ThrowawayP

> "I've recently impressed upon my startup that we don't need to always do "coding tests" of engineering candidates (e.g., if obvious from discussion, past roles, open source, etc.)"

Y'know, I look really good on paper. Long history of significant contributions to projects that are household names at major tech companies, I know my stuff, and I can talk a pretty good game if do I say so myself. I am also so utterly burnt out that I can barely put two lines of code together. Your system would fail to avoid hiring me.

Always do the coding test. Even the FAANGs have hiring mistakes, people who get locked in a niche and let their skills rust, and just plain burnouts that you don't want joining your company.

There are plenty of neurotypical developers who can't communicate clearly or effectively either; I've sat through enough presentations and design meetings over the years to attest to that. Therefore, it's not a good disqualifying criterion.

While of course there are limits, why turn away a good engineer when all it costs you is a bit of patience and accommodation? It's not like talented people are easy to find.

> "fluticasone"

It's a treatment, unless you're one of the people it causes frequent nosebleeds in. Ugh.

> "autistically"

I think many of us would appreciate it if you did not use autism as a negative label.

You might consider experimenting with different masks and pressure settings to see if it helps a bit. CPAPs are awful but the common alternative is surgery.

> "Early this year I discovered medical marijuana. It's completely game changing."

Not to be a wet blanket or anything but, like any other form of medication, watch out for buildup of tolerance. You may wind up having to "dry out" for several months or so if tolerance gets too high.

Fluoxetine is better known by it's brand name, Prozac.

Anyway, though it's an interesting find, this isn't a trial in humans and, to forestall any jokes about it making people happy, the levels used (800 ng/mL) are far higher than what a quick Google says the common optimal blood serum levels are (100-300 ng/mL). It's a reasonable guess that it's not unsafe but would have higher likelihood of triggering known side effects that would be, shall we say, unpleasant.

> "We don't throw people into psych hospitals unless they're at imminent risk of successfully committing suicide - we don't do admits just for suicidal ideation."

Right, which still means that the patient has to very carefully manage what they say. If they are prone to exaggeration, colorful metaphors, or are feeling just absolutely miserable enough to say something they don't really mean out of pain or anger, they may spook the clinician into putting them into an "psychiatric hold" (e.g for California: https://en.wikipedia.org/wiki/5150_(involuntary_psychiatric_...) which can last 72 hours or more. Remember, just like half of developers are below average, so are half of clinicians and you won't know which is which until it's too late.

All of this is not to say that people suffering from mental illness shouldn't seek treatment. Just know what you're getting in to and how to get out of it if need be.

One of the harshest lessons I, as an introvert, have learned over the course of my career is the necessity of going in and putting up the appearance of being jovial at team and corporate social events, no matter uncomfortable and draining I find it. To do otherwise is to risk my bonuses and my employment.

> "For that matter, is there a link between depression and feeling overwhelmed with tasks all the time?"

If you're talking about work tasks, that seems more likely to be from occupational burnout. Here's a comparison chart that might be helpful: https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s...

I've got you beat; neither SSRIs nor gabapentin nor any other of a variety of on- and off-label meds worked for me.

Despite that I don't think it's a good idea to recommend or disrecommend any specific drug; it is very much a biochemical roll of the dice as to whether a med will work on a given individual and the odds aren't even particularly good. My suggestion to the depressed is to try as many as you can withstand to increase your odds of finding something that works, with the understanding you might be among the unlucky ones that nothing works on.

Clinical depression has defined symptoms: https://www.mayoclinic.org/diseases-conditions/depression/ex...

Overprescription? It is so damned hard to get stimulant medications (patients don't even dare ask for fear of being labeled "drug seeking") that even people who need them badly have a hard time getting them.

So, no, it does not seem like a "a pharmaceutical spiral brought on by a sick process", whatever the blazes that means.

Well, if you're going to be snarky about it, all I'll reply with is the famous Big Lebowski quote: "Yeah, well, you know, that's just, like, _your_ opinion, man."

The diagnostic criteria for occupational burnout are pretty well standardized and can easily be found online (e.g. https://www.thoracic.org/patients/patient-resources/resource...) and, based on my personal experience, are pretty accurate. What about these common lists of symptoms do you disagree with?

You mention average hours worked per week being not unreasonable and not feeling you "deserve" to be labeled as burnt out, so I'll also note that, although severe overwork is a risk factor for burnout, it's only one of a variety of risk factors.

By some estimates, a third of people who have depression have it in a treatment-resistant form: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518696/ How much treatment would you require these patients to endure before granting them freedom?

