My Mental Health Story: Depression, Plagiarism, and Analysis

Over the summer, I wrote two articles on mental health and startup founders. One was on how the mental health problems of the founders I know often extend beyond depression and another was about how many founders I know have trauma and mental health issues.

These posts seem to have hit a nerve with a lot of folks, as every week I get a few emails from folks discussing their own struggles with mental illness as founders and asking me to share my story (as promised in both posts). Mental health issues are incredibly common but not talked about enough. They are prevalent almost everywhere and perhaps even more so in Silicon Valley. I hope by sharing my story people might be able to relate to the problem more, share their own stories, or even seek help if they need it.

Taking so Long to Write: Embarrassment and the Too Simple Story

I've really struggled with my write up for two primary reasons.

First, I find my story embarrassing. Not because mental health challenges are embarrassing, but because the critical event that finally forced me to seek help was a prolonged series of stupid mistakes. To mix the illness and the errors together too casually does a disservice to both. I am not sorry for being sick; I am ashamed of my actions. It's the same story, though, and I will trust the reader to have generous intentions.

Secondly, my story ends up tidy. Too linear. Fall, recovery, redemption. It’s true, but it also feels trite to me. I was depressed for a long time. That was terrible. I sought attention by doing something public and stupid. I got caught, I took time off from college, and I went to therapy four times a week for nine months. I had the luxury to address my depression.[1] I made the choice to not take a psychiatric medication, which isn’t an option for many people. I haven't been depressed since. Afterwards I lucked out professionally. So in short, things worked out for me pretty well.

But I have many friends and family members who haven't been so lucky: some have spent years on what clearly in retrospect was the wrong medications or with the wrong diagnosis, some have had terrible times with therapists, some have been hospitalized, some have had their lives put on hold for years, some struggle so profoundly right now that they think their VCs, their employees, or their families would abandon them if any knew their challenges.

Reminder

A month or so ago, a few people sent me a copy of an interview with William Deresiewicz in the Atlantic called The Ivy League, Mental Illness, and the Meaning of Life. The essay touched a number of nerves for me. I was just such a student that he points to: the elite school, the sense of grandiosity, the deep depression, the fear of failure, the strong desire to do more than I was capable of doing, not asking why I was doing things (good and bad), and a very superficial understanding of myself.

That all changed when I took those nine months off from Brown in 2007. I went to therapy four days a week for nine months. I read the entire Contemporary Civilization and Literature Humanities course requirements of the Columbia Great Books curriculum. I built a language of reflection. I asked myself why I was motivated to do the things I did. I changes the trajectory of my mental health and my life.

Crisis

But to get to that utopian outcome, I made an incredibly stupid and embarrassing set of mistakes. I had been a columnist in the Brown Daily Herald, and, over a number of columns and a number of years, I plagiarized. I also plagiarized in a letter to the New York Times.

This ended up being a very important moment in my life. I had been depressed for several years before then. My therapists later described my condition as "long-lasting, complex, deep and persistent."

It's easy to say that my depression had it's root in a complicated relationship with my mother when I was young, or in being raised by my dad from ages ten to eighteen. As I wrote elsewhere:

In my case, my parents had me when they were incredibly young and promptly got divorced. I lived with my mother, an alcoholic, until I was ten. At that point, we had gotten in so many drinking-related car accidents together, that my stepfather was asking for a divorce and child welfare agencies demanded I move to live with my father. I didn’t see my mother again for eight years.

It can also be too easy to cast simple stories for complex realities. It can be easy to blame someone or something. It's not particularly useful, though -- it can often just be a shorthand to describe things to other people. There was some interaction of my childhood and everything else I'm sure of: not feeling completely at home at Brown, coming from such a humble background[2], not being comfortable with my weight[3], being popular in high school, but never being sure why that was, moving four times as a child and feeling like an outsider frequently, etc., etc.

I had what therapists call dysthymia. It's a mild but long-lasting form of depression. It was not so severe that I could not go to school or have outward success. In fact, I had too much of the outside world, I was successful. However, under it all were symptoms of fatigue, despair, trouble concentrating, overeating, and a sense of worthlessness. I did not know where to turn and my friends did not know how to help. I could not identify my problem and had no idea how to treat it.

