Ask HN: I'm disabled and out of money. Now what?

352 points by thrwtllwy ↗ HN
TL;DR: I'm a founder who had some success, but now I'm disabled, can't seem to hold down a job. I'm close to defaulting on my car. I am (unsurprisingly) depressed. I need help but don't know where to go.

I spent the 2010s as a founder. My company was funded by YC and several others. We were moderately successful but didn't see a meaningful exit. After my startup failed, I started consulting to pay the bills.

In 2018 I started having problems with chronic pain and gradually became less and less capable on the job. Consulting gigs were letting me go because I couldn't keep up. The last time I worked was over a year ago, and I finally exhausted my savings in early June 2022.

I live as cheaply as I possibly can at this point. I live with family and only pay for absolute necessities. It comes out between $1200 and $1500 per month.

I'm in the US and I have an application in for SSDI, but, from what I've heard, it's very hard to get benefits, especially if you have an invisible illness like chronic pain. It's likely that my application will be initially denied and I will have to focus on an appeal. It could take a year or more of fighting to be approved.

I am selling some of my old stuff on eBay but it's exhausting and frustrating given my limitations. It's not sustainable.

I have a car payment due soon and I'm already behind by one.

Worst of all, my life is pretty drab at this point. I am obviously depressed. I see a therapist and a psychiatrist but, fundamentally, the source of my depression is the state of my life. I have nothing to look forward to. I can't even afford to toss a few bucks into side projects so I at least have something to do with my time... I mostly watch TV, play video games and lurk on the internet. It's absolutely soul sucking.

I think, given the right environment, I could finish a weekly workload of a bit less than half-time and slowly re-learn how to work again even with my limitations, but no one wants to hire a middle-aged disabled person for part-time work. Further, all of my experience is in startups and that makes me less palatable to larger companies, but larger companies have more options to accommodate disabled people.

I don't know what to do. Has anyone in the HN community been here?

EDIT: A few people have asked what I’d like to do if I were to work again. The answer is that I don’t know!

Before I started having problems, I was a backend-centric web developer but I’m pretty burned out on that these days.

I’ve always wanted to get into embedded, but I have no idea if I can make a lateral move like that in my current state.

Whatever I do, it needs to be with someone who will give me the space to try and fail and try again. That’s really the main thing.

Feel free to EMAIL ME:

tyvm for the shrimp at gmail dot com

265 comments

[ 2.8 ms ] story [ 259 ms ] thread
This chronic pain - what is the cause of it? Are you diagnosed with fibromyalgia?
Fibromyalgia and CFS have been tossed around but never officially diagnosed.

The practical experience that I have is frequent exhaustion from things that should be easy, difficulty focusing, flu-like aches and tons of migraines.

I've lived through this myself. There is hope. I had the great fortune of being able to live with family until I could weather the storm. It turned out I needed to de-stress by life, live with accepting people, and eat delicious and healthy food over the coarse of a few years. I had destroyed by mind and body burning the candle at both ends with little to no nourishment (physically and non-physically), and the tax man came.

Every hope for your success..

Fibromyalgia, CFS, .. labels like that are used when the doctors have no clue, just give up and don't wanna look further into your issues. Then they blame it on stress and psychological issues. That's 1000 % wrong.

Most likely you have a virus or bacterial infection that hasn't been detected yet. I'm in a very similar situation like you so I'm speaking from personal experience. Ever been bitten by a tick? Do you have gut issues?

Read this, very important: https://www.hardtowrite.com/pathogens/

As for earning money: Assuming you're too unwell to consult, you can do mindless tasks on Appen. https://connect.appen.com/qrp/public/home Things like checking search results for Bing or Google, improving Apple & Google maps. Pay is between $15, $24 / hour depending on the project.

Doctors checked me out for various things and then sent me to a psychologist who declared I had “health anxiety” when I was developing adult-onset type 1 diabetes. I had been in pain for months, every day, and lost tons of weight, then turned it around with a very specific diet (coincidentally low carb) and they acted like I was just being paranoid about food. It’s maddening how some doctors, for one reason or another, disregard almost anything a patient says.
You should all (also OP) look into Fabry. It's a genetic disease which for some only shows up in adulthood. My Mum went through decades of chronic pain and though she had Fibromyalgia. There are dozens of papers showing how Fabry is often misdiagnosed as Fibro.
I had increasing difficulty with fatigue for years and it turned out to be Celiac disease. Then, I got type 1 diabetes after going GF to treat Celiac, which was a slow onset which made things very difficult for 1-2 years. My situation isn’t too different than what you describe, actually, even after diagnoses and treatment.

Have you been checked out for celiac? I had all sorts of unexplained health effects but the #1 thing was feeling exhausted all the time and falling asleep after lunch every day.

