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When Severe Mental Illness Keeps You from Working

An invisible disability is one you can't see with the naked eye. Read about what it's like when severe mental illness is disabling. Dissociative Living blog.

The man typed some figures and stared at the computer screen, eventually muttering, “You qualify for $440 a month in assistance. Your rent is $740. Don’t know how you’re going to do it.” I stared at a rip in an orange, Naugahyde chair. I didn’t know how I was going to do it either. It was the year I discovered what it’s like to live on welfare (How to Get Disability Benefits for Mental Illness). I learned valuable lessons about poverty that I won’t soon forget. And I came face-to-face with the realities of severe mental illness and invisible disability.

Mental Illness Can Incapacitate You, Making Working Impossible

I was 16 when I got my first job. I worked at a fast food restaurant and was proud to earn my own money. I continued working here and there throughout high school and college. Later, I got a job in print advertising and thought I’d found my niche. But when I was 29, the opaque dissociative walls that had allowed me to function relatively successfully lost some of their density and the consequences were staggering.

I was diagnosed with dissociative identity disorder, which explained things, but further diminished my capacity to function by exacerbating my dissociative symptoms. I couldn’t work and, to most outside observers, there was no discernible reason why – DID is an invisible disability. A psychiatrist advised me to apply for social security disability. I took his advice, but the blow to my pride and self-esteem was humbling. I felt humiliated and like an utter failure.

Managing Mental Illness Is a Job in Itself

It took me a long time to learn that navigating life with a severe mental illness is not just about symptom management, therapy, and medication. Mental illness permeates every aspect of life. No arena – work, family, physical health, etc. – goes untouched. Dissociative identity disorder allows for extreme compartmentalization. And while that solves some problems, it causes others:

  • You know you have an important meeting at 3pm on Thursday. You know it’s Thursday. But those two pieces of information exist on different frequencies. Did you attend that meeting? No, you were busy color coding your calendar so nothing slips through the cracks. You’re surprised when you realize you missed the meeting.
  • The personality state that’s best at interacting with people spends 40 hours a week out, engaging with external people. The pressure to maintain continuity – not to mention the appearance of normalcy –  is enormous. When the veneer cracks, as it always eventually does, you wake up one morning crippled with anxiety about going to work and facing all those people you don’t know how to talk to.

When Severe Mental Illness Keeps You from Working, It Hurts

If you have dissociative identity disorder, you can probably name a hundred other ways DID impacts your ability to work. It’s not always completely disabling, but there’s no doubt that DID affects you in ways others can’t see, let alone understand. And I don’t know about you, but I often can’t see it either. I forget that I have an invisible disability and I’m disappointed (to put it mildly) every time I once again realize the stringent limits my severe mental illness places on me.

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22 thoughts on “When Severe Mental Illness Keeps You from Working”

  1. Does anybody with DID work? And how did you make it work? I consider myself recovered but i definitely find life very difficult. Any stress, lack of sleep or unhealthy eating and I tend to become really ill again. I thought I was cured, everyone warned me that it doesn’t just go away. I got all excited thinking I can finally start a career, cos that’s what I want. To be successful and have a well paid job in a field I’m proud of. But the past year has shown that I may be incapable of it. Silly things like my car breaking down and not having money to cover it and my anxiety which makes me unable to walk down the road like a normal person has left me lying in bed for days on end feeling like my mind is tearing apart. It’s clear that I may not be ready to work but the thought of not being able to is actually making me feel suicidal. I mean, what’s the point in life if you can’t live? I’d really appreciate some idea advice. I’m mad that I can’t cure my anxiety, I’ve tried everything. Even integration therapy worked so god knows why I can’t cure something small like anxiety

  2. I usually work jobs but find that with lack of sleep my bones start to ache and my chest hurts and then I can’t maintain the job, also no one can concentrate on no sleep.

  3. I’m just coming to terms that this condition is not something I can control and it frightens me that I will do something even worse than I’ve already done in order to hide it. I have never asked for any assistance and have always thought it it as a cop out but if I continue on the path I’m on without sucking it up and going on disability I’m afraid I will lose everything . Any information or comments on how to proceed with any assistance or disability would be greatly appreciated .