Depression can be simplified too far. Often, when people are talking or thinking about depression they oscillate between two characterizations: one being severe depression and the other being the blues, a mild today-is-not-a-good-day mood. However, what I suffered was in between those ends. As my therapist put it once, it was a "low-grade, smoldering bad depression". I cannot recall, late in my high school years or during my college years, a time when I was happy -— at least in the ways others describe happiness.

Plagiarism came from a hope to get the help (I knew deep down) I needed. This is not to excuse my actions -- I think they're inexcusable -- but merely to explain them: In my own head, I needed to find a way to get someone to notice that I was unwell and unhappy, not moving through life as fine as I seemed. Many might turn to alcohol or drugs, but my outlet was as subtle as my condition. It was as self-destructive, too.

When talking to a boss about this, years later, she noted that "plagiarism just comes from laziness, and you would have to do a lot to convince me otherwise." In all but one case I was not lazy though, I wrote almost every sentence with my own ideas but then, hoping that I would get caught, I would add a sentence or two verbatim from an outside source. In retrospect, it does not make any sense. I sought attention, not for glory, but in the hope that someone would say to me that I had a problem, and would help me.

I did get caught. I did get help. I did get exactly what I wanted: for my world to fall apart and for me to build a new one, built on a better foundation.

Reflection

Analysis was a life-changing experience for me.

I began by finding a therapist that I jived with well. Not an easy task anywhere, made harder by living over an hour from the nearest city. Finding her, we agreed upon a commitment of four days a week.

So began the most difficult time of my life: a slow exploration of who I was, what I had done, and a difficult childhood. Every day, I traveled an hour and half, each way, to go through talk therapy. The drives themselves became part of the therapy. Beforehand, I would think about what I wanted to talk about that day. While on the drive back I would reflect on, or "consolidate", what I had talked about.

We named the problem. I remember the moment I said to myself, "I am depressed and it is treatable." Comfortable with this prognosis, I made the personal choice to avoid medication. Although nothing came easily or simply, we talked through the various destructive behaviors in my life.

There is no easy way to explain my analysis. It was slow: somehow both methodical and chaotic. Sometimes nothing much would happen in a session, sometimes a lot of progress would be made and I was upset the hour was over. It's exhausting. It's hard work. It can be yelling or crying. Sometimes my therapist seemed like my best friend, sometimes incredibly distant. Neither is factual but both were true for me.

A lot of work in therapy is, in a way, getting to know yourself. It was learning about my past, sometimes remembering things long forgotten. Acquiring a sense of why I do the things I do, where they came from. Sometimes all of this is simply labeled cognitions or "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses." Mental action is a nice way of putting it while in practical reality it can be a pretty brutal process to figure things out.

And that goes on. Four days a week, every week for months. There were rarely big revelations. One day doesn't seem much better or worse than the last, but one month to the next often seem better. Slowly, steadily, I was feeling better. I was more emotionally and physically active. I was growing to know myself better.

It was also a moment where I had a uniquely large amount of time on my hands and could read all those books. At the time I thought I was just using my spare time wisely, but, in retrospect, reading those books was part of my therapy. The Iliad is about wounded pride and hubris. Hard to read the Confessions without thinking of one's own sinful youth, as it were.

Where I Am At Today

It's been almost seven years now and I can't underestimate how helpful it is to seek help and address one's issues, no matter how hard that might be. Today it can almost be hard to relate to who I was before the analysis. All in all, I appreciate how far I have come, how differently I feel, and how happy I am that I went through the process, especially at that fairly young age.

I would not say I know myself fully, but through analysis I gained a much better idea of how I feel and why I feel the way I feel. My friends who knew me, before and after, noticed that I became a little more quiet, a little more thoughtful, a lot happier, and much surer of myself, not in arguments or intellectually, but in a deeper, who I am, sense.