Those symptoms sound very similar to the fatigue I have, but I have type 2 diabetes and the fatigue started very suddenly after a brief viral infection. I've had the usual tests for Celiac but they were negative. I have seen some signs of improvement on a very low carb diet but it hasn't been consistent and I have trouble sticking to that kind of diet due to cost coupled with the fact that, as an amputee, it's hard for me to get to grocery stores.
My aunt had this exact same symptoms. In her case, after years, she was diagnosed with diabetes, which some prior exams had missed somehow. Treating for diabetes fixed her chronic pain.

It's just an anecdote, of course. I hope you get cured :)

Have you done a sleep study to check for sleep apnea?
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I had similar except the migraines, from gallstones and cervical spine misalignment. I suffered for over a decade, but never gave up hope. Once the obvious pain showed up in the gallbladder and I found a good chiropractor, my issues are almost completely gone.

All I can say is focus on fixing the problem. Do whatever you need to do to diagnose yourself, heal yourself, and focus. Going to work through the pain an fatigue was tolerable only because it kept me able to pay the chiro/surgery bills.

Self diagnosis comes through process of elimination sometimes. Try eliminating or adding different things from/to your diet for a month, one at a time.

Hey. Sorry to hear about your issues. I would love to help, but I don't know how to.

I am based in Europe, but used to live in the US. Is there a specific type of job, even if part-time, that you think you could do well?

Hang in there. You have the courage and intelligence to write such a thoughtful and articulate message. There’s fight left in you yet. Reach out to me directly, and I’m happy to just talk. You can find me online as I’m a member of the Sort Benchmark committee. We as a community are here for you.
Same, disabled. Luckily I paid into insurance and got disability coverage but even still it isn't enough to make ends meet in Los Angeles. I haven't found a solution. It sounds like you're doing better in some regards. I would say do what you can to improve your situation like the claim and what not as early as possible and say fuck you to the negative self talk that might be holding you back from getting help. Talk to some disability advocates or lawyers to help out as well.
I've heard that SSDI with a lawyer is much more doable than without one.
Absolutely get an attorney, they will collect when you are approved. My mother waited years for her SSDI denials to be appealed, and died in the interim before the issue was resolved.

Start the process ASAP. With an attorney with good recommendations from others.

EDIT: AARP link because it was the least biased piece of info I could find on the topic that wasn't a lead or referral generator: https://www.aarp.org/retirement/social-security/questions-an...

First: I have become an evangelist for disability insurance. I know it sucks but total award amounts seem to be higher and more sustainable.

LA would be hard, I feel for you.

Any suggestion on advocacy programs? I am in the Midwest if that helps.

I know that this depends on specific impairments, but have you found ways to do things you enjoy? This is the hardest thing for me right now: I don’t want to spend the rest of my life watching TV.

I do creative things I enjoy but I am unable to be really be physically active. I'm not really adjusted to the situation regardless, so I hope it changes for the better in the future but for now it is a plight.

Maybe you want to pursue a creative endeavor. Piano, art, and game development (albeit at a very slow pace and intermittently) have been helpful for me.

Prior to my last surgery, I got a high energy puppy. Total PITA. Saved my life. Hard to stay in bed when the doggo needs another walk.
I was in a similar situation, minus the physical disability (I was mentally in a really bad place though). The only advise I have is to not think of any job as below you. I don't know your exact situation or your disabilities, but if you can deliver pizzas to at least keep your head above the water, do that. Having gone through YC you're obviously also a bright and intelligent person, how many different companies have you tried consulting for? Some companies could be more understanding than others of your situation, in which cases making 1500 a month shouldn't be a huge problem in this industry. Sorry you're going through this friend..
It’s also worth considering whether providing a lower going rate and longer duration of work would be effective. For some projects it may be possible to effectively work half time.

I’ve met folks in unusual industries that need ongoing tech work/knowledge but have no desire to have this knowledge and effort in house. Medical device manufacturing was one such field. (work was government compliance, and server patching/network maintenance)

Would you have any suggestions for finding work in fields like this? As a developer (mobile with some web and backend), I would love to have ongoing part-time work to provide enough income and free time to pursue other projects.
These jobs are generally considered full time and may even have anti moonlighting clauses. They just don’t have much pressure associated to them as long as you are moderately competent and can reasonably deal with crushing beuracracy.

The way to find these is to really just look for a job which emphasizes enterprise, a tech you know, and the main focus being upgrade from version X to version Y. Bonus points if this is in a large firm with minimal competition in its sector.

These companies largely need someone to be there in case they might need some job done, but generally they need people to pretend to be busy. With remote work, they probably don’t need you to try particularly hard at that.

>>The only advise I have is to not think of any job as below you.

This. I had two tries at starting up last decade, failed. Good for me, I had some back up plans. Beyond all, I realised, a regular salaried job is a privilege. There is nothing wrong in taking up a full time 9-5 job. In my case I had a full time job, before, and just continued it after my venture went under water. For some reason such a job which is something most people aspire for, is considered some sort of a failure in entrepreneur community. You get a salary every month, with annual bonus, and health care plus vacation covered. How is this failure? If anything this is the best thing that can happen to many people on this planet.

