How Silicon Valley is dealing with mental illness

http://money.cnn.com/2016/02/10/technology/silicon-valley-depression-austen-heinz/index.html

by pshaw • 10 years ago

136 186 10 years ago

money.cnn.com

andrewvc5• 10 years ago

I've lost 2 people I know to suicide in tech. I've known others who've come close. We need to do something about it. What, I don't know, but mainstream psychiatry isn't that effective.

TTPrograms• 10 years ago

Why do you claim that mainstream psychiatry is ineffective? How do we know that people simply aren't taking advantage of mainstream psychiatry (to the degree necessary)?

mysticlabs• 10 years ago

A lot of people who commit suicide are typically on antidepressants and seeing therapists. Yet they never report this in the media. Antidepressants even carry a black box warning they can increase suicidal thinking.

Wouldn't surprise me if half the valley was on meds of some kind.

Psychiatry is mostly based on an unproven hypothesis of chemical imbalance in the brain. Of which there's no actual scientific evidence to back up this claim. In fact, studies have concluded antidepressants can cause imbalances where nonexisted before, and can cause severe life threatening withdrawals if you stop taking them suddenly.

Psychiatry is a pretty flawed practice in my opinion as well. I'm sure it helps some people, but it also does a lot of harm as well.

andrewvc5• 10 years ago

A starting point http://www.nytimes.com/2013/05/02/books/greenbergs-book-of-w...

jonesb62• 10 years ago

Anecdotally my personal experiences lead me to believe mainstream psychiatry almost always includes a bottle of pills.

0xcde4c3db2• 10 years ago

It's not so much ineffective as insufficiently effective. At least for mood disorders, most patients need to try more than one treatment regimen before finding one that works (in the sense of having a sustained and appreciable reduction in symptoms without intolerable side effects), and a substantial minority never find a treatment regimen that they're satisfied with. The biggest study on this that I know of is STAR*D, which focuses on depression treatments [1].

[1] http://www.edc.gsph.pitt.edu/stard/

andrewvc5• 10 years ago

The idea that there is one "mainstream psychiatry" is somewhat naive. It varies quite a bit from country to country, and the US does it somewhat horribly.

Don't take my word for it, the man who chaired the committee for the DSM-V thinks so (nd he wrote a book about it called "Saving Normal". Regardless of what you think about psychiatry from a theoretical perspective (e.g. what studies show), there is a MASSIVE gap between what practicing psychiatrists do and what happens in studies. As a country we are over-diagnosed (the DSM says x% of the population will have a given condition based on clinical research, yet somehow a massively larger # of people will be prescribed pills for it due to incompetent doctors and drug company advertising..

On top of that we have almost no idea what the mechanism of action is for any of these drugs. We take people, let's look at veterans for example, who have gone through traumatic events and say: "I guess going through that war there messed up some chemicals, take these!". It turns out there is a lot more in the way of treatment than just pills. At the same time these people are living in the streets and have no connection to community or family. There are more dimensions to mental illness than just chemicals in the brain. Here's an interesting non-pill related approach that's apparently helped some vets who were beyond treatment from pills ( http://www.nytimes.com/2016/01/31/magazine/what-does-a-parro... ).

Here's another example, in convenient peer-review form "The findings, from by far the most rigorous trial to date conducted in the United States, concluded that schizophrenia patients who received a program intended to keep dosages of antipsychotic medication as low as possible and emphasize one-on-one talk therapy and family support made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care." http://www.nytimes.com/2015/10/20/health/talk-therapy-found-...

Unfortunately I can only open the door here, the material is complex and voluminous. I do encourage you to research and read on your own. The foundations of mainstream psych in American are shaky, and drug companies truly have an undue amount of influence in shaping research and policy.

marincounty2• 10 years ago

Psychiatry is at the bottom of a deep pit. My hope is Millenials live long enough for this profession to pull itself back, at least half way up.

We were lied to about the effectiveness of SSRI drugs by the drug companies. Psychiatrists were as much victims as their patients. I don't blame Psychiatrists. I have the look on my Psychiatrist face imprinted, when I sat in that chair, and told him "That drug did nothing." It got to the point where I felt like lying. "It kinda worked?" But I didn't. It was my life--I wanted to get better.

I finally found a drug that worked, a little bit. I think that's the rub. You need to see a Psychiatrist to find a drug that works a little bit. Keep in mind that drug might be habit forming, so only go if you are certain your condition is Not Situational.

If your psychiatrist just offers SSRI's, ot tricyclics; find another Psychiatrist. If you do find a drug that seems to work, be prepared for mandatory office visits. They need to make a living. (These drugs should be regulated differently, but that's another fight. By regulated, I mean, if you are on a long term drug; you shouldn't have to see a psychiatrist to get refills.)

If I was to do it over again, I'm not sure I would take anything, but my anxiety was not situational. It came from "I have no clue. Just life?". I have found controlled use of alcohol helps. Try to keep the alcohol to a minimum. Two drinks for a panic attact. Don't drink socially. You are drinking to control that busted gasket. It needs time to heal. An understanding family really helps.

I have said this before, and I have no reason to lie. You will get better with time.

I have gotten to read my Psychiatrists face/non-verbal tells. I believe it when he says "Anti-depressants do work for some of my patients." I've looked into the litature, and they might help some really depressed patients? Might? If you are seriously suicidial go to the hospital. Don't rule out ECT. (Use it as a last resort, but don't kill yourself. Emergency room personal are prepared to deal with psychiatric emergencies.)

And again, if you are reading this and just not feeling right, a little dizzy, just not right; you will get better with time.

As to the original question; No--mainstream Americans does not need to see a Psychiatrist. Most good Psychiatrists only want to see the patients who don't respond to a Psychologist's therapy.

As to therapy--give it a shot, I guess? I found it completely useless. I think they did more damage to a once innocent twenty something mind? They might have changed? My psychologist was a Freudian. I remember making an a appointment with another Psychologist. "What's your reason for seeing Dr.whatever?" Me, "I was told I have a Electra Complex." Office, "A what?" It's funny now.

Good luck! If you know someone fighting these problems, don't give offer them worn our clichés. Whatever you do, don't take advantage of a wounded individual. I was financially abused at my worst. Will never forget that retched person.

0xcde4c3db2• 10 years ago

For all the faults and limitations of mainstream psychiatry (which are varied and substantial), it's pretty much the only game in town with a verified track record. Arguments against mainstream psychiatry are a dime a dozen, but arguments for alternatives tend to be fluffy philosophical assertions and broad-brush accusations of misconduct rather than real-world demonstrations that something else works significantly better (with N >> 1, of course).

andrewvc5• 10 years ago

Yes, but that's comparing mainstream psychiatry to an alternative. Compared to just not doing anything mainstream psych is often bad. See http://www.nytimes.com/2013/05/02/books/greenbergs-book-of-w...

spangry5• 10 years ago

On the upside, psychiatry and neuroscience are beginning to merge. The disease model of mental illness is such a poor abstraction. And diagnostics in psychiatry is mostly contained to subjective self-reported symptoms. And then treatment is basically a crapshoot; trial and error with antidepressants that don't have well understood causative mechanisms.

As neuroimaging becomes ubiquitous and cheaper, it will replace self-reporting as the primary diagnostic tool. At which point we'll be able to do away from the 'DSM disease model' and actually see which 'neural circuits' are dysfunctional. Consequently, medication will be better calibrated and targeted.

I really think we're on the verge of a psychiatric revolution, and will all be better off as a result.

throwawaymaroon2• 10 years ago

It would be more accurate and insightful, I think, to note that psychiatry is the attempt at a verified track record. It's not so much that it is the only game in town as it is the result of recording our attempts in a coherent fashion.

Its failures point to the difficulty of the problem more than anything.

Mz8• 10 years ago

One of the problems with mainstream psychiatry is that it does not work to pay someone to care. It also does not work to pay someone by the hour for this type problem rather than paying them for results.

