back part-time and see how you do.

Dr. Nicole Washington: I definitely recommend part-time, especially if you have a job and you’re returning to your job. If they will allow it, I think part-time is best because I think there’s very little downside to having you return slowly. Just to kind of increase your chances of success once you go back full time. I think a lot of times when people are ill enough that they have to take extended chunks of time off work and then when they go back, there’s always that anxiety about, But what if I can’t do it? But what if? What if I mess up? Or what if my symptoms come back? And so I think the part-time also kind of eases the anxiety of the person. So if your job is willing to let you do that, I fully recommend that. And if you don’t have a job, I still recommend look for a part-time job first, maybe volunteer first, something very low stakes, right? If you financially don’t just have to have money coming in, I don’t want you to be homeless volunteering because Dr. Nicole told you to volunteer first. The reality is some people can’t financially afford to go back part-time, but volunteering is a great way to see if you have the stamina to make it for a full day.

Dr. Nicole Washington: Not in your house, not in your pajamas, like dressed up, interacting with people. Volunteering is a fantastic way to do that, but if you need to make money, then we need to be very realistic about what kinds of jobs you apply for. And I would say when I see people really, really struggle with being able to go back to work, sometimes they choose jobs, especially if they’re going for a new job. They choose jobs that really are not consistent with their ability at the moment. Right. So if you know that talking to people and interacting with people is tough for you, getting a job as a waiter or a waitress is probably not a good idea, but night stock at Wal-Mart might be fantastic because you then don’t have to do a lot of interacting with folks. You can just do your job, put your headphones on, put your head down and mind your own business.

Gabe Howard: Dr. Nicole, I agree with that 100% because I did it, and I would love to tell you that the did it was got the low stakes job and eased into it. But nope, I went the other way. I got the very stressful high end job. I was a network support person. It was my job to watch a multimillion dollar network, a national network, that if it went down, the company lost like $3 million a minute. And I know that because whenever the network went down, a whole bunch of people were yelling at me, Gabe, fix it. We’re losing $3 Million a minute. And the panic would immediately set in. Every time there was a blip on the screen that I was monitoring, I’d start to have a panic attack. I made myself sick and I just kept saying, but, but the job pays so well. I need this money. I need this health insurance. And I ended up, I ended up walking out. Literally walked out in the middle of an outage. I tell this story, one, because it shows that I’m a dumb ass. But two, nobody cares that I had bipolar disorder. I was hired to monitor a network in-house so that if anything happened, if the network went down, I was already there and I just got up and left. Just got up and left. Do you know how fast word spread around that Gabe Howard will leave in the middle of an outage? It became impossible to get a job. What do they say? Bad news travels around the world three times before good news gets its shoes on. This was quite the story.

Dr. Nicole Washington: I believe that. Oh, my gosh. Do you think it was a little bit of ego too? Like do you think it was a little bit of, I’m not going to take a lesser job because I have a degree or I have this set of skills and I’m going to use them? And is there a little bit of that that goes into you choosing to go back to a job that the writing was on the wall that wasn’t going to be successful versus maybe choosing something that was a little mundane, maybe even below your ability, just temporarily to help you build some confidence, have some money coming in and kind of build back up to that high stress job?

Gabe Howard: For me, I didn’t understand. The ego part for me was based on the misunderstanding. I really thought that bipolar disorder was one of those things that once diagnosed and you started to be med compliant, it was over. I believed, sort of the talking points, right? Take your meds as prescribed, be med compliant, do what the doctor says and you will have no problems. Well, I was diagnosed with bipolar disorder. I took the meds as prescribed. I was med compliant and I followed my doctor’s orders. Therefore, I should be fine. Right? That’s what we hear constantly.

Dr. Nicole Washington: If only that were true, my job would be so much easier.

Gabe Howard: Yeah. Yeah, I believed it. I went back to work, fell right on my ass. It was brutal, you know? I was fired from a job, and then I got another job, and then I walked out on that one. I was making a real name for myself.