Mental Health Beyond Myself

Stigma around mental illness, which is pervasive through academic and success-driven communities, is difficult to overcome. Sometimes, I feel like I should be a mini spokesman around mental illness. One in four students in college is clinically depressed at some point in their college career. I was one of them. I wouldn't be surprised if the numbers are similar among startup founders, and even though I haven't been depressed in over six years, I sort of wish I could do more to support those folks. To help them seek treatment without a crisis like the one I manufactured for myself.

People need to be more candid about mental illness. They need to be more forward. They need to be less embarrassed -- it isn't something to be embarrassed about.

More people need to have more understanding and acceptance. To do that, people need to speak up. The treatment around mental illness in this country could use a lot of help, which is difficult when it's so hard to talk about it publicly.

And on, and on, and on. My depression's public manifestation is the worst thing I've ever done in my life. It makes me feel like I am the wrong person to push these issues much farther. But maybe it gives me the ability to be more public about my mental health. Maybe I can work to address these problems by creating a discourse and finding ways to help.

Side Note: Consequences

I am not going to plagiarize again. It's a stupid, now unnecessary thing to do, and I obviously write so much now that these essays are unmanageably long. But I wouldn't take back the plagiarism, per se. It was a necessary precondition to get the help I needed.

It was a very important, if overly public, period of my life. It's the fourth or fifth link on a Google Search for my name, so it definitely comes up.

Obviously, I've since gotten in to Y Combinator, convinced people to work with me on building Standard Treasury, and gotten normal jobs/internships at Stripe, the City of Newark[4], Bennett Midland, and the US Department of State[5] as well as fellowships at Harvard and NYU. In all of these situations, I've had to discuss this history in a lot of detail with my employers.

On the other hand, there are some jobs I have been seriously considered for that I haven't gotten -- particularly government appointments, both for the Federal Government and the City of New York -- because, well, I did do something very stupid and very public in college. Although most people's reaction seems to be that we all do stupid things in college, most avoid doing them so publicly.

I do hope to, one day, hold another position of public trust beyond being Mayor Booker's Senior Technology Policy Advisor, but that might be a hard thing to do.


Footnotes

[1] I moved to live with my father, who was incredibly supportive. He had moved to teach in Kansas and had an extra bedroom. My maternal grandmother gave me some money for food, etc., and my therapist saw me for nearly free during her lunch hour. I was also 22 and had no real responsibilities to anyone really.

[2] Things got complicated here. When I was growing up, my Dad was a postal clerk and my mother a waitress/chef. When I was fourteen, Dad went back to get a BA at Rutgers and then stayed on there for an MA and PhD. This leads to two simultaneous complications: (1) My Dad and I intellectually matured at the same time and (2) My Dad made...whatever PhD students make...until months before I took time off to go to therapy. I grew up in a small, working class town in New Jersey and without very much money: Brown was a culture shock for me in some ways.

[3] See Losing 58.3 Lbs for Science

[4] Part of my job in Newark was to break some eggs, so, one of my adversaries leaked my appointment and plagiarism to the New Jersey press. Some folks chatted with Mayor Booker's Chief of Staff and Chief Policy Advisor, and everyone decided it was a non-story.

[5] I applied for my internship at the Department of State before leaving Brown in 2007. They let me know in May 2008 that they'd like to do my security clearance. I passed the clearance and showed up for an internship, after deciding with my therapist that I was ready. On the third or fourth day, I told my bosses at the Office to Monitor and Combat Trafficking in Persons. Quite conveniently, they were all Christians and Bush-appointees, and they definitely responded to the story as one of redemption. Ultimately, they thought hard about firing me, but felt that if I had worked so hard to put my personal life in order then they would help me put my professional life in order. That, they did: it definitely mattered to the first person who hired me after college that I had that internship after the plagiarism.

Losing 58 Lbs For Science

This morning was my final data collection for a randomized diet experiment I have been participating in for the last year. Here is a graph of my near-daily weigh-ins on Withings:  

It can be hard to read: on the first day of the study, October 2, 2013, I weighed 236.3 lbs and this morning I weighed 178.0

The study

I have been a participant in the One Diet Does Not Fit All: Weight Loss Study. The theory of the study, which makes intuitive sense to me, is that people's bodies and genetic makeup are different and, as a result, that different people would lose weight on different diets. That is, they're trying to "find characteristics that would help determine differential response to weight loss diets."

