MountainWest RubyConf 2013 Devs and Depression by Greg Baugues

I am a developer, and I have Type II BiPolar and ADHD.
It's not something we talk about, but BiPolar, depression, and ADHD runs rampant in the developer community - they tend to correlate with higher intelligence. Many of the symptoms of this conditions make for great developers, but also cause incredible damage. We recently lost one of our co-workers because of untreated mental illness.
I want to share my story - and let people know that it's okay to talk about these things, that it's nothing to be ashamed of, and how to get help, and how to help those around them.

OK, yeah, so my name's Greg.

I work for a company called Table XI in Chicago.

We're a thirty person Rails shop.

I've been programming most of my life.

I got started programming on a TRS-80 when I was about six or seven years old.

I had cassette tapes and it had BASIC on there.

I remember this magazine called 3-2-1 Contact

would come every month and it had BASIC programs on the back page.

I'd sit there and I wouldn't copy and paste, I would literally copy the program into the thing and run it

and just make the screen change colors and whatnot.

I spent most of my professional career kind of straddling development and client-facing work.

And I also have type-II bipolar and ADD,

not to be confused with Matz's Anniversary-Driven Development from yesterday,

but Attention Deficit Disorder.

Today I want to tell you guys my story.

I want to tell you why we need to be talking more about

depression and mental illness

in our offices, with our peers, at meetups, and at conferences like this.

You might be familiar with type-I bipolar. it's also called manic depression.

It means that you cycle between periods of mania — the good parts —

and depression at the bottom.

The mania can feel kind of euphoric,

and it can also be incredibly destructive,

because it leads to great impulsiveness.

People make a lot of bad decisions at that time.

For type-I bipolar, this can also be rapid-cycling.

So you can go quickly from top to bottom very fast.

My bipolar, type-II bipolar, is much milder,

and the cycles tend to be much more elongated.

So what it would look like for me

is typically anywhere from four to twelve weeks or so of

just this long, slow, gradual slide down.

It felt for me like I was always trying to crawl up a gravel incline

that was really steep, and no matter how hard I spun my wheels,

I just kept sliding back down further and further.

And this was quite frustrating for me.

I first noticed this during my last year, my fifth year

— my "victory lap," although it wasn't particularly victorious for me —

at the University of Illinois.

And I had just broken up with a girlfriend, I had just moved into a place on my own,

my first time living without any roommates.

I was on my way to failing out of school

and things were just getting really rough for me.

I was never a particularly good student

but I was always kind of smart enough that i could kind of fake my way through it.

But that started catching up to me my junior, senior year.

It turns out that, if you're going to go in and take a linear algebra final,

it helps if you actually know what linear algebra means.

I've taken that class twice now. I still couldn't tell you.

And it became pretty obvious that I wasn't going to make it,

that I wasn't going to graduate,

and I didn't know how to tell my parents about that.

And I didn't know how to deal with the fact that everybody else around me

seemed to be graduating just fine,

but I wasn't.

I had a friend who said,

"Greg is one of the smartest guys I know,

but he also just happens to be one of the laziest people I know."

And I believed that shit, because I didn't have any other excuse for it.

You know, like, I slept all day, I didn't go to class,

I knew that I was mentally capable, or at least smart enough,

to go to class and do the homework.

I just wasn't doing it, and that sounds like laziness to me.

I pretty much, when I'm at the bottom of the depression, I sleep a lot.

It's the most obvious symptom.

The best part of my day back then was the time in which I was unconscious

and the time I didn't have to deal with reality that was piling up,

and just physically it was so hard to get out of bed I'd oversleep my alarm.

I'd stop going to class, I'd stop going to work.

I had a part time job with a very flexible schedule

and it took them a while to realize that I had pretty much stopped coming in.

And I had a friend, a coworker, who was just a great friend,

and he really cared, he was concerned, and he sent me a couple emails just saying,

"Hey, Greg, what's going on, you know?"

And I ignored them because I didn't know how to talk to him about it.

And then one day, it was like 2:00 on a Tuesday,

I got a phone call from Bill,

and I was still in bed,

and I ignored it.

And then he called again and I ignored it again.

And then I heard a knock on my door.

It was like, "Hey, Greg, it's Bill."

And I was like, "Shit.

It's fine. Just be quiet. He doesn't need to know I'm here.

Besides, Tuesday at 2, why would he even think i'm here anyway?"

And then I heard the doorknob start to turn.

I wasn't very good at locking my doors back then.

and at the time I was sleeping on kind of a cheap mattress.