I'd advice the OP to consider taking up a full time job. If you have started up and seen any amount of success at all, chances are you will do good at interviews and eventually at your job. Do this for a few years until, fix your health and finances- and then work from there.

That sounds like a really difficult situation. What sort of jobs would you be interested in? What do you think are your relative strengths & skills?
I can't say I have been in a similar situation or that I am qualified to be giving specific advice. I'm glad you're seeking help from a trained professional. I will say this though:

Even though it may be hard to do so right now, try to focus on the things that are in your control at the moment. What was your skillset before your disability. Which of these skills do you still hold now?

Are there any disability inclusion legislations in your country you could take advantage of when looking for a job?

I'd even do some research. What is your long term goal? You said you were a founder in the past. Do you still want to do something similar to this? Try to see if there are founders that had similar situations to yours. You can even look into their lives and the road that they took before they got to where they currently are.

As for the short term things like being late on payments and bills, try to ask a friend or family member for help with your finances. They might be able to look at things more objectively and help you make cuts in certain areas until you get back up to where you may want to be.

This is all of course going to take a lot of work, and it's definitely going to have its challenges. This fight is not going to be easy but I assure you that it will be worthwhile. I wish you the very best.

What are you interested in work wise, do you already have the required skills or can upskill? Perhaps gigs related to your skills? If you need to build up portfolio you could volunteer? I think everything is easier when you have a team, would you be able to join any groups online or otherwise with similar interests or disabilities? Best of luck and let us know how it goes, you’re not alone!

Did you enjoy YC? Could you do it again?

You don't spend money on rent, but are still spending $1500/month? On what?
I'm guessing food, car payment, gas, insurance, it adds up. Also, your comment comes across as really inappropriate.
It's an appropriate question in a forum full of curious people, with no demonstrated animosity.

In the US it's really easy to spend $1500 a month even on medicine alone, not to mention food, electricity, etc.

In other countries, $1500 is minimum wage, and in others it's maximum wage for most people.

Making $1500 a month in Belarus, for example, puts you in the top 1% of everybody.

I think the parent's question may be insensitive, but not inappropriate. The core problem OP seems to be facing is a mismatch between their incoming and outgoing cash flows. If we take it as given that they cannot work, e.g. that their incoming flows are fixed, then I think it's a natural step to examine ways to decrease their outgoing flows.

Of course, that oversimplifies the problem somewhat, since any changes could worsen the situation overall, e.g. decreased mental health. Sitting in a bare room paid for by someone else and watching the wallpaper peel away has very little out of pocket cost, after all.

The counterargument is that homelessness and loss of medication would probably be far worse -- for example, it could be wiser to sell the car and live an ascetic lifestyle for 16-24 months until the disability appeals are processed, at which point the OP could return to an equilibrium. Stretching out the runway, so to speak.

Forming any actionable advice in this vein is impossible without a better understanding of the OP's costs, however.

How is my question inappropriate?

In any case, selling his/her car seems like an easy way to cut costs.

However it sounds like medical costs are the culprit, which was the intention of my question.

Probably mostly meds if in the US; US citizens don't have access to cheap generic medications nor universal healthcare so something like chronic pain can cost a lot out of pocket.
My friend, I am very sorry. Focus on what you can do right now. The first thing you can do is work hard to find joy in every day of life. Yes, it exists, and yes, you have to look for it. This will help you turn around your depression.

My wife found joy every day even though she was terminally ill, and I'd be remiss not to point you to the same place where she learned to find it:

https://www.jw.org/en/bible-teachings/questions/living-with-...

If you want, you can email me to my username@gmail.com and I will send you her Instagram feed which is still online and you will see what she went through and how she stayed positive, peaceful, and even happy despite her awful ordeal.

Lastly, you are more than the sum of your accomplishments. Your material needs are few, and your qualifications many. Get a job doing anything you can do from home, and just start grinding. Don't worry about trying to get back to where you were. Accept your new normal and work it like any other problem.

Hey, FYI, I initially flagged your post because I thought it was spam... thought JW had moved into the online version of door-to-door Watchtowering with drive-by evangelism.

But I was wrong, and I'm sorry. You're just a regular part of this community and your wife happens to have religious beliefs that helped her through tough times.

I apologize for jumping to conclusions, and I'm posting this response mostly so others don't make the same mistake and assume your post is spam.

I appreciate that. I too hold those beliefs and they help me, but I'm not here to proselytize. I share what has helped, and if it helps somebody else that's great. We all hold beliefs of some kind, be they a differing religion or a philosophy that's helped us, and I see people share those all the time and that's all I'm doing as well. I appreciate your seeing it that way.
Jehova's Witnesses aren't a legitimate religion. They're a cult, and the parent comment to you is engaged in predatory behavior exactly of the sort any cult is known for.
You know, I get where you're coming from. One of my good friends was a disfellowed JW -- which is kinda like excommunication, except they're not just cut off from their church, but their community and family and friends too, altogether. This person had horror story upon horror story to tell about JWs. I certainly would never choose that path for myself.