My study is a follow up to "The A to Z Weight Loss Study" which randomized premenopausal women to one of four diets. In that study, among many other things, "the investigators observed a 3-fold difference in 12-month weight loss for initially overweight women who were determined to have been appropriately matched vs. mismatched to a low carbohydrate (Low Carb) or low fat (Low Fat) diet based on their multi-locus genotype pattern."

Thus my study was born. It started as the Diet X Genotype Study and got NIH funding, and then expanded both in the tests administered to each participant and the number of folks in the study through outside funding (see more in the Wired article Why Are We So Fat? The Multimillion-Dollar Scientific Quest to Find Out).

They're testing as many of us on as many factors as they can to see if some of the those factors correlate with successful weight loss on one of the two randomized diets: low-carb and low-fat. For example, they're sequencing the parts of genome that might predict our success on one diet or the other. Additionally, they figuring out how insulin-resistant we all are (through a Glucose tolerance test, our resting energy expenditure, something about how our fat is stored (I had two fat biopsies), and also information about our microbiome. The outcomes seem pretty simple: weight, waist, and a body composition measurement (DXA scan).

Why I joined the study

I've been overweight for a long as I can remember. Actually, obese, which at my height is anything over 190, and "severely obese" at times, which is 250 and above.

My weight didn't really come up all that much on my mind or with my friends. If anything, it was just the target of my own self-depreciating humor. I got made fun of some in middle school, but that might just be why I am a tough fella.

Adulthood is more explicitly forgiving although perhaps not implicitly forgiving. I do remember having a very candid conversation with my high school math teacher my senior year. I was close to him and had him for three years. He had worked in industry for a long time before retiring to teach us calculus. At some point my self-consciousness about my weight came up and he shared with me that as a one-time manager of people he thought I'd be disadvantaged in life for weighing so much. People would assume things about me that weren't true. I might not get jobs or opportunities I deserved for the subtle biases that being obese brings with it.

I didn't think about that all too often though. I didn't think about it much, since I really had never known anything else. I had always felt like I could do the things I wanted to do without much inhibition. I now know that you do get treated differently if you're thinner and more attractive, something I'm sure I "knew" but wasn't particularly pleasant to think about fifty pounds ago.

Thinking a little bit more about my weight had a weird trigger: James Gandolfini dropped dead at 51 last June. My reaction was oddly personal, since it's not like I'm a big fan or anything. I thought to myself: he's an overweight guy from New Jersey, and I'm an overweight guy from New Jersey. I don't want to die when I'm in my fifties. I suddenly became concerned about my long-term health.

I wasn't sure what to do though.

Around this time, Dan and I were driving a lot between San Francisco and Mountain View while we were going through YC. We had lots of meetings with VCs, meetings with potential bank customers, and meetings with startups to understand their financial problems. Over and over again, I heard a radio advertisement for a Stanford weight loss study. A few times I'd think to myself that I have to remember the URL or Google it. Eventually, after a month or two, I did.

I then got invited to be screened for eligibility. One has to be at least overweight, with relatively stable weight, and be within certain blood pressure and cholesterol bounds. (By the way -- the study is still recruiting) I got through that and then attending a informational, consent, and Institutional Review Board session: these things could happen to you, the diet could be terrible for you that's the point of a randomized experiment, will you consent to the extra tests and to having your blood stored forever.

The support and training

After that all, I was assigned to a particular nutrition class. On the first night, I showed up with almost twenty other people. We were a cohort of sorts. We would all have the same diet. We'd see each other consistently over the year to learn from our nutritionist and to share how it was going. It was some mixture between group therapy and a very basic science class.

For the first eight consecutive weeks we got training and support on the diet. Things like how to do lunch, how to snack, etc. After that the classes tapered: every other week, then every three weeks, then just once a month from the six-month mark to the end of the year. The classes also switched to shared topics across the cohorts like mindless eating, making sense of food labels, sleep and weight loss, etc.

