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142

142 RR Depression and Mental Illness with Greg Baugues


02:32 – Greg Baugues Introduction

03:33 – Greg Baugues: Devs and Depression

07:20 – Stigma

15:50 – Getting Help

34:25 – Finding Support

38:31 – Preventative Care

44:50 – Self-Discovery

52:34 – Developers and Depression

57:27 – Preventative Care (cont’d)

  • Physical Exercise
  • Meditation
  • Sleep
  • Diet

01:09:19 – Resources

Book Club

Ruby Under a Microscope by Pat Shaughnessy! We will be interviewing Pat on February 27, 2014. The episode will air on March 6th, 2014. No Starch was kind enough to provide this coupon code your listeners can use to get a discount for Ruby Under a Microscope. Use the coupon code ROGUE for 40% off! (Coupon expires April 1, 2014.)

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Passenger Enterprise with Tinco Andringa and Hongli Lai

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TRANSCRIPT

AVDI:  Josh is such a hippie. ‘

[Laughter]

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CHUCK:  Hey everybody and welcome to episode 142 of the Ruby Rogues Podcast. This week on our panel, we have James Edward Gray.

JAMES:  Thunder Cats. Ooh!

CHUCK:  Josh Susser.

JOSH:  Space Ghost.

CHUCK:  Avdi Grimm.

AVDI:  Hello from Hawk.

CHUCK:  I’m Charles Max Wood from DevChat.TV. And we have a special guest this week and that is Greg…I didn’t even ask how to say the last name. How do you say your name, Greg?

GREG:  It’s Greg Baugues and it’s actually a point of contention amongst even my family members. So, I don’t feel bad about that.

[Laughter]

GREG:  But I’m calling from Chicago.

CHUCK:  Alright. Well, that’s not the only controversy we’re going to have on this show. Before we get going too far, I just want to point out we are going to be talking about mental illness and depression on this episode. So, if that bothers you or if that’s something that you need to deal with in a certain way, we just wanted to make you aware, so that we don’t upset anybody too much. But we are going to be discussing it and we know that it is a sensitive issue. So, I just want to point that out. On a little bit lighter note, we actually reached our goal on our Teespring campaign. Thank you to everybody who bought a t-shirt or a hoodie.

JAMES:  Yay!

JOSH:  Yay, thank you!

CHUCK:   Or had to replace a t-shirt because they washed it with a towel.

JAMES:  Alright, that’s not cool.

[Laughter]

JOSH:  Hey, you forgot to say a red towel.

[Laughter]

JAMES:  It turns out those things bleed. Who knew? [Chuckles]

CHUCK:  If you wanted a pink t-shirt, ask James how to get one.

JAMES:  [Laughs]

CHUCK:  Otherwise, thanks again. We’ll probably do another campaign in another year or something. If you want them sooner, just harass us and then we’ll talk about when we want to do it. And yeah, so Greg, do you want to introduce yourself? And then we’ll get going on the episode.

GREG:  Yeah, my name’s Greg. For the last six and a half years, I’ve been working for a consultancy here in Chicago called Table XI. We’re a Rails shop. But starting in about a week, I’ll be a developer evangelist at Twilio in part, so that I can do more speaking at conferences. Last year, I’ve been speaking about depression and mental illness at various tech conferences.

CHUCK:  Yeah, that’s where I know you from. I was at Mountain West Ruby Conference last year and you spoke about it. It was really interesting. Both during the conference and we actually wound up going to lunch or dinner or something afterward with a bunch of other folks and having that same conversation.

GREG:  Yeah. I really appreciated talking to you. That was actually the first time I’d ever given the full-length talk. And there was this bit of right before I got on stage, what the hell am I doing? Why am I going to get up in front of a couple of hundred people and talk about this stuff? So, I was talking to you almost immediately afterwards and I just appreciate your encouragement afterwards. It was really reassuring.

JAMES:  So, that leads to an excellent first question. What the hell are you doing, Greg?

GREG:  [Laughs] Yeah, that’s a good question. I have type II bipolar and ADHD. I got diagnosed about seven years ago. And the ADD, I accepted a little bit more readily. I went to see someone because I read some books and was like, “I think that’s me.” I had failed out of school and just had some pretty rough patches and couldn’t figure out what was going on. So, I saw a therapist. She says, “You definitely have ADD. I think you also have type II bipolar.” And I was like, “No. I’ll take the ADD. And you can keep the bipolar.” And so, I pretty much lived in denial. I started treatment about five years ago or so because things just got really bad and it’s like whatever treatment looks like it can’t be much worse than where I’m at. I take a pill every morning for the bipolar. Life got so much better. But the reason I started speaking about it is that about a year and a half ago, we had a developer come start working with us and his name was Caleb. And he was just incredibly great. I got to pair with him quite a bit and he was just a great teacher. But he started doing a lot of the same things that I was doing before I got treated. So there was like, showing up late to work and calling in sick, and with different excuses all the time. And so, I just shared my story with him. And he said, “Yeah, you know I think that I might have something similar like that.” And so, I gave him a couple of numbers and he set up an appointment with a psychiatrist for a few weeks out. His appointment was set up for a Friday. He called in sick on Thursday and he sent me an email just saying it’s been a rough few days. And then we found out later that he missed his appointment on the Friday and then he died the next day of a drug overdose. It was accidental. And he didn’t make it to his appointment because he had run out of money. So, I was scheduled to give a talk about genetic algorithms and fantasy football in the office a few weeks later. And I went to the guys and I just said, “Hey, how about instead of talking about that, I just basically get up and I say I have bipolar. I have ADD. I think Caleb did too. He died. If you guys want to talk about this stuff, let me know.” It was just a quick lightning talk. And they were awesome. They have continued to be awesome, super encouraging. So I got up, I gave the talk, and that day, I had a couple of people IM me saying, “Hey, can I have the number for your therapist or your psychiatrist?” So, I applied to speak at some conferences. I got accepted to way more than I expected. I kind of assumed that there were more people in the tech community like me who were struggling with this stuff who maybe had an inkling that they had this but didn’t know what to do or didn’t want to accept it. And what I’ve just been blown away by the last year and a half is just how many people actually are suffering from this stuff. It’s way more than I would have expected.

JOSH:  I think the ‘way more than you expected’ is shocking, how much mental health issues we have, not just in the world but in our country. I worked on a mental health startup for two years and learned a lot about the field. And it’s all the way from about half of people throughout their lives, have something going on that would be a diagnosable mental illness, to the point where they should be getting some sort of treatment. It’s like one in two people have something like that come up throughout the course of their life. And in any given year, it’s like a quarter of the population.

JAMES:  You know, Josh, I like what you said right there about should be getting some kind of treatment. And Greg talks a lot about this in his talk and I’ve definitely seen it too. But there’s a stigma against getting treatment, against admitting that you have these problems, right?

JOSH:  Yes.

GREG:  Yeah, it’s very true.

CHUCK:  Well, I think there are two things here. And one thing I’m going to say is a little bit insensitive but I want to just put it out there. And that is that I’ve known people who have claimed a mental illness, they don’t exhibit any behaviors that make them seem any different from anyone else, and then they use that as an excuse for this, that, or the other. And the other thing is that people are afraid of people who are different. And it’s one thing if somebody has a physical disability because you pretty much know how to deal with that, or at least you understand what’s there. Somebody can’t hear or can’t see or can’t talk or walk or whatever. But with those, it’s somebody that’s unpredictable. And usually when those people are depicted, they’re depicted in a way where they do things that are totally crazy and off the wall. I probably shouldn’t say crazy. But they do things that are very different. And that’s scarier to a lot of people than something that they can see and touch and at least somewhat understand.

GREG:  Yeah, I think that’s true. There’s a very different, we certainly treat mental illnesses quite differently than we treat physical illnesses. On the physical illness, James, I really appreciated your GoGaRuCo talk. And I was just curious because you actually talked in there about how you were treated differently with the servers who will come up and they’ll still ask your wife what it is you want to eat. I’m just curious, what was your response after giving that talk and people coming up and talking to you. And how did that feel for you to get up? Obviously, it’s easier to hide a mental illness than your disability. But what did that feel like for you and what was the general response when people came up and talked to you afterwards?