I don't know how to fix it. I do think military shrinks have a better track record. They are still employed, even if you get better. They don't have an inherent incentive to want you to keep being in need of "help" so they can finance a second home or some shit.

superuser2• 10 years ago

Good therapists are overbooked and have waiting lists for new patients. They will be the same number of hours even with substantially less contact per patient.

such_a_casual7• 10 years ago

Sorry for your losses.

sarciszewski6• 10 years ago

Warning: Autoplay video.

chillwaves• 10 years ago

You da real MVP

goodJobWalrus• 10 years ago

It seems to me that suicide in tech is talked about a lot (more than in any other profession, except for maybe armed forces), but I have never seen data that it is any more common than in other professions. Can anyone point to some actual data on that?

awqrre• 10 years ago

I've heard that the more that you talk about it, the more it is likely to happen...

Mz8• 10 years ago

As someone who has attempted suicide and been hospitalized twice for being suicidal, I will suggest that how you talk about it is a huge factor in whether it makes it more likely or less likely.

tedks3• 10 years ago

This is getting downvoted, but it is in fact true. Copycat suicides are a very real phenomenon. In general, anything that heightens the mental availability of an action (how easy it is to recall) increases the probability of that action occurring. This causes news reports on suicides to increase incidence of suicide, news reports on mass shootings to increase incidence of mass shootings, and last but certainly not least controversially, violent actions in video games to be causally related to (though neither necessary, nor sufficient for) increases in violent behavior.

This is a basic fact of human neurology that many people have trouble accepting because of the illusion of free will they like to indulge in.

trafficjam301252• 10 years ago

It's disgusting and inconsistent that Y Combinator is claiming to be taking a stand against this when it sends people like Buchheit out to attack one of our most talented people, just because Paul Graham doesn't like what he says occasionally.

cpncrunch• 10 years ago

What are you referring to?

coddingtonbear• 10 years ago

I'm supposing he's referring to the public dispute Paul Graham and Michael Church have been having for some time.

dang10• 10 years ago

No more sock puppets, please.

MollyR• 10 years ago

My cousin used to work there as startup developer. He attempted suicide due to depression and loneliness. He was on SSRI's and Klonopin?. He had trouble with relationships, and was isolated from family (all on the east coast). My uncle brought him back, and our extended family has been taking care of him. He's doing a lot better.

I don't mean to be an armchair psychiatrist, but I think loneliness and or stress can exacerbate depression, and family or something like it can make a world of difference.

67726e• 10 years ago

At the very least, it doesn't help. I currently work remote, and I've definitely had more depressive thoughts being alone so damned much. I've also had plenty of thoughts when working in an office with lots of great people.

Part of me wonders if part of what makes me a good developer also hurts my mental health. I have to focus on the grin realities of a situation. I can't just pretend things are all fuzzy and nice.

Theodores2• 10 years ago

Yay! I like what your family are doing, that is fantastic. Keep up the good work. Those pills cannot and will not ever be a substitute for what you guys can do with the love that you are offering this cousin.

Hopefully it is not a one-way street, maybe through helping this wayward cousin your wider family have seen this 'getting better' and found reward in that, to be a happier family, even if there have been set-backs and disappointments along the way.

taurath3• 10 years ago

People don't talk about having anxiety or depression in the office, or mood changes. Its expected that you just hide it. Tech gives you more leeway to do your own thing most of the time which I'm thankful for, but I can't call out to work because I'm feeling extra anxious one day. I DO end up working at home those days, rare as they are. The stigma that would be attached to me as a "weak-willed" person that sometimes has anxiety issues would be devastating for my career - people do not allow others leadership positions unless they can demonstrate a steady hand. Simply the suggestion that you are facing internal strife enough to mention it in the workplace can be a very large hit to your perception as a solid worker.

Managers want consistency in the work output above all else frequently, despite all of our emotional hardware. Simply admitting that you have good days and bad days can sometimes feel like quite a feat.

whitegrape3• 10 years ago

Daily standups and a fear of being "caught" on those days where you maybe spent the whole day getting around to doing something that would take you 30 minutes in the zone add to the stress. Standups become vague/dishonest to further hide the issue. The truth is sometimes you just need to blow off the whole day, maybe even a whole few days. A lot of devs actually understand needing to take random days off here and there even without having underlying issues. But it's hard to justify to managers taking those off, even if unpaid (let alone a random week off after you've determined Monday morning you're just not into it at all). I suspect a culture of open slack would make the stressed out employees a lot less stressed out, but it probably isn't great for the business. There was a startup that was hiring in the Seattle area a few months ago that stated upfront they only sort of want you to work 20 hours a week, very loose, I wonder how it's going.

This is even worse when you're recovering from burnout. If you reveal you suffered from burnout and are still recovering, you're effectively admitting your productive output is some percentage of what it used to be. Even if you used to be above average, you're implying that you're probably below-average now, and it'd make more economic sense to replace you or at least pay you much less. (And I bet a lot of devs actually would probably give up half their salary in exchange for only being expected to be around half the time, which may be a good compromise.)

From the business owner side I sympathize with wanting to have a workforce full of Carmacks. But realistically speaking, that's very hard to accomplish, and there's something to be said for giving even us somewhat defective mortals something constructive to do so long as we're not contributing negative value that isn't based on pure economic utility.

gerbilly2• 10 years ago

A lot of devs actually understand needing to take random days off here and there even without having underlying issues.

Yeah a good manager should let people blow off a day or two once in a while. Especially since these days you are likely to get a text message at any time of the evening or even at night for you to fix something.

This reminds me of a time in 7th grade.

In that class we had these desks where you could flip up the top to access your books.

I was sitting next to Elissa who had a huge collection of wacky packages. [1]

You know how everything is funnier when you aren't supposed to laugh? Elissa and I both lifted up our desks, pretending to rummage around in there, and she would show me cards to make me laugh.

We both laughed uncontrollably and thought we were getting away with it too.

In reality there was no way the teacher didn't know we were goofing off, but since we rarely made trouble he just let us blow off some steam.

Each of us makes surplus value for the owners of the companies we work for. Humans need unstructured time, slack, to goof off, call it whatever you want, and not that fake nerf gun levity that tries to pass for it in most startups.

[1] http://www.wackypacks.com/

chipsy• 10 years ago

I like the "mob programming" concept because it offers a potential win-win here. Not that I've tried it yet... but it doubles down on what works with pairing and acts to diffuse the stress.

https://en.m.wikipedia.org/wiki/Mob_programming

sandworm1012• 10 years ago

> Daily standups and a fear of being "caught" on those days ...

Standups are mental health minefields. They are a hack evolution of an educational process best left out of the workplace. Law/med schools employ such tactics to deliberately create stress. That has a place in education, but to see it continue at a location where people work year after year is disturbing.

Startups that use standups also often miss the physicality of what they ask. They do not realize that they are disadvantaging people based on totally irrelevant criteria. There is a reason that, throughout history, people have sat down together to discuss important matters. Sitting is an equalizer. Sitting removes the threat of immediate physical violence. Save the standup confrontation junk for the courtrooms.

hackercomplex3• 10 years ago

I have a theory about this stuff. Some programmers who need to "blow off" a day here or there spend it by lounging around on the sofa playing video games. I don't mean to rag on gamers because I'm one myself, but the point is I'm fascinated by the fact that many video games are also "mental challenges" that are similar in several ways to computer programming and use similar parts of the brain. What factor(s) then make the game-play enjoyable while the heavy-lifting dev-work feels sometimes more tedious ? Maybe there is a way to adjust our methodology to feel more game-like, relaxing, and fun.

I think I've actually stumbled upon a way to do this, allow me to explain: If you start to read about the statistics around social dynamics in MMORPG games then certain things fall out of the data, and game makers have picked up on these ideas and used them to make their games more fun and addictive, and I think these same insights can be applied to organize software development.