These classes were incredibly important and supportive. Even though people might be on the "right" diet or the "wrong" diet, it always felt like they wanted us to succeed.

The diet

I was randomly assigned to the low-carb diet. For the first eight weeks they'd like you to try to stay below 20 grams of carbs a day. (For folks familiar with Atkins, that's total carbs not net carbs). That's a low amount. I stayed below that number for maybe six months or so, although I've become a little more liberal now introducing things like berries and nuts. I still haven't had grains, bread, rice, potatoes, sugar, etc for a year now.[With few exceptions, see footnote 1]

I find the low carb diet pretty easy to maintain: it's basically vegetables, meat, eggs, cheese, and then pure fats like oil and butter. Thank god for cheese. In particular, I eat out a lot and it's usually pretty easy to manage these restrictions. Many dishes are composed of a carb, a protein, and a vegetable. Almost everywhere I've eaten in the last year they'll substitute more of the vegetable for the carb. I do have to avoid some types of places I've historically loved: pizza, ramen, dumplings, etc, but no one has minded changing locations of get togethers.

I think the low-fat diet is a little harder to manage because you're trying to avoid oil and butter. That's hard to do and eat out. Although, there is an element of resiliency here: maybe if I was on the other diet I'd say that was the easy one.

Sometimes it can be hard for me to know whether it's the diet that made my weight loss. I haven't eaten at Bi-rite Creamery (a famous ice cream shop) or Tartine (a famous bakery) in a year, both of which are minutes walk from my house. That is, importantly, my relationship with food has changed. It's become no less joyful but it has become more deliberate. I think about what I'm eating.

I'm pretty sure I eat less. I eat a lot, more than I need to I think, but I use to go, for example, to an Indian buffet or something like that and eating until I was absolutely stuffed. I've only had that feeling a few times in the last year.

So was it the composition of my food or my changing relationship to eating? The answer is likely both.

The other stuff

Whether or not it was the easy diet, it worked well for me. I've also been particularly fanatical about the diet. I find it easy to have a strict rule-set and then just to follow it without compromise. I like how the diet has limited my choices, particularly as I'm building Standard Treasury. I also think having an oracle -- Stanford, science, whatever you'd like to call it -- is very helpful. I can't break the diet because more is at stake than just my personal well-being.

Most importantly, though, is that I'm at an easy place in my life to do this sort of thing. Some of the other people in my class have spouses who weren't doing the diet and/or kids. It's pretty easy for me to do exactly what I want food wise because I'm not actually beholden to anyone else. It's easy for me to eat protein heavy because the cost of food isn't a concern for me.

I also did not have any naysayers. All of my closest friends, my family, and my colleagues have been incredibly supportive over the year. Some of them have even adopted the diet entirely or almost always follow it when we're together.

There are also compounding returns, cumulative effects, or a virtuous cycle in two senses. The first is the results. I lost ten pounds, people notice. People compliment me. That's feels good. I stick with it. I lose ten more pounds. Etc. At some point the speed at which I was losing weight certainly slowed down, but by that time I had lost a lot of weight. It doesn't happen all the time, but I have pretty constantly seen people over the last year who haven't seen me since before the diet started: and their reactions have only gotten bigger and better over time. That's a big motivator.

The other place I've seen compounding returns is in exercise. Even before the diet, I had exercised pretty consistently, but as I lost weight it became easier to exercise so I would do so more intensely or for a longer time. Just last week, for example, I was in Boston and didn't have access to the gym. I decided to run around the Charles. I don't think I've run a continuous mile in my life: I easily ran three nine-minute-ish miles. Not fantastic. Not world class or anything like that. But also doable. I repeated that three days in a row. In short, I exercise more because it is more fun because it is easier.

Lastly, in class we learned about the National Weight Control Registry: "The NWCR is tracking over 10,000 individuals who have lost significant amounts of weight and kept it off for long periods of time." These folks have some common behaviors. Among them is: tracking their weight, tracking what they eat, eating breakfast, and being active. Of those, I have done everyone but tracking what I eat over time -- I find it a big pain in the ass. The other three habits have been critical to my success though, and I think I'll keep them.