> I do think it's useful for treatment-resistant patients to shift their focus away from recovery and towards symptomatic management

Would be nice but it seems risky for a patient to suggest that to the clinician; depending on the exact symptomatic management being sought and the competence of the clinician (who are not, unfortunately, exempt from Sturgeon's Law), it might get the patient falsely labeled as "drug seeking". That would be problematic, to say the least.

> A colleague of mine calls suicide 'a permanent solution to a temporary problem' - not to diminish it, but to recognize that for most people the desire to die is a temporary state.

I've seen that quote floating around and never much liked it. For those afflicted with long-term treatment resistant depression, it's more like "a guaranteed solution to a permanent problem".

Prozac has among the lowest side effect profiles for anti-depressants and is dirt cheap since it's long out of patent. That's why it's often the first thing tried despite not having the highest rate of effectiveness, as far as I understand it.

> Some people just have a terrible fate and nothing that comes in their life changes it because not everyone gets a good job, significant other, place to call home, and the healthy body.

There's actually a term for this, SLS: https://en.wikipedia.org/wiki/Shit_Life_Syndrome

Apparently it was coined as a "ha ha, only serious" joke but came into more general usage in the UK: https://authenticmedicine.com/did-i-discover-the-concept-of-...

> Rationality is defined over some goal, and there's no obvious goal here.

Relieving themselves of (to them) unbearable misery is a goal, quite possibly the most rational of all goals.

> I mean, what is “burnout” other than not wanting to work?

Burnout is more like desperately wanting to be able to work but a variety of things ruining your sleep, your concentration, your memory, and your health so that you can't.

During the interview, expect them to be fairly generous with accommodations; the disabled are a protected class and they're scrupulous about observing the rules.

In the workplace, it's kind of a double-edged situation. FAANGs and similar big companies will be really generous with equipment, accommodations, and so forth in general. On the other hand, if the disabled person isn't visibly (emphasis on visibly) as productive as others, well, they can become persona non grata very, very quickly. The disabled person is competing with non-disabled people who are smart, aggressive, and eager to get ahead (promotions and bonuses add up to big money), so expect no mercy beyond whatever little your friendships get you.

> "...life should be enjoyed and not sucked through because you're in some rat race with your imaginary/real competitors"

Reminds me of words from Mary Schmich's famous "Sunscreen" column (https://www.chicagotribune.com/columns/chi-schmich-sunscreen...): "... Sometimes you're ahead, sometimes you're behind. The race is long and, in the end, it's only with yourself."

Not sure whether I agree with you and her or not. Yes, the race is damned long and I recognize that it is ultimately only with myself. On the other hand, much like trying to beat your own high score, it can be kind of fun and, perhaps more realistically, like many I have nothing better to do.

> ...both depression and anxiety are extremely treatable.

When did that happen? As someone who has undergone treatment for many years and read a lot of the literature, the long-term success rates for treatment of depression are mediocre, at best.

And what does one do when one is struggling with burnout/depression/insomnia and the only legitimate thing to write down is "Not a whole lot really." for days in a row? (A problem a um, ... friend has, of course.) Risky habit to have under those circumstances.

> "...these summaries report that patient self- reported memory loss tends to be more persistent than the deficits that can be measured on formal neuropsychological testing. However, for those patients who do experience memory or cognitive impairment, they consider this to be a considerable source of distress for themselves and their families."

https://psychcentral.com/lib/research-findings-on-memory-and...

> "...We aimed to examine whether long-term effects of ECT on discrete memory systems could be detected in patients with B[ipolar]D[isorder]... Compared with healthy subjects, patients had verbal learning and memory deficits. Subjects who had received remote ECT had further impairment on a variety of learning and memory tests when compared with patients with no past ECT. This degree of impairment could not be accounted for by illness state at the time of assessment or by differential past illness burden between patient groups..."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911194/

I don't think there's sufficient evidence on the long-term effects yet and a high incentive for clinicians to reach for ECT as something that works when nothing else will.

I dunno; retaining functioning memory is rather important, particularly if one wants to hold down a job. Plus it doesn't jibe with the occasional anecdote of patients who report permanent cognitive dysfunctions after extended treatment.

Personally, I choose to believe my clinician, an experienced psychiatrist, who said bluntly to me "You don't want that. ECT makes you stupid." Loss of cognitive abilities is something I (and many techies) can't afford to risk.

As another data point, magnesium supplementation doesn't do squat for my depression. Reputable brand, used the glycinate form, proper dosing, etc. No perceptible effect.

> lisdexamphetamine

Out of curiosity, for those who use ADHD/ADD medications like this, do you get insomnia as a side effect and, if so, how do you deal with it?

The one time I was prescribed this type of medication, I was still terribly unfocused during the day because I was barely getting any sleep even after lowering the dosage considerably.