Lets start with World of Warcarft. The statistics prove that World of Warcraft is a highly addictive game for many diverse people, but almost everyone agrees that if you were to join an empty server you would find that it's not an addictive game in one player mode. If you take this a bit further and say.. "ok, now you're on a server with other people, but you're not allowed to join a group, but you are allowed to conference with several players, exchange weapons and loot, and message individual players. Well I think in this scenario people would agree that the game does indeed become more fun, beacause now it's social, but yet it's not as much fun as regular WOW.

I'll just cut straight to the point: Pair-programming is more fun even when it's done remotely, because it's like real-time grouping in World of Warcraft. The problem is, just like in World of Warcraft not every group that you join will be fun! The enjoyability of a particular group will depend on both the obvious factors such as the weapons, experience, and spells that the other members bring to the table, but also certain social factors which are perhaps more philsophical in nature and therefor difficult to talk about briefly.

I think that there is real hard evidence that this strategy works, and because of this it's actually the gold standard for the world's leading web-dev consultancies, at least in the Rails space which is my center of gravity.

examples (in no particular order): http://pivotal.io/labs/process https://thoughtbot.com/ https://hashrocket.com/ https://www.thoughtworks.com/insights/blog/effective-navigat...

sarciszewski6• 10 years ago

I don't know how it is in the Valley, but if someone told me "I'm suffering from extreme anxiety and if I try to force through it I'm worried the quality of my work would suffer, can I take today off?" I doubt I would say no.

Depression sucks, anxiety sucks, having both can be personally and professionally catastrophic.

taurath3• 10 years ago

Most of the time its not extreme enough to take a full day off. It just means you run at 50%, or 30% capacity. But you can't really speak up about not having that capacity, and if you take the day off it comes out of your vacation. At the end of the week though, the work is done because you buckle down.

This is why open offices and daily standups and constant micromanagement are terrifying to me - everyone is VERY happy with my work output and I'm considered an A player, but if you watched me on an hour by hour basis you'd have a much different opinion of me.

mbrock• 10 years ago

For a lot of people with anxiety, I bet that message would be really hard to write if they didn't know explicitly up front that it would be accepted and understood.

dang10• 10 years ago

There was a not-bad post yesterday about talking about feelings at work: https://news.ycombinator.com/item?id=11070056. I don't know that I'd want to have a formal check-in process, but I look forward to the day when the barriers between emotional and professional expression aren't so rigid. It seems obvious that we're headed that way.

Imagine that you actually could "call out to work because [you're] feeling extra anxious one day". What else would be different?

13of402• 10 years ago

You totally can, and it's even legally protected:

"Hi all - Woke up this morning not feeling too well, so I'm going to stay home today. Thanks, Mike."

I had a therapist tell me a few years back that I should call in sick every once in a while and go do whatever I want for the day, guilt free. Best advice I ever got. Doctor's orders.

qjighap• 10 years ago

I find the stigma might be something to embrace in a non-emergency. While employers should absolutely keep an open-door and a supportive policy to these kind of issues, your friends and co-workers are not your psychiatrist or other mental health professional. Telling a depressed person that they should go home and relax with a stiff drink seems like a unreasonable thing to say, it has only become so (relatively) recently.

I will also mention that some people have boundary issues due to various conditions and a employer/employee relationship can not support a healthy recovery. Similar to how some psychiatrists don't take their patients out socially.

I mention all this as I hope that it makes it your choice to not share and not a onus to stay perfect all the time.

girvo• 10 years ago

People don't talk about having anxiety or depression in the office, or mood changes

Thats one of the many things I love about where I work currently: we can, and do, all the way up to the top. It makes life a lot easier when I've been able to be open and honest about why things are they way the are at a certain point in time.

calibraxis• 10 years ago

And it's not just depression — also aggression. Being aggressive spreads mental illness to others fast.

humanrebar6• 10 years ago

What does that mean?

20years• 10 years ago

I may get down voted for this but I wonder if this is partly due to the false hype that is associated with being a software developer in Silicon Valley. Young kids with stars in their eyes go out there thinking they are going to hit it big with their startup or working for a hot startup only to discover it is not so easy.

It would be interesting to see stats of suicides or attempted suicides for tech workers in Silicon Valley vs other areas. If much higher in SF to the ratio of workers then that should be something to look at.

pmorici• 10 years ago

When you get out of college and enter the work force it is also the first time a lot of people will really see the world as it is instead of how they were taught it was. That can be depressing.

eruditely2• 10 years ago

A mental illness that is actually dealt with perfectly with the line of medications on the shelves is ADHD, in which you get symptomatic remission as long as it's in your bloodstream.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3568402/

It's not only severe, but will pretty much screw you up(not being able to perceive time and act on time across long distances and all), but hey it works!

Nothing else works as well as what's available for ADHD for other mental disorders.

http://www.medicalnewstoday.com/articles/289931.php <-- Showing that adhd doubles your mortality rate compared to the general population. Here is the abstract

http://www.thelancet.com/journals/lancet/article/PIIS0140-67...

unimpressive3• 10 years ago

It's not only severe, but will pretty much screw you up(not being able to perceive time and act on time across long distances and all), but hey it works!

The medication, or the disorder? Because that's a pretty succinct description of ADHD.

eruditely2• 10 years ago

The disorder.

gizi2• 10 years ago

Many things can help you to overcome feelings of depression. It is not an issue impossible to address. However, what certainly contributes to it, is social isolation. Therefore, the rampant individualization of western/urban society badly exacerbates the problem. Nowadays, many people do not even have something like a wife or a husband. Gone are the days when people would share their lives with someone special to them. They are too immersed in hardcore individualism for that. Another issue contributing to the problem is the lack of spirituality. People often underestimate the therapeutic value of things like religion. Growing levels of atheism and skepticism concerning the meaning of life take away this resource and in that way prematurely terminate lives otherwise worthwhile to live. Medication can obviously do its part to assist with depression, but not on top of the ruins created by hardcore individualization and totalitarian de-spiritualization.

gerbilly2• 10 years ago

I myself now know that I self selected for software development _because_ of my anxiety, and I think anxious people might be over-represented in the profession.

As we all know programming is complicated, and even the simplest algorithm can produce wildly unexpected results. Anxiety makes you better at detecting danger, and in the realm of software the danger is bugs and bad interactions and so on.

We all approach programming differently, there are some deliberative types, some who wing it etc, but I expect that anxious people may be a big sub-population.

(Also if someone is anxious, it doesn't necessarily mean they are socially anxious or shy. I myself seem 'normal' and can be gregarious and give talks, but I do have trait anxiety.)

orionblastar2• 10 years ago

I was doing alright until from the stress I developed schizoaffective disorder. I ended up on disability. Once people know you are mentally ill they don't want you around as an employee and find reasons to get rid of you. HR finds out when a doctor diagnoses you and you get psyche medicine on your health insurance. Then you are seen as a liability. So a lot of people don't seek help for fear they might get fired and not be able to work again.

This has to change in the industry so that mentally ill people get help and support so they can keep their jobs and contribute to the company.

When companies think about disabilities they think about people in wheelchairs, the deaf, the blind but not the mentally ill who have a hidden disability and still need support and accommodation.

nradov• 10 years ago

I find it hard to believe that your health insurer informed your employer about a prescribed medication. That would be a serious violation of federal law and most insurers are careful about compliance. More likely your employer found out some other way, or fired you for a different reason.

orionblastar2• 10 years ago

Maybe they found out another way? When I got sick I filed for short-term disability in June 2001. I had doctor's excuse notes, and one of them was from a psychiatrist. I returned in November 2001 and was fired after being back on the job for two weeks. They claimed to have lost my doctor's notes and claimed I did stuff at work during the days I missed. When it went to unemployment the state sided with me as their days conflicted what they claimed, including I was in a hospital for some of the days they claimed I did stuff at work. Someone visited me at the hospital and asked me questions and wrote things down about me. I never knew who they represented. They might have found out by that way.

