ON MENTAL ILLNESS: Difficulties of Employment

By Jack Bragen
Friday March 29, 2013 - 09:02:00 AM

Persons with chronic mental illness often become gleeful when successfully employed. Employment seems like a reason for liking oneself and a way to have more self-esteem. Most "normal" people, regardless of their demographic or what country they are from, put a lot of value on having an education and having employment or entrepreneurship. Most Americans, mentally ill or not, receive a blow to self-esteem when unemployed. 

However, the need to be employed in order to like oneself could be a socially induced neurosis. This psychological pattern can be deprogrammed through cognitive techniques. In the absence of a job, it requires a lot of work on one's innards to create self appreciation, acceptance of oneself, and self-esteem. For me, it became less work to simply like myself, by convincing myself of my own worthiness, compared to the difficulties and the effort of holding a day job. When one has a legitimate disability, one should not berate oneself for not having a job. 

The barriers faced by persons with mental illness when trying to hold a job are several and are difficult to overcome. Someone with mental illness could be basically capable of doing the work, but could have other problems that interfere. 

Symptoms of the illnesses, which medication won't entirely resolve, can affect the perceptions of one's environment. People with paranoid tendencies are more likely to feel intimidated by coworkers, and may lack the social skills that would enable them to feel "safe" in the work scenario. Being able to get along with coworkers and having social ability are a significant factor in keeping a job. 

A person with mental illness may not have the same level of self-confidence compared to their "normal" counterparts. When anyone, with or without a mental illness, experiences enough setbacks, it can affect self-confidence. Persons with mental illness tend to have numerous setbacks in their history. Resilience only lasts so long, and becomes less with age. 

Medications used to remain stabilized affect work performance. A person with mental illness may not be hirable at a job that entails going up on a ladder, because employers may fear the person will have dizziness, and companies may be limited by the dictates of insurance. Any job that requires a lot of reflexes or a high level of exertion could be a problem for someone with mental illness, because some medications affect reflexes and can inhibit physical exertion. 

Antipsychotic medications often impair concentration. This could affect a job that requires intensive reading, studying or working intensively on a computer. This impairment varies and can make it painful to concentrate. Yet, this can sometimes be counterbalanced with practice and effort. 

Slowness from medication can affect the speed of performing repetitive tasks such as data entry or merchandising. Medication can make it difficult to wake up in the morning. Medication can make a person depressed, which can cause "giving up" on working. 

Another negative factor is people telling us "you can't do it." I have heard that message from counselors who felt it was their job to get me past my "delusions of grandeur." A counselor once wrote in a log that that I had not yet faced the fact that I could not work. This wasn't accurate. The counselor left her job shortly after I discovered the comment. 

Another counselor once said that I had a better chance at becoming a pro basketball player than a professional writer (I am five foot six-usually not tall enough for pro basketball.) 

Counselors seem to universally assume that persons with mental illness can't do something that requires intelligence. My wife, who has a bachelor's degree, went to Department of Rehabilitation for job assistance, and was referred to a training to become a motel maid. Taking pot shots at the confidence of a person with mental illness is not acceptable. 

When a person with psychiatric illness learns to sell oneself short, and accepts jobs that are actually below their level, it is a form of self sabotage and yields nothing. Social Security benefits exist so that we need not get psychotic while cleaning toilets. 

Post traumatic stress is another limiting factor. If someone has lot of misfortune associated with work, it can induce extra fear and stress in a job. Emotions associated with PTSD might trigger overt symptoms of the person's neurobiological disorder. 

A case of burnout is roughly in the same vein as PTSD. When someone has "been there, done that" enough times-having too many negative experiences-it might be a good time to retire. 

Work at a regular job is not always a good fit. Sometimes, an individual is better off if self-employed. Jobs in which a person is an "independent contractor" may allow more independence and more freedom. If you are an entrepreneur or if you work in a job that has a high enough rank, the performance issues related to the medication or the illness may not affect the job. Reaching that point may be the difficult part. 

The above essay is not intended to make persons give up on work, except for instances where a job is doing them emotional or physical harm. If anyone feels that they would like to try a job, an adequate level of determination and motivation can sometimes counterbalance the impairments of the illness, the medication, and the discrimination of employers. I believe that for people who want to work, it is useful to identify exactly what one is up against so that these obstacles can be dealt with.