
Screw stigma. I’m coming out. - markmassie
https://medium.com/journalism-deliberated/6809e83f355e
======
ds9
This is admirable and I wish the author well. His example may also help
others.

It should not be taken as a signal that "outing" oneself is advisable for
others in comparable situations. This guy is very fortunate that he is well
established in a career and can point to good performance in his positions,
unaffected (from the employer's point of view) by his condition.

Others are much more vulnerable to prejudice and discrimination, and might be
better advised to stay closeted.

~~~
DanBC
US law means you must disose your illness if you wish to use anti-
discrimination protections.

(As I understand it; I am not a lawyer; corrections welcome).

~~~
chris_wot
That's absolutely ridiculous.

------
Jtsummers
One thing I'd like to add to this discussion. It may be difficult, and it may
not be something you should do until they're older, but talk to your children
about issues that you have and that run in your family. It can save them a lot
of heartache and difficulty down the road if they have similar issues. In
particular, knowing my family's history of alcoholism and drug abuse helped me
avoid both. Given my issues with depression, if I was drinking like my peers
in college, I probably wouldn't be here today. Similarly, I didn't know the
cause of their issues (depression) _until_ I was already deep into an episode
that lasted a couple years. If I'd known beforehand what to look out for, and
that it wasn't uncommon in my family, it might not have lasted as long.

------
milesf
I used to struggle with Bipolar Spectrum disorder. After 9 years of
medication, therapy, prayer, and a lot of ups and downs I've been declared
free of the diagnosis by my psychiatrist.

I gained a lot of weight because of medications (normal weight is 210lbs,
which is fine for my 6' 4" frame, but medication caused me to balloon up to
over 444lbs). I have not been able to work at my peak for many years. I'm now
almost 45, and I feel like I'm starting to get my life back. Now that I'm off
the main drug that treated my disorder (risperidone) my weight is starting to
drop.

I know people are scared of mental illness. I see it in their faces, or the
way they treat me differently as time goes by. But that's okay, I have close
friends who have accepted me for who I am without that fear.

My wife wishes I wouldn't tell people about my history. My health is no one's
business but mine. However, I choose to tell people about it, because of the
stigma. Because I'm neither ashamed or afraid for people to know. I _will_
lose friends, work, and opportunities because of my choice to be open about
it, but I don't care because I want to fight the stigma.

Everyone has a friend or family member that struggles with some form of mental
illness. Everyone. I have seen too many people suffer in silence, and some
even take their own lives because the pain is too much.

I was suicidal years ago. I suffered horribly for many months on end, waking
up in the morning and just focussing on getting through the next hour, until I
finally reached the end of the day and could go back to sleep so I could have
some relief.

There is no shame in mental illness. People used to be afraid of people who
had heart disease, as if they might "catch something" from them. The brain is
the most complex organ in our bodies, and it's prone to have problems just
like any other organ.

My name is Miles Forrest. I have wrestled with mental illness for many years,
and I'm happy to say I have overcome it with help from doctors, family,
friends, and God (if you're offended by my attribution to God, please don't
be. I respect a person's right to believe whatever they want, all I ask is
they respect my right to believe whatever I want). I can't say I'm cured,
because there's a possibility I might relapse at some point in the future. But
I have acquired the skills, knowledge, and support network that I know,
without a doubt, I would be able to beat it back down again. Mental illness
doesn't define me, but learning to fight, persevere and lean on others when I
need to has made me a better man.

You can mock or ridicule me if you want, but I'm not talking to you. I'm
talking to the man or woman out there who is afraid there might be something
wrong with their mind, and who feel alone and afraid. I know how scary it is.
I know how you feel like you're the only person in the world who has felt the
way you do. You're not, and you are not alone. If you are that person, email
me at miles@coderpath.com, and I will walk with you as a friend and stranger
to get you help.

~~~
comrh
I think one of the benefits of mental illness is it makes a person incredibly
empathetic and in tune with other people's pain. Being in such a dark place
and succeeding in getting into the light makes you want to save everyone from
ever having to relate your experiences.

It is still hard to be this honest and open. To put your full name on
something like this. I respect the hell out of you and we share a disorder,
thank you for your post.

