Mental Illness and Startups
blog.tesser.org
blog.tesser.org
There are people who think that depression means 'feeling low', and that if you try hard enough, you can 'snap out of it'. These people are idiots. It's not a matter of being strong enough or dedicated enough. For me, like most people with depressive illnesses, there will be times when I just plain can't. In my worst states I can barely remember what a for loop does, let alone code one. Accept that there will be times when you can't work, and make the most of the times when you can.
There is an approach called "behavioral activation" that my psychiatrist taught me. Basically, instead of saying "I'll do it when I feel better", you say "I'll do it so I'll feel better".
Doing things I didn't feel like doing, that felt almost impossibly difficult (like putting on real clothes and going outside) was probably the most effective tool I've ever had with dealing with depression.
Still, though, there are severe forms of depression that can become invulnerable to all the self-help approaches.
The science is pretty clear that a combination of medication and professionally-guided CBT has the most effective rates for treating depression, and that some specific treatments specifically don't work at all for some people.
http://therapists.psychologytoday.com/rms/content/therapy_me...
Which one is "most effective" (by what measure?) is very debatable.
Here's a Jungian critique of CBT ("Psychology's New God") :
http://hbmag.com/jungian-psychology-series-psychology’s-new-...
In code if something is wrong or not working right you know it can be fixed. Sometimes the fix is not easy, and requires lots of work, and research, and testing but after nearly ten years of coding experience I know that if something is wrong I can fix it. There is no problem in code which can't be solved. (Obviously excluding some things like the traveling salesman problem, etc.)
Real life isn't like that, because many factors are out of your control. You can not debug a relationship, or undo a mistake like you can roll back a code update.
At times I find myself retreating to the dependable, stable world of coding, in which changes can be implemented easily and quickly, and where mistakes are easily discovered and corrected. That's isn't necessarily a healthy thing though.
That said, if I can write code, I find that work is sometimes one of the most effective ways to stop the depression from worsening
i've found smaller companies are much more tolerant & flexible with nutters (like me).
there seems to be more focus on results than politics. in larger places I've felt more pressure not to rock the boat, and produce the illusion of work, rather than actually delivering things on time. it doesn't seem to matter if you actually do anything as long as you look like you're not doing /nothing/.
and I don't mean a startup. even startups can grow into kafkaesque nightmares because it's the only way they've ever thought to run a company. really, you have to be in a small, autonomous group if you want to get away with not being that normal.
the moral is: being a startup in and of itself is no guarantee of tolerance for off kilter people, the people and culture within the company are important. there is a correlation between small companies/startups and tolerance, but it isn't causation.
As long as I deliver what I'm supposed to, when I'm supposed to, they're very reasonable.
Sometimes it is all manageable or heals on its own, but sometimes the illness progresses and the results are tragic, so it needs to be viewed seriously.
...alcohol's a cheap medication, anyway.
I have to disagree with this statement and ask you to provide better sources than just the result of some Google search. The evidence gathered with citations to peer-reviewed literature in one of the definitive medical textbooks on the issue,
http://www.amazon.com/Manic-Depressive-Illness-Disorders-Rec...
strongly suggests that lithium for bipolar mood disorders has long term benefit. (That's based both on the decades of human use of lithium in some countries and on the basis of animal studies followed up by necropsies of brain tissue.)
Apparently we are all in agreement that "self-medication" with alcohol is a very bad idea. But prescribed medication under supervision by a medical doctor can be a very good idea indeed.
After edit: Thanks for the mention of the interesting book in your reply. I read some of the reviews, and found this useful interview
http://www.salon.com/books/feature/2010/04/27/interview_whit...
with the author, who has a balanced point of view:
"Q: So do you think psychiatric drugs should be used at all?
A: I think they should be used in a selective, cautious manner. . . . I think we should look at programs that are getting very good results. This is what I love about Keropudas Hospital’s program in Finland. They have 20 years of great results treating newly psychotic patients. They see if patients can get better without the use of meds, and if they can’t, then they try them. It’s a best-use model, not a no-use or anti-med model."
After one more edit, an interesting review of the book mentioned in the reply to first version of this post:
http://carlatpsychiatry.blogspot.com/2011/01/anatomy-of-epid...
Also, that Finland program as described in Anatomy uses very few psychiatric drugs, and it does in low doses and tries to keep people off them. Whitaker is just explaining that his opposition is not to 'psychiatric drugs' like some groups, but to unscientific & harmful practices, which is exactly what gives him so much ethos. The Finland program is from what I remember of it, far from modern psychiatric practices.