JAMES:  It’s a good question. It’s like you say. People look at me and there’s no doubt that I have a disability. So, it’s not like it was the worst-kept secret ever. Actually, the reason I did it is because people commonly want to know things and are generally just afraid to ask them. But I think that’s probably good, to be cautious in general, because you don’t know what’s going to bother a particular person or whatever. But I’m just not like that. I’m totally an open book and I’ll tell you anything you want to know. And so, I really just wanted to do it to let people know you can ask me whatever you want. And if I can answer it, I will. And a lot of times at conferences, people will actually pull my wife aside because she’s always around when I’m around, helping me do things and stuff like that. And they’ll pull her aside and ask her questions and she’ll just come and get me and bring them to me and have them ask me or whatever, because she knows I don’t care. And she encouraged me to do it. She’s all, “There’s lots of things people want to know and just have no idea about.” What’s interesting is some things are surprisingly different. If you get far enough out of your context, it can be amazing how quick the world changes. And I think people don’t realize that sometimes. I was constrained in GoGaRuCo because I was in my manual wheelchair and so I couldn’t move around and that kind of thing. But I did the talk again here locally in my electric wheelchair where I could do some other things. And I showed people what shaking hands was like for me, which is something we do at all of our conferences. But it’s a surprisingly crazy thing. You just can’t understand until you consider all the factors involved. And you could see it was very eye-opening to people to discuss that. At the same time, I would not say I’ve had as many people come up to me as you have. I’ve had tons and tons of people thank me for doing it. But the odds of somebody else having my exact condition, say if they do, they’re going to know. So, I don’t think I was a channel for other people to see how, as much as just expanding your world view kind of thing.

GREG:  Yeah. What I love about it is that we live in a culture that does not in any way promote or reward talking about your weaknesses or talking about being vulnerable, especially in front of crowds of people. And you guys were saying earlier about the stigma attached to things, attached to mental illness. If you were struggling with say cancer or diabetes and it was affecting your ability to get up out of bed or to go to work, nobody would say that you were using that diagnosis as a crutch. And we often talk about the difference between physical and mental illnesses. But there’s a TED talk, I can’t remember who gave it. He says that we should probably stop using the phrase mental illness and start talking about brain illnesses because people forget that the brain is just as much an organ in your body as say your kidneys or your heart. And it can malfunction. And there are some very good doctors and very good researchers who have come up with very good treatments for this that have helped tons of people. But for some reason, and I think that it’s, Chuck for a lot of the reasons you said, it’s harder to diagnose. It’s harder if someone has depression, to look at them and say, “Yeah, you definitely have something biologically malfunctioning in your body,” than if someone were to say, “Look at James.” But there are a lot of people who would really benefit from going to see a doctor. And if it was a physical condition, there would be no hesitation and no stigma around doing so. But because it’s a mental condition, or something having to do with their brain or something just above their neck, they’re not nearly as likely to go see somebody.

JOSH:  Greg, while I don’t disagree in general with what you’re saying, I think the message there is really important. I don’t want us to exclude people who are actually dealing with highly stigma-laden physical issues.

GREG:  Wholeheartedly.

JAMES:  Sure, yeah, yeah. There are plenty. But it is a point. I’ve seen even in just my local group of friends, friends that are reluctant to go see a psychiatrist because they were concerned that they might need medication or something like that. Yet if that same person had a heart problem or a kidney problem or whatever that required some medication, I know they wouldn’t think twice about going and getting that drug.

JOSH:  Right.

GREG:  If their eyes didn’t work, they wouldn’t think twice about wearing glasses.

JAMES:  Right, yeah, yeah, yeah.

JOSH:  I think that there’s a lot of, speaking of stigma, I think there’s stigma associated with some of the medication-based treatments. And back in the 80’s, it was the era of Prozac. And I think at one point, over 10% of the country was taking Prozac. And people who were on Prozac, you could tell they were on Prozac.

[Laughter]

JAMES:  Now, that’s just reality TV, right?

JOSH:  [Laughs] I don’t know. I don’t watch reality TV.

[Laughter]

JOSH:  Chuck, let me just finish. What I’m saying here is that I think that, I’ve actually talked to friends who have avoided going and getting therapy because they didn’t want to be put on some sort of psych med that they felt would prevent them from enjoying the little of life that they got to enjoy. So, there are definitely people who, they don’t actually have a good idea of what therapy could be like and what the different ways of getting treatment are. But there’s this whole range of treatment options that are available. Some of them involve meds, some of them involve talk therapy, and there are other things as well. So, it’s just that focusing on the meds, meds are an important component of the options we have, but it’s not all about that. And there are plenty of ways that you can get help that don’t involve putting strange chemicals in your brain that you may not enjoy.

JAMES:  Yeah. I maybe wasn’t clear about that. What I meant to say is that the thought of possibly having to take meds sometimes talks people out of even just going to see a psychiatrist. You don’t know they’re going to put you on meds or that you even need meds or anything like that. There are plenty of psychiatrists that believe in non-med approaches and things like that. What I’m saying is that the stigma is there and it may even kill the game before it ever gets started.

JOSH:  Agreed, agreed.

CHUCK:  So, what my question is then, and I’m going to spend some of my ignorance currency here, I’ve not experienced this much. I don’t know very many people that have really gone through something like this. And so, what I want to know is how do you diagnose yourself at least to the point where you know that you need help? And then the other question that I’m going to ask in a little bit so you can be thinking about it is how do you identify the people who are in trouble and help them without triggering some of these stigmas in their own head?

GREG:  Yeah, that’s an excellent question.

CHUCK:  But the first one I really want to know is how do you know you’re in that danger zone and need help?

GREG:  Yeah, that’s great. What helped for me or what finally got me to see someone is looking at patterns in my life, because everybody has periods when they are happy and periods when they are sad. That’s the normal human condition. You don’t want to just have a monotonous life. What I started to realize was that I would look at my life, especially when I was going through the depth of it, I just moved to Chicago. I was broke. I really didn’t enjoy my job, certain parts of it. I just failed out of school and it was like, of course I’m depressed. Why wouldn’t I be depressed? I have all these life situations that are just making things really hard. And then things would start to change and I’d get a new job that I really enjoyed or I had some money in my checking account. And I would go through periods where I’d be happy for a couple of days and then I’d look back and say, “Oh man. I have this job I love but I still can’t get out of bed to go to it.” I recognized that I had talents and abilities, that I could code and that I had ideas. And after I looked back on the last year or two, I would see none of those things have come to fruition. And I know that I want it. I know, know, know that I wanted it. And I know that I’m capable of doing this. Why is this not happening? I can understand if I had a week or two where things weren’t getting done, but this is, I’m making no progress here no matter how many times I say, “This time, it’s going to be different.” And I fought. I did not want to take meds and I fought it. And I was just like, “I’m going to man up. I want to try harder. I’m going to stop being lazy. And this time it’s going to be different,” and maybe sometimes I could make that last for a week or two. But then I’d always end up right back in the same place. So for me, I would hope that other people can learn from my mistakes. I finally went to see someone when I exhausted all other options, when I got Io the point where it was pretty obvious that I was going to get fired in the next month or two if I didn’t do something else. And for me seeing somebody was the last resort. And I feel like I wasted a year or two in between my initial ADD diagnosis where they say you also had bipolar and actually getting treatment for what was by far the much more severe issue. So, I would say if you’re getting to the point where you have an inkling that something might be wrong, there’s been a pattern and regardless of life situations, depression seems to, and I’m speaking just about depression, not all the mental illnesses because I don’t have a ton of experience with them, that’s what professionals are there for. If you found a little lump on your skin, you’re like, “Oh how do I know if it’s cancer or not?” Well, you don’t. Go see a professional who went to school for this stuff. And that part can be really hard. And I don’t want to trivialize, and we can talk about that later, the difficulties in actually setting up an appointment to see a professional. But if you’re worried about it, go talk to someone. If you go talk to them and they say, “Hey you need to go on meds or we think you could go on meds,” you can decide then if you want to do that or not. Or you go see a therapist and you don’t like them, you can decide whether you go back too. But seeing a professional, all it does is just give you more options and it lets you be a little bit more informed and just opens up a couple of other paths for you.

