Bipolar disorder is, without a doubt, an affective mood disorder that brings true misery to many millions of individuals. What is it about bipolar that makes it so bad? As a playwright once wrote, let me count the ways.

Bipolar disorder, like major depression and dysthymia (a milder form of depression), involves feelings of sadness and depression. However, there's more to the condition than depressive episodes. As the name suggests, bipolar disorder involves two separate poles. The second pole involves manic episodes and behavior and what makes the condition so difficult to deal with and treat is the fact that mood cycling will cause an affected person's moods to alternate between manic and depressive states.

Bipolar patients, as they cycle between poles, will find themselves experiencing feelings of mania and euphoria, only to later experience depression, guilt, and feelings of worthlessness. And what makes the condition especially difficult is the fact that, at either pole, a bipolar person may experience sleep deprivation (though in the depressive state, an individual may desire to do nothing other than sleep).

Difficulty in the area of maintaining normal sleep cycles is one of the chief impediments facing a bipolar patient who desires to work and hold a job since, generally, inadequate periods of deep level sleep will invariably lead to an erosion of the ability to maintain sustained attention and concentration. Brain fogginess as a result of sleep problems can result in on-the-job mistakes, something employers are not typically fond of. Making matters worse, when continued sleep difficulties lead to exhaustion and collapse, repeat work absences may result. Unfortunately, again, for the bipolar person, few employers are comfortable with work absences that exceed two days per month.

Bipolar disorder would be difficult enough to deal with were it not for the various other conditions that come with the impairment. What are those conditions? For starters, altered perceptions and thinking that can progress to the level of delusions and even hallucinatory experiences. Bipolar persons are also sometimes subject to suicidal ideations that may be present in a depressive or manic episode. And then, of course, there are the other behaviors that tend to be viewed as indicative of low character: irritability, fits of anger, self-destructive behavior, and attempts to self-medicate through the use of illicit substances that may, later, turn to addiction.

However, the chief obstacle faced by a bipolar individual may be himself, or herself, particularly if they refuse to seek treatment, or are inconsistent with regard to treatment compliance. In such instances, the importance of having a solid support infrastructure composed of family and/or friends is paramount.

Can a person with bipolar disorder work? Yes, of course, but the ability to successfully maintain regular employment will, most likely, be impaired, perhaps to the point where long-term self-sufficiency is so adversely challenged as to be nearly impossible.