  4. We don’t concider ourselves DID, but we are definitely multiple. I’m not exactly sure where the differences and similarities are, but I do remember that “appearance of normalcy” and how hard it is to maintain…. but we found a solution, at least for us. Maybe it’ll help somebody here.
    We threw away that apparance. Yes, it was hard, it was stressful, we just threw it away. I was at work today, I was front. My client asked me my name. I didn’t say “body name”, I didn’t say “Mia” or “Rebecca” (our other workers), no… I said “I’m Luna!”. That is MY name. We’re up front with it! “…but wasn’t your name Rebecca yesterday?” some might ask, and I’ll tell them “No, I’m Luna. Rebecca is one of my headmates”.
    Yeah, terrifying. However, we were about to be fired anyway from failing miserably at that veneer you talk about. It was always “Why did you lie?!” from the boss when one of us REALLY thought we got it right. So, we took the risk. The result? Our life is a BILLIION times better. Turns out, most people don’t care. They want their computer fixed and they don’t give a flying **** which “alter” (we HATE that word!) fixes it as long as it’s fixed ASAP!!
    In fact, a few of our regulars greet us by name! We arrive on site and get a name badge matching who’s front!
    We don’t get “Why did you lie?!” anymore. We just say “Hold on, I’ll get her. She knows” and whomever it was who knew just answers the questions.

    We have a blog about our life as a publicly open multiple. Check the link http://publiclyplural.blogspot.com/

    Like I said, we don’t consider ourselves DID. I don’t know if this will work differently for a DID system. So PLEASE, consider all the risks and benefits before following any example you might see us as. We can’t be responsible if your millage varies!


  5. I’ve recently had to leave work and am so conflicted internally. In addition to managing my DID and getting the therapy I need, I was recently diagnosed as a type-II diabetic and that threw my whole system into turmoil.

    Both my psychologist and my Dr. think it’s good for me to be off to deal with this, and it does give me the time.

    Financially it’s a strain. Luckily I have DI (disability insurance) but there’s a 3 month waiting period. And like many of you I have no available sick leave, so 3 months with no income is tough.

    The conversation inside about all this is pretty messed up. Hopefully once everything is in place, and my insurance kicks in, things will get better. But in the meantime, I think only other people that have this disorder can understand.

    Thanks for the post holly,

    1. Hi Glen,

      Thanks for commenting.

      I’m not surprised your system is struggling – this would be a lot to process even without DID to complicate things. I understand why your doctors say it’s a good idea to be off of work but I also understand the conflict it’s causing to do so. There are so many threads tied to work, income, wellness, physical and mental health – both practical (like bills) and emotional (like self-esteem).

      “Hopefully once everything is in place, and my insurance kicks in, things will get better.”

      I will tell you, for whatever it’s worth, that it did eventually get better for me. The chaos and conflict calmed down and in hindsight, I think having plenty of rest (i.e. not working) was part of what enabled that. So hopefully the very thing that’s causing you stress and grief right now – not working – will also be part of what eases that stress and grief. It’s probably hard to imagine right now. Hang in there.

  6. “Hi Stephanie,

    ” … YES, what I’m doing is monumentally HARD and near impossible. The only reason I was able to do it before was because I had dissociation as an automatic defense mechanism. Now I’m trying to learn to stay at that level of functioning without the dissociation and it’s taking a horrible toll on my mind and body.”

    Oh yes, what you’re doing is monumentally hard. And that last sentence so beautifully articulates the anger I have about my limitations. I am working to be less dissociative, more aware … and this is the price I pay? That I can’t work without sacrificing my mental health, let alone the rest of my life? It might not be very adult of me, but that makes me angry.

    I appreciate your comment. It was really validating for ME. Thank you so much.”

    I just wanted to say that this is validating for me as well. I have trouble putting my thoughts into words sometimes, so I need to borrow from the above comment, because I relate to every bit of it.

    I simply cannot function at work without my dissociation. I just can’t, and it is not only frustrating, but scary as well. It feels as though I, as myself, do not know a thing about my jobs or my co-workers. I’ve had some days at work where it seemed as though the parts of my system who normally do my work for me just up and took a vacation. I ended up in my therapist’s office in a total panic begging her to not let me lose those parts. At the time I feared, and I think my parts feared that my therapist was there to get rid of them. After my therapist assured me that she had no intention to “get rid of” any part of me, things at work improved again. I still have some days where it seems like those parts of me are gone, and I have to “wing it” at work, but it helped to know that my therapist just wants some communication between my parts, not to get rid of my parts.

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