~~~
dredmorbius
It depends on the illness. Psychopathy, antisocial personality disorder, and
similar diagnoses, are marked in large part by the _lack_ of empathy
presented.

~~~
comrh
That is a really good point and something I hadn't really considered. I could
also see a lot of my feelings of empathy being instead turned into anger if
things had been different so I might have generalized a personal experience.

~~~
dredmorbius
I'm well out of my pay grade, but with the various anti-social / psychopathic
disorders, it's not an empathy/anger axis so much as just _not caring_ about
consequences for others. It's a total disregard. More troubling: there's very,
very little by way of treatment for many of these disorders, whether you're
looking at pharmaceuticals or talk therapy. The DSM can make for interesting
late-night reading.

------
natural_capital
Showcasing your own story to set the precedent for people to acknowledge
mental illness as a real illness is a bold and admirable move. I would note
however, that the recovery process for every individual is wildly different
and shouldn't be overlooked.

Acknowledgement of the mental illness issue is one part of the problem, which
will hopefully lead to better, more integrated treatment lines in the future.

------
quanticle
This quote seems apropos:

 _Though many object to psychiatry’s perceived encroachment into normality, we
rarely hear such complaints about the rest of medicine. Few lament that nearly
all of us, at some point in our lives, seek care from a physician and take all
manner of medications, most without need of a prescription, for one physical
ailment or another. If we can accept that it is completely normal to be
medically sick, not only with transient conditions such as coughs and colds,
but also chronic disorders such as farsightedness, lower back pain, high blood
pressure or diabetes, why can’t we accept that it might also be normal to be
psychiatrically ill at various points in our lives? The answer seems to be
that psychiatric disorders carry a much greater degree of stigma compared with
medical conditions. People worry that psychiatrists think everyone is crazy
because they make the mistake of equating any form of psychiatric illness with
being crazy. But that’s like equating a cough with tuberculosis or lung
cancer._

[http://aeon.co/magazine/being-human/have-psychiatrists-
lost-...](http://aeon.co/magazine/being-human/have-psychiatrists-lost-
perspective-on-mental-illness/)

------
markbot
This was really well written. It says a lot of things that I feel the tech
industry tends to ignore.

------
teahat
Aside from medication, for OCD in particular there are therapeutic options
that can be (life-changingly) effective. The OCD centre
[[http://www.ocdcentre.com/about-us](http://www.ocdcentre.com/about-us)] is
one such place. If you think you might have OCD (last I read the incidence was
around 1/30) talking to someone about is the best first step. Especially as
one common and pernicious effect of OCD is that it will convince you that you
do not have it.

------
TAC1234567
This will not be a popular opinion, nor is it a nice opinion, but sometimes
the truth is neither and I think it is valuable to be explicit about these
things sometimes.

The "stigma" against mental illness makes sense in a lot of ways.

I do not mean: that the mentally ill deserve fewer legal rights than others,
deserve any kind of bad treatment or violence or ridicule, shouldn't be
"accepted", or bear any "responsibility" for their condition.

I do mean: life is full of subtle social contracts that mental illness often
causes people to flout. Mental illness (in many cases) makes people less
predictable and reliable. Harder to deal with.

Some people reading this will say "obviously that is true, which we all
acknowledge but have no reason to dwell on, and that is why it is a complex
situation that demands awareness". Others will say "that is false and you are
a bad person". First group, I refer you to second group.

If you are 100% committed to the goals of your organization (growing a
startup, winning a war, whatever), you will be very hesitant to add a mentally
ill person to your team/company/platoon. This makes sense. It sucks. Being
mentally ill sucks. This is one of the ways.