JOSH:  So Greg, that sounds like a good way to frame things. One of the things that I’ve learned is how challenging it can be to get from that point where you say, “Oh I need some help. I want to go talk to somebody. I want to be in therapy,” and getting yourself from the moment of that decision or that realization to actually sitting down in a chair in someone’s office can be very challenging and quite a difficult journey for some people.

GREG:  It is so incredibly frustrating. If I were going to start a startup right now, it would be solely around reducing the friction to getting someone their first appointment with a mental health professional. And I hope that somebody out there goes and does this or can do it some point in the near future. And I don’t know if you want to talk a little bit about what you did with the CBT stuff.

JOSH:  Well sure, I can talk about that a little bit. I was doing a startup that was for doing CBT online as a website. And our eventual goal was to help people with depression and anxiety and all the common mental illnesses. So, CBT.

CHUCK:  I’m going to ask you for a definition, Josh.

JOSH:  Okay, that’s totally fair. Cognitive Behavioral Therapy. It’s a relatively modern form of therapy. It involves some talk component usually, where you’re having conversations with a therapist. But a lot of it is exercises that you do on your own time where you have some techniques for identifying thought patterns that contribute to whatever condition you’re experiencing and ways to break those thought patterns down, see where they come from, see which ones are helpful thought patterns and which ones aren’t, and that’s an incredibly simplistic overview of it. But there’s a ton of research that shows that CBT can be incredibly effective at dealing with things like depression and anxiety and a whole range of issues. And you can often do it without medication and still make good progress. And the thing that I think a lot of people really like about CBT is that it’s possible to start getting relief very quickly. It’s not like psychoanalysis where you spend years talking with your therapist before you start to uncover the foundation of these issues and be able to deal with them. CBT is something that you can start to get results in a couple of weeks. It’s something that’s very straightforward. And these days, it’s pretty well understood how to use if for a lot of different things. So when I was working on the startup, I discovered how challenging the whole field of online mental health is. There’s never been a significant success in that area, maybe not even a modest success in that area. So, it’s very difficult to get funding for a startup that’s doing this because nobody has any track record in the field. So, it’s difficult to convince investors that they should put money into an unproven field. And then there’s all the stigma around things. And then there’s all of the infrastructure challenges putting together a whole new field and dealing with things like [inaudible] regulation and insurance. So, it’s going to be really valuable when something like this appears and people can start using the internet and our most advanced communication technology on the planet to help us get help with mental health issues. But there are still a lot of roadblocks involved in doing that. And it’s probably going to involve some big player getting involved and knocking down a lot of these roadblocks, because it’s a very challenging thing for small players to do.

JAMES:  You know, I just wanted to chime in here and say that while we were talking earlier about how mental illness can be quite different from physical illness and in some ways, this is one way in which they are almost identical. Getting help is difficult. [Chuckles] People are just naturally resistant to that, for some reason. I definitely have this problem and I’ve talked about it a little bit in my talk. But over time, I grew weaker. So, I’ll wake up some morning and realize that I can’t do something the way I used to do it. And my first instinct isn’t to go get help immediately, it’s to reevaluate and try. Okay, so I can’t do it that way anymore, but maybe I could find this other way that makes it easier for me, or whatever. And typically I can. I almost always can find a different way. But there comes a point when the cost benefit doesn’t make sense anymore. Can I pick an object up off the floor? Yes, I typically can. If it takes me 30 minutes to do that and it totally wipes me out, does that make sense? [Chuckles] If Dana’s in the house, I could say, “Hey Dana, could you hand me this thing on the floor?” that takes 60 seconds. I get the item. I’m not worn out and I have energy to spend somewhere else. But that’s almost 40 years of experience of me talking there. I’ve learned to pay attention to the cost benefit analysis. And that was very difficult in some things. I can name things that I’ve only started asking for help on in the last six months or so that were just ridiculous. We all have this natural aversion or think we can handle it ourselves when sometimes it’s okay to admit you can’t.

JOSH:  Greg, how did you actually get yourself into therapy?

GREG:  Yeah, that’s a great question. It’s fairly easy to get yourself prescribed stimulants for attention deficit disorder, perhaps too easy. But I finally had a doctor who was writing me the prescriptions who said I’m going to stop writing these for you until you see a psychiatrist. And so that’s how I ended up seeing a psychiatrist. Prior to that, I thought I had the ADD. I found someone who specializes in that and then she made the recommendation, or she made the diagnosis of the bipolar. What I found in the last year or so, if you have someone who’s looking for help and you want to take that first step, you have a couple of different, let’s just call it classes, class is the wrong word, but people who are in different situations. So you have a situation where you’re employed and you have health insurance. And I’m talking about people in America. James and I were over in Scotland and there, they’re like yeah. So, there was a guy who sat in on the talk, called up his general provider the next day, and got a referral. And then two days later walked out with meds and everything. It was free and it was infuriating that our system’s not like that. But let’s say you have insurance. You can call up your insurance provider and/or you can look online. But their websites tend to be pretty horrible. And you can find a provider. That’s the worst-case scenario. Best-case scenario is that you get a referral. But because we don’t talk about these things, it can often be difficult to get a referral from a friend. There’s probably someone in your office who sees a therapist or a psychiatrist and you probably just don’t know about it, which is another great reason why if you are struggling with this and you feel comfortable talking about it and letting people around you know, it’s great to be able to refer them. So, first step is you can call your insurance or get a referral. If you don’t have insurance…

JOSH:  Get a referral from your primary physician?

GREG:  You can do that too, yeah. You can talk to your primary physician or just from a friend. Because what I found at least is the greatest indicator of whether or not you’re going to be successful with therapy is if you feel emotionally comfortable with that person. And unfortunately, there’s a pretty wide range of quality amongst psychiatrists and therapists. We pair in programming so that we can get better and so that our peers raise us up and learn to make each other stronger. Therapists and psychiatrists operate almost entirely independently for most of their careers. There’s only one therapist in the room or one psychiatrist in the room when you’re doing this stuff. So, there are some amazing psychiatrists and therapists out there. There are some incredibly poor ones out there as well. And it’s hard to tell that. There are some sites, and I have a couple to links to them on my blog at baugues.com/depression or you can go to DevsAndDepression.com that are basically like the Yelp of mental health professionals. But it’s hard to tell when you’re looking at 20 or 40 people which one you should go with. And often if you’re already dealing with some sort of anxiety, that paralysis analysis or what is it, analysis paralysis kicks in. And it’s hard to choose. And that’s what Caleb said, is I’m not going to just hold call a bunch of psychiatrists from the yellow pages. So, just having a friend, say make it simple for you, it becomes about are you going to call this person or not and not which one of these 40 people are you going to call makes that first step a lot easier for you.

JOSH:  So Greg, I’m actually dealing with some issues right now and decided okay, I can use some therapy. And I live in San Francisco. It’s like half my friends are in therapy. So, it’s actually nice being in a place like this where there’s some consciousness around therapy and mental health treatment so it’s not as huge a stigma around here and around here people at cocktail parties talk about their therapists and their meds.

GREG:  Yeah.

JOSH:  I mean, not all cocktail parties, but it’s a fairly comfortable environment for that. So, I’m actually looking for a therapist right now. And my sister’s a therapist. She’s a psychiatrist. And she knows how to deal with this stuff. And she told me, you should go out and interview people. It’s like you were saying Greg, there’s a wide range in not just treatment approaches but in quality of therapists and things like that. So, she said you should have a little interview sheet and call people and have about a 10-minute phone conversation with a therapist to see if you’re even in the right realm of they’re going to be a good match for you.