In fact, in my email communication with Whitaker, he has stated that no patients would miss antipsychotics if they were banned. Based on his books and many interviews/videos I have seen of Whitaker, I think he would probably agree with the statement "The way most drugs are prescribed, they make the illness worse in the long-run." (note I don't know Whitaker personally)
This is a very complicated debate because one can't talk about psychiatric drugs in general, you have to look at the individual evidence for each one. For example, I have much less faith in the Harrow Study that Whitaker cites as evidence that antipsychotics do worse, because I found the critique that its just the worst patients who stay on antipsychotics very salient. This study indicated the health of the off-med and on-med groups diverged after two years (with the off-med group improving significantly.) However, there seem to be a dearth of studies that are this long testing antipsychotics versus placebo (because of the inherent difficulty of that study, I imagine).
My personal opinion is that, while sometimes useful, we just don't know enough about how humans work to really fix a large number of issues. People tend to go to psychiatrists persistently even after no track record of improvement out of the fear that they'll get worse. No one will ever recommend that anyone 'give up' on professional help out of the fear that saying so will make them responsible for the negative consequences.
Pursuing therapeutic response without success may point (especially with continued "They'll even admit to it") to problems with the therapist specifically. Finding a "good" therapist is very difficult. Personalities "gel" or "click" or "culture is important to us at company _ with programming skills _."
Hypochondriac behavior with therapy should be treated as such, not discounted due to perhaps a false sense of "therapy is bullshit, everyone I know is in therapy." The tragic stories of "noone even knew he/she was depressed" of suicide exist for a reason in abundance.
Take Meds. It's no solution, but it's the beginning of a solution.
Quit school.
Go to the Italian country-side and *become a man*, Italian style (it involved a lot of wine and pasta).
Work Mike Rowe-style jobs (like learning how to build an entire house in France).
Refuse to do any more stupid shit (for others) in your life.
Stop feeling guilty about anything. (Doesn't mean you lose your conscience).
Do what you love, do what you love, do what you love.It's easier if you're a founder.
I feel the chaos of a startup doesn't help things. I long for a structured 9 to 5 job in an office. Being alone at home just exacerbates things and having a bed behind me just makes me want to crawl under the covers and sleep. I tried going to various cafes to work but there's no free wifi (which I suppose I wouldn't use anyway) and the prices are ridiculous. Libraries are great when they aren't packed and when the homeless aren't using it for shelter.
I have to admit I do have a sudden burst of energy when I stumble across an interesting github repo.
Purposeful / meaningful activity is a great way to combat depression.
Just my opinion, I'm not a subject matter expert.
It's hard to think, it's hard to talk with people--- the social scripts are all broken and the baseline feeling of my reality is warped into something ugly. When I'm depressed there is nothing "really awesome", it just doesn't exist.
On the other hand, I've found the whole condition can be fluid/mutable and have felt these sorts of low states much less often since I started meditating and paying attention to my internal state.
If the things that once made you feel really awesome (sex, motorcycling, coding, gaming, cooking, whatever) no longer hold any appeal for you, that means you're very likely not merely "feeling down" but actually clinically depressed.
It's like when a finger is numb -- you touch things with it thinking, "How odd, I ought to be feeling something." But you don't.
It's not just feeling down. It's your brain's ability to feel pleasure being physically broken.
I originally thought I was just different from everyone else, or that "they" were wasting their lives on pointless pursuits. Now I actually understand why it's so great having a niece to take to the park.
It is a lack of momentum and a heavy inertia to stay miserable and avoid change. It becomes a sunk cost where it's almost impossible to change something small in your life, let alone something big or huge.
Your advice is naive, and tantamount to asking "Have you thought about not being depressed, I hear that could work". If it were as simple as thinking your way of depression, it wouldn't be such a problem.
The best advice I've ever encountered is to take care of the little things, like sleeping on time, remembering to eat every day, doing laundry and getting out of the house. These are often the first things to go and often the hardest to get back into the routine of doing. Once you can manage a day at a time, it's easier to start to try managing a week at a time.
Large changes won't matter if you can't take care of the smaller things in life that support you. Depression isn't one of those things you can snap out of, but one that you can gradually work yourself out of.
It's not fun or easy though.
The issues of "doing something awesome" and depression are totally orthogonal.
Most people already are trying to do whatever they think is really awesome. For example, raise a family and have a steady income; or create a startup; or be an artist; or move to Europe.
In fact, the depressed person is probably already trying to do whatever he thinks is really awesome, or at least contemplating it, in real life, and being depressed is just getting in the way.