Dr. Nicole Washington: But does your self-esteem take a hit when you keep having those kind of experiences? I mean, it would seem that you probably would have felt a lot better about yourself and your ability to take care of yourself and all those things if you had gone the opposite way first and took the lower level job first and built your way back up.

Gabe Howard: I dove headfirst into this job that I could not handle because I thought that was what was best. Luckily, after all that happened, my family sort of circled the wagons around me and I was able to take some time off work. I was able to take about six months off work, which made all of the difference. I got stable. I understood medication. I learned limitations. I, I volunteered. I did a lot of stuff around the house.

Dr. Nicole Washington: Right.

Gabe Howard: And that’s what I want to touch on right here. So now I have this six months and I was very fortunate to have the six months, but I didn’t just sit on my ass and watch television.

Dr. Nicole Washington: Right.

Gabe Howard: That’s not going to get me back into the game. I took over household chores.

Dr. Nicole Washington: You basically were in training

Gabe Howard: Yeah. Yeah.

Dr. Nicole Washington: To go back to work.

Gabe Howard: I was in training to go back to work and I know it sounds funny, feel free to laugh. But I decided that my job was to take care of the house and complete my wife’s honey do list. And she left me a list every single day. And part of that, and here’s the part I don’t want you to laugh at, was getting up at the same time. Every day my alarm went off and I got up, took a shower, put on clothes, and you’re thinking, okay, so you took a shower to clean the house? Yes, I did,

Dr. Nicole Washington: Yes.

Gabe Howard: Because that was, that’s part of my normal routine when I get back to work. Now, many days I did not complete the list. Many days I spent 4 hours in the shower, not literally just to get there. It was just, you know, I’d have to rest. It was a problem. But I was always, always trying. But here’s the thing, Dr. Nicole. I knew that I was ready to go back to work because about the six month mark, I was springing out of bed. I was taking a shower, I was getting dressed, and I was getting this honey do list done in like an hour.

Dr. Nicole Washington: Right.

Gabe Howard: If you’re at home every day and you don’t have children, you can run through almost any list in an hour, especially six months later, my wife would come home and she’d be like, What’d you do all day? And I was like, You know what? Not a lot. And she’s like, It’s time to go back to work. And that brings me to step two of the plan. I realized that I could no longer do these high pressure jobs. I couldn’t have people screaming at me. I couldn’t have networks going down. I couldn’t have alarms going off. I needed something very low key. So I went out and found a low key job. It had a flex schedule. It was during the day. I started out at 30 hours a week with health insurance. It took some doing, but it was out there and I did find it. I built from there, but it was a dramatic pay cut. And it was hard. It was very hard. We had to change our lifestyle up. But, you know, listen, all the money in the world isn’t worth it if you don’t have your health or if you die. And I didn’t want to risk my mental health in this way.

Dr. Nicole Washington: Right.

Gabe Howard: But I don’t want anybody to hear, oh, it was super easy. I just took a giant pay cut and went on and yay. No, it’s sucked.

Dr. Nicole Washington: Yeah.

Gabe Howard: It sucked hard.

Dr. Nicole Washington: Yeah, it is hard, but you have to look at the bigger picture. You said earlier that you walked out on a job, right? You walked out. It affected your ability to get other jobs like that because news travels a lot of times in certain industries, depending on how large of a city you’re in, people know each other. They call up like, hey, this Gabe Howard is applying for a job over here. And they’re like, Oh, that guy. He walked out on us. And you said it, your employers don’t care about your illness. They need you to get the job done. Ultimately, you did yourself a greater disservice by going back to that higher paying job than if you had gone the other way. So we have to think about the bigger picture and kind of take our egos out of it and be willing to kind of humble a little bit. And this happens for people with physical health concerns that they can’t go back to the kind of jobs they were used to. This happens to people for a variety of reasons, not just mental illness, but I just want you to hear me say I support people 100% in returning to work. But sometimes folks get mad at me when I say, Are you sure that this is the kind of job that’s going to be great for you? Because you just told me that you’re very irritable and people talking to you or being overstimulated, really upsets you. This doesn’t sound like a great fit. I think you have to be willing to listen to those around you and ask for advice from people that you know care about you.