Anyway since they had the conflicts in the dates, I should have filed a suit with the EEOC. But somehow they knew I was mentally ill and tried to get rid of me because of it. At work I had an episode where I heard two airplanes crashing into the building, so people knew I was hearing things. That could have tipped them off as well.

donretag• 10 years ago

I find this article ironic since every time I visit San Francisco, I see loads of homeless people, many with mental illness, on the streets. I guess Silicon Valley only cares when it is their own.

dang10• 10 years ago

"Only" is a bit uncharitable. The one doesn't exclude the other.

Mz8• 10 years ago

You know, I have had a class on homelessness through SFSU and I have spent a bit over 4 years homeless. I am still on the street. A few facts:

The problems of homeless individuals are typically intractable and not readily solved.

They often gravitate to larger cities both because you get to be more anonymous that way and because there are more support resources available than in a small town.

When I took that class on homelessness through SFSU, I learned that New York is about ten times the population of San Francisco and they have similar numbers of homeless people on the street. Part of the reason is the beautiful weather in San Francisco. You are much less likely to freeze to death there or die of heat prostration there than in most other places in the U.S. and it rains relatively little. Part of the reason is the generous benefits in San Francisco. It actively attracts homeless people.

When I first hit the street, I traveled from the East Coast to San Diego. It has less rain than San Francisco and a lower cost of living, but is a large enough city to have soup kitchens and other resources. I spent six months in downtown where there is a concentration if support programs, then traveled north as I became less needy. I later left the county entirely, seeking out a lower cost city, but one still large enough to have the resources I need and where I won't stand out excessively.

Although I fervently wish that there was not so much prejudice against me for being homeless and I fervently wish I could get more help, I mostly do not want charity. I mostly want people online to take my need to develop an online income more seriously. I wish people online, in places like Hacker News, were more capable of seeing me as an intelligent, competent human being who is medically handicapped, not an incompetent dolt and not "just a skirt."

I am on the street to get myself well. I very much need more earned income, a message that mostly falls on deaf ears while people treat me like a beggar, a charity case or a damsel in distress who is after their money. My pleas to help me figure out how to develop an online income stream of earned income are dismissed and ignored, often by the same people who would like for me to shut up and stop telling people I am homeless because they interpret that admission as a request for a handout.

I have had at least three friends offer me a place to stay. I turned them down. They were on the East Coast or the Gulf Coast and the housing would not have been adequate to my needs for other reasons. I very much would like to get off the street, but not at the cost of the health improvements for which I have paid such a dear price.

Your judginess of people in Silicon Valley is rooted in nothing but ignorance. It takes a lot more than good intentions and money to help people with long term, intractable personal problems. I absolutely would accept housing at this point, but only if it met the picky standards necessary to keep me healthy. This rules out both homeless shelters and rental housing. It is imperative that I somehow go from homeless to homeowner.

If you think you are morally superior to the people in Silicon Valley, feel free to stick about $50k or $100k in my PayPal account so I can go house shopping. If not, perhaps you can at least rein in your ignorant contempt for a city that has more homeless people than average in part because it gives them more support than average.

Outdoorsman• 10 years ago

Jobs in our industry are "intense"...

Speaking for myself, I chose this profession, years ago, because I loved problem solving, absolutely loved it...

I also knew I was the type of person who needed a certain amount of time away from other people, for long stretches of time, to "recharge" my social self...

Which means I am, at heart, an introvert...I need time away from people to be at my best....my wife loves me for that...I can't explain why, but she does...I married better than she did in my opinion...

Nevertheless, as our industry "speeds up" I wonder how many excellent "problem solvers" will be pushed beyond their "mechanical limits"...?

askafriend• 10 years ago

She probably loves you for that because she gets her own space too, to do things that she likes without having to constantly always think about this anchor of another person.

I'm horrified at the idea of being in a relationship where people don't get their own space to pursue their own interests and grow/learn together but also independently.

grimmdude3• 10 years ago

I post a lot of dumb comments on HN, mostly because I find too many people take things too seriously here. But anxiety is something that I can very much relate to being a work from home developer. I'm still learning the best ways to cope/treat, but I can't say enough about getting enough exercise. I definitely don't do it enough now, but when I do there's an unmistakable decrease in my anxiety level the following day. But I'm talking like running, or something else that really gets me exhausted; not just a walk around the block. I'm a skinny guy too, which for me is another excuse to not have to exercise; which I think is not uncommon amongst developers.

such_a_casual7• 10 years ago

Not to start a flame war with you, but in the hope that maybe I can make this panacea a little less popular I want to get something off my chest. Every time someone has a problem with mental health, whether it's depression, anxiety, drug withdrawal, etc the answer from the audience is always exercise.

I'm only one data point, but I've exercised more days of my life than not and have observed absolutely no difference in mental health between the me that exercises and the me that doesn't.

What about athletes: students-athletes, NBA players, olympians. Do they show a significantly lower rate of mental health issues?

This argument has been floating around in my head for a while. The reason I think this suggestion is harmful is because it is the most vocal and popular, and yet excludes anyone who already exercises.

Who is recommending this? My hypothesis is people who only exercise every once in a while and so they get a huge hit of endorphins and think, "Man if I did this every day I would feel great." Maybe, some people with mental health issues use exercise as an escape and are really recommending it for its temporary relief. But I'm just in denial about the majority of people being people who didn't exercise, were miserable/anxious/whatever, started exercising and now they're happy/normal/perfect.

Again, I'm not trying to start any arguments here. For those of you who have been saved by exercise, I'm envious. I would really just like to see more answers than this instead of seeing it as the go to answer. It makes the assumption that people who have mental health issues don't exercise.

andrewvc5• 10 years ago

If I had to guess people at the highest level of any profession are more likely to have mental issues. I wouldn't say that looking at the mood of Olympic weight lifters would say a lot about the general population's response to exercise.

projectileboy• 10 years ago

I think you hear people recommend exercise because many of us in the tech sector don't get enough exercise, and for many it can make a huge difference. After I started jogging regularly a year ago, my depression lessened dramatically. But of course, everybody's different, so your mileage may vary.

PragmaticPulp3• 10 years ago

It's not uncommon for mild depressive symptoms to resolve with exercise. In fact, it's rare for exercise to not be helpful in depression.

But where most commenters go off the rails is in assuming that other people's depression is equivalent to what they experienced in the past, which couldn't be farther from the truth. If exercise produces a mild improvement for you and your symptoms were mild to begin with, you'll likely approach remission, which is awesome. But if your depression is moderate or severe, then intense exercise may only move you from "really miserable" to "still kind of miserable". Again, not arguing that exercise shouldn't be encouraged, but it's critical to remember that your depression experiences are not equivalent to others' depression.

grimmdude3• 10 years ago

Believe me I'm not saying exercise has solved my issues because it hasn't. But I know that science shows that it does in fact help with many mental health ailments such as anxiety and depression, and I'm merely noting that I recognize the benefit.

escape_goat3• 10 years ago

It's a legitimate answer in that, given any of those --- depression, anxiety, drug withdrawal --- you will probably quite literally feel better, more often, if you exercise than if you don't.

Of course, the same is true of someone who is experiencing no mental health problems. But although someone without mental health problems perhaps ought to exercise, and probably would enjoy both a significant improvement in mood and a reduction in stress levels; that person nonetheless doesn't need and hasn't been identified as someone who needs a significant improvement in mood or ability to cope with stress.

To my understanding, the reason that exercise is mentioned so often in the context of mental illness is that (a) it very, very likely to have a definite and subjectively detectable positive effect (unlike many potential medications), (b) it has very few potential negative side effects, (c) it may improve the body's ability to metabolize some drugs, (d) it is something that the patient can have control of, (e) it can add some structure to an otherwise unfocused life. Although it might have a "tipping point" effect for some people at some times, and some people may associate it with the end of an isolated episode of chronic depression, I don't think that it is often recommended (by doctors) in the hopes that it will 'cure' mental illness, per se. It can help treat it, and it can help treat confounding factors like lack of purpose, lack of success, lack of agency or autonomy, lack of social contact... et cetera.

