Telework and bipolar disorder

Telework developed considerably during and after the COVID-19 pandemic. It seems interesting to evaluate the consequences of the use of teleworking in the population of bipolar patients. Increasingly accessible thanks to new technological and digital tools, it is however losing notoriety, because it presents some disadvantages, both for employees and for their employers. Yet, one of the essential benefits for bipolar people seems to be working at times when bipolar people are most productive due to their sleep/wake cycle for example.

Introduction

Bipolar disorder, which is also known as manic-depressive psychosis (bipolar disorder type 1), is a disease that causes mood disorders manifested in both depression and excitation phases. These phases appear either in reaction to stress or for no apparent reason and may be of varying intensity and intersect with periods of stability. It is a category of mood disorders defined by the abnormal fluctuation of mood, oscillating between periods of elevated mood or irritability (mania or in its less severe form of hypomania), periods of depression, and periods of normal mood (euthymia) [1].

In a recently published article [2], there was no mention of telework. Indeed, it is a situation that remained exceptional before the COVID-19 epidemic [3], which we had to face recently, and the consequences of which we know very little about for teleworkers and of course for bipolar patients.

Internet psychoeducation seems rather ill-suited for the bipolar teleworker [4]. Indeed, the latter may suffer, psychoeducation via the Internet risks appearing to him as an extension of his work and his effectiveness would suffer.

The concept of telework is defined as work carried out in a location where, away from central offices or production facilities, the worker has no personal contact with colleagues, but is able to communicate with them using new technologies [5]. It was created during the oil crisis of the 1970s when it was observed that "if just one in seven workers gave up commuting, the United States would no longer need to import oil. During this time when some employees were doing their jobs remotely, other benefits were discovered. The oil crisis of the mid-1970s showed that telework offers flexibility in the execution of work from which companies and individuals can benefit [6].

The potential benefits of telework?

The benefits of telework have been regularly cited in numerous empirical research and review articles [7]. Most of them allude to practical benefits and include:

A better balance between private and professional life: Workers are able to spend less time away from home and therefore use the time they would otherwise have wasted traveling or in the office; with their family [8]. They can also better cope with domestic problems and thus be able to call the plumber or electrician, receive a package, etc.

Increased flexibility: Remote workers can often (but not always) choose their working hours, allowing them to do off-peak shopping at the supermarket or go to the gym, pick up the kids from school, or simply work at times when they are more productive [9]. There is also the freedom and flexibility of being able to work from home for more than one employer or being able to find work even if it is difficult to access the office due to disability, the location of the rural home, or family responsibilities.

Reduction in commuting: Reducing commuting, which has potentially positive effects on reducing costs, time, and stress, is perhaps the main reason why workers choose to telecommute [10].

Reduction of overhead costs for the employer: A telework experiment on British television (BBC) resulted in savings of around 25%. Businesses achieve these savings by reducing the need for expensive office space and overhead costs such as heating, electricity, and wear and tear on-premises.

Increasing the skills base of employers: Organizations with telecommuting programs are able to take advantage of a job market filled with skilled personnel who are not necessarily able to work full-time in a conventional office environment, such as people with disabilities, or those who have childcare or eldercare responsibilities [11].

Increased productivity: The literature reports higher productivity among teleworkers than other workers and this higher level of performance is attributed to fewer interruptions, longer working hours, and flexibility in scheduling work schedules. work. Additionally, because most people engage in telecommuting by choice, they tend to be more motivated to prove that this alternative work mode is successful, but it is worth emphasizing that with a few exceptions, the increased productivity of telecommuting is based on self-report data. Since most remote workers request to work from home, they might have a bias toward claiming success to prove that their chosen method is effective. This will perhaps evolve, we will perhaps note an evolution, if because companies, will have to expand their teleworking offer for ecological reasons [12].

The problems or disadvantages related to telework

A wide range of problems associated with telework have been documented. These include:

Social isolation: Social isolation is the most commonly cited disadvantage of telework; a survey carried out revealed that 60% of teleworkers saw this as a major disadvantage. A study showed that we need the example of others to give us an idea of ​​how we should behave. We use others as social barometers. The lack of reference points is a problem for teleworkers [13].

