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On Being a Science Writer and Managing a Mental Illness (theopennotebook.com)
104 points by fern12 on July 20, 2017 | hide | past | favorite | 55 comments



> For one thing, choosing writing as a way of making a living can nurture insecurity and doubt—especially for those, like myself, who are early in their careers. For me, at least, publishing a story is like handing in an exam essay, an invitation for strict judgment by both the intended audience and my peers.

I think people in tech tend to underappreciate the benefits of being able to just do the job and enjoy a (comparatively) lesser-stressful life with enviable benefits. Programming is creative endeavour too, but, no one is asked to build a product that succeeds in the market; that's the job of management.

Being a writer, or a musician, on the other hand, entails a perennial anxiety over the success of whatever you're doing. How will you ever know if your next thing will be liked or not? How will you know if you should continue working on your project when it starts to feel like an incoherent mess?

I have moments of self-doubt too but I am confident that I won't suddenly cease to be a decent programmer who gets things done. For many creative people who do it full time, it means fighting the monster every day.


You can be creative for your own self, and not for others. You don't always need to show your creations. That removes the success anxiety. You should not try to be liked by others, it's very unproductive. Or at least it should not be your primary concern.

Even if people say they don't like your creation, it doesn't matter as long as you like it. Nobody cares about your sleeping position, and if somebody criticizes it (unless it's a doctor), you already know their opinion doesn't matter because 1) evolution works by listening to our feelings 2) you can't know the absolute truth about anything 3) there are many diverse opinions out there. It applies to creativity as well.

Only time and long term execution will tell if what you do matters (and to be honest, it does not matter anyway). But ultimately your cannot apprehend your work and the expectations of people. People are not able to tell you what they want, so it's not worth it to listen to them. I like to think creativity works in the realm of evolution and natural selection. It's impossible to predict what will work or not.


I agree with a lot of this, and I think it's helpful to remember that people perceive things differently. In much the same way that cilantro tastes like soap to some people, certain images, tropes, and turns of phrase will not resonate with some people - no matter their quality. If the work is of high quality, it will resonate with some people/some groups - in your lifetime, if you're fortunate.

Take your work seriously, but don't take your art seriously. Do the best you can, experiment, test your limits, but at the end of the day, have perspective. Even if you reach the highest level of your craft, you're still just you. If you spend time developing yourself, trust your instincts and creativity, and you're a brutal self-editor, you should put out work representative of where you're at as a person/artist. To my understanding, that's all you can do.


> no one is asked to build a product that succeeds in the market

Except startup owners and many others. Even in many large companies an unsuccessful product can lead to teams being let go or reassigned to do boring work. Also, stack ranking...

> Being a writer, or a musician ... perennial anxiety

That's the tradeoff for doing a really creative job. I love the creativity of development but nobody will read our code in public in 500 years from now.

> I won't suddenly cease to be a decent programmer

Burnout happens to do that.


> Programming is creative endeavour too, but, no one is asked to build a product that succeeds in the market; that's the job of management.

Really? Maybe in really large companies, but even then, management just decide what product to build. It's still the engineers that build it.


> Being a writer, or a musician, on the other hand, entails a perennial anxiety over the success of whatever you're doing. How will you ever know if your next thing will be liked or not?

I'm sure most musicians don't care about that. It's big media that thinks this way, and coincidentally produces mostly stuff that real music-lovers find crap.


"Most" musicians (at least, all the ones I know personally) spend most of their time freelance teaching, doing relatively dull studio/session/gig work freelance (with all the stress and uncertainty that entails), practicing several hours a day just so they don't degrade, gig work at clubs/pubs/etc. and only occasionally managing to find time to do anything truly creative and new-new.

Re-arranging crappy piano scores so they fit a scratch band they've been asked to work with, figuring out how to stretch the tiny school budget into buying a less awful keyboard...

If they do have time and energy to put into 'green field' music production, there may be some stress over whether or not it's liked, but realistically they're mostly doing it because the concept of the album inspires them so they can't sleep at night because the melody is stuck in their head.


That is not my experience at all, and I believe the term imposter syndrome is widely used by others in the industry.


>A 40-year study published in 2012 found that writers are more likely than people in other, less creative occupations to suffer from mental illnesses such as bipolar, depression, and general anxiety disorder.

This bothers me. It's correlated but the following analysis assumes at least partly that being a writer is one possible factor for depression. Very common mistake most HNers are probably aware of.

For a science writer to read papers so wrongly is rather ironic.


> It's correlated but the following analysis assumes at least partly that being a writer is one possible factor for depression.

And why shouldn't it be a possible factor? Correlation doesn't tell that it has to be a factor but neither the opposite.


Yes, maybe, but there's no proof so why assume it and make an article like this which doesn't even has any reserve about it (reread the paragraph I quoted if you doubt my claim) ? There's not even one "maybe" in his whole essay !


