Q:  Third Shift Work Detrimental?

Dear Dr. Phelps:

I was diagnosed Bipolar I about eight years ago.  I am on lithium, Wellbutrin, unithroid, and occasional clonazepam. 

At work, I recently got reassigned (INvoluntarily) to a shift that necessitates my waking at 2:30 am and not getting home until 1 pm.  My symptoms (both medication related and mood related) have been dramatically affected.  No room to detail them here, but suffice to say any physical or emotional characteristics have been increased at least tenfold, to the detriment of my work.  I'm not fired yet, but I feel like I will be!

My prior shifts were noon or later, and I have found in my life (MANY jobs in my 38 years) that late morning/early afternoon starts are best for me.  I have been an exemplary employee at my current company for over a year on later shifts.  I am trying to convince my (huge corporation) employer that it is in the best interest of my health to switch me back to later shifts on a permanent basis, not just for this shift bid but for any bid subsequent to this.  I believe this also falls under the auspices of the Americans with Disabilities Act, Reasonable Accommodations. 

I remember hearing or seeing somewhere a study stating that third shift work is very detrimental for BP patients.  I can find studies about sleep deprivation (also germane), but I wondered if you knew of any specifically regarding third shift that I can forward to them to bolster my case.  

Thank you for any help you can give!
Elizabeth



Dear Elizabeth -- 
There is ample evidence that sleep deprivation worsens bipolar disorder.  Perhaps it would be sufficient to cite Dr. Sachs' (Harvard) routine lecture on what makes bipolar disorder become unstable, where sleep deprivation is right at the top. Or the fact that I routinely request employers to give daytime shifts to my patients with bipolar disorder, and that at least in my town, these requests are routinely granted.  Or that the Americans with Disabilities act requires employers to make "reasonable accommodations" for people with disabilities, and that mental health disabilities count under this statute (which may be why employers so routinely grant my requests!). 

I dug around a little for a reference from the literature on this topic.  I did not find a single simple reference to cite, if your employer needs that kind of thing.  Perhaps better yet, ask your doctor to write "This woman requires a daytime shift to protect against worsening of a medical condition I am treating".  This is what I do. 

Dr. Phelps
 

Published May, 2002