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Society's "work ethic" can be a source of self-punishment, usually in the form of self-critical thoughts. The terminology people use, "working" and "not working," are non-coincidentally the same terms we use when a vacuum cleaner or television are either operating properly or broken and in need of repair.  

Many people have been raised in an environment in which praise and acceptance from parents and others was contingent on the job we were doing. This translates later in life to our sense of self-worth being conditional on having a successful career.  

As persons with disabilities, this expectation can be a heavy emotional weight. We might believe we "should be working." Yet, trying to fulfill "the work ethic" might be part of the reason why we became ill.  

People without a disability who have been raised from childhood to perform academically and then in a career, may never question the work ethic and may not believe work is difficult. Many nondisabled people take it for granted that they are able to perform in a job and earn money.  

A psychiatric illness, however, may throw a monkey wrench into the works before we become fully developed as "working" adults. This is especially so with illnesses that have early onset.  

Problematic development related to work and/or relationships could lead up to a psychotic break, a manic episode, or depression. Once medicated and in outpatient institutionalization, we are up against even bigger barriers if we are trying to have a job or have a relationship.  

Psychiatric medications often prevent performing competitively in a job. This is because many of these medications limit the energy level of the body and mind. Yet, we generally have little or no choice in taking these meds, because without them, there is a huge risk of relapse and getting acute symptoms of mental illness all over again.  

Outpatient institutionalization exposes us to reinforcement of the idea that we can't work in a job. This negative expectation can cause a lot of distress, and it sabotages future work attempts.  

Most people, when working at or toward a professional career, need positive reinforcement from friends, family, and associates at their job. Yet, as soon as we are medicated and institutionalized, we are getting reinforcement of the idea that we are sick, can't do anything, and need help.  

This also impacts relationships, since most people who are not mentally ill who are seeking a relationship would never consider going out with someone with a psychiatric disability.  

Because of all of this, the "reality" we are expected to return to when we are in recovery is not the same as the reality we left behind when we became psychotic, depressed or manic. This is remotely analogous to what happened to Vietnam veterans who went off to war with the noble idea of fighting for our country and came back to the U.S., only to be vilified.  

The work ethic apparently works fine for most people. However, if we have a psychiatric disability, we need to give ourselves a break, and not persecute ourselves for "failing" to live up to this often self-imposed standard.