Presenteeism: Presenteeism, in the strictest sense and as opposed to absenteeism, is the fact of being assiduously present, particularly at work; it involves not only working long hours but also working when sick. Available published data generally indicate a decline in absenteeism among teleworkers because these workers can, for example, take a morning off when they are sick rather than a full day, return to work when they are not fully recovered - or take no time off at all [14]. While this presenteeism may be something that managers view as a benefit, it is clearly not in the employee's best interest to work while sick or not take sufficient time to properly recover. This problem of presenteeism, whereby people feel unable to take time off work due to illness is, of course, a prevalent problem for all workers in the current climate of job insecurity. employment, and not just for teleworkers.

Lack of support: Technical support issues are a major concern for remote workers. It's hard enough to provide the level of technical support required for personal computers in a managed office environment, but for the nomadic remote worker, the failure of the mobile office is far more catastrophic. Assistance is the “key to work success” [15].

Career progression: The difficulty of career prospects linked to a lack of information networks seems important in terms of career prospects. This is fraught with consequences and has long been identified as a problem for home workers [16].

Blurring of boundaries: The commute to work often allows for the transition between “roles”. It was found that 60% percent of workers find the commute to work a useful break. Although many teleworkers attempt to develop spatial and temporal boundaries between work and home life, such as creating a dedicated work room, working from home blurs the distinction between roles not only for the teleworker but also for the family. There are spillovers of negative and positive emotions from work to family life and from family life to work and vice versa, even in traditional work models, how can they be compared with telework? [17].

Consequences of telework on mental life

The psychological impact of teleworking is only beginning to be scientifically evaluated; when it comes to addressing issues such as isolation, blurring of work/home boundaries, and emotional “fallout.” [18]. However, most studies still focus on practical issues such as technical support (such as technicians, managers, etc.) and legislation. It was indeed thought that these were the main problems which, resolved, would facilitate teleworking. However, if teleworking is to succeed, its impact on health and psychological well-being must be taken into account so that organizations and individuals can take steps to minimize the potential negative impact.

One of the first studies investigating the psychological implications of telework examined its emotional impact. His results from this study suggest that some of the emotional impacts appear positive, such as a reduction in stress related to travel or irritation caused by interruptions in the office [19]. On the other hand, other emotional factors suggested a negative effect of telework: increased loneliness from the isolation of working away from the office, more frustration from lack of technical support, more guilt when sick, and more resentment about the impact of remote working on family life. The current research aims to address these limitations by examining the psychological impact of teleworking in terms of its effects on:

- Emotions

- Stress and health of teleworkers.

Telework for bipolar patients

It's like Aesop's tongues, the best or the worst of things. In times of pandemic, this is an essential solution, but we understand that the isolation of the teleworker who lives alone can be great [20].

The employer can find a contract with his bipolar employee that benefits both:

- Ensuring that mental well-being is optimal.

- Aiming to maintain a good work-life balance so that employees have time for work, leisure, and social relationships.

- By being flexible with working hours, and schedules.

Teleworking appears to benefit employees with bipolar disorder, by allowing longer or more frequent breaks and time off for their therapy and related appointments.

- Providing additional training on time management skills for interested employees.

The bipolar patient, if he is well surrounded, can experience less stress with teleworking and less conflictual situations with his colleagues. The personality of the bipolar person will undoubtedly be fundamental in their adaptation to telework [21]. I think that histrionics will not benefit from this, nor will depressive or dependent temperaments. On the other hand, it seems to me, that the obsessive and schizoid temperaments; may have found benefits linked to teleworking. It remains to evaluate these various situations. One of the essential benefits for bipolar people seems to be working at times when bipolar people are most productive due to their sleep/wake cycle for example. We do not have studies to evaluate the positive benefits of telework for bipolar patients, but in the context of a favorable family environment, it should lead to less stress and increased emotions [21].

Conclusion

Telework for bipolar patients must be considered with caution, in fact, it can desocialize the individual but it can also avoid additional fatigue linked to the duration of transport. As with any worker, it will be appropriate to evaluate with patients the advantages and disadvantages of a given case. By adopting mixed formulas combining face-to-face work and periods of telework.

