Replace "upper" with "caffeine" and the absurdity becomes apparent.

"either your performance, judged by coworkers, will be equivalent or below theirs and the stimulant is seen as the only thing keeping you in your job (which can get super depressing internally) - or, if you're doing well in your position, it can breed internal and external doubt as to whether your performance would just be normal and is being boosted by the caffeine."

the difference between them lies only in the degree of effectiveness. I dream that within my lifetime uppers will be as de stigmatized as weed.