That doesn't necessarily mean anything needs to or can be done to change it.

~~~
thenomad
There's a huge list of highly successful, productive people who are a credit
to the projects they work on, who have or have had mental health issues in the
past.

If I had the chance, for example, I wouldn't be at all "hesitant" to work with
actors Hugh Laurie, Stephen Fry, or Johnnie Depp, despite all of them having
well-documented mental health issues.

I'd also be very happy to work with Richard Branson (ADHD), or if he were
alive today, Nikolai Tesla (OCD and anxiety).

~~~
TAC1234567
But these examples stand out because they are unusual exceptions.

Also, it is possible that acting is a profession unusually accessible to
people with certain mental illnesses.

~~~
thenomad
I've also worked with multiple people with various mental health conditions,
who weren't actors, but whom were extremely good at their jobs and I'd
cheerfully hire again.

Honestly, I've never seen a correlation between "mental health issues" and
"would not hire".

------
D9u
From day one here at HN my profile states that I am schizophrenic... Not that
it's done me any good here, but I don't see why I should hide this fact from
people I am likely to never meet in real life.

Kudos to those who could care less about social stigma.

------
h1karu
In case you never considered it before there is a heavy PROFIT INCENTIVE for
your psychiatrist to diagnose you with some form of mental illness that he is
familiar with. You need to become a domain expert yourself in order to figure
out if you're being manipulated for profit or if the diagnosis is legitimate.

~~~
cperciva
At this point, does it really matter if the diagnosis was legitimate? The
treatment clearly helped him improve his life dramatically.

~~~
h1karu
Fair enough, although I suspect it was the act of taking time to reflect on
his own inner processes which helped him and this could have occurred outside
of the context of a "diagnosis" and without drugs. It's sad that in modern
society people are trained to not talk to each other about their emotions and
feelings outside of the context of a "sick ward" where one party is being
financially motivated to behave in a certain way.

------
joyeuse6701
I enjoyed that read. I think the world is a better place getting to hear his
story.

------
insensible
It's wonderful to have a courageous person breaking the ice on difficult
topics. Bravo to Mark. And the love shown by his wife is deeply touching.

------
pyduan
This is a courageous article.

Sadly, it seems mental illnesses are one of the great taboos of today (and
don't even get me started on the state of mental health care in the US).
Similarly, mental illnesses are extremely misunderstood, and people tend to
distrust people who suffer from one even though illnesses such as depression
may affect 5 to 10% of the population [1] and as much as one in four adults
are affected by a mental illness in general in a given year [2]. A significant
portion of the population is affected, but for the most part it remains
unadvisable to talk about it. It's the elephant in the room.

This is compounded by the fact American culture in particular tends to
disproportionately value extroversion and appearance of happiness. This leads
many people to remain closeted by fear of repercussions, both on one's social
and work life. Even worse, it prevents people from seeking necessary help
because of the attached stigma ("but I'm not crazy!"). There are known cases
where people are punished for having seeked professional help. For exemple,
people who admitted to "suicidal tendencies", however serious, may be refused
US visas [3]. The discrepancy between how willingly people talk about their
trip to a doctor vs. a therapist is huge and obvious, and it shouldn't be.

Now why should this be relevant for the HN crowd? As someone who's very close
to these issues, it seems to me this is one of the few social issues where the
tech industry is not as progressive as it could be. Our industry tends to
produce myths of super(wo)men with alpha personalities; we admire leaders,
disrupters, bigger-than-life personalities, sometimes even assholes.
Furthermore, this is a small world where, for better or for worse, a lot
depends on word-of-mouth and personal reputation, and where "cultural fit" is
openly hailed as a criterion for employment despite the vagueness of the term,
which can hide what would otherwise be considered blatant discrimination (cf.
that article on ageism not so long ago). The same goes for founders: would you
think twice about investing in a non-established individual with a history of
OCD? Depression?

What I am getting at is that mental illness is a combination of
neurobiological and psychological causes, not a weakness in character -- but
in an industry that values strength of character above everything else, the
fact many ignore this can be extremely destructive.

We can do better. The author has done the world a great service by publishing
his story. I hope more follow suit.

[1]
[http://www.nimh.nih.gov/statistics/1mdd_adult.shtml](http://www.nimh.nih.gov/statistics/1mdd_adult.shtml)

[2] [http://www.nimh.nih.gov/health/publications/the-numbers-
coun...](http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-
disorders-in-america/index.shtml)

[3] [http://www.nolo.com/legal-encyclopedia/how-health-issues-
can...](http://www.nolo.com/legal-encyclopedia/how-health-issues-can-make-you-
inadmissible-the-us.html)

