
Founders and mental health - zt
http://blog.zactownsend.com/founders-and-mental-health
======
7cupsoftea
I'm really glad these issues keep coming up. I think it shows real growth in
our community. Many great points here, but I'll just highlight one:

"But whatever your particular problem is, I promise you, other people have it.
People in the community have gone through it. Many people have gone through
it, in fact."

The technical name for this is universality. It is one of the most helpful
parts of group therapy. You hesitantly share what is on your mind and then
suddenly discover that in a small group there are usually at least 1-2 other
people that can really identify with what you are describing. For us, as
founders or startup people in general, we can tell ourselves, "I'm really
struggling with X right now. Okay, it is very likely that many other people
are struggling with X right now or have struggled with X in the past. They've
made it to the other side and I will as well. It is just going to take time."

X might be normal startup concerns like growth, retention, co-founder issues,
employee issues, client issues, bugs, investor issues etc. Or, it might be
more personal issues that are often tied to startups: pressure, unrealistic
high expectations from self or others, stress, anxiety, depression etc.
Whatever X is, there are many other people that are currently experiencing it
or have made it through to the other side. It helps to know that we are not
alone and we can keep moving forward by taking one step at a time!

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robg
If I had one wish to come true it would be to banish the terms "mental health"
from the universal language. The mind is to the brain as the heartbeat is to
the heart, or if you'd rather a more historical example, the humors to the
body. Talking about the product is fairly useless if we don't work hard to
understand and treat the underlying causes. Unfortunately, where cardiology
came of age in the 1960s, neuroscience is about 30 years behind.

The brain is the organ here. We all have brains that get tired, damaged, and
diseased. Substituting "brain" within "mental issues", "mental problems", or
"mental disorders" would go a long way toward changing how we think and
address the underlying concerns. In fact, just simply talking about your
concerns is therapeutic. Good friends as in effect therapists. But who would
want to if they think they have a "mental" illness?

The brain is a bodily organ like any other. Let's start treating it as such -
get good sleep each night, exercise often, and maintain good friendships. If
all three of those are being met, and you are still concerned, absolutely talk
to your doctor. But keep in mind that depression and anxiety appear to now
follow from sleep disorders.

~~~
tomhoward
Having been working though brain & mind health issues for nearly 10 years,
trying a vast array of treatments and reading through a large volume of
research, I can say with confidence that this position is an
oversimplification.

I understand the point of view; for about the first 8 years of my journey I
treated it as purely a physiology problem - and I did make some progress.

But since more recently turning my attention to the concept of emotional
health - particularly subconscious linked to early-life traumas - the
improvement in my life has been far more dramatic.

I hope to write on this topic soon to explain my experiences in more detail.

~~~
robg
I don't see a disagreement with anything I wrote. Even emotional health is
physiological, most especially trauma. The autonomic nervous system impacts
every organ in the body. After over a decade as a neuroscientist, I don't know
what the mind is. But I do know what the brain is. And therapy, even self-
journaling, is shown to change connectivity patterns in the brain.

The problem is simply shown by the vast array of medical professions trained
to treat the brain: neurologists, psychiatrists, psychologists, therapists,
neuropsychologists, brain surgeons, and neuroscientists. By contrast,
cardiologists treat the heart.

To put into practical terms, increasing evidence is showing how sleep
disorders precede brain health concerns. The role of sleep appears to be
critical for trash collection at the cellular level in the brain. Yet, few on
the mental health "side" treat sleep problems. You see one specialist for
sleep, another for therapy, and a third for medications. The whole paradigm is
stuck in a dualistic paradigm of the 19th century. Then we used to drill a
hole in the head to let the evil spirits out.

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brackin
Well done for writing about this. I think that people in SV think that this is
such a simple issue, if your startup is "doing well" (or if you say things are
going well) then you're fine but people are much more complicated. Also that
certain feelings are something to be expected and not to be dealt with or
talked about. We doubt our abilities, we worry about our external perception,
how others will treat us if we fuck up.

~~~
hluska
I once spoke with a doctor who told me, "People like you worry me. From the
outside, your life is going so well so nobody will ever reach out to you. But
on the inside, you are in absolute turmoil."

Your excellent comment brought those words back to me. Thank you for that -
this is a lesson that I seriously need to internalize.

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mwsherman
I don’t see anything in here that’s specific to Silicon Valley or to founders.
Is there any evidence that founders have a greater incidence of mental issues
than the greater population?

By which I am not asking, do we have things to worry about. Of course we do.
But do we have greater reason to worry than a single mother, a middle-aged
construction worker, or a 70-year-old accountant?

~~~
mqsiuser
I really don't like when people say "but everyone has problems, you know. Now
go back to programming and I'll do my thing". There _are_ differences and the
article and others point out the specific problems of our business.

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dreamweapon
This talk of mental health issues seems to obscure (and glamorize) a far more
basic fact: many "founders" are simply too immature and inexperienced to
handle the level of responsibility they've signed on the dotted line for.

Kind of like back when they might have, you know, signed up for that machine
learning course with all that tricky linear algebra and stuff (which they
never really learned the first time around -- perhaps because they were
figuring that, like Peter Thiel, they were probably just going to drop out
anyway).

