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In the course of battling a mental illness, a number of mental health consumers ultimately discover that regular employment is not a good fit. While “normal” people occasionally have a “bad day” in which their work isn’t up to par, a person with a mental illness may have a bad day more often, and may need a work situation that can accommodate this factor. Such an accommodation isn’t done in most companies--they may expect that their employees be efficient at all times. The effects of psychiatric medications in combination with residual symptoms of the illnesses often slow down and impair job performance, sometimes to the point of the work not being at a competitive level. The mental health consumer is then stuck in a lifetime of not being able to work, and thus of not having a lot of the good things in life that people in mainstream society frequently take for granted. A reader writes: 

I appreciate your openness and willingness to start a discussion on the repercussions of mental illness. Often, I question myself as to whether I'm being lazy or am allowing my own mental health issues to rule me. I've never been able to work a steady job and have doubts I ever will. When meeting new people, the most often asked question is: "what do you do?" and since I can only reply, I'm on disability with the follow up being: "for what?", I tend to shy away from people. ...people are judged by how many degrees they have and what sort of work they do. After so many years, I've identified myself as --- the mentally ill person. I don't know what I am otherwise. I'm just getting this off my chest; and I'm sure that there are many others like me out there.....we appear normal i.e. don't walk around muttering, or shuffling around, yet, we don't fit in regular society. 

Unfortunately, our society expects people to be educated and have jobs in order to be “an acceptable person.” Certainly, most of us have been programmed not to have esteem for ourselves unless we prove, by holding down professional employment, that we’re as good as the next man or woman. The strength level in these societal expectations is such that these ideas are not easily dismissed. The reader above is in the same boat as are large numbers of intelligent people with mental illnesses. We aren’t cognitively impaired, and thus will want the same things in life that “normal” people are getting. Yet because of other factors of living with these illnesses, the good life is often out of reach. This can be extremely frustrating. At some point we may be presented a choice of whether or not to accept that life isn’t giving us things we very much wanted. If we accept this destiny of having a “lesser” life, it allows us to enjoy the things we do have. If we don’t accept it, and want to live in defiance of it, we run the risk of a major “crash and burn” later on in life. This can potentially create a lot of misery. (If we are not keeping it a secret that we are working toward a goal, often the mental health counselors will conclude that we have “delusions of grandeur.”) I don’t know which is better, accepting a very imperfect fate, or fighting it. Acceptance of the situation is more comfortable, while defiance of it is riskier, is without guarantees, and is more ambitious. It is a personal decision and no one can tell us what to decide.