I'm sorry that exercise doesn't provide any positive benefit for you. It's not entirely clear whether you're comparing sustained periods (on the order of weeks or months) of low exercise to periods of frequent exercise, or whether you're expecting to find a difference between a day on which you exercise and a day in which you don't. From my experience, I tend to think of it as a general metabolic effect. It's possible that it genuinely doesn't or won't help you; it's possible that you do exercise more than enough, and that you might (or might not) feel worse than you do now were you to cease exercising entirely.

I certainly share your frustration with people who deflect conversations in the direction of exercise as an answer to (let alone cure for) mental illness, most especially when they are proposing to "solve" a problem that they themselves have not experienced or have no substantive knowledge of.

bjwbell2• 10 years ago

What actually made a difference, for me, was changing my work. My dad experienced this too. If you're depressed maybe you need to change your life, this is hard. It was for me.

fapjacks3• 10 years ago

I have been diagnosed with PTSD after many years in the infantry and being deployed many times. While I still believe that exercise is the best medicine that has -- for most people -- an immediate benefit (in addition to something else, which I will talk about briefly at the end of my post), there was a period of my life when I ran five miles a day and still could not shake the crushing anxiety and depression. At the time, there were some added stressors piled on top, a death in the family and my ex-wife had left me. I had exercised myself out of depression/anxiety previously, and so was dismayed to find it not working during this period of my life. This is one of the worst times of my life. I would go to the psych and get so angry because there was nothing for them to do. The only thing that worked for me were benzos and time, and in retrospect I believe the benzos were a huge mistake and the reason I do not remember the first six months of 2011. The benzos did help somewhat, but I was also set up for failure by the Army docs, as I had totally forgotten my supply when I went overseas and came off of them cold turkey and almost died. I was totally unprepared for that, having been given no warning. I wasn't educated enough about the drugs they were supplying. I wish I had better advice in this lengthy story, but when I have friends or family contact me and tell me that they know someone who is going through a lot and exercise (and sleep and proper diet) are not helping, I can only answer with "time" and that is unfortunate. My other suggestions are psilocybin mushrooms or MDMA. This may prove to be extremely unpopular here, but I would say my own life has been saved by the use of those two things and almost nothing else. You can google for research done by MAPS (in fact I was enrolled in one of their pilot research studies looking at the efficacy of MDMA in treating PTSD and anxiety). And while I must warn you against breaking the law, please buy a test kit from DanceSafe.org and know what you're putting into your body. I guess with this post I am only trying to say that I understand where you are coming from with this, and I'm really sorry exercise isn't more helpful for you.

johnchristopher• 10 years ago

What about athletes: students-athletes, NBA players, olympians. Do they show a significantly lower rate of mental health issues?

We have this testimony from Pete Sampras: [Letter to My Younger Self](http://www.theplayerstribune.com/pete-sampras-letter-to-my-y...)

HN discussion: https://news.ycombinator.com/item?id=9803867

kaitai• 10 years ago

Exercise is shown in a number of clinical studies to benefit people who have ADHD, depression, anxiety, etc.

You know one thing those studies do, though, that we don't on HN? Screen every participant to make sure they qualify. Those screening tests take out people who don't meet clinical definitions of (ADHD, depression, anxiety, etc.), screen out people with physical problems that prevent them from completing the protocol, and then track participants.

Exercise is good medicine, but it's not the only one -- and the parent post here points out that sometimes it isn't the answer at all. For an anecdote I'll pull out a friend diagnosed as "just depressed" -- stomach hurt, some tough family situations. "Exercise! It'll help!" All the running, swimming, rock climbing in the world didn't really help. You know what did? Two surgeries to take care of the endometriosis that wasn't diagnosed for 6 years.

We're complex creatures. Try exercise: it's cheap, don't need a prescription, might have benefits esp if you form more social ties while you're at it. If it doesn't help, don't ignore that -- keep looking!

spangry5• 10 years ago

Anxiety/Panic disorder suffer here too. I've found the same: exercise is definitely helpful, but unfortunately not sufficient in my case. If you want to try in addition: I've found mindfulness meditation to be extremely helpful, perhaps more so than exercise. It's torture at first (who knew sitting still could be so hard), but once you get in to a routine (even 10-15 minutes a day) for a few weeks you'll notice a difference.

Feel free not to answer if you're not comfortable, but would you say your anxiety is more 'mental' (e.g. catastrophic thinking) or 'physical' (e.g. shaking, butterflies in stomach etc.)?

grimmdude3• 10 years ago

Interesting, I'll have to give that a try. I'd say my anxiety is a mix of both mental and physical symptoms.

amelius2• 10 years ago

but would you say your anxiety is more 'mental' (e.g. catastrophic thinking) or 'physical' (e.g. shaking, butterflies in stomach etc.)?

Not the parent, but are there different types of anxiety?

For me, the most prevalent effects are faster heartbeat at anxious moments (this even happens in the morning after waking up) and elevated symptoms of tinnitus and muscle pain in the neck.

Interestingly, working hard mentally seems to make the anxiety go away, but at the end of the day it hits me back hard.

I wonder how such symptoms would be classified.

aswanson• 10 years ago

A lot of it comes down to exercise and diet. Skipping breakfast after a night of drinking can lead to a low level of blood sugar; this gets worse as we age and has the effect of depression. You have to closely monitor your blood sugar level, even if you have never been diagnosed as having any psychiatric precondition.

gizi2• 10 years ago

Besides diet and exercise, there is also the issue of social hygiene. Many people have become hardcore individualists. They do not even have a husband or a wife, let alone have meaningful interactions with other family members. You see, regular sex is not just a way of having fun. It is also something that contributes to your mental well being and assists in keeping you out of depressions and other mental issues. The same holds true for meaning-seeking spirituality such as in religion and meditation. It is one of the things that helps keeping you mentally healthy. For hardcore individualists and anti-spiritualists is their entire lifestyle that is in question.

xxpor• 10 years ago

So not being married is a sign of being mentally ill?

humanrebar6• 10 years ago

The same holds true for meaning-seeking spirituality such as in religion and meditation. It is one of the things that helps keeping you mentally healthy.

Ironically that's a fairly meaningless statement. "Finding meaning" can actually be counterproductive if I find a self-destructive meaning or one that hurts the people I care about.

Now if you mean we should break out of day-to-day scurrying about and searching for actual truth... I can buy that. But I've seen people "find their own meaning" with catastrophic personal consequences.

PragmaticPulp3• 10 years ago

I won't disagree that diet and exercise are a great way to improve your physical and mental health, but you can't equate low blood sugar with clinical major depressive disorder. MDD is much more pervasive, consistent, and miserable than the effects of transient hypoglycemia. And major depressive disorder certainly doesn't remit by having a meal to raise your blood sugar.

lr4444lr• 10 years ago

... Let me guess, by moving those afflicted into management? As for the founders, isn't it expected to some degree?

PragmaticPulp3• 10 years ago

The comments here are a great example of why mental health treatment is such a difficult problem for the tech crowd: Most of the comments are from people who believe they have a better handle a mental health diagnosis and treatment than actual psychiatrists, and many of them are quite wrong. Some of them dangerously so.

Depression, anxiety, suicidal ideation, ADHD, and other mental health issues are extremely complex issues that can't be universally explained away by blood sugar or lack of spouses or loneliness as some of commenters here confidently claim. Every case is different, every person has their own complex set of issues and maladaptive coping behaviors and external stressors, and everyone responds to medications and lifestyle changes differently. Perhaps more importantly, navigating all of those individual variations is best left to a close patient-doctor relationship, leveraging each patients' feedback against the doctor's years of clinical experience.

The mistake many people make is trying to map others' mental health disorders on to their own prior experiences. That's why you see so many comments from people confidently declaring that curing depression is as simple as exercising because they felt sad a few years ago but felt better when they started running. That's great, and exercise is likely to help everyone, but that doesn't mean that another person's depression is simply a lack of exercise. Don't ever discount or downplay another person's mental health suffering, because that's only going to make things harder for them. Mental health sufferers often feel significant guilt about their symptoms, and having someone dismiss or downplay their suffering only compounds that.