It was on one of those cheap bedframes with the casters on it

and there was a gap between my bed and the wall that's about this big.

And I very slowly slid into that gap

and I pulled the blankets up over my head

and I just held my breath while Bill walked into my living room

and he poked his head in my bedroom

and then he walked into the office and then left.

That's what shame feels like.

I failed out. I moved back home, went to Indianapolis, lived with my parents again.

I started doing freelance work.

I actually signed up for classes at a college there.

After six months or so it became pretty obvious that I just wasn't going to be able to physically or mentally do that.

So I lied to my parents and I told them I graduated.

And i just came clean on that one about four years or so ago.

And it was so frustrating,

because even when I wanted to,

even when I would go to class,

I couldn't focus.

Even when I wanted to do client work,

and unless it was 2 in the morning the night before the work was due,

i couldn't do it.

When i got there, when I got focused on stuff,

I could produce pretty good work.

But I just felt like I had no control.

And there's this verse in the Bible that says,

"I do not understand what I do. What I want to do, I do not do.

But instead that which I hate, I do."

And that's what it felt like.

It felt like anything that I tried to do, even the simplest task,

it felt like I was walking through a swimming pool,

like I just couldn't force myself, I didn't have control.

I was like, "Why is this? Why can't I control myself?"

So I did what you do when you have a question and need an answer to it, and I googled it.

One night it was like 2 AM, and just out of desperation I googled "chronic procrastination."

And it wasn't long before I was reading about attention deficit disorder.

And I had always kind of joked that I had ADD,

but I never meant it,

because ADD is what lazy people use as an excuse

because they don't want to work hard,

and that's not me.

But I read this book by this guy named Thom Hartmann

called "The Edison Gene," and his premise was that

ADD is genetic. And that inventors and creators have it.

It's common. He said that tens of thousands of years ago,

we had hunters and we had farmers, or gatherers,

and in order to be a good hunter, you need to go out into new territory every day

and you need to be constantly scanning the horizon

and able to shift your focus from this thing to whatever comes into your peripheral vision

and rapidly shift.

In order to be a farmer, you just have to be good at doing the same thing every single day.

You have to be methodical about it.

And neither skill is better or worse than the other.

It's just that, over time, as civilizations grew, farmers became

much more useful than hunters,

because you can support larger population bases.

And when we'd go to war, it'd be the hunters who would go off and get killed

and so their genes would get removed from the pool much more quickly.

And over time, that portion of the population dropped,

and now it's estimated that about 10-20% of the population

could probably be diagnosed with ADD.

He talked in that book about how people with ADD are just non-linear thinkers

and people who don't have ADD are more linear thinkers.

And what I found most encouraging about this is, he said

that the symptoms that we attribute to people with ADD,

things like lack of focus or procrastination or indecisiveness,

those symptoms disappear during periods of high pressure.

2 AM before the paper's due.

Those same symptoms appear in linear thinkers

during the same periods of high pressure.

So you have to take a linear thinker and put them into a high pressure situation

and they will exhibit indecisiveness. They will have a hard time focusing.

And I found this really encouraging.

Because it wasn't that I was broken — it was just that,

in our society, we've built it so that we don't have a lot of high pressure situations.

If you want to play nice with everyone else these days,

you need to be good at showing up to work every single day at the same time.

You need to be good at paying your bills or balancing your checkbook,

whatever that means.

So I kind of accepted this.

It took me a year between reading this book and these other books I'd read

and actually going and seeing someone about it,

because again, I just wanted to fight through it,

try harder, do it myself.

But I did. I went and I saw a therapist, and I took the test.

And she comes back and she says,

"Yes, you absolutely have ADD, you're off the charts."

And I was like "Yessss."

She said, "But, I think you also have type-II bipolar."

And I was like "Noooo....

no, I will take the ADD, and you can keep the bipolar,

because that's what crazy people have,

and clearly that's not me."

And so I pretty much lived my life like that for two years.

I went to see a doctor, told him about my ADD.

He said "There's two different kinds of drugs we can give you.

One's going to take about two weeks or so to build up in your system for you to notice a difference.

The other one we can give you, a stimulant,

you'll notice a difference in about fifteen minutes."

I was like "I'll try option B."

And he was right. Fifteen minutes later my world went from out here to like right here.

It was the first time in my life I could just make a list of A B and C, focus on it, do it in that order.

It was amazing.

But the depression remained.

And it got worse because the meds helped me focus,

and if the thing I was thinking about was how depressed I was,

then it just helped me focus on how depressed I was.