~~~
standupkid
Thank you for these comments. I really appreciate your thoughts.

------
vizza
ERP and mindfulness are really, really effective in treating OCD. I know,
because one of my children had a crippling case and now is free of it. I spent
several months at UCLA's Pediatric Intensive Outpatient Program with him and
have seen it work on about a dozen children. The same treatment can also be
used on adults.

ERP stands for Exposure and Response Prevention. The idea is that you
progressively expose the person with OCD to their fear(s), during which, they
cannot perform any compulsions. Eventually the brain is retrained and the OCD
falls away. For example, someone with a fear of germs would be asked to touch
a door handle and then not wash their hands for as long as possible. This is
extremely hard for them. However, this simple technique, applied over weeks or
months in conjunction with therapy and meds, can reduce a person's OCD to
almost nothing.

Another point is that the kids respond to the group setting. They form bonds
and support each other during the process.

The UCLA team is absolutely amazing at this:
[http://www.semel.ucla.edu/adc/ocd_treatment](http://www.semel.ucla.edu/adc/ocd_treatment)

If you have or know a child suffering with the disorder, please look into this
program or one like it!

If you have any questions for a parent that has been through this with a
child, contact me at capitalism99@gmail.com

------
JackFr
I'm not sure what to think about this. I accept that the author is suffering
and in anguish, and I truly wish him well. Despite his obvious accomplishments
and all the trappings of success, I would not trade places with him. His
subjective experience seems to be painful and is no less real to him than mine
is to me.

At the same time, I don't think he is ill. While I don't doubt that he is
suffering, I don't think it it is helpful to class his suffering as an
illness. I don't think anyone argues that his symptoms are caused by an
infection or a defect in an organ, so his disorder lacks the physical basis
for a typical illness. At the same time, he has symptoms. And therapy, and
possibly drugs, make him feel subjectively better. He chooses to engage in a
regime of therapy which (presumably) has self reported benefits.

But I don't think it is helpful to think of his plight like we think of
malaria or polio or heart disease. When we talk about 'emotional disorders',
we implicitly take on an enormous amount of cultural context as well as
normative judgements about how someone 'should' feel. And the danger is that
one will come to believe that an unpleasant mental state in an otherwise
healthy brain is something to be cured through the application of science.

That being said, I agree with the main point -- that there is no shame in his
mental state. I suppose my point is that it is not necessary (and should not
be necessary) to reclassify what a disease is in order for a class of people
to maintain their dignity. And above all, I wish this man well and by no means
mean to diminish his pain, or the courage it took to write this.

~~~
moron4hire
This attitude--that mental illness is not a real disease--is what helps the
stigma to continue.

You mince it up with nice words around the edges, but it boils down to this:
you're part of the problem.

~~~
JackFr
I would say it boils down to this: I believe that mental illness is
fundamentally different than infectious disease and defects and injuries to
organs, and it is not productive to treat them as fundamentally alike.