However, I don't think I should be the one deciding what the OP is interested in or not. If they want a religious discussion they are free to follow up, or else they can ignore it. I just didn't want to erroneously mark it as spam.

<aside> Really though, what's the difference between a cult and a religion? The amount of real estate they own? Every mainstream religion presumably started from a small cult at some point. Yeah, there are some questionable JW practices and adherents who do shitty things, but you could say that about any religion, or really any group of people. As an agnostic outsider who never believed in any religion, they all seem kooky and silly to me, but I also recognize that they fulfill deeply-rooted human needs for belonging and meaning.

The OP is already in a rough place, between the chronic pain and the depression. It's not up to me censor their options. If they can find some respite and peace, be it in a religion or in mindfulness or in nature or in community or in harmless drugs, you know... good on 'em. As long as they're not hurting themselves or others in the process, not my place to judge how they find solace.

Our society is so obsessed with materialism and the worship of greed that sometimes even just asking people to consider other spheres of being -- spirituality, community, personal meaning, whatever -- might open up avenues they wouldn't even have considered otherwise. IMO, when you're truly desperate, no option should be off the table.

But of course others are free to disagree, and I'm also glad the OP is getting informed about the downsides of JW so they can make a balanced opinion of their own. </aside>

Contact your city sometimes they have programs for people in your situation.. recently at my work we were contacted through one of these programs about a an older dev in a similar situation as yourself. We interviewed them for an internship and if we take them on the city will pay their wage for the length of the internship.
Now you go on welfare and find a $400/month apartment in rural Nebraska
If you don't have anything good to contribute at least don't be a dick to others. Life can turn on a dime and any of us could be in a similar situation.
I mean it must be obvious but the source of your problems seems to be your chronic pain. What is the source of it?

Do you need to go undergo an operation and don't have the resources for it? If not, do medications help? At least to help you get work done?

I suffered with chronic pain related issues for some years. I might have some insights, feel free to shoot me an email if you feel up to it. Mail is in my profile.
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I'm not sure what the cause of your chronic pain is, but I would highly recommend reading John Sarno's "The Mindbody Prescription." I've dealt with chronic pain for years and it's the only thing that's had any effect. Please, please, don't write it off until you've read the book. Note that Sarno's work focuses on back pain, but it applies to all types of chronic pain (including migraines, which he discusses in the book).

- https://www.youtube.com/watch?v=8jQtmSZetJM

- https://aaroniba.net/how-i-cured-my-rsi-pain

- https://www.nytimes.com/2021/11/09/well/mind/john-sarno-chro...

- https://www.nytimes.com/interactive/2021/well/chronic-pain.h...

Aaron's article was discussed here at the time:

How I Cured my RSI Pain - https://news.ycombinator.com/item?id=1269951 - April 2010 (75 comments)

Lots of Sarno over the years:

https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...

I read about here last year, and gave it a shot based on the many recommendations. It definitely helped me.
Helped me too. I still deal with pain but it totally changed my mindset about it and relieved a lot of the suffering associated with the pain. I saw an associate of Sarno’s who co-authored one of his books, she looked at my imaging and was like, I’ve seen way worse than this, you’ll be fine long term, which was a huge concern of mine. That was a decade past now.
Everybody should read Sarno's book. It's a short read and even if it doesn't help your back pain it will probably alleviate something else. My partner and I both had pain that disappeared from reading Sarno. Back and wrist pain are gone.
This might sound snarky I apologize. How do you know that you pain disappeared from reading a book, when it could have been random coincidence?

Or to phrase it the other way: I have had some or the other sort of pain in my life, and these pains did, rather randomly leave. Would I have read a book or done some random ritual at this point in time, I might now misattribute the relief to the random ritual.

> How do you know that you pain disappeared from reading a book

I can't know for sure. Though there is this:

https://www.nih.gov/news-events/nih-research-matters/retrain...

> “For a long time, we have thought that chronic pain is due primarily to problems in the body, and most treatments to date have targeted that,” Ashar says. “This treatment is based on the premise that the brain can generate pain in the absence of injury or after an injury has healed, and that people can unlearn that pain. Our study shows it works.”

My back was feeling worse and worse until I read the book though. My partner reported the same thing. It could be a coincidence but the book was short, contained a few good lessons, and costs me nothing to recall the information in the future.

This sounds very odd - I read this book with skepticism as a PhD neuroscientist, and found much of it to be completely preposterous, and yet, somehow, it still helped me get back to running after being unable to run properly for 2.5 years. I didn't even have to fully believe the weirder aspects of his theories - the core, and more defensible parts were enough to give me benefits I didn't really expect, as a skeptic.
This is not without merit and to some degree I suffer from TMS but I also have EDS (hypermobility syndrome) which is a very real physical condition, and the two work in tandem to make life somewhat uncomfortable, to say the least.

So while I agree the mind does play a part in chronic pain, it is not necessarily the only part.