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Gabe Howard: And we’re back discussing a return to work with bipolar disorder.

Dr. Nicole Washington: I do see a lot of people who I think give up too soon. I think they continue to try. But maybe they’re trying not the right kind of jobs, too intense. Maybe the plan isn’t quite rock solid. And then when they don’t have success, they say, Well, I guess I might as well just go. I don’t think people out there should say, Oh, oh, well, I’m not ever going to go back to work. I’m just going to apply for disability. If you need it, that’s great. But I do want to encourage people to go ahead and seek out the right kind of job, because I do think there’s value in managing your mental health, whether it’s bipolar disorder or whatever else it is. There’s value in getting up every day and having something to do, contributing to the world in some way. I think that helps your self-esteem. It helps your confidence.

Gabe Howard: I know many people who live with disability because of bipolar disorder, and I completely understand why they do that if they’re not able to work full time, especially since that’s where they’re getting their health insurance. They need health insurance. But the ones who are doing the best and the people who I meet, who have the best quality of life, who are living with disability, they’re doing something else. They have a part-time job because they’re allowed to make a certain amount of money. They have a volunteer job, they’re active in their communities, their churches. They become stay at home parents and are they’re always the room parent. They’re the ones always volunteering to drive, or they become super active with nieces, nephews. They offer to provide care for other family members. The point is, is that they’re doing something and they’re doing something that has real value to them and to the people around them. And this becomes what they’re known for. There is a plethora of things that you can do with disability, and I strongly encourage people to explore those because the confidence boost alone

Dr. Nicole Washington: Oh, yeah.

Gabe Howard: Is worth the price of admission.

Dr. Nicole Washington: Yeah. It’s just not all or none. It’s not like I get up every day and do stuff or I’m on disability. Like, there are really a lot of things. You could get involved in your local NAMI chapters. They’re always looking for people to help them go out and do the Lord’s work in the community and advocating for those with mental illness. Your local mental health association, if you have a clubhouse in your area that you can become a member. Clubhouses are fantastic ways to get up and get out and do things. There are work programs, there’s part-time work. Like Gabe said, just getting up and getting out, people’s moods are so much better. It’s really hard for people to say, Yeah, I feel like I’m in a good space if they have nothing to look forward to.

Gabe Howard: As you get more comfortable with the part-time job, with the volunteer responsibilities, with whatever it is you’re doing with your life, you build up, you build up confidence, you build up resiliency, you build up experience. And I know many people who have been able to transition from disability to full time work

Dr. Nicole Washington: Yeah.

Gabe Howard: Because of these experiences.

Dr. Nicole Washington: Yeah.

Gabe Howard: I love this story, but I have to tell it. I don’t have permission to use her name. She just asked me to just call her person. She got a part-time job at Sam’s Club 15 years ago when she was on disability, worked 15 hours a week, 15 years later, she’s now a manager. She makes an incredible salary and she just won an award where she gets to go to Vegas and she’s going to be honored and get a plaque. And the majority of the people that she talked to, they don’t realize that when she started that job, she was on disability.

Dr. Nicole Washington: Right.

Gabe Howard: They didn’t know. They just thought that she was a part-time worker that came in. But she was able to parlay that into this incredible career one step at a time. Listen, you can’t win the game if you’re not in it.

Dr. Nicole Washington: No.

Gabe Howard: And if you’re sitting at home, you’re probably not in it. And it’s not good for your mental health. It’s definitely not good for your career. Get up, get moving, get going. Good things will happen very, very slowly.

