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Comment on How I Overcame Bipolar II (and Saved My Own Life)

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I think that the prevalence of manic-depressive (bipolar) illness among software entrepreneurs is many times greater than that of the general population. Many of the symptoms characterizing manic or hypomanic behavior are possibly extremely helpful for software entrepreneurs and I would argue that founders exhibiting manic-depressive characteristics have a higher rate of success than those without such traits.

However, success is really dependent on founders being careful to manage their symptoms to avoid the 'burn-out/depression' cycles that generally follow the manic and hypomanic cycles. It IS possible to have some measure of control or regulation of these cycles by some combination of medication, careful diet, proper sleep, CBT (Cognitive-Behavior Therapy) or Psychoanalysis. And there are lots of books on Amazon discussing these topics (but very very few reliable online websites). But this is more of an ART than a science and it can take a very very long time to figure out the proper balance.

The main main issue for all software entrepreneurs with manic-depressive illness is that they need to avoid having their entrepreneur lifestyle trigger their mania/hypomania episodes and run out of control.

And I would wonder if the caffeine-fueled programmer paradigm actually leads to stress-related brain damage that makes software entrepreneurs more susceptible to full-blown manic-depression. A kind of entrepreneur PTSD.

The article is good if it spurs people to do more research on their own and to seek out professional evaluations (from people very experienced with bipolar/manic-depression. not just anyone please...) if they have a sense that something about their moods just might be a bit off.

The average time from onset to diagnosis of manic-depression/bipolar is approximately 10 years. An entire decade lost. Greater awareness of manic-depressive illness and its causes might help entrepreneurs create companies that are more conducive towards promoting mental health. How many companies have utterly failed after a co-founder or key programmer hits a depressive cycle and is suddenly completely able to perform their jobs?

I'm speaking from my own experience here: I only sought out help after starting and having only marginal success with 3 startups. After a decade of these failures I had the sinking feeling that something was wrong with me and I couldn't justify placing the blame on my co-founders and poor market conditions. And then after eliminating sugar and white flour from my diet and take small doses of lithium I finally realized how off I had really been all this time.

I think it'll take a few more years at least before I have a full understanding of the illness and how to best manage it. It'll be expensive to see all these specialists, etc. but the alternatives are severe depressive, likely financial ruin and a high chance of eventual suicide.

A few books that helped me learn more about manic-depressive illness (and made me feel like there was actually hope...):

- Touched with Fire: Manic-Depressive Illness and the Artistic Temperament by Dr. Kay Jameson -- Documents how creativity and manic-depressive illness are linked, and discusses the prevalence of mood disorders among the most famous artists and writers in Western culture.

- An Unquiet Mind: A Memoir of Moods and Madness by Dr. Kay Jameson -- The author is a clinical psychologist and wrote this breakthrough memoir revealing her own battles against manic-depressive illness.

- Loving Someone with Bipolar Disorder by Julie Fast -- This is extremely useful for founders who may have a member or their team or company that does have or seems to have manic-depressive illness. It helps explain how to communicate with manic-depressive friends/loved-ones in a way that they can hear you, particularly when they are in the midst of a manic/hypomanic cycle. And it will help you learn how to avoid triggering manic/depressive episodes.

Nutrition-related resources are a bit more complicated and if you have the resources I would suggest consulting with a professional with training in Orthomolecular Psychiatry. These types of people are MD's so they can prescribe medications and know a lot about medications, and they also know about nutrition and its interaction with medications and mental health. The combination of these skills is extremely important when you are dealing with serious medications like lithium and also changing your diet, since medication and diet interact with each other in complicated ways. But the people who possess both types of knowledge are very rare, and there aren't too many of them around. If you are in the Berkeley area I would recommend seeing Dr. Michael Lesser. If he doesn't have open appointment times he can probably refer you to reliable colleagues of his.

But in the meantime the basic advice that he gave me is:

- try and completely eliminate white sugar and white flour from your diet. -- Switch to using honey as a sweetener and 100% whole wheat bread.

- reduce caffeine intake to around 1 cup of coffee in the morning or switch to tea instead if that works for you.

- Make sure to get as much high-quality sleep as your body really needs. -- this is the hardest one for me... still working on it.

Switch to using honey as a sweetener

Not such a great idea. Honey is full of fructose -- this indeed gives it a lower glycemic index than sucrose, but causes other problems. Watch this (long but very interesting) video: http://www.youtube.com/watch?v=dBnniua6-oM

My takeaway from this talk is that it's best to avoid all sugars, but if you must eat something sweet, eat it with plenty of fiber to slow the absorption of the sugar. Of course, the easy way to do this is just to eat fruit.

I'm definitely not the expert here and the suggestion to use honey as a sweetener was given to me by an Orthomolecular Psychiatrist. The context was that if I want to use a sweetener in my tea or coffee, I should use something like honey over white sugar or cane sugar.

Honey may have other issues, which definitely reinforces my feeling that it's really best to consult an expert when attempting to regulate mental disorders by using a special diet or vitamins. However as a common sense solution it seems that using honey to sweeten tea or coffee is a reasonable alternative to white sugar, and it is a situation where fruit simply won't substitute. For a quick snack, fruit is a great idea and I would definitely prefer it over some kind of honey snack or a candy bar.

googling: "honey bipolar refined sugar" leads to a bunch of links comparing white sugar with honey, but again my experience with internet research for vitamins and mental disorders is that the information is extremely unreliable and all over the place. This is an area (similar to searching for information about cancer online) where I think that the most reliable information comes out of books written by qualified professionals and directly from qualified specialists.

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