I often get these feelings like when I turn down work (I work casually so I can pick shifts to work or I sometimes get offered them). Often when I am feeling worse than usual, I'll will get into two minds on whether to work or not, a number of thoughts will start rushing into my mind, on the one side the thoughts would be "If I go I will feel good and rewarded and at least I can relax properly afterwards"or "I felt like this before and went to work without anything bad happening" On the other hand will be "You're lazy and this is just an excuse not to go to work". And these thoughts can bring feelings of self loathing and guilt. I try rationalize these away, as I know of I push myself too much then I might get worse, which could make me feel more guilty as I already knew what could potentially happen. Does anyone else get these thoughts or feelings whether relating to work or anything else? I sometimes wonder if I have accepted my limitations because if I have then shouldn't these thoughts/feelings not be bother me. The other thing is that you shouldn't live life in fear of crashing/PEM all the time but sometimes it is difficult to really know when you are pushing too far and when you could be doing something.