Dr. Nicole Washington: Slow is the key. Sometimes we just move too fast. We want to go from part-time employee to managing the store in six months, and that’s just not how it works. And then if it doesn’t happen, we’re like, Oh, guess I’m just relegated to being on disability forever. And I will be the first one to say the disability system is so jacked up. Just beyond words, so jacked up. Because I really think that we really don’t encourage people to get back to work. Right? Because we’re going to rip your insurance away. It can be very scary to face not having insurance. So I just want everybody to hear me say, I know it sucks, the system is terrible, but slow and steady. Slow and steady.

Gabe Howard: I remember all those years ago when I took the massive pay cut and I lost my house and by losing, I sold it and moved into an apartment. I don’t want anybody to think that I came home and it was gone. It was hard. I lived in a house, I had a nice job and suddenly I’m living in a 600 square foot apartment. But it was mine, right? It was mine. I hung on to it. In some ways, that apartment was meaningful to me because I earned it. Now, the house was meaningful too, but there was just something about this apartment, right? Because it symbolized stability. It was a stronger foundation than the house was. I always lived in constant fear that I was going to lose the house because of my medical conditions and not being able to hold down a job and constantly getting fired or walking out or quitting because of panic attacks. It was, it was terrifying. Whereas the apartment, it was stable and that stability was worth way more than the house, even though I had to go to a laundromat. Dr. Nicole. I don’t like laundromats like I hate laundromats. Laundromats are terrible. But still, that foundation, the stability and the foundation of that apartment is how I built the rest of my life. And I did slowly move up. It took many, many years, but if you got to get older anyway, you might as well be moving up in your career as well. If you don’t do anything, you’re still going to get older.

Dr. Nicole Washington: Facts. Drop the mic.

Gabe Howard: I can’t. It’s expensive.

Dr. Nicole Washington: Facts. Drop the mic.

Gabe Howard: Come on. You know better than that

Dr. Nicole Washington: [Laughter]

Gabe Howard: Healthline Media will not tolerate that.

Dr. Nicole Washington: Drop the mic.

Gabe Howard: I want everybody from Healthline to know that was just a joke.

Dr. Nicole Washington: That was good stuff.

Gabe Howard: Dr. Nicole was not advocating that I break your equipment. We apologize.

Dr. Nicole Washington: That was good stuff. Yes. We want Gabe to keep his job. We don’t want Gabe to be on the other end of this looking for a job thing.

Gabe Howard: Listen, Dr. Nicole, one of the things that was really hard for me when I did go back to work, I did start small, but I had to explain on my resume. And your mileage may vary. Not not everybody is the same. But I had these higher end jobs. Right? That paid very, very well. And then I had a stretch of time where I had no jobs. And then I had a stretch of times where I had significantly lower end jobs. And I would walk into an interview and people would naturally be curious about this.

Dr. Nicole Washington: Right.

Gabe Howard: What happened? Why were you off work? What were you doing. Now, I would love to say that the answer is you just look them in the eyes and say, Hey, I had serious and persistent mental illness. I had bipolar disorder, I was sick, I took care of myself. I’m better now and yay! And everybody would be like, That’s good. I’m glad you got better. I’m sorry that happened to you. Don’t do that. That is not the right answer.

Dr. Nicole Washington: Yeah. Ten out of ten. Do not recommend. Do not recommend.

Gabe Howard: Yeah, we do not recommend that.

Dr. Nicole Washington: I do not recommend.