Except this time around the consequences aren't about having some professor
get grumpy at them, or wasting their tuition fees. It's about people -- who
once considered them as friends, and trusted them implicitly -- being laid
off, missing mortgage payments, having romantic partners leave them... fun
stuff like that.

So "anxiety", "depression" are nice ways of saying that they've bitten off
more than they can chew, and are basically shitting their pants... and praying
for some higher power (an investor, an advisor, or a customer) to bail them
out. Except it's not gonna happen. There's nothing going to stop their car
from hitting that brick wall at 50 miles an hour this time, without a
seatbelt.

So what's happening isn't that they're succumbing to mental illness... it's
that they're _learning_ , through their bodies and their minds, the way the
world really works, and what impact their actions (and naïveté) can sometimes
have, in terms of real consequences.

In, you know, that big scary world out there.

~~~
mrev19
Downvotes are probably there due to sarcasm and because you assert that it is
all learning and discount mental illness in 2nd to last paragraph.

But I agree with your argument.

In my opinion the current strong social pressure to be a "founder" has led
many people to attempt it who are unfit to handle the challenges it brings.

Its the way of nature. Attempting to lead and failing is painful and possibly
fatal. If you're a lion you don't start a convention celebrating your and
other beta lion's failure to unseat the alpha. You either get busy plotting
your attempt, or ctfo.

What is anyone railing against anyway? Founders risk depression. Alpha chimps
test extremely high for stress. If you play the game for the biggest rewards
it will be brutal, full stop. If your potential upside is 50 zillion dollars,
you have just run out of sympathy points with everyone but your own kind.

~~~
dreamweapon
I certainly wasn't intending to trivialize the suffering that some founders go
through as a result of their experiences.

The point I was trying to make is what's touted as "mental illness" may be
better looked at as a normal human response to the highly unusual, and
extremely stressful circumstances these people have chosen to place themselves
in.

That is to say: to the extent that we might subscribe to the concept of a
"pain signal", and that depression and anxiety are among the various kinds of
pain signals our body creates for us -- the "signal" in this case is not that
they're "broken", or that something is systemically or constitutionally wrong
with them. But rather, an indication of the fact that they've embarked on a
course that perhaps they shouldn't have, and threatening to become (or perhaps
already has become) unmanageable for them.

~~~
mrev19
Aside from sarcasm, which invites opposition, I think you've touched on a
taboo subject. I think what you say is true. At the same time I'd wager that a
disproportionate number of founders have bipolar 2 tendencies, which will
provide fuel and context to depressive episodes. If both are true, it becomes
very tricky to determine cause. It becomes easier to focus on those potential
causes which are outside our control, that depression is something that
happens "to" us. Of course this is often the case where there is a medical
issue, but as you point out, it is also often a result of circumstances and
our reaction to them. Or even more confusingly of course, both.

Getting back to the original comment and how it was received, at the beginning
of your comment you make a claim that is going to be controversial. From that
point on, any introduction of sarcasm will push anyone not allied with your
view towards open hostility.

~~~
dreamweapon
Point taken. Thanks.

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damonpace
"many startup founders had some deep personal trauma in their early lives."
\--- Can you elaborate on this quote? What makes you say this?

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mh120
How does one go about finding a mental health professional? Throwaway account
here, I am personally aware that I should seek mental healthcare, but have no
idea where to start.

How do I choose between therapist, psychologist, and psychiatrist? How do I
pick one therapist out of the many therapists in my city?

~~~
zt
Therapy is mostly offered by psychologists or social workers. I'm pretty
highly educated and can really fight back, so I choose a psychologist who had
a PhD. I found I could relate better to her on that level. That's sort of
elitist of me, but it worked.

A therapist primarily talks to you. Teaches you coping mechanisms. Works with
you to understand yourself over time -- usually sessions every week. They
often work in conjunction with a psychiatrist, who is a medical doctor who can
give you prescriptions. Most people, or I think most, do both -- drugs and
talk therapy combined I think have proven to be the most effective through
clinical studies.

I did not want to take any drugs though. That has to do partially with my own
family's history of addiction but also the uncertainty in the science around
the drugs. SSRIs are particularly scary to me. My Dad is a research
psychologist (he has a PhD in psychology but is not a clinician) and I was
very scared of those drugs, how hard they are to get off, etc. I choose to to
intensive talk therapy without the drugs, which is very hard, I think, but
worked for me. The human brain is very complicated and questions about the
long-term effects are mostly unanswered. I didn't want to be taking an anti-
depressant for the rest of my life.

As for how to find a psychologist, I always tell friends that they should go
shopping. You really need to jive with the person. You need to be willing to
tell them your life story and to think that you could speak with them week
after week. In the two times in my life that I have had to find therapists,
I've gone to five or six and basically told them about myself. From that --
which isn't so much an interview as it is a practice session -- I've chosen
the one I want to work with. This can be a real pain in the ass, as you're
wasting insured sessions, but I think it's worthwhile.

The practical reality of finding that list of five people: once I just asked
some friends and another time I just used my insurer's database.

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CmonDev
Certain sexual deviations are considered norm nowadays. Maybe other mental
disorders, such as anxiety are normal (though unpleasant) as well, and we just
don't know it yet?

------
niels_olson
Anxiety is a symptom of depression. They're two sides of the same coin.