Ok, I'm really more bothered by the expected scientific rigorous from an essay like this.

He's a writer and is experiencing the difficulties of his work and how it effects his emotional well being. It shouldn't then really surprise that he sees a strong connection between his work as a writer and the depressions he has. That doesn't mean he's telling an objective truth about a writer's life, but he's telling a subjective "truth" of his life as a writer, and sometimes these subjective "truths" can tell you quite a bit about life.

Sometimes the HN crowd can get quite a bit annoying with its scientific thinking, because it's not always the appropiate method, and sometimes a single person can tell you more about a certain aspect of the world then any kind of scientific study.

I'm certainly not arguing against the scientific method, but to apply it in a reasonable way.


The suggestion that there are other kinds of valid thinking besides scientific thinking is way off.

No matter how obvious something feels, you can't know it's truth value. Humans can have auditory, visual and conceptual delusions that are completely convincing and completely opposite of what other humans experience.

The only conclusion you can draw from this essay is it's actually how the author says he thinks he feels. This may be a good starting hypothesis for a more rigorous study, but it says very little about life in general.


For some definition of real, all these internal experiences are real. Not interpersonal, maybe, but they will have an effect on the person and on how they interact with the environment including other people.

Accounts like this also tell you what's possible. It might and probably won't be true for everyone, but nobody is unique enough that it won't be encountered again.

So even if it's just one author telling you about his internal world I'd say there is a little more to learn from this.


>The suggestion that there are other kinds of valid thinking besides scientific thinking is way off.

That's a very religious attitude you have about the scientific method. ;-)

Might we say that, based on our tests so far, the scientific method has produced reasonable results for explaining shared reality? (Defining truth is a different matter entirely.)


> but it says very little about life in general.

But you said it yourself, we can never know the absolute truth value.

I say let go of what life truly means, and enjoy the process of iteratively improving your own perspective. Humans always seek closure though - that's religion for me (!)


So you're saying your comment isn't valid thinking?


My comment would fall under the hypothesis generation step of the scientific method, just like the article.

It may or may not be proper thinking - without executing the remaining steps to test a theory, we can't know.


On a related note, Phillip K Dick's work seems to have gotten better over time the more his schizophrenia progressed.


reads like a medication pamphlet.

therapy is more useful than drugs, even if drugs are needed eventually.

but I think this follow the US school of thought, where therapy is just one session required for liability before you're sent to a psych who will prescribe a pill regimen on the very first session. unbelievable.


    > reads like a medication pamphlet
I did both. The therapy was of limited use. The pills were like a light switch that have simply turned off my mental illness with almost no side-effects.


> The pills were like a light switch that have simply turned off my mental illness with almost no side-effects.

That means that you're in the not particularly large fraction of people that the pills work well for. Good for you.

For the rest of us, well, the pills can be a hell of side-effects, tolerance, and rebound ... and that's if they have any primary positive effect at all.


the pills does have lots of side effects. if they work on one aspect, they do work on others, because there is not a single pill on the market that can target one receptor only. absolutely no reseach, not even the ones very favourable to the drugs, show zero side effects. none. zero. targeting a single receptor with full confidence is the holy grail of big pharma.

what happens with your case, is that you do not care about side effects. or even welcome them. just like most depressed people in bad marriages welcome the lower sex drive, or stressed people at work welcome the drone like sleepless life. And you will not even know you are living like that until you go to a good therapist, which seem to be very rare in the US.

all that said, I sincerely whish you get well and eventually go without the meds. And I am happy you did seek out help. That's the rigth spirit. Just do not shrug off therapy. Do take the time to work with a few different ones during a year, even if you honestly believe the meds cured you 100%


    > what happens with your case
Thanks Dr Nick!


    > not particularly large fraction
Citation?


Draft NICE guidance on depression probably has lots of information.

https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/dr...

Pages 38 to 45 probably most useful, especially pages 40 onwards.

(Personally, I think meds are useful, and I think good quality talking therapies are useful, and I think people should have access to both, and access to a range of psycho-social interventions.)


> therapy is more useful than drugs, even if drugs are needed eventually.

Is it your opinion based on... ?


There is a growing body of research [1] that questions the usefulness of drugs for mental health. I personally know a case at a local hospital (in Europe) where a switch off meds and into therapy brought serious improvements in elderly patients.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582668/ , https://blogs.scientificamerican.com/cross-check/are-antidep... , https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/


says the whole world. almost every european country requires you to do minimum hours of therapy before and to keep with therapy during the drug usage.

to begin with, I could refer you to the study the article is about. it correlates a social setting with high occurrence of depression. then it proceeds to promote the solution with medication. when the obvious solution is changing the social setting! that is the definition of the 80s joke "prozac for bad hair day"


Or, in other words, (at least some part of) the medical industry is driven by the neoliberal ideal that it's never anything else that's the problem, only yourself, and you're meant to deal with it with minimal impact on anyone around you?