GREG:  I think that’s a great idea. The ideal situation is you set up an appointment with three different therapists and you take one session with each and then you stick with the person you feel the most comfortable with.

JAMES:  As long as your insurance allows that, right?

GREG:  Exactly.

JAMES:  It can be tricky on that kind of stuff.

GREG:  Exactly. Yeah, they make it incredibly difficult. If you don’t have insurance, a lot of therapists will operate on a sliding scale. So, it’ll be cheaper. And then depending on your city, often times there are some free resources or free mental health clinics available. But obviously, the quality of care is probably less than what you’ll get individually. But it’s got to be better than nothing.

JAMES:  I actually know of one case where someone got to the point where they thought maybe it was something they needed to do, so they see someone, and they admitted this horrible fear of doing this whole process, this finding someone to talk to or whatever. And it was actually a couple of their friends that stepped up and were like, “Well what are you looking for?” and they talked it all out and made a sheet. And then these two friends actually went through and looked through a bunch of professionals that were available and limited them by they took their insurance and they did the things that they wanted. And I just thought that was interesting how it was weird how this person was willing to go and probably thought that needed to happen. But just this first step, so many barriers there just pushing back at you. And once they got some help with that stuff, they went and that was that. They had to have that help.

JOSH:  I think there’s a terrible positive feedback loop that happens when you’re dealing with an issue like depression. And depression stands between you and the rest of the world. Some days you just can’t even get out the door. And all of the things that you need to do to deal with your depression and find a therapist and get out the door and go to the sessions and do the work, doing that stuff that it takes to get yourself better is something that is made more difficult by the condition that you’re trying to deal with.

GREG:  I met my wife right around the same time that I set up my first appointment with the psychiatrist. And I don’t think I would have made it without her. And the problem with depression is that for me before I was treated, here in Chicago in the winters it can just be really depressing if you suffer from any kind of seasonal affected disorder. And so in Februaries my goal for life was get out of bed and feed myself and make it to work. And if I could do that, that was a successful day. That felt like the limits of my mental capacity. So to wade then through insurance, which is a, I can really think of many things that are more painful for me to consider than dealing with insurance. To do that when I have such limited mental and emotional capacity is so hard. And then on the good days, I feel like, “Oh hey I’m fine. I don’t need anything.” [Chuckles] So, it’s like when you know you need help, you are mentally incapable of getting help and then when you’re capable, you feel like you don’t need it. So, having someone else along will help. And I try to be really careful as I talk to people who reach out after the talk not to try to solve their problems and just to try to listen and validate what they’re feeling. And the one thing I will do though is just ask, “Would you like some accountability in seeing somebody?” So, if they tell me I’d like to set up an appointment or want to do my best, I’d say, “Okay. Would you like me to check in with you in a week and just see if you did that?” And every once in a while for some friends or whatnot, I’ll go through and just say, “If you tell me what your insurance is, I’m happy just to go through and I’ll pick, even if it’s at random, two people, so that then you’re decision’s between two people and not 40 that are on this list.” And just getting that first appointment can, if you know someone who’s suffering, I think James has just such a great point, that it’s something that might be a lot easier for someone who’s not struggling with mental illness than the person who is.

JAMES:  We know that from programming too, that more choices just paralyzes us. If we say, “Please estimate this feature,” you have the infinite range of time to answer. Or if we say, “Is this a feature that’s going to take you an hour, a day, or a week?” then it’s a lot easier to put it in one of those boxes, right?

GREG:  Absolutely.

JOSH:  So, I think the flipside of that, your own path to do what you can and overcome barriers to get yourself some help, is what you’re saying about offering help to friends. And sometimes when you’re in a really deep hole, you can’t climb out on your own. You need somebody to throw you down a line.

GREG:  Absolutely.

JOSH:  And a lot of times, people are down in that hole and they can’t even see that they’re in the hole or that there’s a way out.

GREG:  Yeah.

JOSH:  And I found that just talking to your friends, if your friends seem to be struggling or stuck or they’re not showing up for events or what have you, just talk with them. It’s like, you’re friends. You should be able to just talk with them and say, “Hey how are you doing? Are you okay? Do you need some help?”

GREG:  Yeah. And it’s tough, because you have to do that gently.

JOSH:  Right.

GREG:  Because we don’t like asking for help in our society. And what I’ve found, for me the best way to do it is just to share my story and not even to share it under the pretense of, I don’t think I could have gone up to Caleb and say, “Hey I think you have bipolar,” because he would have said no and then probably not wanted to talk to me ever again because the first phase is denial. So I just shared my story and made a segue in a conversation one day and said, “Yeah I used to struggle with this stuff. This is what it looked like for me.” And then pause. And he’s like, “Yeah, I think I might be struggling with some of that stuff too.” “Oh, really. Well, if you’d like any help with that, I’d be happy to help out in any way I could.” And it might… JOSH:  That’s a beautiful way to throw someone a line.

JAMES:  Yeah, absolutely.

CHUCK:  Yeah. But the problem that I have is I don’t have the story. I don’t have, “Well, this is what I went through.” So, how do I do that?

GREG:  You might not have mental illness per se, but there’s probably something in your life that is shameful for you or somewhere in your life where you felt weakness and where you needed help. And I think one of the biggest killers with mental illness, if you hold back a step, is the shame. And it’s the shame of feeling like a lazy bastard or shame of feeling like you’re wasting the talents that were giving to you. And so some people have mental illness. I think that James getting up and talking about his disability in front of a room of a couple of hundred people, I guarantee that somebody was able to then talk about one of their weaknesses because of that. And so, it might be depression. It might be anxiety. For women, eating disorders are often, for men to sometimes. It might be a physical disability. It might be a divorce. There are so many different things that happen in our lives that we just feel shame about. And I think just the act of being vulnerable about whatever it is that you’re going through will encourage other people to be vulnerable about what they’re going through.

JOSH:  Right. Greg, something you said brought up an action for me and that’s there’s a lot of life events that can knock people into depression. A very common one is getting a cancer diagnosis. And I think a lot of oncology programs now, you get a cancer diagnosis and part of what they do is they start referring you to a therapist so that you can start getting some counseling. Because the mental outlook on how you deal with your physical illness can have a huge effect on the outcome.

JAMES:  That’s absolutely true. It’s well-known in M.D. circles, the particular disability I have. It’s exactly that. If you run into something you can’t do anymore, you have two possible responses. One is you get very upset about that realizing that you could do that yesterday and you can’t do that today. The other is like, oh I’m going to have to find another way to do that or whatever, which the person with the positive outlook is more likely to go that way. And thus, they have significantly less problems. [Chuckles]

GREG:  That’s really interesting.

CHUCK:  So I’m going to come back around to the other question then. I haven’t really, and I don’t know if I’m just not sensitive to this, but I haven’t really run across people who are in that place where they could use help or use encouragement to get help. And maybe it’s just because I don’t recognize the signs. Maybe I’m just not sensitive. Maybe I’m too focused on myself or what I’ve got going on. I don’t know. But what I’m really concerned about is the people that I work with, the people that I care about, the people that I interact with, are there signs or signals that they’re going to give you that they don’t even recognize that are going to say, “Hey I’m really struggling”?

JOSH:  I want to get just a little personal around this too, because I think a lot of people in our community remember. It wasn’t that long ago that one of the founders of Diaspora committed suicide. Although the details around his death are still not publicized, it’s pretty commonly accepted that it was a suicide and that it was depression was involved. And I wasn’t close with Ilya but I knew him and he was a fixture around the Pivotal office for quite a while, always seemed like a happy, positive outlook kind of guy. And I think that his suicide affected a lot of people and got a lot of people out there thinking about mental health issues in a new way. But one of the things is that sometimes there just aren’t any obvious signs that someone who’s a layman could notice. Even if you really know someone really well, they can have a lot of stuff going on that they’re just really good, they have a very well-constructed set of coping behaviors and you can’t tell.

GREG:  Especially in our community, where we’re dealing with incredibly intelligent individuals who are great at putting up fronts.

