ON MENTAL ILLNESS: Attempts at Working While Medicated

By Jack Bragen
Friday April 20, 2012 - 04:32:00 PM

Most of the persons with mental illness who I have encountered have some level of difficulty with employment. Being able to work, for persons with mental illness, is often incorrectly perceived as symbolic of being a worthy human being. Being diagnosed with a mental illness took away self esteem for many of us. It may seem to us that being able to keep a job could restore most of that self esteem. In fact, we deserve to like ourselves whether employed or not.


Being medicated, especially with antipsychotic medication, is a barrier to work activity. The only thing worse than being medicated, for someone with schizophrenia, is not to be medicated. Psychotic symptoms at high levels will make it extremely difficult if not impossible to function in a work environment. Antipsychotic medication, however, will slow down or impair someone's attempt at work to the point where he or she is not competitive.


In my twenties, I tried to do a number of jobs and succeeded at some. Unfortunately, there was a lot of baggage attached when the work attempts were not successful; I berated myself and was berated by others when jobs didn't work out. In my twenties, I didn't keep jobs for longer than a year.


I also tried self employment. However, I usually did not do well enough at this to make a profit. When my enterprises were profitable, my businesses were usually too stressful for me to maintain.


Medication played a part in some of my jobs being unbearable. The depressing effect of antipsychotic medication made it very hard to show up for work. In some jobs I couldn't keep pace with the speed of work that was expected. Medication has a slowing effect. In several instances of work attempts, the person who hired me believed, as I did, I should be able to handle their job because I presented well. Unfortunately, we (me and the employer) would later find out that my actual performance level didn't match how I presented myself.


For persons with a mental illness who are making a work attempt, it is a common mistake to quit medication against medical advice in order to work at a competitive rate. This is a bad idea. Usually, doing this invites a relapse of the illness which entails a setback of a number of years. You are better off losing a job due to performance or other issues than you are pushing it too hard and/or going off medication and as a result having a relapse of mental illness. I found that family members and treatment professionals had trouble understanding why I had so much difficulty with jobs. However, I was experiencing impairment from the medication and from the illness as well. I still had symptoms of paranoia while medicated, more so than I realized.


People had the incorrect notion that I wasn't trying hard enough or that I needed more fortitude in order to keep a job. This "judgment," in which others and I laid blame on me, actually fed more energy into the negative pattern. Because of this past pattern, today I am very careful about what jobs I will accept, to the point of usually being unemployed. It also helps to have a self assessment which is accurate.


In my twenties I could often work competitively at electronic repair, but could not do so at jobs that required less critical thinking. Other people had more speed of performing simple tasks and perhaps quicker manual dexterity, but they could not think as well as I could. Satisfying an employer often boils down to whether or not a person can work as quickly and as well as their peers, since a typical employer wants to use the most efficient person they can get.


At the present, as a person who writes but with no day job, I am in good company. Due to the poor economy, unemployment has become a socially acceptable profession. There are a number of jobs that exist that bring about less respect than being unemployed.


It's not uncommon for persons with severe mental illnesses, because of the medication and the illness, to have a hard time with jobs. This is in spite of the fact that the afflicted person may be more intelligent or more talented than the average person who lives next door. While you don't have to just give up and accept unemployment without a good try at working, you should at least be kind to yourself and not be your own worst critic in cases where a job doesn't work out. You also should not internalize the criticizing that other people, who may mean well, are giving you. A person can be happy with or without a regular job if their expectations allow it.


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Just reminding you that my book with a year's worth of columns is available at Amazon and at As always, I can be reached with your comments at