For those curious enough for a brief explanation -

>Sarno explains how your unconscious mind can provoke physical pain by manipulating your autonomic nervous system to deprive muscle tissue of oxygen. The book posits that the unconscious does this because of unresolved, unconscious stress that exists deep in your mind. By inducing physical pain, the unconscious creates a distraction that prevents this stress from becoming conscious. You can eliminate the pain by addressing the unconscious stress and becoming consciously aware that the pain is merely a distraction, thus rendering the unconscious's technique unnecessary and ineffective. The book provides specific methods for accomplishing this. I applied these methods and my pain disappeared.

Seems like it could be very effective, and something I'll keep in mind if I ever end up suffering from chronic pain.

Summary linked in the comments:

https://web.archive.org/web/20101210060431/http://podolsky.e...

> Here is my summary of what I think is most important in Dr. Sarno's theory:

> 1. The mind and the body are linked. Classic example: the placebo effect -- your mind thinks it's gotten a pill that's gonna fix your body, and what do you know, believing that leads to your body fixing itself.

> 2. Not only can the mind-body connection lead to your body healing itself (as with placebos), it can also lead to the body harming itself, or creating pain.

> 3. Now why would your body do this? In my experience, people with chronic RSIs are, deep down, not happy.

Not terribly impressed, especially the last one, try to be happy when you have pain every minute, especially when you were happy beforehand.

From wiki:

> Sarno's most notable achievement is the development, diagnosis, and treatment of tension myoneural syndrome (TMS), which is currently not accepted by mainstream medicine.[...]

> Patients typically see their doctor when the pain is at its worst and pain chart scores statistically improve over time even if left untreated; most people recover from an episode of back pain within weeks without any medical intervention at all.

> James Rainville, a medical doctor at New England Baptist Hospital, said that while TMS treatment works for some patients, Sarno mistakenly uses the TMS diagnosis for other patients who have real physical problems.

This is a mischaracterization of Sarno's work. One doesn't need to be "happy" to have relief of pain. Sarno's thesis is that chronic pain of this sort is caused by unconscious stress/emotions and the mere acknowledgement of the underlying issues is enough to cure chronic pain. Furthermore, Sarno stresses that patients must first undergo physical examinations by their doctor(s) to ensure that the pain isn't caused by anything structural. Only then should one proceed with his treatment. Note that Sarno (who has since passed away) was not some quack--he was a bona fide medical doctor who treated patients at NYU Medical Center's Rusk Institute.

I would ask you to read his books' reviews (of which there are thousands on Amazon). Are all of these people who were cured from many years of pain lying? Are the other commenters in this very thread lying? There is mounting evidence that Sarno's theories are, in fact, of merit--e.g. https://www.bidmc.org/about-bidmc/news/2021/09/researchers-m....

I have no opinion on the book or author in question, but I’m not clear on why you are so dismissive.

The ability for psychological expectations to cause physical pain and even physical symptoms (like those of an allergic reaction) is relatively well established science.

Doctors are very dismissive of chronic pain patients and regularly make you doubt you have anything, generally with language very similar to Sarno's, in my case I had to fight a lot until they found I had a variation of Parkinson's disease, it was very distressing and a huge part of my unhappiness.
He stated exactly why he was dismissive. You merely reassert the author main point, but fail to address the counter arguments he gave.
Calling a single sceptical statement "counter arguments" is disingenuous at best. The linked bidmc article is a good starting point if you really are interested.
He quoted 3 sentences from the Wikipedia article, in addition to his own. All of which are relevant and valid points.

You didn’t address any of those. Neither did you address his own.

Even if it was only one, reasserting the author thesis, pretending to ask why he is dismissive while ignoring everything he brought is not a constructive contribution. It’s manipulative at best.

I is relatively well established but it is also used by people and physicians to dismiss of sufferers' pain by assuming that psychological aspect are the _sole_ cause of physical symptoms. Blame the sufferers' attitude etc. Quackery at it's very finest.
"The Way Out" by Alan Gordon is a modern treatment of the idea that has been super effective for me.

https://www.goodreads.com/book/show/50021854-the-way-out

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> Chronic pain is an epidemic. 50 million Americans struggle with back pain, headaches, or some other pain that resists all treatment. Desperate pain sufferers are told again and again that there is no cure for chronic pain.

> Psychotherapist Alan Gordon was in grad school when he started experiencing chronic pain and it completely derailed his life. He saw multiple doctors and received many diagnoses, but none of the medical treatments helped. Frustrated with conventional pain management, he developed Pain Reprocessing Therapy (PRT), a mind-body protocol to eliminate chronic pain. He subsequently founded the Pain Psychology Center in Los Angeles to bring his treatment to other pain sufferers.

> PRT is rooted in neuroscience, which has shown that while chronic pain feels like it's coming from the body, in most cases it's generated by misfiring pain circuits in the brain. PRT is a system of psychological techniques that rewires the brain to break out of the cycle of chronic pain.