CHUCK:  Yeah. I can tell you that some of the people that I’m closest we that I see periodically in person, if I see them in person I can tell because they’re behaving differently than the way that they are when they are happy and healthy, so to speak. But for other people, I care and I want to help if I can. But I just don’t see any of the signals at all until it becomes apparent in another way that they really were in trouble.

JOSH:  Yeah. So what about, this is a little bit of a segue here, but what about just monitoring and preventive care and things like that? With our bodies, everybody’s all about Fitbit now and tracking their steps. And for centuries you go to the doctor and they measure your blood pressure and your temperature and your basic physiological markers. And we get better at that all the time. Now we can measure all sorts of things about our biochemistry and or genetics, even. So there’s all this attention that we pay to monitoring our physical bodies and keeping them well and changing our diet and changing our exercise and taking supplements. What do we do about that and our brains, our brain mental health?

GREG:  Certainly, so we were talking before the show about mood trackers. There’s one. I haven’t personally used it. It’s Moodscope.com. And it will, I think it could either send you an email or it’s an app that you have to track. And it basically says, “How are you feeling today?” and I think you give it a score. What I like about it is that it will, you identify a couple of your friends. So the woman who told me about it had set up I think her sister and her best friend. And it emails them every day and says so and so checked in and they’re at a 4 out of 5 or they’re at a 2 out of 5. And so there’s just this aspect of involving friends to keep you accountable because you’re typically not going to loop them in when you’re feeling really bad, so setting up an automated system to do that. But there are a number of mood trackers out there. Fitbit has one. It’s buried in the app. And then there are several apps available. And then this one here is Moodscope.com. But they will, I think for programmers, just data helps. And there’s the Drucker principle that what gets measured gets managed. And if you can just keep track of where your mood is, oftentimes that can be quite revealing when you look back at patterns over history.

JAMES:  I listened to the Heroku episode recently which I was not on for and there was a great quote in there from Ryan Smith I believe that said, you don’t have a performance problem in your web app, you have a visibility problem. Because once you can see where the performance is going bad, you’ll fix it, right? [Chuckles] That’s how we do things. So I imagine a similar thing applies here. You have to somehow get some visibility to the patterns, like you were saying Greg.

JOSH:  I think we also have this habit of we go to our doctor and we get an annual checkup, you get your annual physical. Should we be doing mental health annual checkup?

JAMES:  That’s an interesting question. How come we don’t think about that? [Chuckles]

JOSH:  I don’t know. [Chuckles] But if there are all of these, if it’s hard to see warning signs in our friends, if it’s hard to reach out for help yourself, it’s like you brush your teeth twice a day whether you need it or not. You just go check in with somebody once a year whether you need it or not, just to make sure you’re doing okay. And I guess it doesn’t have to be a mental health professional, but it should be somebody.

GREG:  Yeah. That’s a great idea. If you have a spouse, that’s just a natural person right there who can be quite close to you and can tell when things are different. And I found with my wife and I, for us just to be able to, I can say to my wife, “I’m feeling a little bit depressed today.” Because even though I’m treated, I still have days when I’m depressed. They’re days now. They’re not weeks or months. I’m not crippled by them. I can still get up and go to work. But I still have days when I can say to her, “You know, I’m feeling kind of depressed. I don’t want to go out with friends tonight,” or, “if I’m [inaudible] or whatnot it’s because I’m feeling a little depressed.” And it’s incredible just to have someone who I can speak that to and she just responds with lots of love and empathy about it. So it might not be a spouse, but if you have a friend or someone like that that you can check in with, it makes all the difference.

JOSH:  Greg, I wanted to ask you about something that I think is a potential barrier for people getting help and that’s fear of self-discovery. I grew up in a very introspective culture. So I have a very long personal history of mediation and introspection. And I think I’m fairly aware of my own internal landscape and a lot of my issues. I know that I have tons work to do because I’m a human being. But I at least have this attitude that I like learning about how things work inside my head. But I know that there are a lot of people who don’t have that kind of background. And especially when your head is a little messed up and I don’t want to use that term flippantly or disrespectfully. But I think when there’s that kind of stuff going on inside your mind that makes you feel broken, the whole idea of going out and learning more about yourself and what’s going on in your mind can be really scary. I can see how a lot of people might be afraid to learn what’s going on. And that could be related to, “I’m going to have to go on meds,” but it’s more just like, “Oh what am I going to find out about myself?” and “Maybe I’m not going to like it.”

AVDI:  I’d much rather think that I’m having a series of bad days than think I’m sick.

JAMES:  We all do that. I agree.

CHUCK:  Yeah.

GREG:  I would much rather have a series of good days. And I think that’s where I finally got to that point, where I didn’t want to admit that I had bipolar because I didn’t want to admit a) that something was wrong and b) that I couldn’t fix it on my own. So I suffered for two years after a professional told me that I had it. And I finally just got to the point where I said I will be more valuable to the people around me, I will be more valuable to myself, and ultimately I can tell you now after five years of treatment, that life is just immeasurably better. And the cost was truth and humility and facing whatever’s going on in your brain, it’s there. And that’s the truth. And you can put your head in the sand. This is not something that works particularly well in programming and it doesn’t work particularly well when you’re dealing with your own brain. And so yeah, there are going to be costs and you just have to ask yourself what would be the benefits of getting a diagnosis and getting this information. And programmers are typically people who the more information they have, the happier they are. And so, do the benefits outweigh the costs?

CHUCK:  I think it’s an interesting comparison between the two, because a lot of times when we’ve talked a little bit about this we’re like, “Well, I don’t want to be a burden on anybody.” But the flipside is that if you’re not at a hundred percent, then you’re not helping anybody either. And so you will be better off and everyone else will be better off if you just take the opportunity and go get the help. The other thing that I think is interesting that came to mind when Josh was talking was that a lot of times the tool that we’re trying to use to fix our mind is our mind. And a lot of times, we just need somebody else to come in and take stock and measure this stuff so that we can get an understanding of things. Because if your mind is the problem, then it may not be able to come up with a solution on its own.

GREG:  That is such a great point. And that it’s one of the hardest things for me to realize, was that some days my brain lies to me. And that my brain can take in facts, run them through a faulty analysis and spit out a totally incorrect conclusion. Things like, “There is no hope,” “It’s always going to be this way,” or, “People are talking about you behind your back,” or whatever, a whole host of things. And it just forced me to seek external confirmation of my thought process both from other people or say, I journal quite a bit and so I try to see. Are my thoughts or conclusions about these things consistent over time or is it possible that my temporary emotional state was affecting my though process and my conclusion and my decision-making? But absolutely realizing that your brain is telling you that everything’s fine, but if your brain is wrong, then you can’t fully trust that, which is just a huge epiphany that finally got me to get help and seek external help on this.

JAMES:  That’s true in so many things. I’m lactose intolerant and for years, I just had trouble with it but didn’t realize it and then finally got to the right doctor who knew the right questions to ask. And it’s amazing how he just knew the lies I’d been telling myself. He was all, “Let me guess. The last couple of times you’ve eaten pizza, the pizza was bad.”

[Laughter]

JAMES:  Or just things like that. He knew how you would explain it away. And everybody does that. Their brain does that. It explains it all away and makes it okay and you can’t trust it. You have to validate from an outside source, like you said.

CHUCK:  Yeah. And I really want to just drive home a couple of points we’ve made here. And one is that if you’re struggling with anything, and the thing that I run into is most of the time I bounce back. If I have a hard time, I bounce back. But even then, for a “normal” person, somebody who doesn’t struggle with some of these issues, it still helps, whether you’re making excuses and you actually need help or whether you don’t necessarily need professional help, talking to somebody always helps. Always, always, at least for me it does. And so go talk to somebody and just get that external validation. It doesn’t have to be a doctor. But you may get the feedback that you need to determine what you need to do next to make things better or you may get a determination that you really do need to go talk to a professional. But go talk to somebody. And the other thing that I really want to just drive home is that there are these social stigmas but most of them are in our head. It sounds like Greg, Josh mentioned he’s struggling a little bit. People just want you to be happy, really. The social stigma is it’s real. But at the same time, it’s just not important when it comes to this stuff. And I really hope that we can find ways to help people help themselves and help other people figure out how to help the people that need the help.