Gabe Howard: What I recommend is doing something called a skills resume where you put all of your skills on and it’s devoid of dates, right? So instead of saying, I had this job from this date to this date, you just put I’ve got this skill set, I hold this certification or I’ve got this degree or a high school diploma. I worked for these companies. Again, you don’t put the dates on them and you provide references available on request. This clears up this glaring void of, Hey, why didn’t you work for two years? Also, since it’s a skills resume, you only put things that are in relation to that skill. So my job at Walmart, it wasn’t relevant, so I could leave it off and nobody said, Hey, what did you do between this time? A lot of times people don’t even ask why. And listen, depending on how old you are, this is a common thing that people over the age of 35 do to avoid age discrimination so that somebody sees it and they don’t know how old they are. It’s an imperfect world, ladies and gentlemen. But, you know, most of the time people just don’t care. It seems like the majority of the time interviewers asked about the gap because they were staring at the gap. Once it was removed and you use the skills resume, nobody seemed to care because hey, interviewers are people too. And they just want to know if you can do the job. And if you can and you put your best foot forward and you show up not smelling, they’re pretty happy with you.

Dr. Nicole Washington: But if they do ask you for dates because some applications are online and they do make you put in, you worked from here to here to there to there, and they do have it. So I would say if you’re going in for an interview at a place where you have documented gaps and they know about them, just know how you’re going to answer the question if they ask. It also matters how you answer. So if they ask you, Oh, so I see you had a six month gap here. If you start stammering and stuttering over your words and sounded like you’re making up stuff on the fly that’s going to be suspicious. Right? But if you say, yeah, that’s a really great question. You know, during this particular time, I had some things going on and I ended up not being able to dedicate my attention to full-time work. And so just be prepared on how you’re going to answer. I think the fact that they bring you in for an interview after seeing those gaps already lets us know they’re interested, right? So the gaps maybe weren’t a deal-breaker. Prepare ahead of time and sound confident. And your answer, I think, goes a long way compared to if I ask you and you go, well, well, you know, if you kind of go through all of that, I’m going to think, oh, my gosh, Gabe’s lying.

Gabe Howard: What I practice saying was, was some version of this phrase. I said I had a medical condition I had to take care of. I’m perfectly fine now, and now I’m ready to get back to work. And I just said it exactly like that. They’re not allowed to ask follow-up questions

Dr. Nicole Washington: Exactly.

Gabe Howard: About your medical. So that is done. I’ve talked to other people who have said things like caring for a sick relative, doing child care. I’m a real big believer in not lying because once you get the job, it could bite you in the ass later. So, you know, just be careful with that. Don’t make something up out of whole cloth, because, again, you’re building a solid foundation and moving forward.

Dr. Nicole Washington: You get to tell the story, you get to drive the narrative. If your answer comes out smooth and polished, it just sounds a whole lot better. And I think you’ll be much better off. But yeah, lying is probably not going to get you anywhere. Like you can’t say you were giving child care. And then later on somebody say, Hey, Gabe, what about your kids? And you’re like, I don’t have kids. I don’t have kids.

Gabe Howard: The advantage to not lying is you don’t have to remember anything.

Dr. Nicole Washington: Yeah. You’re like, Oh, those kids. Oh, yeah, they’re great.

Gabe Howard: Yeah, yeah, yeah, yeah.

Dr. Nicole Washington: They’re good.

Gabe Howard: To tie this all up in a nice little bow, do something. Routines are very important. And listen, if you have to start over, be angry, be mad. I completely understand why if you’re at the top of your career and you have to take several steps down, you would be angry. It’s okay to be angry. But remember, a journey of a thousand miles begins with a single step. You built yourself up once and you can do it again. Thanks everybody for listening. My name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations.” You can get it on Amazon or you can get a signed copy with free swag by heading over to my website,

Dr. Nicole Washington: And I’m Dr. Nicole Washington. You can find me on all social media platforms @DrNicolePsych to see all the things I have my hand in at any given moment.

Gabe Howard: And hey, can you do Dr. Nicole and I a favor? Wherever you downloaded this episode, please follow or subscribe. It is absolutely free and also tell somebody about the show, social media, email, text messages or good old-fashioned word of mouth. Sharing the show is how we grow. We will see everybody next Monday on Inside Bipolar.

Announcer: You’ve been listening to Inside Bipolar from Healthline Media and Have feedback for the show? E-mail us at Previous episodes can be found at or on your favorite podcast player. Thank you for listening.