And the pattern throughout my life,

because I was not willing to consider that my unhappiness was coming from inside of me,

was internal, I would look to external factors,

and the most obvious external factors are where you live and where you work.

So when I was in college, I was like, "Screw this place.

If I was just not in college, like, I'm not built for this, then things would be better."

And so I moved to Indianapolis.

And then after a year, I'm like, "Well, screw this living with my parents stuff, like, I'm going to move to Chicago."

So I move to Chicago, I get a job with a software startup with like five people,

it's a great job for me,

and I'm rocking it out for the first several months.

And then, eleven, twelve months later, I'm like, "Well, this place sucks."

Like, I'm pretty unhappy again.

Maybe I'm just burned out on technology.

So I go get a job showing apartments.

And that's great. I'm like the top performer for a few months.

And things start getting bad again.

Around this time I met a guy named Josh Golden

when i was playing poker, which i was doing a ton of at the time.

And Josh Golden was the CEO of Table XI.

And he and I became pretty good friends over the course of the year.

He told me, he found my background, the mix of sales and programming interesting.

He said, "You know, whenever you get tired of doing what you're doing, let us know."

So one day I just up and quit my job.

I texted him and said "Hey, if you're still interested, I'm available."

And about six weeks later I started working for Table XI.

On that day, I had exactly one dollar in my pocket

and seventy cents in my bank account

because I hadn't been doing a very good job at the 100%-commission sales job.

I'd been pretty much non-functional.

And my roommate and i had had our hot water shut off about a month earlier.

We didn't have enough money to get it turned back on, so

I was taking cold showers most days.

I got to work, I didn't really know what I was going to do for lunch,

and that was the day I found out that Table XI buys lunch for its employees every day.

We have a chef now, but that day around 11:30,

Josh just IMed me and said, "Hey, give me your Jimmy John's order."

Table XI started out great. I mean, it was perfect.

It was exactly the company that I moved to Chicago hoping that I would find.

There were only six of us at the time.

There were many days when I felt like the dumbest guy in the room,

which was amazing.

We worked on interesting projects,

we had this cool loft place,

it just was cool and I was doing great work.

And sure enough, six, seven, eight months later, a year later,

things started getting pretty bad.

And it got to the point where I was dropping the ball every time it was put in my hands.

And I had a string of weeks when i didn't show up to work until about 2 pm.

I'd oversleep my alarm every day.

And things finally came to a head one day when it was a Friday,

we had a big project due with a client, it was on me.

I had stayed at the office all night trying to work on it,

left defeated, wasn't able to focus on it,

came home, said I'd get up early, overslept my alarm, and Josh was leaving that day

to fly to Italy to propose to the woman who's now his wife.

Josh lived about a block down the street from me.

So once again, I woke up to someone walking into my apartment,

saying, "Hey, Greg, are you in here?"

And this time there's no gap between my bed and my wall

and I just had to face it.

I set up an appointment with a psychiatrist that day.

I realized that it was pride that was keeping me from seeing someone.

I didn't want to admit that something was wrong with me.

And I said to myself, "I can't control this, but at least if I can localize the damage to myself,

I'll be ok," and I realized that I was just harming

everyone else around me by not seeking help for this thing too.

Four hours after I set up an appointment, I met my wife Rachel, who's right down here.

The doctor says, "Yeah, we've got drugs for that."

He says, "Type-II bipolar, sounds like exactly what you have."

He says, "These meds we have, lamotrigine, they're great, they work almost all the time.

Every once in a while there's this one side effect,

Every once in a while, in small cases,

you'll end up getting a rash inside your anus."

And I said, "Well, I'm pretty sure that if I get a rash inside of my anus,

I'm still going to be depressed."

Fortunately that didn't happen. So far, yeah. It's been like five years.

And I've been remarkably stable ever since.

It took me a while to climb out of that hole.

Not to say that everything's been happy since then.

Not to say that I don't still have days when I feel depressed. I do.

But now they're days, not weeks or months,

and I'm no longer crippled by them.

I'm incredibly fortunate. My meds worked the first time,

I had health insurance, I could see someone.

Table XI didn't fire me even though they should have, over and over again.

I'm still there six years later.

I met my wife who helped me get out of this hole.

A lot of people who have what I have aren't as lucky.

It's estimated that about 5% of the population suffers from bipolar.

10-25% of them will die from it, and one in three will attempt suicide at some point in their life.

Why does this matter to you guys?