JOSH:  Yeah. I want to add to that a little bit, Chuck. I think that what you said was great. The thing about when your friends talk to you about it, a lot of times, maybe even all the time, when somebody shares an issue they’re having with you, they just want you to listen to them and let them know that you heard what they had to say and that you can understand a little bit of what they’re going through and that you’re still their friend. You’re going to be there for them. I think a lot of us, our first reaction when someone starts sharing difficulties they’re going through…

AVDI:  Josh, I’m an engineer. I can fix you.

[Laughter]

JOSH:  Thank you. Thank you. And that’s almost certainly the wrong response when someone opens up to you.

JAMES:  It is.

JOSH:  Because if I’m depressed and I’ve been struggling with this depression for years, I guarantee you everything that’s a quick fix, I’ve probably thought of and tried.

JAMES:  When we had Angela Harms on the show, she toted how good the book ‘Nonviolent Communication’ is. And I’ve mentioned it before, since Angela’s been on. I read it on her recommendation. And it covers this in great detail about how the first reaction we have that Avdi demonstrated so beautifully is just totally wrong. People don’t want that. It means you’re not listening. You’re not validating them. That’s not what they’re after when they start telling you their problems. It’s a good read.

GREG:  That goes for husbands, too.

[Laughter]

CHUCK:  I was going to say the same thing. I found that with my wife, it’s much that way where she doesn’t want me to tell her how to fix it. She just wants to know that I get it.

AVDI:  I don’t know. It’s kind of an ill-formed thought but I wonder if the style and pace of at least part of our industry encourages some form of depression or maybe exacerbates them. We do brain work for a living and there is this emphasis, especially in the startup world, on just going all-out and working yourself so hard. And I’m not sure if this is scientifically validated, but I feel like there is a strong link between doing brain work and depression. In fact, I feel like I’ve read some stuff about depression basically being the mind’s way of resting. Sometimes. I’m not saying it’s always that. There’s depression that’s just basically there’s something, a hormone that’s off in your head or something. But then there’s also depression that comes and goes as a result of your mind just saying enough. I don’t know. Do you think that’s something that our industry can push people into?

GREG:  I think it absolutely can. I also think that people with depression and bipolar and ADD are attracted to our industry. If you look at some of the symptoms bipolar, ADD, they’re things like hyper-focusing, social isolation, irregular sleep patterns, especially onset insomnia where it’s difficult to fall asleep at night and hard to wake up in the morning. We know that mental illness and depression correlate with people with above-average intelligence. So if you are struggling with this stuff as a kid or as a young adult and you happen to stumble across the software development world, you’re going to find a whole bunch of people who are just like you. And you’re going to find a place where you can be a loner, a place where you can stay up ‘til 3 in the morning working and where it’s okay if you have three days where you barely sleep and you’re incredibly productive and then a week when you don’t do a whole lot. And I think that software development tolerates the symptoms of mental illness way more than, say accounting does.

AVDI:  I would say it sometimes glorifies it.

GREG:  I would absolutely agree.

JAMES:  Yes, yes. Have you ever seen when Blizzard is getting ready for some big game release? If you go through and read their blogs, sometimes they’ll have pictures of the offices where the devs are working and if you look back in the corners, you can usually see the sleeping bag in the corner. I always see that picture and think it’s hugely tragic, you know?

GREG:  Agreed.

AVDI:  Yeah. Yeah, I have a tricky with this whole concept because it’s basically the story of my life, is I have periods of maniacal focus and I have periods of depression. And thus far, it has not interfered with taking care of my family. And so I haven’t pursued professional help for it. I’ve just viewed it as, “Okay, this is the way I work.” But I just imagine a younger me, well I guess I’ve been here at some points, in a situation where there’s a company that’s taking advantage of that style or that propensity and not really considering the side effects. These days, I pretty much can organize my life the way I see fit and so I can organize my life in such a way that that doesn’t really hurt me or anyone because I can take time to recover from those periods of maniacal focus. But I worry about a lot of these people in startups, particularly, and also really any software company where their companies aren’t taking into account the blowback of encouraging that lifestyle.

JOSH:  I agree completely. And to build on that, I think that there’s just a pervasive culture of that in the whole startup/entrepreneurship/investing community. There’s this culture where hardworking young people are viewed as disposable commodities. You look at Y Combinator which has had a couple high-profile successes and the returns that they make off of those investments are so big that they can afford to chew startups out and spit them out and leave them broken and depressed and with no idea of how to move forward, as just the cost of doing business. And investors make a lot of things possible, but I think that they don’t do it in a way, like the whole culture is set up so that the failures around startups aren’t dealt with. And there’s just a whole bunch of people who feel like they have broken lives after having spent a couple of years working on something that they got nothing for.

AVDI:  Yeah.

JOSH:  And I think that’s pervasive in our culture. And it’s something that as a culture and a community, we need to do more about addressing. And that’s why we’re having this podcast today, right? As part of that.

CHUCK:  So this leads into one other question that I have, and we’ve talked around it a little bit. Avdi mentioned sleep and things. But are there particular things that we can do to make ourselves more healthy mentally or more…

JOSH:  Resilient.

CHUCK:  More resilient. That’s a good word. And basically avoid some of these things, so preventative measures. Some people, they’re just going to run into these issues no matter what, I think. But for a lot of us, we can hold it off or just not have them if we’re doing the right things.

JOSH:  Okay, so there are two things. You know, I mentioned preventative care before and I forgot this when I was saying it. But there are actually two really simple things that are easy for everyone to do and are good for maintaining your mental health. And the first one is physical exercise. Getting a half-hour of cardio every day, it will absolutely clinically proven have huge effects on your mood. Even if it’s just like going for a walk for a half-hour, or wheeling your chair around for a half-hour, maybe.

[Chuckles]

JOSH:  But yeah, just the whole getting your body engaged. We’re physical beings. We have these bodies. We need to eat. There’s a whole bunch of stuff we have to do to take care of our bodies. And getting out and moving, getting your heart rate up is really important. So do yoga, go for a run, do something. And then the other thing is meditation. And there have been tons of studies done, a lot of research done, that show that a regular meditation program is as effective, if not more so, than medication for dealing with depression. And so, if you can find 10 to 20 minutes in your day to sit quietly and do some meditation, and there’s a zillion different ways to do meditation, some of them are extremely simple, just doing meditation can have a huge effect. And there’s tons of research that supports that, not just somebody’s opinion.

AVDI:  Also get enough sleep.

JAMES:  Yeah, that’s the one I would say I see over and over again. People sacrifice sleep every time.

AVDI:  And that will just kill your mood. And it does weird things to, what serotonin or something, I don’t know.

CHUCK:  Both of those things though are really easy to skip on, right? It’s like, “Well, I’ll just push this another few hours.” And you don’t have drastic effects from staying up late one night. You don’t feel it so much if you don’t work out just one day. But over the course of quite a period, it does add up. And so…

AVDI:  Yeah, I remember I experimented with polyphasic sleep at one point. And a few people, a very few people, have actually made that work. But it’s one of these things where you take frequent naps instead of one long sleep. And the goal for people that try to do it is to reduce the amount of time they spend sleeping overall. And what was fascinating to me was that besides, the biggest effect that I noticed as I was trying to make it work as that I just became depressed. The biggest thing that I wasn’t getting enough of I think was whatever the brain does to just process negative emotions and make you feel level.

JOSH:  Yeah, so sleep. That’s definitely important. And then the last thing I’ll add here is diet. And that there are all these chemicals that we put in our body that we call drugs, there’s a lot of things that we put in our body that we call food that have similar kinds of effects on it, very powerful effects on how we think and our mood.

JAMES:  Are you trying to say Red Bull without saying Red Bull?

[Laughter]

GREG:  Sugar especially.

JOSH:  Yeah, I’m actually trying to say sugar.

