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In the previous article, I set the context of a personal journey of health within the backdrop of larger issues of quality of life in our industry. In this article, I continue that journey with my own personal experience of burnout and depression.
Originally posted at: http://www.altdevblogaday.com/2013/05/19/life-can-be-better-part-2-of-3/
In the previous article, I set the context of a personal journey of health within the backdrop of larger issues of quality of life in our industry. In this article, I continue that journey with my own personal experience of burnout and depression and what it took me to regain my own health, vitality, and enthusiasm for the work that we all do. My personal wish is to not see any more bright, creative people suffer from work-related stress. Extended stress has odd effects on both the body and the mind.
NOTE: Please consult with a health professional before making any changes with your own health. I am certainly not a doctor and will assume that you are an adult that will ultimately be responsible for your own health. I’ve done my best to portray this post as personal truth and not accepted science. I realize that every person’s body is different and therefore may respond differently to a specific health regimen.
Background
I grew up playing role-playing games (RPGs) like other hackers, geeks, nerds, and escapists out there. However, fantastical worlds like that of Dungeons & Dragons didn’t grab my interest as much as sci-fi did. Although I remember getting lost in the dark, gritty world of Shadowrun on my Super Nintendo (based on the RPG), for some reason I chose Cyberpunk 2.0.2.0. (a different RPG) when it came time to run a campaign. I loved the idea of a futuristic world where man and machine could meld. Through Cyberpunk, I became acquainted with the use of the term “meat,” crassly used to describe the human body. “Cyberspace” was the place where netrunners existed, while their “meat” resided in “meat-space,” otherwise known as the physical world. Essentially, a netrunner could bring consciousness into an alternate world without reliance on the body.
I connected with Cyberpunk as a teenager mainly because of my growing interest in computers. As I tried to figure things out with computers, I found that my mind gravitated towards combing through my thoughts to better process them, as a memory manager might do to defragment allocations. I also found that I was entertained simply with thought itself, traversing different paths to see where my mind would end up. I realize that these behaviors are what primarily distinguish introversion from extroversion and as a result, believe that they lend the identification of self to the thoughts and processing of the brain. Instead of “I am what I can do” it becomes “I am what I can think”. I also think that those same behaviors help us become better software engineers. Even though I enjoyed skateboarding, football, baseball, paintball, and other physical activities, I somehow managed early on to form a mental model where the brain/mind and body had little, if nothing at all, to do with each other.
Oddly enough, my naivety around health later in life didn’t stray far from that teenage fascination with cyber-augmented posthumanism. In the last article, I mentioned that after starting to work out w/ co-workers at lunch, I was able to get into the best physical shape that I had been in since high school football (hey, in Alabama, we did two-a-days). Unfortunately, even with having increased strength, my energy, mood, and mental health were declining. At age 25, I thought that health had more to do with the way I looked than how I felt. In all honesty, I’d rather have a sexy mind rather than trying to look sexy. Well, during the summer of 2005, in the midst of my third extended crunch for a console game, I finally hit rock bottom and decided that I needed help.
Depression
I used to think that it was shameful to talk about depression and/or any mental impairment. I believed that this was one thing that I was supposed to figure out on my own. In my judgment, sitting with shame around depression let me run circles around questions of “Why?”, rather than looking at the “What?”. As I wrote in my previous article, I did notice the warning signs of feeling chronically tired, feeling “heavy” to move around even though I wasn’t grossly overweight, and starting to think that most things I had to get done were weighty tasks. For me, this was a dramatic change from how I remember feeling when I got my first internship in the industry. I went to a general practitioner for a check up and when the blood work came back inconclusive I decided that I just had to push on. I continued that way until things got worse and I didn’t know what else to do, so I finally decided to see a psychologist.
According to the National Institute of Mental Health (NIMH), “depression is caused by a combination of genetic, biological, environmental, and psychological factors”. In other words, we don’t quite know the causes. Trying to answer those questions of “Why do I feel this way?” or “How did I come to this place?” resulted in many years of sitting with different psychologists. I think a good psychologist can provide temporary help to calm acute anxiety or depression with talk-therapy, but dialogue is less useful at resolving any root physiological cause(s) of emotional disturbance when they exist. While I’ll agree that psychotherapy has its own benefit to healing emotional wounds and looking at long-standing issues, on a practical level of my day-to-day experience it didn’t provide the answers.