The future

The results of the diet have been good for me. I've lost weight. My blood pressure has stabilized to normal. I'm more energetic. I exercise more. I'm more confident in some parts of my life. It's been good.

I'm still losing a few pounds a month and I'd like to keep that up. The BMI line between "normal" and "overweight" for my height is 155 lb. My doctor has said I shouldn't force that since I'm much wider (in the shoulders) than an average person my height; however, I'd like to stabilize in the 160s. So, another 15 lbs to go to reach my goal. We'll call is 75 lb. from when I started the study. I think it will be pretty easy to get there: mostly just time and keeping up the fanatical devotion.

More importantly, weight maintenance is a big problem for most people, so I'm not celebrating that much or declaring some sort of victory. I doubt that I'll stick with the diet forever as strictly as I have over the last year -- I'd like to eat a chocolate chip cookie again in my life -- but my relationship with food has been reset. Hopefully that will be the most enduring lesson.

[1] I'm often asked when I've broken the diet. I've broken the diet four times:

  • Dan lost a bet to a group of friends and we scheduled a meal at Manresa;
  • Thanksgiving;
  • I was at a wedding that instead of normal, boring catering had a New Haven thin-crust pizza truck roll up and cook pizzas fresh; and,
  • I went to Japan for a week and wasn't not going to eat any carbs, which would have been quite difficult anyway.

Mental Health, Trauma, and Startup Founders

A conversation seems to be slowly starting about mental health and Silicon Valley, or at least mental health and starting one's own company. And in a more serious fashion than "you'd be crazy to do it". Sam Altman on Founder depression started the conversations. TechCrunch continued by noting that We Need to Talk about Depression (which also has a good list of links to other similar articles) and Founders on Depression.

In my earlier post, Founders and mental health I wrote primarily about the range of mental health issues that founders can face. We should remember that depression isn't the only manifestation of mental health challenges.

Many people emailed me, talked to me in person, and even wrote a Quora question on one particular thought from that post though: that lots of startup founders I know have experienced some trauma in their past and that that trauma is often a strong factor in their motivation. Sometimes that trauma is a root cause of depression or anxiety or motivation, sometimes it is just present and something to deal with, and obviously sometimes it doesn't exist at all.

I thought I would explain the idea a little more though.

Over the last year I have found that most startup founders had some deep personal trauma in their early lives. Not all people but more than I might expect. Glen Moriarty, the founder of 7 Cups of Tea, and I have discussed it at length but it has also come up with many folks both inside and outside the YC community. It's a topic that someone resonated as something to talk about when you're stressed out and bonding late after one of YC's Tuesday dinners.

The trauma theory made immediate sense to me as I have made a similar observation about many, if not most, of my friends and classmates at Brown. Either they had screwed up childhoods and were motivated by that somehow, or that had intensely attentive parents and were trying to live up to expectations. Either way, I did not find many settled content geniuses who found their way there.

There is a fundamental difference between schools and startups though: in one you know the goalposts and in the other you don't. At school, you are told what targets to hit for success while startups are much more chaotic and kinetic. To me, the idea that some deep, often traumatic, motivation is a powerful catalyst for success, made all the more sense in the world of startups. You have to really want it for whatever reason.

And that reason is often something from one's childhood.

Perhaps I shouldn't use such a broad brush to paint so many people with so common a set of neuroses. It's certainly not the case that everyone that succeeds in life has trauma. (And not all trauma leads to success obviously). But I wouldn't doubt the predictive power of the idea either. As I talked with new friends in YC, throughout Silicon Valley, and beyond about deeply personal topics the theory seemed more accurate. Or at least I had more data supporting the idea. (Although this could all be a selection bias).

In my case, my parents had me when they were incredibly young and promptly got divorced. I lived with my mother, an alcoholic, until I was ten. At that point, we had gotten in so many drinking related car accidents together, that my step-father was asking for a divorce and child welfare agencies demanded I move to live with my father. I didn't see my mother again for eight years.

You know, perhaps if my startup succeeds my mother-of-1997 will treat my ten year old self better? I'm partially joking and partially not.