[Chuckles]

JOSH:  And sugar, caffeine, there’s all these things that we put in our body all day. Smoking I’m sure has a big effect too. I’m not a smoker myself. So, there are all these things that we just consume. And sugar is probably the worst offender of the lot. But there’s a bunch of others, too.

CHUCK:  Yeah.

GREG:  I think it’s also helpful to just be aware of the fact that you might be self-medicating depression or some other. For me, I smoked half a pack a day and tried quitting for about nine years. And I tried quitting for about nine years and I tried quitting a bunch of times. And once I actually got on my bipolar meds, I was able to finally quit. I take Lamictal. And it’s just a mood stabilizer, but I really feel like I was self-medicating my depression through the little bursts, the nicotine bursts that I would get from that. And I know that I drink a lot of caffeine when I’m off my stimulants, my ADD meds. Sugar gives you, or if I’m feeling really depressed, then I might just go eat a whole bunch of McDonalds because it makes me feel good for five minutes and then hate myself shortly afterwards. So just know that diet is really important. Exercise is really important. It can also be really hard to control those things if you are crippled by mental illness. So for me at least, getting on meds acted as, especially the ADD meds in the beginning, acted as a scaffolding for me where it was a stopgap that helped me get a little bit stronger so that then I could build in healthy routines and I could get more organized. And so I took those for about five years and now I don’t take the stimulants for ADD anymore because I built up these other habitual support structures like diet, exercise and whatnot. But I wouldn’t have been able to make that leap initially had it not been for the meds. That’s my case. Your mileage may totally vary. But that was my personal experience.

CHUCK:  What about alcohol?

JAMES:  It’s totally fine.

CHUCK:  I’m just totally throwing it out there.

JAMES:  Totally fine. It doesn’t [inaudible] affect you. It’s fine.

[Laughter]

GREG:  When I was going to Scotland to speak about this, somebody said, “You know you might want to be careful just with the terminologies different over there.” You say therapist over here and over there they might say analysis, I think, I can’t remember what it was. You say anti-depressants over here and over there, they say whiskey.

[Laughter]

JOSH:  Oh, man. Okay, so there is a lot of co-morbidity in mental health issues. I believe that’s the technical term for having more than one diagnosable condition at the same time.

GREG:  Yeah.

JOSH:  So very often, depression goes hand-in-hand with anxiety or PTSD or various other things. And alcoholism is something that can co-occur with a lot of mental health issues as well.

GREG:  Absolutely.

JOSH:  Because people are trying to self-medicate and they get stuck. There are a lot of other substance abuse problems that people get too, not just alcohol. There’s a whole range of drugs that people get stuck on.

GREG:  I was smoking a lot of pot before I started my meds too. Because it made me feel better temporarily. And I know a lot of other friends who do the same. And it’s really easy to demonize addicts, alcoholics, or drug users. But I was doing it because it helped. It made me feel better. It gave me a little bit of relief from the pain. And these things became much easier to walk away from. So alcoholism can be so incredibly destructive. And you were talking about what are some things you can do? Die and exercise, help. For me I found that the biggest help has just been recognizing that there are mental and emotional limitations. James, I loved your talk. I like your metaphor for the spoons. In your talk about how, maybe you could just talk about that really briefly.

JAMES:  Sure. It’s just that when say a physical therapist is working with you, it’s often difficult to quantify how much energy you might have in a given day. Some people have a limit. Most people have adequate amounts to do what they need to do so they don’t have to monitor it so closely. But if you have a disability like I do, then you have to be acutely aware of where you’re choosing to spend energy. And one way they might teach you to do that is to give you a handful of spoons and say, “Alright, these are your energy that you have for the day, so now walk me through your day.” And you might say something like I’d get up and get dressed. They’d take away a spoon. You know, I take a shower, they take away a spoon. And now you can see, there’s this quantifiable thing and you can see how you’re spending it and it’s very helpful to understand what you’re choosing to spend energy on.

GREG:  I really related to that when I heard your talk in regards to my mental and emotional energy. And I think just recognizing the fact that my mental cycles are limited and there are going to be days when I run out, and just saying that’s okay, and just being willing to give myself grace and saying I’m not superman. I have mental limitations. And there are going to be days at 3 o’clock where I just have to say my productive day is over. I’m going to be okay with that and I’m going to start again tomorrow. And just realizing that it’s going to take, if you start treatment or start going to see a therapist or whatnot, hopefully things will get better but it will take time. And in the meantime, it’s great to exercise. You’re not going to be hitting up the gym five times a week from the beginning. And if you try, if you set that as your expectation, you’re going to be disappointed. You’re probably going to stop. So when I started exercising, my goal was show up at the gym. I can show up. And if I show up and I walk out, that’s fine. The goal is just to start building a habit of showing up automatically. And then keep myself entertained. So if I’m on the treadmill, I’ll do this thing where it’s like I got to go run two miles on the treadmill. Well sometimes I get bored, and I’m like, “Okay well maybe I’ll just do the elliptical. Maybe I’ll just show up to the gym and find it interesting in some way.” And over time, you’ll build up habits but just give yourself grace and just know that these things are not going to get better over time. If you try quitting smoking ten times and it doesn’t work, just try to learn something each time about what caused you to fail this time and you’ll get better at it. Same goes for drinking and these other things. So I find grace and just giving yourself, like loving yourself and recognizing that things won’t change overnight more than anything else has made a difference in my life.

JOSH:  I love what you just said there. One of the most important life lessons that I’ve learned, which is something that has come to me relatively recently, is having compassion for myself the way I do for others. There are a lot of things that I do in life where I just beat myself up for it. I do something stupid, and I’m like, “God you’re an idiot. What were you thinking? How could you do that?” And if I’d seen someone else do the same thing, I would have been like, “Oh he must be having a bad day,” or, “Oh gee, I wonder if I can go give him a hand with that?” The love and compassion and support that I’m willing to show the people I care about in my life is so much greater than what I’m willing to do for myself most of the time.

GREG:  That’s so true.

JOSH:  And if I just cut myself some slack the way I cut other people some slack and offer them a hand or just give them the space to go through what they’re going through, when I can let myself do that for myself, then it’s like I don’t feel so stuck. And at least I’m not putting all my energy into beating myself up. I can use that energy to go work on fixing the situation or working on myself.

GREG:  That’s a great point.

JOSH:  This has been a great talk, by the way. [Chuckles] I didn’t know where this was going to go when we started. But I like where we’ve travelled.

CHUCK:  Yeah, I agree. I feel like I’ve really been empowered to help people out and really just be a little bit more aware. And I think it’s important. And I’m hoping that we help people that are either suffering the effects of some of these things or help somebody reach out to someone who’s suffering and just make a difference. And that’s really what this whole show’s about, is making a difference in the community. And this is an important way we can do that.

GREG:  Just a couple of things. I really believe that the first step to getting better on this is just talking about it, and we mentioned that earlier. Table XI launched a site called DevPress.com. It’s a Discourse, the forum thread, just out of the box and there are some developers on there. It’s just a community where developers can talk about this. So that’s DevPress.com. If you don’t have anyone else to talk to, you can email me. I’m greg@baugues.com. And I just want to give encouragement to people who feel like there’s going to be a backlash against them if they talk about this stuff. And like I was saying earlier, right before I got up on stage to speak about this the first time, I was like, what the hell am I doing? I have just been so blown away by the response of people. If there are people out there who hate what I’m doing or think I’m an idiot, I haven’t heard from them. But I’ve got over a hundred emails from people who have seen the talk at some point who would just write paragraphs and thank me for it or who’d say I went to see someone. So, your brain is lying to you in that regard, saying that your friends are going to turn away from you. You’d be amazed at the capacity for love from the people who care about you and even the strangers who will just come to you. And yeah, so I’d just encourage you, find somebody to talk about it. If there’s no one else, you can talk to me. You can just email me.