If that makes me part of the problem, I guess it's not clear to me what the
problem is.

~~~
Tenhundfeld
I will try to answer you authentically. Your belief is not _necessarily_ a
problem. Every illness is different; that's not really debatable. The problem
is how you treat people who suffer from an illness.

Imagine a friend is lying in bed and refuses to get up and go to work.

Let's go through some scenarios: 1) His pelvis is broken from a recent car
accident. 2) He has a fever and fatigue from the flu. 3) He has testicular
cancer and is recovering from yesterday's chemo. 4) He is depressed.

These scenarios are all fundamentally different. It's common for people to
have sympathy in scenarios 1, 2, & 3: "Of course you can't get out of bed,
poor fella'. Anything I can do to help?" It's common for people to be
skeptical and annoyed by scenario 4: "Why won't you just get out of bed? What
is wrong with you? Jesus, go for a walk or something. You need to get your act
together."

These responses are caricatures, but they represent "the problem" that often
results from people saying they believe "mental illness is fundamentally
different." Mental illness is not identical to other illnesses, but to the
sufferer, it is just as real and just as debilitating. The problem is that
people treat it as less real – not a disease but more of a personal failing
that needs to be overcome. You wouldn't tell a cancer patient to just get over
it, but for many types of mental illness that is society's attitude.

Does that clarify anything?

~~~
harshreality
_You wouldn 't tell a cancer patient to just get over it, but for many types
of mental illness that is society's attitude._

Of course, because we understand how cancer works, enough to know that wishing
it away, or meditating, is unlikely to address the problem, and has not been
scientifically demonstrated to fight cancer.

There's a spectrum of severity and causes of mental illness. In some cases a
patient needs to be medicated just to be able to get through a therapy
session; in slightly less severe cases therapy can be tried first, but perhaps
without medication the patient will never be normal. In a lot of cases, I
think probably the majority, patients on psychotropic drugs could improve well
into the normal range through therapy alone without meds. And there are cases
where a particular social environment—like a middle class urban lifestyle,
trying to make ends meet—may cause certain psychological disorders even when
the same people in a different environment would be perfectly happy.
Especially in that latter case, can that be called a "disease"?

If psychological intervention or environmental change is enough to turn
someone normal, what does it mean to label them "diseased" before the
intervention... particularly if the "disease" was due to bad prior
psychosocial development (bad parenting and/or bad school/peer environments,
generally), rather than genetics or something in the air or water? In other
words, if the same person had grown up in a different social environment, or
in a different culture, and failed to develop the psychological illness, can
it be called a disease or illness at all?

(Of course, availability of professional therapy, or peers or parents who know
how to intervene productively, may not exist in many cases. That's a separate
issue.)

Psychiatry does not really distinguish the forms of psychological disease
based on their likely cause, nor on whether they can be treated to acceptable
norms without medication. I think that's what frustrates a lot of people who
either object to, or are uncomfortable labeling DSM diagnoses as illnesses or
diseases.

~~~
DanBC
... But you can see that there's a difference between 8 hours of CBT (at one
hour per week with a skilled therapist) and someone saying "Cheer up!"?

I've met people who had severe OCD but who had their life changed by talking
therapy. I have no problem calling it a disease.

------
rokhayakebe
One thing I would like to offer would be for American doctors to perform
comparisons across cultures, countries, and societies. I am restricting the
above purely to mental illness. There are many mental diseases I only
witnessed in America, and not in Africa. I do not know what the meaning of
this observation would be if proven factual, but I think it is worth
exploring.

~~~
quasque
This is definitely an observed phenomenon, such illnesses are known as
culture-bound syndromes. There is the sub-field of transcultural psychiatry
which examines these and other cultural differences with respect to mental
disorders.

Out of interest, what were the mental illnesses you refer to?

------
Camillo
Speaking of stigma keeping people from seeking treatment, how does this
interplay with the fact that most people in America get health insurance
through their jobs? Aren't people afraid that some information will leak out
if they seek mental treatment through their insurance? And what about the
"counseling" services many large organizations offer?

