Ask HN: How do you cope with mental illness as a founder and/or employee?

Everyone "continues to deal with mental illness," getting professional help does not just resolve things. It takes a lot of work.

This resonates with me, and it's taken a ton of work on my part. I have compassion and empathy, but real talk, it is of utmost importance that you get this very specific thing in check. As an employee, that's legitimate grounds for termination; as a new employer, it's a lawsuit that will end your business.

Learn your triggers, and learn your triggered behaviors. In my life... that happened over the course of 20 years of failed romantic rationships; seeing harmful behaviors in my partners and doing hard self-reflection to identify those behaviors in myself. Maybe you'll have better luck in counseling. Maybe not? Progress is hard; setbacks are easy.

Once you can recognize that you're about to do harm, you can pull yourself away. Take a mental health day. Work on something else. Avoid that co-worker, but be explicit about it: "hey, I can't do this right now, can we come back to it tomorrow?". Be vague but open about mental health issues -- saying the words "mental health" is great to establish why you're stepping back; going into detail about your challenge in the moment is never a good idea, in my experience.

Generally I've noticed that an unfunded, stressful startup environment magnifies their existing problems.

Some suggestions to avoid a breakdown:

- wait for the right time to begin your own startup (get funding based on a powerpoint first, start a popular blog or podcast to have PR traction before writing any software, get caught up at the dentist, buy a new car if needed, see if any medication is needed/works for you, etc.)

- or join an early but funded startup

- understand that startups are usually 7-10 year marathons before the final success or failure, so you need to be able to keep it together for several years. That includes maintaining the best physical and mental health you can so you can handle inevitable setbacks. Even if you're an introvert, that includes relationships.

Starting your own company to "escape" civilization usually doesn't make sense unless you can self-fund it for several years, or your existing contacts can quickly be paying clients.

What happens when you're not prepared is that paranoia will dominate your relationships, depression will deepen, etc. so your startup marathon doesn't have a chance of finishing.

Having said that, manic people can accomplish a lot during their manic phases, but to sustain that over several years means they need to follow the preparation above.

If you're a non-technical founder, understand that engineers are very expensive to make payroll (which adds to your stress), and have options (don't really need you or other mentally ill people in their life.) So ensure you have adequate runway, or structure your staff relationships, so that you don't stall your project.

Also, in the US, ensure you've considered health insurance expenses before doing the startup thing. Most small businesses struggle with that, and it gets worse every Jan. 1.

It's not easy, but I feel that if at least one person is helped by me speaking up it's absolutely worth it.

0: https://osmihelp.org

But ultimately, everybody is dealing with some mental health issues (Sigmund Freud said something along the lines of perfect mental health being an unattainable goal for any civilized person), so being aware of your specific issues might put you ahead of the game, if you use this as motivation to monitor your symptoms and counteract your detrimental behaviors, instead of normalizing them.

Feel bad about it, repeat.

Try and be better about it tomorrow, repeat.

Where’s my drink?

When I came to, I found myself in a very literally dark, distored, and morbid hell-scape. I was very confused and although I still had memories of being “me” I no longer associated them with whom or what I was now and likewise for family and friends. I was a stranger to myself and everything and everyone I had ever known.

I went to see my primary and the nurse went to take my pulse and it was so high that she brought in the doctor to take it multiple times because they thought the machine was broken. I was recommended to a psychiatric clinic by my home and went there for about eight months before I switched to a private practice psychiatrist. This was because clinics are too afraid of being sued and thus their doctors rarely are willing to experiment or go off-label on their patients in order to cure them.

After almost 8 years of experimentation and trying pretty much every medication on the market and with the help of my doctor, I can say I have recovered to my satisfaction. My disorder is rare and thus isn’t well documented in the DSM and therefore is hard to treat and diagnose. I still, from time to time, have periods of “missing” weeks that I can’t account for but I’m still functional and appear normal during those periods.

I learned many lessons about the medical industry over the years, but the most important is: “Only experimentation cures patients”. You have literally 5 minutes per month with your psychiatrist because they “prescribe“ whereas psychologists “talk”. Buy the best healthcare you can afford and only go to pharmacies and doctors in very affluent neighborhoods. If a medication or class of medications, such as SSRIs, didn’t work the first time, they won’t work a second time. Be patient, because your doctor has other patients—this means you have to be responsible for doing your own homework about your disorder and what treatments might be effective for you. This also means you have to learn a considerable amount about neurochemistry and biology sadly and keep a journal of controlled experiments to determine what factors are significant or not. Don’t be afraid to fire your doctor if it’s obvious they don’t value your time, such as routinely being late for appointments, or ignore your every word and just follow a scripted dialogue with you. I wish I could tell the readers here all that I’ve learned, but for brevity’s sake I won’t here, but I can comment on any responses.

Lastly, my advice is do NOT tell your employers nor your coworkers about your condition. They won’t care nor understand what you’re going through and they will use it against you the first chance it becomes convenient for them. I’ve seen this happen time and time again with past employers; they love to say “Oh, he was crazy” as the reason they fired a developer who dared challenge their authority. This is the unfortunate stigma the mentally ill have to contend with on a daily basis and only makes things worse for those of us whom are struggling.

One final word: true mental illness is a life long struggle and what has kept me from giving up so far is remembering, “There’s always something better”. No matter what stage of recovery you’re at, you can always be a better you—never stop improving.