JAMES:  I just wanted to say that it’s more common than I thought. I actually had no idea going into this episode how common something like bipolar is. So I actually looked it up. And I’ll just tell you what I found. According to the National Institute of Mental Health, bipolar disorder affects about 5.7 million American adults or about 2.6% of the US population 18 and older. So just to put that in numbers, that makes sense. Our listening audience does not come only from the US so this isn’t a hundred percent accurate. But if that percentage held true for our podcast, then over 200 people listening to this episode would probably have bipolar disorder.

CHUCK:  I think the important takeaway there too is that you are not alone.

GREG:  Absolutely.

CHUCK:  And there’s nothing wrong with you. And you can get help. And it’s okay. Don’t feel singled out. And really, I really hope that it’s come across that we all want to help and we all hope that people will just do whatever it takes to make the most out of life. And if that means to get professional help or help from a friend or whatever, then that’s what they do.

GREG:  Agreed.

JOSH:  Yeah, thanks. Cool. So good time to switch to picks now?

CHUCK:  Yeah, let’s do it. James, do you want to start us off with picks?

JAMES:  Sure. Well, since we have Greg on the show today, I’m going to pick his blog. It’s pretty good stuff. Actually, I’m going to pick a specific article which was Code Like a Chef: Work Clean. It was a great article that spoke to me when I read it a little while ago. It was a little bit controversial and Greg talks about that in the article. But it really spoke to me and this is definitely a good thing. But while you’re here, shop around for the rest of the blog because it’s pretty cool stuff. I learned awesome things about the Super Bowl reading this blog yesterday. So, good blog.

GREG:  Thank you.

JAMES:  Yeah, sure, and thank you. Another thing I’m going to pick, I got to pair with Benjamin Fleischer recently and he has a plugin called code_notes. And I don’t know if everyone knows, but in Rails you have this rake task that can hunt through your Rails app looking for certain kind of to do fix me, stuff like that, and print out a little output showing you where you’ve put these special comments and leaving yourself little breadcrumbs. That’s been extracted in this plugin called code_note. So you can use it on other projects, which is cool.  It’s just a simple little handy thing. And then finally, just for fun, I saw this amazing Lego interface yesterday called Build with Chrome. So I assume you have to use Chrome to use it but you should really go. I’ll put the link in the show notes and you should really go check this out. Just unbelievable 3D interface building with Legos and boy is it nice, just really great showing you some of the web at its best, I think. So those are my picks.

CHUCK:  Awesome. Avdi, what are your picks?

AVDI:  Well, let’s see. Two people have mentioned the dash documentation browser for OS X, in past episodes. And there is a Linux project to do something similar that uses the same documentation bundles. It’s called Zeal and it works pretty well. So I found that kind of cool and it seems to be under pretty active development. You use Linux and you’re missing something like that, check it out. The other day I decided I wanted to get up to speed quickly on Node.js. And I looked around a bit and I found the book Node.js the right way by Jim R Wilson. And this book has two of my favorite properties in a programming book. It is short and opinionated. [Chuckles]

AVDI:  So, it was a very nice concise introduction to the Node world. So that’s recommended if you’re interested in that topic. And for a less programmy pick, I will just note that the series An Idiot Abroad, which is a British travel documentary series, is now available on Netflix. And I’ve been hearing about it for years and I’m enjoying watching it now. It’s a trouble show, which is a little different because it shows somebody, portrays somebody who is not particularly keen on traveling, traveling to the wonders of the world. And it’s fun.

CHUCK:  Alright. Josh, what are your picks?

JOSH:  I think Dave has picked Brené Brown before, hasn’t he?

JAMES:  Yes.

JOSH:  Yeah, so I stumbled on one of her TED talks just a couple of days ago and finally had a chance to watch it. And so I think I’m going to pick her talk on vulnerability because I think it’s relevant to what we just talked about today. Because so much of the healing process begins when you’re willing to show some vulnerability. So I think that’s relevant. And then, let’s see, technical. I’ve been on a bit of a language bent lately. I get that way sometimes. So I caught up on Gilad Bracha’s languages Newspeak. And Newspeak is what you would get if you try hard to make Smalltalk semi-functional or like a multi-paradigm object-oriented functional language. And I think he’s done some really interesting stuff with the language. It’s pretty cool if you’re into languages. And this whole object-oriented versus functional thing, I think it’s a great way to look at it. And then, let’s see. There’s a quick video that I saw. Square does this Code Camp thing every year where they bring in, it’s basically an internship program. But I just loved the video. It was pretty good. It’s all about bringing a bunch of women in, like doing internships for the summer or a week. I don’t know. The Code Camp thing is a week then they have a different internship program. I’m getting confused here. So clearly, I should stop talking.  [Laughs] Anyway, good video worth checking out. And I think that’s it for me this week.

CHUCK:  Awesome. Alright, I’m going to jump in with a couple of picks. One is that I’ve been a freelancer for three and a half years and my website for my consultancy of my business or whatever you want to call it has pretty much been non-existent. It’s been various stages of broken WordPress. And I’ve decided that I want to get something together that represents what I can do and what I’ve done. I have clients ask about that periodically. What have you worked on and things like that. And so I’ve started various Rails apps and that’s always been a headache because all I really need is a content site. And so what I finally settled on was Jekyll. And I’m sure that plenty of people who listen to the show are aware of Jekyll, have played with Octopress on GitHub. Anyway, so Jekyll is basically a static site generator. It’s written in Ruby, and you can actually use it to host websites on GitHub. I’m not doing that part of it, but I am using Jekyll and it’s been really nice because I just pulled everything together and then rest of it’s just writing HTML and for the blog, writing markdown, and it’s done. And so I’m really happy about that. I’m also going to pick the Digital Ocean blog post about deploying it. It took me all of 3 minutes to get it setup so that I’d do a git push to the server I’m hosting it on. And it deploys it for me. And that’s all there is to it. So it’s basically as simple as the Heroku setup in that regard. So I’m really happy about those and those are my picks. Greg, what are your picks?

GREG:  I just want to say I use Octopress for my blog and I love it. I love the simplicity of it. I’m writing a book about this stuff, so you can check that out. Devs And Depression. Also, on another book, a friend Noel Rappin, he’s writing one called a trust-driven development, which I’ll write a little bit of. And I think it’s going to be great. It’s about how do developers build trust with their clients when the clients inherently don’t understand what we’re doing. And everything he writes has just been awesome for me. I don’t know how many listeners do speaking. But I’ve just been learning a lot about how to craft presentations over the last year. And generically speaking, there are a lot of speech coaches out there and I worked with one. You can find it, speechIRL.com here in Chicago, but she can also do remote. Her name’s Katie. It’s like speech in real life. But just in general, I just wanted to recommend that if you’re doing any kind of presentations, find a professional. There are a lot of really great professionals out there. And just doing a couple of sessions with her was incredibly beneficial for me. So I just encourage you to check that out. And you can find her online. And the lastly, I am going to be working for Twilio in about a week or so. I’m not officially on the payroll yet, so I think I can talk about them without, I don’t know what the word is there. But they’ve been great and I had to setup several apps just as part of the interview process. And it’s just ridiculously easy to send text messages and make phone calls and receive phone calls with their stuff. Patrick McKenzie uses it for all the things he does. And I’ve just been blown away by both their project and the company in general. So check them out and I should know a lot more about them in the future. So that’s it.

JOSH:  Yeah Greg, our motto here is that there’s no shame in shameless self-promotion.

[Laughter]

GREG:  Awesome. Very good, very good.

CHUCK:  Awesome. Well, thanks again for coming, Greg. Like I said before, I really hope this helps some folks out. And I really appreciate your expertise on this particular topic.

GREG:  Thank you guys so much for having me. It’s just really cool to just be able to talk about this stuff. And I hope more people can do that.

JAMES:  Thanks, Greg.

CHUCK:  Yep. Now, before we wrap up, there’s one more thing I want to bring up and that’s our Book Club book. We’re reading Ruby Under a Microscope by Pat Shaughnessy. So, if you haven’t had a chance, go pick it up. And yeah. Alright. Well, thank you all for listening and we’ll catch you all next week.

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