1. Emilien G, Septien L, Brisard C, Corruble E, Bourin M. Bipolar disorder: how far are we from a rigorous definition and effective management? Prog Neuropsychopharmacol Biol Psychiatry. 2007; 31:975-996. DOI: 10.1016/j.pnpbp.2007.03.005.
2. Bourin M. Management of bipolar disorder at work. Arch Depress Anxiety. 2024;10(1):041-044. DOI: 10.17352/2455-5460.000091.
3. Lang G, Hofer-Fischanger K. Factors associated with the implementation of health-promoting telework from the perspective of company decision makers after the first COVID-19 lockdown. Z Gesundh Wiss. 2022; 30:2373-2387. DOI: 10.1007/s10389-022-01717-z.
4. Poole R, Simpson SA, Smith DJ. Internet-based psychoeducation for bipolar disorder: a qualitative analysis of feasibility, acceptability and impact. BMC Psychiatry. 2012; 13:139. DOI: 10.1186/1471-244X-12-139.
5. Athanasiadou C, Theriou G. Telework: systematic literature review and future research agenda. Heliyon. 2021;7(10):e08165. DOI: 10.1016/j.heliyon.2021.e08165.
6. Urien B. Teleworkability, Preferences for telework, and well-being: a systematic review sustainability. 2023;15(13):10631. DOI: 10.3390/su151310631.
7. Gohoungodji P, N’Dri AB, Matos ALB. What makes telework work? Evidence of success factors across two decades of empirical research: a systematic and critical review. Int J Hum Resource Manage. 2023; 34:605–649. DOI: 10.1080/09585192.2022.2112259.
8. Mann S, Holdsworth L. The psychological impact of teleworking: stress, emotions and health. New Technol Work Employ. 2003;18(3):196-211. DOI: 10.1111/1468-005X.00121.
9. Wohne F. Work flexibly, travel less? The impact of telework and flextime on mobility behavior in Switzerland. J Transport Geogr. 2022; 102:103390. DOI: 10.1016/j.jtrangeo.2022.103390.
10. Ekberg K, Pransky GS, Besen E, Fassier JB, Feuerstein M, Munir F, Blanck P; Hopkinton Conference Working Group on Workplace Disability Prevention. New Business Structures Creating Organizational Opportunities and Challenges for Work Disability Prevention. J Occup Rehabil. 2016; 26:480-489. DOI: 10.1007/s10926-016-9671-0.
11. Pearce JA. Successful corporate telecommuting with technology considerations for late adopters. Organ Dyn. 2009; 38:16-25. DOI: 10.1016/j.orgdyn.2008.10.002.
12. Beckel JLO, Fisher GG. Telework and worker health and well-being: a review and recommendations for research and practice. Int J Environ Res Public Health. 2022;19(7):3879. DOI: 10.3390/ijerph19073879.
13. Haddon L. The experience of teleworking: An annotated review. Int J Hum Resource Manage. 2014; 5:193-223. DOI: 10.1080/09585199400000010.
14. Aroles J, Granter E, de Vaujany FX. "Becoming mainstream": the professionalisation and corporatisation of digital nomadism. New Technol Work Employ. 2020; 35:114-129. DOI: 10.1111/ntwe.12158.
15. Batistic S, Tymon A. Networking behaviour, graduate employability: A social capital perspective. Education + Training. 2017; 59:374-388. DOI: 10.1111/1468-005X.00121.
16. Pabilonia SW, Vernon V. Telework, wages, and time use in the United States. Rev Econ Househ. 2022;20(3):687-734. DOI: 10.1007/s11150-022-09601-1.
17. Delanoeije J, Verbruggen M. Between person and within-person effects of telework: a quasi-delineate. J Work Organ Psychol. 2020; 29:795–808. DOI: 10.1080/1359432X.2020.1774557.
18. Nemțeanu MS, Dabija DC. Negative Impact of Telework, Job Insecurity, and Work-Life Conflict on Employee Behaviour. Int J Environ Res Public Health. 2023;20(5):4182. DOI: 10.3390/ijerph20054182.
19. Figueiredo E, Margaça C, Hernández-Sánchez B, Carlos Sánchez-García. Teleworking Effects on Mental Health. A Systematic Review and a Research Agenda. Int J Environ Res Public Health. 2024;21(3):243. DOI: 10.3390/ijerph21030243.
20. Speirs B, Hanstock TL, Kay-Lambkin FJ. The lived experience of caring for someone with bipolar disorder: A qualitative study. PLoS One. 2023;18(1):e0280059. DOI: 10.1371/journal.pone.0280059.
21. Panchal P, de Queiroz Campos G, Goldman DA, Auerbach RP, Merikangas KR, Swartz HA, Sankar A, Blumberg HP. Toward a Digital Future in Bipolar Disorder Assessment: A Systematic Review of Disruptions in the Rest-Activity Cycle as Measured by Actigraphy. Front Psychiatry. 2022; 13:780726. DOI: 10.3389/fpsyt.2022.780726.