> The University of Colorado at Boulder recently conducted a large randomized controlled study on PRT, and the results are remarkable. By the end of the study, the majority of patients were pain-free or nearly pain-free. What's more, these dramatic changes held up over time. The Way Out brings PRT to readers. It combines accessible science with a concrete, step-by-step plan to teach sufferers how to heal their own chronic pain.

I've suffered from severe chronic back pain for the past 12 years or so, starting at the age of 16. It manifested as sciatica initially, and gradually became more severe. I had flare ups that would last months. It eventually started manifesting as SI joint pain, constantly switching sides.

Over the years I had been to 4 different physiotherapists, tried everything from regular core exercises formulated by Stuart McGill, to Infrared heat bands, climbing alot. It would always come back.

I picked up Sarno's book about 6 months ago and I approached it with a highly skeptical eye. My back pain is nearly completely gone. I have had very minor flare ups that last a day or two, but I just repeat a few mantras and it disappears the next day (whereas before the same kind of flare up would last for months).

I even had MRIs done at the start of the pain, I had multiple bulging disks and even a spine that appeared too straight. For anyone reading, don't let this discourage you. 50% of people who have had bulging disks appear in an MRI don't experience any pain at all!

Sarno's book has some pretty flaky theories behind how the pain manifests and the physiology of it all, but the overaching theme is that repressed anger / anxiety can manifest as severe back pain. Once you recognise this you can lose the pain. I never thought I would fix my back pain, but now I have.

Read the book if you're suffering!

psychosomatic effects are strange, i'm gonna peak at this book

also there are non individualistic leverage to curing the mind/body aspect

I tried a lot of meditation, hygiene and sport, but nothing had as much impact as having a daily life (commute,job,colleagues). It seems we're also very dependent on our context.

Routine seems to be a master regulator.
The social aspect of routine. I am a clock like person, but it doesn't fill some needs to relate to others.
Q: My life is falling apart on all fronts and I'm struggling with physical and mental health issues; what should I do?

A: Read this book.

Only on HN...

I admit it sounds crazy, but it works. I was extremely skeptical too.
It really doesn't work for everyone.

OP needs to see a doctor first instead of trying to use a placebo.

I'm incredibly confident that OP has already seen a doctor.
Well put. The sheer number of well-intentioned people who tell you the obvious thing to try out is annoying.
HN bashing can only go so far, every where people have the same prototypes of answers, HN, reddit, boards, public transportation :)
I didn't read it as bashing, but as a joke
Maybe I was lacking some humor that day
Bashing people trying to help is usually a reddit thing, but here we are.

This website is a text based medium. Literally the only thing that can conveyed here is information.

Books, as you are aware, can contain even more information and advice than this website.

If the person was looking for something other than information and advice, they would be looking elsewhere.

I have an intuition that there's a reasoning problem in this comment but I can't point out what exactly this time.

Verbal clues and facial expressions are also pieces of information, so the fact that HN is a text-based medium does not set it apart from other communication mediums only because it conveys information.

People going to HN to ask for help probably do this because they are familiar with this community, not necessarily because it is text-based and probably haven't rationalized this aspect that much.

Anyway, good luck to OP. I don't have any insight on this matter.

When my grandmother was in her 20's, her hair turned white and she started losing weight. Convinced it was psychosomatic, the doctors at the time gave her 10 rounds of electroshock therapy. Later it was discovered that she had Addison's disease, an autoimmune condition. All she needed was some medication.

So, let's say I'm skeptical when it comes to the "mind body connection".

Not everything is psychosomatic. It's good to be skeptical!
Sarno's work comes up periodically on HN, and I always have to chime in to say that it cured my RSI. Everything is still completely, 100% cured at 15+ years. As a developer, I have no idea what I would have done without it, my career would have been over. Here are my previous comments:

From 2016: https://news.ycombinator.com/item?id=12990976

From 2021: https://news.ycombinator.com/item?id=26120633

Yes same here. For me Sarno gave me my life back and reading my comments it seems it has helped a lot other people here too, so I always chime in too. Here is my comment from 4 years ago and that was the the start of the end of my struggle with pain. (1)

Nowadays I've started doing the wim hof method and it's unbelievable my body can endure 7°c bath and I don't feel that cold or fall sick taking an ice cold baths everyday even during winters. The reason I'm mentioning this is because it really seems our minds are much more capable of things for which common sense goes against.

I think like the way germs were discovered which changed our understanding of medicine, within a few decades it will also become a norm to assess patient's mental condition before checking for physical and hopefully using the mind to cure a lot of disease. I feel like a hippie saying these things but after sarno and wim hof I've become more open to the power of human mind.

(1) https://news.ycombinator.com/item?id=17982355

While it might be a possible reason for OP's pain, a lot more often, it's actual physiological issues.

I read this book and it did nothing for me. I had actual medical issues, and I kept going to different doctors and physios until I found one that found the issue and solved it.

OP needs to go see a sports physio and neurologist.

Personally I think Sarno is BS. He's telling people what they want to hear and covering up for the failures of of our medical system.