If it's 5% of the general population, my guess is that it's three to four times that for developers.

These are some cherry-picked symptoms of bipolar disorder:

Hyperfocusing. Sure, it's hard to focus sometimes, but once you actually get down, you get into it,

the whole world just blurs away.

You can sit there for 12 hours at a time and just crank on it.

Racing Thoughts is exactly what it sounds like.

Pressured Speech is when those racing thoughts try to escape

through the small hole of your mouth.

Social Isolation. Irregular Sleep, especially onset insomnia,

which means that it's hard to fall asleep at night

and almost impossible to wake up in the morning.

And Grandiosity, thinking that the rules don't apply to you,

thinking that you're better than everyone else,

that you can solve problems that have eluded everybody else.

If you're a young adult or an adolescent struggling with these symptoms,

finding software development probably feels a little bit

like coming home. We accept the socially isolated.

We will work with irregular sleep patterns.

We will seek out people who have the grandiosity to believe

that they can solve problems that others can't.

We'll accept irregular bursts of productivity.

And our heroes are the people who are crazy enough to believe

that they can change the world.

Last September, we had a developer come and interview with us. His name was Caleb Corman.

And his resume was very impressive.

He had worked with three of the best Rails shops in Chicago: Hashrocket, Obtiva, and ThoughtWorks,

But he only spent a year or less at each one of them,

which raised some red flags.

But we hired him on as a contractor, and he was just great.

I got to pair with him, and he was one of the first guys I had ever paired with.

And I learned so much.

I mean, it's so rare that you find these people who are brilliant

but patient and good teachers.

He taught me about code smells. He taught me about the Pry debugger.

He tried to teach me vim, but that didn't really stick.

I remember, I had never paired with anyone before

and he taught me all these verbal shortcuts that we used

for punctuation, right? Because the names for punctuation are long.

So we don't say "exclamation mark," we say "bang."

And we don't say "question mark," it's a (inaudible).

And it's not an "underscore," but it's a "skid," is what he taught me.

And we don't say "pound sign." We say "octothorpe."

I never got that, I never understood it.

It's like we've got two commonly accepted monosyllabic names

for that piece of punctuation and we call it an "octothorpe."

It's just a bad-ass name, I guess.

A couple weeks after he started working for us, Caleb started calling in sick.

And he started showing up late.

And the excuse was a little different every time, and it just felt way too familiar to me.

And I told him my story, and I pulled him aside, and I was just like, "What's going on?"

And he said, "Yeah, you know, I've kind of wondered for a while

if I have something like that."

He was like, "But what am I going to do?

It's not like I'm just going to cold-call a psychiatrist from the Yellow Pages."

So I gave him a couple names, and he called around,

and it took a little bit of time because it's hard to get availability sometimes

but he got an appointment set up with a psychiatrist for a few weeks out.

The appointment was set up for a Friday.

The day before that, he sent an email to the team that we were working on,

and he said he was sick, he was seeing a doctor tomorrow and he wouldn't be in.

And then he sent me an email, and it just said,

"Hey, I'm having a rough couple of days."

And he said, "Right now I'm just struggling with a lot of things in my head,

and my emotions, it's kept me up the last two nights,

and that in turn has taken its toll on my mental and physical capacity this morning.

I'm scared that if I come into work, I'm going to make a fool of myself with our guests today.

I think it would be better if I just focus on making it to my appointment tomorrow."

He didn't make it to his appointment.

We found out later that he had run out of money

and the day after that he died of an overdose.

It was an unintentional overdose, we're quite certain.

He called 911 from his phone and he died at the hospital,

and his roommate, who was the first to his apartment after,

said it was set up just like he was settling in for a Saturday night.

He had his videogame controller on one side of his couch

and an open pack of Oreos and a can of Dr. Pepper on the other.

Apparently he had had a struggle with addiction for quite a while.

Some of his friends knew about it; we didn't.

His friends said the problem was, Caleb was just so damn smart,

he was really good at covering it up and making it seem like it wasn't so bad.

The thing that pisses me off most about this is that

Caleb died of an overdose on speed.

Speed is an amphetamine,

and the meds that are prescribed to me for my ADD are dextroamphetamine.

I'm quite certain that Caleb died self-medicating an untreated mental illness.

The history of computer science is too littered with tragedies like this.

Alan Turing, the father of computer science,

committed suicide after facing intense persecution from his government.

And earlier this year, we lost Aaron Swartz to similar circumstances.