Modern psychiatry isn't perfect and has plenty of room for improvement, but frankly it's a whole lot better than the comments here make it out to be. If you're struggling with mental health issues, make it a priority to see a professional. Get a second or third opinion if you're not happy with your treatment. But whatever you do, don't get sucked in to the misinformed internet commenters trying to discourage people from seeking treatment. Psychiatry can take some time, but the area under the curve of even marginal mental health improvements can add up to a huge difference over the course of your life.

milkytron• 10 years ago

Your statements don't only apply to the tech crowd; I feel as though what you just said could easily be pasted across the web to provide a huge amount of help to anyone suffering from symptoms of mental illness. I am no expert, but this certainly helped my understanding of the issue a great deal, and I'm sure it would for others as well.

phaus3• 10 years ago

I'm not saying people in the comments are any good at helping people with mental illnesses, but from my experience the professionals are pretty fucking terrible at it too.

I'm autistic and my wife has PTSD and anxiety disorder. She's been through about 6 therapists, all of whom were highly recommended by other people we know or other therapists. We've been to three marriage counsellors. I've been to a therapist that was an "autism specialist" who told me after speaking to me for 3 minutes that I'm not autistic because I have at least 1 friend and I'm married. Perhaps these were all smart people, but between the 10 of them, they have so far been completely unable to help my wife and I with any of our problems. We've been throwing a small fortune at our various issues, and our lives are still a nightmare.

I'm even about to pay 10-15k out of pocket for a fucking therapy dog that's probably going to be a waste of money, because we are desperate and the professionals aren't very useful.

Spiritus• 10 years ago

What's the difference between a therapy dog and a regular dog?

lentil_soup• 10 years ago

Can I ask why you think you're autistic if therapists tell you you're not? Or was it just that one?

throwawaymaroon2• 10 years ago

I don't think it's particular to the tech crowd, and I think it's a stumbling block even for psychiatry.

The problem is that psychiatry as practiced is an attempt to solve people, and people can't be solved; or if they can, it is unique (as you say) to the individual.

And really you're no different: you're giving out advice to people on how to manage their mental health. Your advice is harmless from a societal perspective in that it's literally what psychiatrists want you to be saying.

That doesn't mean you're not one of the misinformed internet commenters. It's not universally applicable. Most people don't have the time and money to shop around, even if the actual problems of their mental state allow them to seek help.

You can't come up with the words that are going to make people better. Nor should you be expected to!

Recognizing that psychiatrists are the ones we pay to be expected to act to make people better and they are themselves human and subject to human failures: this, I think, is why criticism of psychiatry emerges in topics like these.

I'm not disagreeing with your general advice, just criticizing your smugness and certainty in your opening lines. You're not better at this than we are just because you're giving the generic safe advice.

such_a_casual7• 10 years ago

I think the real issue is that whether they are psychologists or psychiatrists, there seems to be no accountability in the field (outside of extremes like malpractice) in terms of whether or not they actually provide any value to the patient. If someone goes to a psychologist for 20 years and at the end of it they're still just as bad as when they started, there's no, "I'd like my money back from the last 20 years". Sometimes a professional might not know if they can help, but even if it becomes obvious to them that this is someone they can't help, they don't say, "I'm unable to help you. Stop being a customer." They just continue down the path. This isn't to say that most mental health professionals are taking people's money without actually doing anything (I have no idea if that's the case), but rather it's difficult for the patient to know if they are actually getting any help, it is difficult for the patient to hold the person accountable if they don't get the help they expected, and it is difficult for the patient to even know if they're right or wrong about the matter (since they are not the expert). This makes it easy for the patient to doubt and blame the mental health professional or the entire field, there's just so much grey area.

bcarlyle• 10 years ago

I'm a clinical psychologist who was in charge of the largest randomized controlled trial of online cognitive behavioral therapy for depression (n=500).

There is nothing that annoys me more then the every person is a special snowflake argument for why we can't use standardized treatment for mental health problem.

Exercise works really well for curing depression. I talked to a depressed patient yesterday who had no idea what he could do to combat his depression. I finally convinced him that if he couldn't think of anything else to do he should just try going for a walk and he told me later that it really helped.

I've had that exact conversation a hundred times.

Almost all patients I meet have the faulty belief that they are special. That they function in a way that is different from others and that often make them resist treatment.

Your head is connected to your physical body and therefore we can figure out what helps for everyone in the same way a doctor knows what to do about a broken foot.

Did you know that almost half off patients who suffer from anxiety take too shallow breaths and this creates respiratory alkalosis that creates a lot of the anxiety symptoms.

Did you know that by breathing calmly you will cure yourself from panic attacks? Forever.

Did you know that psychologists know how to cure insomnia in a single session?

The biggest hurdle to overcome is the idea that there exists a magic barrier where your disorder goes from being something that you can cure yourself to something you need a professional for. The barrier is an illusion.

You always have the power to change your mood for the better.

I'm not saying that therapy isn't useful. It is extremely useful and helps people tremendously.

I'm saying that every single individual can make a conscious effort to focus on improving their mental health irregardless of the fact that they are seeing a therapist.

Also. Almost every single person is illiterate about how to treat mental health problems.

I've been a fairly happy person all my life and I believe I owe it to the fact that I developed excellent coping mechanisms.

If you haven't got those you need to learn them. Once you have them it gets much easier to have good mental health.

I'm actually working on building free online treatment for depression right now. It is a work in progress but if anyone is interested they can check it out here.

https://getpsychologistsnow.com/cbt/depression/

nikmobi• 10 years ago

Did you know that psychologists know how to cure insomnia in a single session?

Can you please elaborate more on this point? :)

alanctgardner3• 10 years ago

I'm a clinical psychologist who was in charge of the largest randomized controlled trial of online cognitive behavioral therapy for depression (n=500).

Peer-reviewed study, please?

every person is a special snowflake argument

Right off the bat, you sound like a condescending asshole. I would never go to more than one session with you if this is how you treat patients.

Exercise works really well for curing depression.

You really think you _cured_ someone's depression by telling them to take a walk sometimes? Granted, I find strenuous exercise is really helpful, but there are also days where you cannot will yourself out of bed to go to the gym. Having some asshole psychologist tell you that it's your fault just makes things worse.

Did you know that by breathing calmly you will cure yourself from panic attacks? Forever.

Yeah, tell this to my girlfriend, who gets _more_ anxious when she's trying to take deep breaths.

I've been a fairly happy person all my life

Because you never experienced significant trauma, you don't have an imbalance of chemicals in your brain, basically you just won the goddamn lottery. Do you take advice from people who win the Powerball about how to get rich?

I'm actually working on building free online treatment for depression right now

This sounds really admirable. Looking at the website, it's so cluttered and confusing I don't think anyone could benefit from it. And it seems like you're recommending that people contact you over Telegram? Like anyone? Just your formal patients? This is a giant ethical and HIPAA minefield, offering professional medical services via text message.

Malician2• 10 years ago

"Estimates say that 20% of all people experience depression at some point in their life. It’s a bit more common among women and half of all women experience depression compared to one in four men."

.5 women + .25 men > .2 all people

escape_goat3• 10 years ago

No offence intended, doctor, but I would like to see citations for a couple of your statements, specifically "by breathing calmly you will cure yourself from panic attacks..forever," and "psychologists know how to cure insomnia in a single session." These certainly aren't common knowledge, and they sound a bit overstated, while your broken foot analogy would not survive any degree of detailed examination -- as I am sure you know -- so I'm a but unsatisfied with your comment.

I'd like to suggest that your patients' beliefs might originate with a valid, correct observation from their lives; their experience is that they do function in a way that is different from others in their lives, and they have generally, in their lives, seen that those who have insisted that they do not function any differently, do not, in truth, actually understand their experience at all. I would suggest that you cut them some slack.