He basically says that your pain is coming from stress from psychological issues and what you need to do is therapy and Journaling.

I believed this nonsense in regards to my own back pain for a long time. Ironically my pain of 5 years started to subside as I gave up these beliefs although I don't think that was causal.

I had a physical injury to my neck muscles. It turned out what I needed was years of rest and pt to that muscle system. No amount of Journaling is going to fix real injuries

My experience is the exact opposite of yours. I was told for 12 years my back pain was caused by bulging discs, having a spine that has a reduced natural curve and also caused by poor posture. I read Sarno's book and I have been pain free since November last year. I have never gone longer than 2 weeks without severe sciatic or SI joint pain.

Please don't dismiss Sarno's work as BS. It may have not been the right fit for you, but it is for countless other people. Sarno's work is aimed at exactly people who don't have a real biomechanical issue like yourself. It's not a one size fits all, nor is Physiotherapy or surgery.

Also in general, Sarno doesn't reccomend journaling to everyone. A simple mindset change works for most people. Worked for me.

I don't think your story should lead you to conclude that his theories are BS. Like clearly a lot of pain has a physical basis. Sarno's argument was that there is a fair amount of pain that does not have a physical basis, and that once structural causes are eliminated one should consider emotional/mental sources for the pain. The fact that you had pain with a structural basis doesn't really suggest that any of that is untrue.

I'm pretty skeptical of what he says, but there is definitely enough smoke that a fire is possible.

No horse in this race, by the way. I've never had chronic pain, I just think the topic is interesting.

As somebody with chronic pain I think Sarno is a total crank. It has been decades and TMS still hasn't been demonstrated in a way that's objectively measurable. He puts forward what should be testable hypotheses about what's going on in the body and yet still can't publish anything showing it's actually happening. When you read the forums for his books it's a bunch of people cultishly telling each other that they need to believe in order for it to work.
Can you write code? Plenty of places will hire part time, let you work from home, etc. Don’t look for big companies, look for small and mid sized private businesses. As an aside, I think this is an important reason to develop and maintain a social/professional network that you can lean on in times like this. I’m sure I have friends that would give me a chance at work under these circumstances. Maybe you have some of those from years past that you could reach out to? You may be surprised who is willing to help.
Would you have any suggestions for finding work in small-mid private businesses like this? As a developer (mobile with some web and backend), I would love to have ongoing part-time work to provide enough income and free time to pursue other projects.
Sorry to hear about your pain =/ That really sucks. I have had friends in similar situations and without friends and family to help, they're pretty stuck... the US is terrible at taking care of its people. That's not on you, our social safety net just sucks. Have you looked into local instead of federal (city/state/NGO) support systems? Some areas have better support than others.

I'm glad to hear you at least are able to play video games and lurk on the net... having SOME activities and socialization is better than nothing!

That said, in terms of income... if you can do computer stuff, have you considered doing some freelance work from Upwork or similar? It's not consistent, offers no benefits, doesn't pay that great... but it's better than having no work at all. And maybe that would let you build up more of a portfolio for other companies to see.

Maybe the tech sector proper is at a glut right now, but other sectors (manufacturing, retail, etc.) still need devs & people with tech skills, and presumably the big ones are better about ADA accommodations. Maybe those are worth looking into, whether you want to go into the office or find a job that can accomodate you working from home?

-----

Also, work aside... it sounds like at least you have time on your hands, and have some mobility. Do you have national parks or monuments near you? Can you get an America the Beautiful National Park Access Pass? https://www.nps.gov/subjects/accessibility/access-pass.htm For a one-time $10 lifetime cost, it lets you access all of our national parks (which often have good ADA accommodations and interpretive systems) and similar recreational sites... a great way to spend a day or two away from the computer. A lot of them offer volunteer or limited part time work opportunities too. You won't get rich out of any of them, but it's a good way to feel better about the world and yourself and meet cool people to boot.

I'm really sorry you're dealing with this. I'm going to mostly share info about public benefits in case it's helpful, just because that's what I know (and I don't have as much knowledge about some of your other questions.)

What state are you in? I know you mentioned SSDI, but just to relieve some of the stress of getting by, you should try to apply for as many public benefits as you might be eligible for (SNAP/food assistance, Medicaid [medical care], affordable connectivity program [internet], Lifeline [phone.]) With little or no income, you should get some decent support from these programs.

For getting disability support (SSDI, or SSI), you might consider getting a lawyer. You're right it can take a long time to get this, but odds go up if you have a lawyer helping you. You can also contact your local legal aid which you may qualify for based on income.

In terms of jobs I'll do some thinking and see if I can post more. Are there any activities that you can definitely do without getting stuck due to your disability? There are definitely options for flexible computer work, and also things that are more phone-oriented.