Work must never be an issue, or we might have to treat workers well. Society and societal structures must never be an issue, or we might have to care about each other on a more than skin-deep level and drop this whole "we are all independent beings who are completely unaffected by external factors" madness.

At least some part of mental healthcare is essentially a system designed to help people cope with a society which does horrific things to them, and then gaslights them into believing it's their fault for not coping with it.


> and then gaslights them into believing it's their fault for not coping with it.

I don't understand why you say that.

Are you saying therapy make people feel guilty of their own self?


No, society does that. Our society is, apparently, perfect, and if you have trouble living in it, it's your fault - says society. However, how we often approach mental healthcare - as something individualistic and separate from society - is one of the things that normalises it.


> is one of the things that normalises it.

Why ?

It depends, coping with the imperfection of society is also something to work on. Accepting its flaws lets you walk around it. Sometimes it's not the individual who is the problem, but it doesn't mean he should not accept how the society is flawed.

Mental healthcare and therapy have an individualistic approach because that's what they do, how else? To change society you would need politics, and that's another matter entirely.

I often say that mental illness doesn't really exist, because as long as we don't understand the brain there is no "normal" behavior. But as the same time you can't deny that society has its norms.


> To change society you would need politics, and that's another matter entirely.

That's the point - it's not another matter entirely. If society is damaging people's mental health, it's entirely unethical to look the other way and pretend it's each individual's problem. If mental healthcare professionals want to ensure the wellbeing of their patients, they need to be fighting alongside us for widespread societal change, and they need to fight against the myth of poor mental health being an individual anomaly.

But getting to that point requires an understanding that mental health isn't individualistic in the first place, which is not what we're told, and it's not what our doctors are taught. What we have right now is, a lot of the time, treating symptoms and providing coping mechanisms instead of treating the causes. Imagine a doctor did that with a broken leg - refused to touch it, but instead provided you painkillers and explained how to plan routes around the city with lots of seats you can sit in when the pain gets too much.


I see what you mean, except mental illnesses can't be treated like a broken leg can be.

Mental health is a difficult subject.

Imagine the problem it can be to treat homosexual as equals in the political scene, it will be another story to have consideration for the mentally ill.

The more we become a society of people with knowledge rather than social norms and morals, the more we will be able to progress.

I also really believe that group therapy should be the future of therapy...

Maybe you should have a conversation with a psychologist or a therapist and talk about those things. A possibility is also that patients need to be told that nothing is their fault. It can take a lot of time to defuse the person's belief that a he/she is not "defective". There is no shame in going to therapy, it's all about talking, because that the most concrete thing you can do with a brain.


Maybe individual people have this attitude, but it is certainly not a tenet of medical/psychological practice.


>>"we are all independent beings who are completely unaffected by external factors"

>Maybe individual people have this attitude, but it is certainly not a tenet of medical/psychological practice.

This is indeed evidenced by the big pharma "chemical imbalance" sales pitch, as it implies your brain is a self-enclosed system


Much like being in a kind of depressive state from time to time is now considered depression because you need to be at 100% productive all the time.


But you can have the best social setting, and mental illness will still happen and still affect you dealing with things. Depression makes it just as hard to get out of bed on nice days as foul ones.


Quite. Sadness, apathy and anxiety are all symptoms of mental illness. But they're symptoms of all sorts of things too -- including social setting etc, and so people tend to conflate the two.


yes, but thats off topic to the article, which focus on a very specific region/profession/time.


You are confusing therapy being the front-line treatment with it being the most useful treatment.


1. In the United States most insurance will pay for a handful of Therapy sessions.

2. I had a breakdown years ago. Looking back it was just a massive Panic Attack. What really surprised me is I woke up the next morning feeling o.k., then out of the blue--life crushing anxiety. Anxiety so bad I just physically shook, and was always in tears. This went on for years.

3. After a week into the anxiety, I saw a Ph.D in psychology. I spent all my savings on these sessions. The result--not a bit of help. Now, they will claim that twice a week for 9 months is "not giving it enough time", but at a $100 a session it was just a waste of money.

4. I was finally referred to a Psychiatrist. He put me on all the antidepressants. None worked. He put me on a long half life benzodiazepine, and with a bottle of wine I was kinda functional.

5. My point is try Psychology/Psychiatry. Remember it's more of an art, than a science. I didn't realize this when I was in my twenties. Over the years, I have seem the spark dwindle from my Psychiatrist's eyes. I think if he had a do over, he would have picked a different speciality.