It's generally true, to my understanding, that one "always [has] the power to change [one's] mood for the better;" but its also true that human volition isn't very well understood, that self-control is understood to be a limited (albiet apparently trainable) resource that correlates strongly to blood glucose, that some people seem to have innately poorer impulse control than others, and that everyone experiences absolute freedom of choice at all times only in a crass and unsatisfactory Sartrean sense.

This leaves me wishing to suggest to you that you might want to avoid relative comparisons of mental health that admit a "strength of will" argument as to why one person might succeed in overcoming depression where another might fail.

I am sure that you do have excellent coping mechanisms, and I am sure that you are happier for it; I am sure that, by definition, most anyone would be happier if they improved their ability to cope with events in their lives; I am sure that every single individual can make a conscious effort to focus on improving their mental health. However, some will fail; others will fail to try. I am sure that you understand that it is nothing other than good luck that you were able to develop excellent coping mechanisms, even if it is a good luck that most people, perhaps even most people with mental health problems, might share. But your remarks make some strong generalizations and propose a virtuous course towards self-empowered mental health without being duly respectful of the actuality.

spangry5• 10 years ago

What's your view on use of medication to treat depression, anxiety disorders, ADHD etc? And just to be clear, are you categorically stating that any panic or depressive disorder can be cured with breathing and exercise respectively?

marincounty2• 10 years ago

Please tell me you are not a licenced Psychologist?

If you managed to get through med school, and finish a residency in Psychiatry; I have a money making idea:

Write a book on just how you got into medical school.

(Wow--could you imagine pulling out you wallet/purse after this session?)

Sorry dude, but please, see a psychiatrist. Bring this post.

such_a_casual7• 10 years ago

It's not okay to lie about mental health. This is a dangerous post.

If you are someone who read that post and are about to take what was said as fact at least google the statement that is the most obviously fake: "Did you know that psychologists know how to cure insomnia in a single session?" and in doing so remember the word that was chosen: cure. -------------------------------------------

Red flag: (you don't need help you can help yourself)

The biggest hurdle to overcome is the idea that there exists a magic barrier where your disorder goes from being something that you can cure yourself to something you need a professional for. The barrier is an illusion.

-------------------------------------------

To blatantly dangerous and false statements:

You always have the power to change your mood for the better.

From another one of this user's posts:

In the last 50 years clinical psychologists have figured out effective psychological treatments for almost all mental health problems and manualized them so a professional can know or easily look up the best way to treat a disorder.

and:

I regularly meet patients who are very depressed when we first meet who manage to overcome their depression in a couple of weeks.

Which would be like 2 appointments?

I would place serious doubt on anything this person claims.

raddad• 10 years ago

I'm actually working on building free online treatment for depression right now.

It already exists. 7 Cups of Tea

http://www.7cups.com/

"Glen Moriarty, Founder and CEO, is a psychologist passionate about the Internet’s power to help people lead better lives. He has been involved in a number of services and organizations that support people in need. 7 Cups of Tea is his most recent endeavor; marrying his background in psychology with his love for technology. "

Best explanation of depression I've ever heard/seen is "Andrew Solomon: Depression, the secret we share" https://www.ted.com/talks/andrew_solomon_depression_the_secr...

Dr_tldr• 10 years ago

Did you know that psychologists know how to cure insomnia in a single session?

I've spent quite a bit of time and money working with psychologists, psychiatrists, done sleep studies and kept up with the latest research, and there's nothing I'm aware of that would support your claim.

So, I have a few questions for you:

1) Peer-reviewed sources?

2) Are you concerned that making these kinds of claims non-anonymously without publishing any data to back it up could cause you to lose to your medical license?

bootload• 10 years ago

"Did you know that almost half off patients who suffer from anxiety take too shallow breaths and this creates respiratory alkalosis that creates a lot of the anxiety symptoms."

When in stressful situations, [0] 'take big breaths, then breath out', repeat. This should lower your heart rate by 10%. There's a nice overview explanation of "respiratory sinus arrhythmia". [1]

[0] https://www.policeone.com/Officer-Safety/articles/7811997-Ho...

[1] https://www.psychologytoday.com/blog/the-neuroscience-mindfu...

zwischenzug• 10 years ago

This is a really odd post. No citation for this trial, some very peculiar sweeping statements (pointed out by others), and a link to a website that looks more than a little hokey.

CBT is proven to be effective when the depression is low-level, ie not acute. Like when people can get it together to get out of the house and see a therapist. Really it amounts to little more than reversing the causality of standard behaviours (eg exercise to make yourself feel good rather than because you feel good).

The website linked to is extremely poorly written, and contains zingers like: 'The way out of depression is all about getting started doing all the things you once loved to do! Getting started is the hardest step but trust us, you will feel better after doing all the things you love!'

This is the kind of wonderful advice you get from people who've never suffered from crippling depression.

I'm curious to know which nation this person is a clinical psychologist in.

It's a shame because exercise is probably the single thing most likely to help depression. That and drugs.

jorgecurio• 10 years ago

hey guys I hope to offer some words of comfort.

The delusion is that life is infinite. It is not.

Especially so when we are young. As we get older, we feel like we are running out of time, we haven't done enough.

This is why I think some people commit suicide when their startups dont take off. They can't accept a reality that everything they are doing is ephemeral.

So when your startup fails, or some software you worked on for 4 years without any pay goes to shit because you couldn't get enough customers, brush this shit off because life and universe is ephemeral and even more so ephmeral are the failures to meet your own expectations and others. So what? Failing at startup isn't a fucking crime? There's no Russian mob coming to reclaim the "equity" that you owe them. Similarly if you succeed, the world just goes on. You might get cover, you might serve as inspiration, you will have changed your life and everything money can buy. But I think that in the end, if you think about it, money is important but not the entirety of our human existence.

At age 29, having boostrapped to failure for the past 6 years, I'm no longer hung up about it. Now this might sound like the fox claiming that the grape is sour because he can't reach it, but money, a single fixation on success or a particular product that you built (and you fall in love with your own creation), is unhealthy and frankly a waste of pure fucking energy.

This is why I've given up on chasing one idea or marrying myself to one goal. I'm also slowly turning my back away from bootstrapping and focusing on how I can raise money. The only painful realization is that I could've done 6 years of work in just 6 months with 6 engineers. Now that I've done the entire shit myself from the ground up, I have a pretty fucking good idea how to build something from scratch and turn it into a product. Startup is not a one man game, it's really coming together, sharing the pain and growing as individuals and as a group. Success should be the goal but I believe the process is equally important in getting to that goal. I may not ever reach it and that's fine. What's important is that I've tried the best I absolutely can and being proud of what I've built. That's all you can do and just walk away and keep going.

And don't get caught up with trends, noise, techcrunch and other non-essential activities that adds to the anxiety. Just do you.

Remember that life is ephemeral. Suicide is a permanent approach at a temporary problem! This failure, the stress, the depression, the mania, all this, even the lack of money...all of this is just temporary. Nothing lasts forever.

Theodores2• 10 years ago

I would like to invite some hackers out there to apply the 'hacker approach' of problem solving to the task of helping others that have depression. Please do so out of your own self interest (rather than pity, charity, guilt or social obligation).

At time of writing I only have two people that I go out of my way to 'level the playing field' for. This costs me time and money, real time and real money. For one of my 'clients' I have taken time off work to help them find a proper roof over their head and I covered a few bills to make sure that worked out (things like furniture and food in the cupboards had to be magically paid for). Notionally they are expected to do some work in my sister's allotment when the weather gets better to repay the favour. Obviously I won't hold them to that, this was just a creative device to move things along a bit without there being any feelings of pride getting hurt. Importantly I don't pass on silly advice, e.g. 'you should get a job...' blah, blah.

In this example, why bother??? I could have bought myself toys, or I could have gone on a really exciting city break given the time + money outlay.

Well, to answer that question, yesterday, this mystery 'client' of mine sent me through some jobs that they really wanted to go for. I was hoping that might happen in about 3 months time, no pressure though. But yes, I was delighted that, out of the blue, they should send this stuff through to me. We don't normally talk work, I assumed it was not what they were ready for.