Dan, my-cofounder, his father died when he was one. His mother was in a coma for some time and had to learn how to talk and walk again. Hopefully his father will be proud of his first billion dollar company.

Time and time again, there are similar stories that come out from co-founders I meet, mostly because I can be candid about my background and this theory. Some with less intensity perhaps but no less motivating to the individual. Some with a lot more intensity but with less motivation. I don’t necessarily feel empowered to share their specific stories here but they're often there, serious, and touching. The speed and positivity with which folks, many profoundly publicly successful, respond to this idea further suggests that it hits on some truth about the startup community.

Ultimately, I spent years of my college life in a path of depression, crisis, and then renewal that have made me stable, happy, and sure of who I am. In many ways I am fortunate that that happened so early in life and not when the consequences of my errors affected many people beyond myself. But at other times I wonder if I lost a little something. Something that people who haven't faced down their demons still have. After all, I was amazingly productive and won many collegiate awards in 2007, all the while self-destructing.

This is correct in the sense that what I do now is no longer compulsive (i.e, unconscious). I was succeeding out of an unconscious drive or push. Now that I have awareness, I can see that I still have this same drive and push, but I can choose where to focus it. It isn't compulsive now.

A number of friends and many people who emailed me after the last post asked me about my experiences through depression and therapy. That write up will be my next post.

Founders and Mental Health

Last week Sam Altman wrote about Founder Depression. Catherine Shu followed on, among others, with a candid telling on TechCrunch of her struggles with depression. I applaud them both.

Many startup founders I know aren't depressed though. They are anxious.They are on the spectrum of anxiety disorders. Real existential concern about whether they'll make it. Whether they're doing the right thing. Whether they'll raise money. Actually that last one isn't anxiety: strictly speaking anxiety is generalized and unfocused fear. A lot of people who are running startups fit that bill though, they have terrible unspecified fear (of failure). You can get pretty far down the anxiety spectrum and just seem like a founder who cares. That is dangerous.

Highlighting depression is useful but also limiting. It can demarcate people who have had certain problems without highlighting others. I believe our community — Silicon Valley, Y Combinator, startup founders, or all ultra-high-functioning professionals — should be having a conversation about mental health more generally, about the sources (sometimes quite dark) of our motivations, about pathologies, about depression, about anxiety, and about other problems. Or, at least, be more comfortable having those conversations privately.

I know founders who are on the depressive spectrum too, which can range from the blues to deep clinical depression. I have a history of depression myself. I have not had a serious depressive episode since I took a year off from college and invested in intensive therapy, but most people don't have that luxury — or they are not comfortable taking that much time given how taboo mental health can be. I remember when I was in the depths of my depression spending eighteen hours in bed with a dreadful sense of melancholy. That's a serious case — I couldn't have run a startup when I was depressed — but depression hits people in different degrees. Someone who seems fine often isn't.

Depression and anxiety are just two examples of the challenging mental health that startup founders can have. Anxiety and depression are often described as opposites, which is too simple a story, and they need not be opposites in our mind. Either can be dangerous and destructive. We need to talk about both. The names of anxiety and depression can sometimes just obfuscate things more: We need to talk about much more too. I know a few (medicated or not) bi-polar founders. I know a few diagnosed with OCD.

No matter the diagnosis or the name, founders can feel isolated by their mental state. They can feel alone, which can make them more depressed, more anxious, more obsessed or whatever. 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.

Over the last year I have also found that many startup founders had some deep personal trauma in their early lives. Glen Moriarty, the founder of 7 Cups of Tea, and I have discussed this idea at length and it has come up with many folks both inside and outside the YC community: startup founders insatiable motivation often comes from trauma.

We are all unique but most of our problems are not. Startup founders are so often a community that helps one another with introductions or advice. I hope that in time we can all be as comfortable talking about our mental health. That we could be as comfortable giving advice about our depression or our anxiety as we are about fund raising.

I might write a lot more about this soon. I don't know. Some of my friends, colleagues, and investors have cautioned me against being too public about my own history and my own traumas, but any founder should feel they can contact me, if no one else, whether they're depressed or anxious or something else (or use 7 Cups of Tea).