To add on to this comment, many public benefits are based off of financial households (who shares bills), rather than physical households (who happens to live under the same roof). For example, SNAP eligibility calculation is based off of who purchases&prepares food together. If you purchase and prepare food separately from the family you live with, then your SNAP household size is 1 (just you) and is based off of only your own income. Even if you don't think you'll qualify, it's worth applying because a) the benefits you receive are based off of application date and b) your caseworker may know of unobvious ways to adjust your income so you are eligible.
You could try making money on a youtube channel, document your journey. Could help a lot of people and make a few hundred dollars on the side. See if there any exercise that you can tolerate. Yoga or kayaking something to keep you moving. Fishing could help with getting enough protein on a tight budget or even something like trying to grow microgreens on your window sill could help you eat healthier. Instapot pressure cooker for cooking beans and rice would also help to get enough protein on a budget diet.
Debt: Can you sell the car? Now is a great time to sell. If it's a lease, you could post it on leasetrader.com (or similar)... again, it's a great time to get out of a lease. It's nice to have a car, but it seems like getting out of that would be a healthy financial decision. Remote jobs are a plenty, and you live with family, so you can tag along with them when you need to get groceries until you've got a job and can afford a car again.

If you live within a couple miles of a cafe, then you can walk there and back everyday to get out of the cabin fever feeling, get some exercise, and change up your scenery for a boost in energy. I know a couple miles sounds like a lot, but you have to recalibrate your thinking to your current needs. When I didn't have a car, I used to walk 4 miles/day. Then I got a bike, no car payment or insurance. Then I got a car. Find your path back to what makes you happy. Chances are, that doesn't require a car.

Depression: It sounds like you've gone down the clinical route, so there's no need to cover that. From there, I'm not sure what your aspirations were in the startup world, but you might have to be honest with yourself about what is realistic and where your skills are now. Again, recalibrate your thinking and take it one step at a time. Your immediate task, besides your health, is to get a job that you can do.

Again, remote jobs are a plenty. What are your skills? Keep applying, keep working, eventually you'll find a remote job were the expectations are low and you can keep up. If we knew what your skills are, maybe there's even someone here who needs a part time person with those skills. Avoid startups and consulting, those are going to be high demand and that's not right for you right now. You've got this.

First of all, I’m very sorry to hear about your situation. My wife has chronic pain and had to give up a career she loved so I have some second hand experience with this.

Can you code? If so please email me and I may be able to give you some work paid per deliverable. You can work on your own schedule without pressure. Nothing huge, just enough to get you started.

Email in profile

> Can you code? If so please email me and I may be ble to give you some work paid per deliverable. You can work on your own schedule without pressure.

I'm not the OP, but I'm in a somewhat similar situation, and yes I can code, but my useful hours are very limited by chronic fatigue.

Do you think that what you're describing is generalizable ? I mean do you think that there are enough people who could use the kind of work you are describing so that it could benefit the, probably very many of us, who are in the OP's situation, rather than just be a one off for one person ?

Please get in touch if you are interested. I think there is definitely enough work, but I think you need very talented managers to enable this kind of work mode. I would argue there is a shortage of high enough quality managers, and no clear incentive to train up managers to this quality.
Although it doesn't help the OP, another option in private LTD. I knew someone who had terrible bad pain that even surgery didn't help and they used their employers LTD and it was easier to get approved along with much higher payments than SSDI. And if structured right, its tax free. So even if running a startup or consulting, you should make sure you have LTD coverage.
Everyone (in America at least) should make sure they have LTD coverage of some sort if they can. The public benefits options just aren’t there. This was a mistake I made.
Write. My career blew up early and I've clawed my way back, but can't imagine what it's like to be in your shoes, but..

I read a Priceonomics article entitled "What it's Like to Fail" and it really moved me during a low point in my life. The subject of the article wrote over 100 episodes of the TV show Roseanne, and wound up living in a van. The article, and the book he wrote to earn money, put a lot of emphasis on writing jobs; gig jobs. He wrote, wrote, and wrote more and slowly pulled himself back up.

https://priceonomics.com/what-its-like-to-fail/

Also, when I volunteered with the homeless I found the mormons to be an incredible resource. Most people don't know this, but the Mormon church is VERY giving and expects nothing in return. If you live near a larger city, the church has stores of food and supplies, and produce food to give to those in need.

Call your local mormon church, talk to the Bishop or a Missionary, and they will be slap happy over the moon to help. At the very least they can help supply food and other necessities.

One more thing, and this I know from professional experience: If you get turned down for SSDI, appeal. Most get turned down the first time, but nearly 100% of people are accepted on appeal.
I’m sorry to hear about your situation. It may seem hopeless at times but remember working at startups is quite challenging and you did that - and faced challenges lots of people wouldn’t care to try to.

Your current assets and your psychology are two different things. Every improvement you can wring out with the latter, could be the piece of strength you need to deal with the other. Seek out any way you can to build up mentally bit by bit. Even little things if they can make a difference.

I’m no expert on this stuff but I wanted to let you know you’re not alone out there.

Wow downvoted for trying to be encouraging? Guess I need to practice that more, I honestly intended the words compassionately.