I would describe my approach as fairly hands off, we text/message most days but not all. We do things together about once a week - meals, cinema, gigs, galleries and all those normal things that normal people do as well as just hang out in the reasonably appointed flat.

At the moment I am on a bit of a winning streak with this mystery 'client'. Health has been restored, which to me is quite a miracle, something I did not expect to see. Mystery 'client' also has friends and other social invites out, again quite miraculous given the 'no mates' start.

My 'clients' can be from any walk of life, any age, any gender. I mentor difficult teenagers too, one at a time, with work placement stuff. I am truly stoked with the success I have had on that front, the last two have been no-hopers, total worries to their respective mums. One of them is now at Oxford University, the other at Imperial College. I played a little part in that, helping them become sons their mums are truly proud of. I would say the process was 'osmosis' with no expectation of such stellar results.

Furry animals and elderly neighbours are also on the books from time to time. I am proud of all of them.

Sure I choose carefully, I do not reach out to those with alcohol dependency problems (I have tried though...). However, both of my current 'clients' would possibly be actually homeless without my on-going help.

So, for anyone reading this, please do reach out to others, even if it costs real time and money with no promise of results. Just imagine what the world would be like if everyone able to do so did go the extra mile to help out a couple of others with depression related problems. Imagine how inspiring the world could be.

tbrock• 10 years ago

Oh my gosh, Austen was in my class in college. I didn't know he had passed away until reading this article.

BananaPelican• 10 years ago

I wish that I could be more vulnerable with my coworkers. Last year I grappled with intense impostor syndrome that ballooned into generalized anxiety and depression, exacerbated heavily by the feeling that I couldn't let any sign of weakness through. Eventually I reached a breaking point and had to say something to my manager; fortunately he was understanding, but I still worry that his confidence in me has been eroded. My breakthrough came when I was given an important task. It seemed logically inconsistent for someone who was hanging on by a thread and really not an effective employee (my self-narrative) to be entrusted with a task that genuinely mattered.

I still feel weak for saying this, but hearing another person say, "It was hard for me when I first joined this team too. Don't worry, you're doing a good job." was all I wanted.

Is Silicon Valley unique in lacking this openness? I suspect not, but have no basis of comparison.

Infinitesimus• 10 years ago

I think it's up to us to begin to make that change in our work environments. I've made it a point to be a bit more vocal with new devs whenever I can about the reality of impostor syndrome and that it's 100% normal. Use your experience as a way to guide new hires on your company and slowly, change will come

lettergram• 10 years ago

There's a good book/presentation by Greg Baugues I saw a while back about developers and depression. Essentially, it's about how he had a lot of issues, how he dealt with it, and how we as a whole culture need to help improve repport about mental health.

https://vimeo.com/72690223

timwaagh• 10 years ago

I suppose they don't. but its still much better to dislike your life and be rich than to dislike your life and be poor. after all one can always get treatment after getting rich and retiring.

hackercomplex3• 10 years ago

I'll tell you an open secret: Focusing very intently on difficult maths for an extended period of time can make almost anyone begin to experience aspects of mental illness.

The physics community has dealt with this, DOD code breakers deal with it, the manhattan project, etc. It's a well studied phenomena because of how it related to the war effort and much of the research documentation is declassified, in the public domain, and is a matter of the historical record.

My point is software development is just another domain where this research applies. This information is generally recognized by the pop culture as evidenced by the fact that there are several blockbuster movies about it, for example the film 'Pi' by Darren Aronofsky and 'A beautiful mind'. However this phenomena is generally not accepted by the startup community. I assume that the reason for this is because recognizing it could theoretically lead to a rise in insurance cases by engineers who developed serious mental illness over time due to prolonged exposure to what were known to be unsafe working conditions. In my opinion it should be thought of as a high risk job akin to scuba instructor, or roofer.

So the whole thing is swept under the rug. Never the less I will give my recommendations as a developer who works all the time and has wrestled with this phenomena in the past:

- Force yourself to hike/walk/bike outdoors for at least an hour per day. I'm convinced that merely jogging on a tread mill or gym excercise does not have the same benefit. Think of the outdoors (and the sun) as a relief valve for the "cabin fever" effect.

- A daily Zazen practice (15 minutes+) This is the kind of meditation from Japanese buddhism where you're not trying to accomplish or "do" anything, you just sit, in a good posture. I think of this as putting your overclocked CPU in hibernate mode long enough for the heat sync to do it's thing. I think this can provide a similar effect to having had a couple extra good hours of sleep, and all it costs is a few minutes of your day. The more you practice it, the better it works.

- healthy diet and exercise

- yoga (or just plain stretching)

- Do not under-estimate prolonged caffeine consumption as a likely co-factor for many symptoms. Always eliminate this as a possibility whenever you can

- As a relaxation excercise take a break during your day and spend a few minutes in a quiet place directing your attention to any area of your back, neck, shoulders, or even your face whereever you expereince a sensation of pressure or weight. Sometimes just stopping to pay attention that these muscle groups are becoming tense is enough to help them relax some.

- super mellow music at a low volume even if it's not what you prefer generally can help when writing software. Classical music, downtempo, ambient, chill-out, atomospheric drum and bass, even unusual stuff like gregorian chant. It can be slow and boring, after all it's less about entertainment and more about the cumulative effect it has on your brain when used as background music.

example of downtempo genre: https://www.youtube.com/watch?v=tYdebVcZDPw

soma.fm/groovesalad plays a good mix imho. There's good studies on this on mice. A good rule of thumb is asking yourself this question "could this song be characterized as 'intense' in any way ?" if so then save it for some other activity

mettamage3• 10 years ago

Perhaps this link is slightly relevant. I just received it last night through an IFTTT alert.

exercise + meditation one hour for two days per week --> 40% reduction in symptoms of major depressive disorder.

To me the results sound a bit too staggering but the most interesting idea is that the researchers believe that exercise + meditation have an additive effect. So meditation or exercise alone is less effective than doing meditation first (breathing meditation, they didn't body scan) and then exercise right after it (running). In my humble opinion, that's an idea worth considering and that's an idea worth implementing in the company's culture. Provided that this study replicates well and is actually true ;)

http://www.sciencedaily.com/releases/2016/02/160210134834.ht...

Sam Altman suggested in Startup School to "fix it" (w.r.t. burnout) because when doing a startup you don't have the luxury of taking time off. This is a way of how to fix it, and if you don't have the luxury to take an hour off to boost productivity, then there's an uneven trade going on (more hours working for less productivity). It's not a silver bullet unfortunately, but then again what is?

thephyber• 10 years ago

I always find it curious to treat "exercise" as a boolean.

I have played basketball, football, ran cross country, multiple events in track & field, jogged, lifted weights, snowboarded, played ultimate frisbee, and done daily situps by the hundreds (a la American Psycho).

They all have a different affect on your body and they require differing amounts of preparation and concentration. I don't think all forms of exercise are considered equal and I suspect that different kinds of exercises would likely yield different results.

Notice that many of the examples of exercise I used are team sports and others are individual activities. I don't think this distinction can be ignored. Also, having concrete goals for exercise gives a person a different level of motivation than just a vague "allot X minutes in my schedule for some sort of exercise".

The idea of the combination of exercise + meditation is interesting. I feel like this would also lead to better sleep habits and more concentration and self-regulation of your schedule, which are both beneficial in their own ways.

mettamage3• 10 years ago

Good points. In addition to team vs. alone the other distinction could be aerobic vs. non-aerobic (emphasis on heart/cardiovascular system vs. emphasis on muscles).

humanrebar6• 10 years ago

In my humble opinion, that's an idea worth considering and that's an idea worth implementing in the company's culture.

Or just let people leave work at work. Give people weekends and evenings again. There used to be business hours (including being closed on Sundays) for a reason. Now, companies should be available more hours per week, but it's not healthy to ask individuals to be always on, or even always on call.

mettamage3• 10 years ago

That's one way of implementing it ;)

Good point :)

How Silicon Valley is dealing with mental illness

Related Stories