------
DanBC
People say the treatment in England is much better, and it is, unless you are
under 18.

MH treatment is underfunded in England (and this has recently been written
into commissioning contracts) and it is worse for children and young people.

In patient beds for children are limited. A child who needs an in patient bed
may have to travel hundreds of miles to get that bed. They may even need to
travel to a different country.

A child in the south of England may not have a bed available anywhere in
England and might need to go to Scotland for a bed.

Apart from the obvious cost of distance and the distress of being so far from
home (although getting distance from an abusive home can be useful) that child
is now under a different legal system. Thus, the rules for detaining them
against their will; force feeding; forced medication; etc etc are all slightly
different.

~~~
vacri
I used to work in an outpatient neuro department that had a large paediatric
patient population. One of the paediatric neurologists there had done her
training at a famous children's hospital in London (GOSH) and said that it was
a fantastic place to train in, but terrible for the outcome of the children.

Where we were in Melbourne, we had four paediatric neurologists for a
catchment area of about 400k give or take. GOSH had six neurologists for a
catchment area of 2 million. "By the time the kids in London got to see us,
the symptoms were so florid and easy to see. Great for training, not so great
for outcomes".

She did her training in the 90s, so it may have since changed. It's also a
story about neurologists, not psychiatrists, but I imagine it wouldn't be that
much different.

------
mbesto
Someone very close and dear to me has a mental illness. She was super nervous
to disclose this to me for fear that I may think differently of her. The thing
she most appreciated about my reaction was that I said "Let me know if there
is anything that I should know about your illness that may affect you in a way
that may make you behave differently than you normally do, otherwise I will
behave and act as if it simply doesn't exist." Suffice to say, I don't
actually remember what illness she has.

------
comrh
Another "coming out" story is from Michael Landsberg, a Canadian hockey
analyst on TSN. His hashtag #sicknotweak inspires me when I'm feeling like
crap. [http://www.thelavinagency.com/blog-mental-health-speaker-
mic...](http://www.thelavinagency.com/blog-mental-health-speaker-michael-
landsberg-on-the-cover-of-vista-magazine.html)

------
ngcazz
Thank you for posting this.

The testimony on intrusive thoughts hits so close to home, I'm considering
seeking professional help. I wonder if there is a different way to think and
live!

------
michaelochurch
Cyclothymic. That's a bipolar spectrum disorder, but it doesn't match the lay
image of the manic-depressive. The episodes are milder and shorter, but they
come on quickly. A "depression attack" can last 3 hours, resolve in a panic
attack, and be gone 20 minutes later. Most people who know me wouldn't know
that I have it. The one "insane" thing I've done (trolling, back in the day)
had the specific purpose of keeping insanity out of my "IRL" existence.

As with all spectrum disorders, people seem to focus on the visible,
uncontainable, and publicly dangerous 0.1% and ignore that 99.9% of people
with the disorder or "on the spectrum" are not dangerous, wouldn't fit most
people's image of "mentally ill", and can be very well-adjusted.

I tend to think of mood disorders as anti-psychopathy. Psychopaths have low or
nonexistent mood and emotional sensitivity, which is why they're social high
performers and (if ambitious) excel in the work world. Some mood disorders
seem to be uncorrelated to context (i.e. episodes happen "for no reason") and
that's probably more true of the severe cases, but _most_ people with mood
disorders are normal people with hypersensitivity, such as the OP whose brain
would take personal criticism extremely seriously, unable to block it out or
cope.

Aaron Swartz comes to mind as a archetypical anti-psychopath. They tend to be
moralistic, less fearful of negative consequences when doing what they think
is right, and prone to mood and anxiety disorders. Anti-psychopathy isn't a
desirable thing. It can be just as ill-adjusted. Just as psychopathy tends to
be good for the individual (in terms of material prosperity, social rank, and
sexual access) but bad for society, anti-psychopathy tends to be good for
society but harmful to the individual.

What's happening right now, in Silicon Valley, is a battle to the death
between real technologists (who tend to be _anti_ -psychopaths) and the
mainstream business culture of entitled executives and board-whores
(psychopaths). With Snapchat and Clinkle setting the tone in the current
Valley, rents becoming unaffordable, and no-poach agreements all over the
Valley, psychopaths seem to be winning.

I think that mood disorders in particular require a certain balance. People
tend to do unwise or harmful things, especially when inexperienced, and those
with mood disorders are not exceptions. You have to own your actions, even if
you made them in a struggle that most people wouldn't understand. That said,
it's also important to realize "it's not me, it's them" and keep your pride
intact. Mental health issues often give you a front-row seat for how shitty
people can be when they think you're weak.

Much of what comes out of these disorders isn't harmful in the least. It's
just slightly embarrassing, but plenty of people will hang you out to dry just
because they're weak, useless cowards. This may be why people with mood
disorders (at least, the milder kind that won't interfere with ethical
behavior; a truly "manic" person, noting that mania-- not the milder
hypomania-- is very rare even in people with bipolar, does not know who he is)
tend to evolve into moralistic, hyper-ethical anti-psychopaths.

I'll give a semi-fictional example. Let's say you're a programmer and you have
a hypomanic episode. You still go to work, don't cause any issues, and spend 2
weeks building something you were never assigned to do. It turns out to be
really good work and useful to the company (as much, or moreso, than putting
that time in on your assigned work) but your boss is pissed off that you were
working on this side project, instead of your assigned work, and tags you as
"unreliable". A morally decent person would recognize that as wrong (it's
health discrimination, and counterproductive, to punish people with "creative
flare-ups") but, even still, stories like that are so common in Silicon Valley
as to be unremarkable. Anti-psychopaths tend to need an R&D environment where
they're measured by performance over time, rather than minute-by-minute
superficial reliability (at which they can't possibly compete) and those,
sadly, tend to be turning rare in the current anti-intellectual (and pro-
psychopathic) environment.