6. If I had a do over, I would have skipped it all. I did eventually stop drinking, but for years it was the only drug that worked, besides having to beg for low doses of benzodiazepines. I'm now trying to get off benzos, but figure why, at this point in my life. It's still a bitch getting any controlled drug from most doctors.

7. I can say this. So many of you will just get better with Time, but it might take awhile. (The "Professionals" conviently leave this out. There are some studies praising time verse therapy/drugs, but they are buried, and were small studies. I my case, it felt like I wounded my brain that night of the huge anxiety attack, and it would take years to heal. The experts told me most people do get better in a few weeks. I didn't. The depression arose because my life went from great to just lucky to get to sleep. Exercise did help eventually. At first, it didn't at all. I needed alcohol. I didn't want to blow out my liver in my twenties, so I only drank when I absolutely needed it. Don't overload that liver.

8. I once had a talk to a resident Psychiatrist. At first, he was a a cheerleader for his decision to specialize in psychiatry. After some debate, and honest reflection, he admitted to me all the modalities/drugs work a tiny bit in some patients, and the profession has a way to go.

9. I do know this, patients whom have been on a drug for a period of a few years shouldn't have to go into those prearranged sessions, just to refill a script. If the drug does not require blood monitoring, the patient should get refills. I know so many people who self medicated with alcohol, because our American system of treating mental illness sucks.

10. Time. I know, who has time. I need to function tomorrow. You have my heart.


Not the OP but Feeling Good states that people responded to CBT as good or better than drugs, though, both at once were more effective again.

They could also be thinking of Anatomy of an Epidemic where long term results of people on drugs are worse than those off. Specifically that there's never been such a finding for CBT having a long term negative impact.

(Disclaimer: I'm not a medical specialist just a sufferer and reader)


[flagged]


I think this is a scummy reply because it is purely written to exploit vulnerable people and provide them baseless hope.

You do not say how, what, or why your religion has done to help you and you make a broad sweeping statement that some thing (a god) will magically solve mental illness. If anything this sort of crap will prolong suffering, and or exacerbate the problems associated with mental illness because it's not a solution or treatment.

Tangentially (off topic), I'd argue you were never truly an atheist if you could be "converted." There is no turning back, I won't one day believe in Santa Claus again.


If Santa Claus showed up at your doorstep and took you on a ride in his sleigh, you'd stop being an atheist. You no longer become an atheist when your experiences or reason casts doubt on it, same as no longer being religious. For some people, atheism is really weak, and tends to be held culturally in the same way religion used to be.

I think personally in the west atheism is more akin to victorian christianity..it's just a baseline belief "cultured" people hold, and generally is held without thinking much about the consequences as people go about their daily lives.


A programmer once believed in the God of Spaces. But they were never quite sure how many spaces were the One True Number. They grew up with Four. Younger believers told them Two. They even tried Three in their wilderness years, but that made them feel odd.

Then a stranger asked, "Why do you worry so with your counting? Do you ever expect to find the right number? Just use a tab, my friend, and the number will always be One."

In that moment, the programmer was enlightened.

But in their previous days, was this programmer not a true Believer of Spaces?


And that's why you don't trust random strangers spouting wise-sounding sayings.


> Tangentially (off topic), I'd argue you were never truly an atheist if you could be "converted." There is no turning back, I won't one day believe in Santa Claus again.

Even more tangentially :), someone who does not believe in the existence of a god is an agnostic. An atheist is someone who believes that god does not exist (which is just as unproven as the opposite claim that god does exist).


"no true scottsman" fallacy lol. Life experiences can change people deeply... That's a pretty religious way of seeing atheism you have here. Not to mention the analogy between religion and santa claus belief not only suggests contempt but is very cheap. Religion is much more than the belief in a supernatural being. And that's coming from and agnostic person.


Brother, you disappoint me. This doesn't help anyone. Helping does. We can't always find a way to do that for someone. But we can trust that God will. And when we focus on what God has done for us, we all too easily ignore the inspiration God sends us at those times when there is something worthwhile we can do.


What, specifically, does baptist christianity offer over any other religion? Or counseling given by an accredited therapist? Or, well, any other life experience?

I think the church can offer a sense of community that many people are seeking or lack, but this is just an outrageous claim. If "god" was the answer to mental illness, and this fact was definitive, there would be no mental illness left.


There's nothing unique to Christianity here. It's just very easy for someone who's found what he needed to imagine that that's what everyone else needs, too. It's also a lot easier, I think especially for Christians but by no means only for us, to go that way, than to realize - and live up to - the fact that what we're truly called to do is not merely to speak easy words, but to take difficult actions; not to profess an answer to someone's problems, but as best we can to be that answer, even if only for a minute.

Our faith, in short, requires that we live for others. That's hard to do, and most of us are not good at it. My brother errs. I'm sorry for that.




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