Bipolar disorder (BD) is a complex mental health condition marked by extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). Military service requires personnel to maintain consistent psychological stability and readiness for deployment in austere or high-stress environments. Military regulations ensure service members meet rigorous physical and mental requirements to preserve safety and mission effectiveness. A serious psychiatric condition like BD often conflicts directly with the standards necessary for military accession and retention.
Recruitment Disqualification for Bipolar Disorder
A history of bipolar disorder is an automatic disqualifier for entry into the United States military. The Department of Defense (DoD) maintains strict medical standards for enlistment and commissioning, classifying mood disorders like BD as conditions that preclude service. This disqualification is based on the inherent risk of recurrence, the need for continuous medication, and the potential for impaired judgment during manic or depressive episodes.
Any history of bipolar and related disorders, including cyclothymic disorder, is specifically listed as a disqualifying condition for accession. This rule applies regardless of whether the applicant has been stable or symptom-free for a significant period. Unlike some other mental health conditions, the severity and relapsing nature of BD make it a barrier to entry. The only path for an applicant is a medical accession waiver, but for severe psychiatric conditions like bipolar disorder, these waivers are rarely granted. Policy guidance deems bipolar and psychotic disorders strictly disqualifying for deployment, which means they are also disqualifying for accession.
Medical Review While Serving
For individuals already serving who are diagnosed with bipolar disorder, the process shifts to retention standards. A diagnosis of BD while on active duty triggers a mandatory medical evaluation designed to determine if the service member can continue to meet the physical and psychological demands of their role. This process begins when a military medical provider identifies a condition that may affect the individual’s ability to perform their duties.
The service member is then referred for a formal review known as the Medical Evaluation Board (MEB) process. The MEB is an administrative review documenting the service member’s medical history, the extent of the illness, and its impact on military duties. This board compiles the necessary medical evidence, including a detailed narrative summary, but does not make the final decision on separation.
The MEB’s findings are then forwarded to the Physical Evaluation Board (PEB), which formally determines if the service member is medically fit for continued service. A diagnosis of a bipolar spectrum disorder usually does not meet medical retention standards, leading to a presumptive referral to the PEB. This non-optional process is designed to protect the service member and the operational readiness of the military unit.
Fit for Duty Determinations
The Physical Evaluation Board (PEB) uses the concept of “fitness for duty” to determine the outcome for a service member diagnosed with bipolar disorder. Fitness for duty is assessed based on whether the condition interferes with the ability to perform the duties of their military occupational specialty, their rank, or their ability to deploy. For BD, the condition itself and its required treatments often make a service member non-deployable, which is a significant factor in a fitness determination.
Bipolar and psychotic disorders are considered disqualifying for deployment due to the risk of symptom recurrence under high-stress conditions and the need for continuous, monitored medication. Medications used to manage BD, such as mood stabilizers like lithium, require regular blood monitoring that is often unavailable or impractical in a deployed environment. The inability to deploy or maintain required standards often leads the PEB to find the service member “unfit for duty.”
Retention is possible only in rare cases, typically for less severe forms of the disorder or for service members in specialized positions with no deployment requirement. However, a finding of “unfit for duty” results in medical separation or retirement, depending on the condition’s severity and the service member’s length of service. Medical separation ensures the individual receives appropriate care while maintaining the military’s expectation of universal deployability and readiness.
Veterans Affairs Disability Ratings
A service member who is medically separated or retired due to bipolar disorder is eligible to apply for disability benefits through the Department of Veterans Affairs (VA). The VA assesses mental health conditions based on the severity of the occupational and social impairment experienced by the veteran. This evaluation uses the VA Schedule for Rating Disabilities, which assigns a percentage rating from 0% to 100% in increments (10%, 30%, 50%, 70%, and 100%).
The rating percentage is determined by the frequency, severity, and duration of psychiatric symptoms and how they limit the veteran’s ability to work and maintain relationships. For instance, a 70% rating is assigned when a veteran experiences occupational and social impairment in most areas, characterized by symptoms like suicidal ideation, near-continuous panic, or impaired impulse control. Veterans found unfit for duty due to BD often receive a high initial rating because the condition was severe enough to warrant separation from service.