~~~
wdewind
> You still go to work, don't cause any issues, and spend 2 weeks building
> something you were never assigned to do. It turns out to be really good work
> and useful to the company (as much, or moreso, than putting that time in on
> your assigned work) but your boss is pissed off that you were working on
> this side project, instead of your assigned work, and tags you as
> "unreliable". A morally decent person would recognize that as wrong (it's
> health discrimination, and counterproductive, to punish people with
> "creative flare-ups")...

Isn't this behavior psychopathic by your definition? the person goes to work,
disregards agreements he's made with his coworkers and does whatever he wants.

~~~
Jtsummers
It depends on the why. Using michaelochurch's classifications.

Psycopathic: I break the agreement because I want to do what _I_ want to do.

Anti-psycopathic (particularly for the manic/hypomanic phase): I break the
agreement because my brain is creating thousands of ideas a minute, I'm
churning out code, I've solved 20 problems that we'd been having just this
morning, but none of them are my assigned task(s). It's almost a compulsion,
and not one driven from personal want. I don't _want_ to delay the actual
work, or procrastinate, but my brain keeps focusing on all the wrong (for
work) things.

EDIT: Another fun bit is the after effect. After that spirited creative
period, you realize what you've neglected and it feeds the part of the mind
pushing you into depression as guilt.

~~~
nostrademons
Outside people tend to judge you on what you _do_ , not on what you _intend_.
The latter is invisible to them - they can't reach into your mind and
understand what was going on. So from an outside perspective, someone who
breaks the agreement because they _want_ to and someone who breaks the
agreement because they mentally _have_ to is indistinguishable.

~~~
Jtsummers
This is true. First, get help from a therapist. Second, if you're finding
yourself unable to focus on the actually assigned work, but something still
useful, try to sell your bosses on it. If you can't convince them, and still
can't regain focus, hopefully your therapist/doctor can help you find a way to
regain that focus.