In 2007, Aaron Swartz wrote this:

"I have a lot of illnesses. I don't talk about it much for a variety of reasons.

I feel ashamed to have an illness. It sounds absurd,

but there's still enormous stigma around being sick.

I don't want to use being ill as an excuse,

although sometimes I wonder how much more productive I'd be

if i wasn't so sick.

Surely there have been times when you have been sad.

Perhaps a loved one has abandoned you,

or a plan has gone horribly awry.

Your face falls. Perhaps you cry.

You feel worthless.

You wonder whether it's worth going on.

Everything you think about feels bleak:

the things you've done, the things you hope to do, the people around you.

You lie in bed and want to keep the lights off.

Depressed mood is like that,

only it doesn't come for any reason and it doesn't go for any reason either.

Go outside and get some fresh air, cuddle with a loved one,

and you don't feel any better,

only more upset at being unable to feel the joy that everyone else seems to feel.

Everything gets colored by the sadness.

Depression causes nearly half of all disability,

it affects one in six, and explains more current unhappiness than poverty.

Sadly, depression, like other mental illnesses, especially addiction,

is not seen as real enough to deserve the investment and awareness

of conditions like breast cancer, which affects one in eight,

or AIDS, which affects one in 150.

And there is, of course, the shame."

The shame is what's killing us.

And the shame and the stigma around mental illness

is why our coworkers and our friends are suffering from this.

If I stood up here and I told you guys that I have cancer,

I wouldn't be afraid that anyone would think,

"Oh, it's just all in his head."

If I told you that I took insulin,

no one would say, "Aren't you afraid that you're going to be

dependent on that for the rest of your life?"

No one would think that I was using it as a crutch.

If I broke my leg, no one would say, "Just try harder."

They'd say, "Go see a doctor!"

But we have different rules for how we perceive

illnesses that affect the brain

than we do for anything else.

Which is ironic because the brain is actually the most complicated

organ in the human body.

And yet so many of us are reluctant to use

modern medical advances to help cure

the illnesses that affect it.

I think this is particularly true for developers,

because we've spent so much of our life being praised

for how well our brain works.

But the idea that it could possibly be misfunctioning

threatens our identity and our self-worth.

I can understand why, if you feel like you're struggling with this stuff,

you might be reluctant to go see someone

or reluctant to take meds.

It took me a year from diagnosing myself with ADD

to seek someone. It took me two years from having

a medical professional tell me that I had bipolar

to go get treatment for it. I get that.

I was afraid that it would affect the parts of my brain

that made me really good at what I do.

I was afraid that it would rob me of my creativity.

And yes, it's true. My brain works differently now.

I code differently now.

I no longer am consumed by thoughts and stay up all night

and pull these coding benders and crank stuff out.

I'm now much more like the tortoise.

I can be measured, I can have an objective view of the ideas as they come in,

and I have control over them.

And most importantly, I am now dependable and reliable,

which is something that i've never been able to tell my friends

or feel like i had before.

Going to see a therapist or psychiatrist has a lot of stigma around it

and I don't get that.

Michael Jordan had a coach. Tiger Woods had a coach.

Why would you not want an objective third party

whose job is to shut up and sit there and listen to you

and then occasionally make suggestions and

"Maybe you should try doing this just a little bit differently"?

And just as an aside, even if you have no mental health problems,

if any of you guys are married out there,

go get marital counseling.

Rachel and I have been doing this for about a year.

It's like you get to fight with a referee in the room.

It's amazing.

It's had a huge impact on us.

Even if there's no acute problems, just go see someone.

It will help.

Finding a therapist is hard.

They tend to be a little bit less tech-savvy than we are.

They tend to operate more by phone than email.

If you go to my blog, baugues.com/depression ,

there will be some resources on there that you can look up.

Unfortunately I'm not from here so I can't give any personal recommendations

for people in this area.

But there are some resources on there that will help you find someone.

If you're not there yet, just talk to people.

If you can't find anyone else, talk to me.

If you feel like you're struggling with this stuff,

just let your friends know.

If you have struggled with this stuff,

you can subtly let people know.

And you're going to be surprised at how many people will say, "Yeah, me too."

And if things seem so bleak for you right now

and you feel like it's not going to get better,

just know that, ten years ago, I was at college laying in bed at night,

and I was praying that God wouldn't wake me up in the morning.

Six years ago I had one dollar in my pocket and no hot water in my apartment.

And today i'm standing on stage at Mountain West Ruby,

my beautiful wife in the front row.

Things get better. We just need to start talking about it more.

Thank you very much.