Let’s be clear about one thing: I am not saying that stress in our industry causes depression for everyone. Some level of stress is actually healthy in helping us to achieve our goals. Chronic stress, on the other hand, seems to show up in different ways for different people. Separate from major health problems, I have seen stress have impact in minor ways, too, such as frequent irritability or negativity, relationship problems, or motivational challenges to name a few. What I can say is that, at the time I experienced depression, I was working more (including weekends), sleeping less, had little time to socialize, and eating outside for most of my meals if not skipping them altogether. My worst night was working until 6 am on a build that we had to send off to magazine reviewers and being asked to come back in around 10 am. Most crunches I experienced at different companies from 2003-2008 lasted for more than 4 months out of the year. Even though there was some time off and a slower pace following the release of a game, somehow my batteries were not getting recharged.
Moving past the shame allowed me to see the questions of “What can I do?”. Well, in parallel with psychotherapy, I also met with a psychiatrist to hear another point of view. I worked through different SSRIs, SNRIs, and anti-anxiety medications; battling different side-effects in an effort to find the “right one for me”. My judgment of these drugs are that they can work as a crutch, but in the same way that caffeine can keep me operating out of touch with my natural energy levels. The drugs provided relief and got me back on my feet, however, in the end they pale in comparison to my current experience at a holistic level.
When I experienced depression, it was damn near impossible to distinguish that I was not my thoughts. At work, I was unhappy with most of what I was tasked with doing, irritable with requests from others, not motivated to get my work done, and negatively thinking about what the company was doing and the manner in which we were doing it. Now, I’m not saying that some form of each of those thoughts/feelings/behaviors aren’t welcome in order to alert me to doing or suggesting something better. However, preponderance of these thoughts/feelings/behaviors as my M.O. led me to believe that I am a negative, unhappy, and unmotivated person. My invitation to you if you’re in that space: don’t draw conclusions there. From my experience, I can attribute more of the ways I was thinking at that point in my life to my overall physical health.
After experiencing a gradual decline in my state of being over the years, I realize now what negligence towards health in the face of stress has afforded me. I also carry deep concern for any others that, like me, are/were not as well equipped to deal with stress. As an employer, I think it is ever important to protect our employees from burnout. In the process of learning about my own health, I’ve come to a rudimentary understanding of how stress works in the body.
Stress
The PAT (pituitary-adrenal-thyroid) axis is an important system that regulates the hormones in the body in order to keep the body in balance. I think of them as good friends who have my back during good and bad times (regulators, mount up!). When stress comes and goes, each gland does their part. Everything I encounter in the day impacts my PAT axis from my alarm clock in the morning to the traffic on the way to work to the tasks I’m trying to complete on any given day. Additionally, how I choose to react to those stressors can also tax my system. All of these stressors deplete the stores of hormones and endorphins in my body, which is why I’m sometimes exhausted by the end of the day and not able to handle much more. The food I eat helps replenish what has been used after being digested and synthesized into what the body needs. However, under chronic stress the body is producing elevated and continued levels of hormones and endorphins in an attempt to keep the body in balance. Unfortunately, the immune and digestive systems are suppressed, among other things that are affected, which can lead to a non-optimal state for both energy absorption and perception of well-being.
I mentioned perception in the previous article because I wanted to allude to the possibility of being stuck in a fearful, anxious, doubtful, exhausted, etc. state that elevated stress levels can help bring about. To put this in perspective, I consider what happens when adrenaline rushes through my body and how much my thinking can change in the moment. I’ve experienced this while driving when I am in a happy, easy-going mood and with a flash of a potentially dangerous situation with another car I have both a physical and emotional/mental reaction. The world I was seeing as beautiful only moments ago has now become “out to get me.” In a similar way, I see elevated levels of stress having effects on my perception of how I’m performing, the relevance or efficacy of what I’m working on, how others are doing, and so on.
Beyond Depression
Even though I got back on my feet eventually, I somehow never felt as good as I did when I entered the industry. I no longer felt terribly bad, but I didn’t feel energized or great either. Unrelated to energy levels, stress, depression, or any other things I’ve spoken to already, about a year and a half ago I had started working with a nutritionist in preparation for a surgery. The belief was that I would have a quicker recovery from the surgery if I was in a healthier state. So, laughably now, I considered “getting healthy” as something I’d do for a short while up until the surgery. Gradually, I changed my diet, started drinking more water (which was up from almost none at all), reduced my caffeine intake, took tailored supplements and started to feel radically different in the first three months. I think it is more a testament to the shoddy state I was in more than any one thing that I was doing in particular. I started noticing that when I woke up I had energy to boot and was ready to take on the day. I also noticed that my brain function seemed to change. I no longer would get stuck worrying about something incessantly. My brain processing was becoming razor sharp again and my focus improved. When I started to feel the anxiety that I carried around ease up and become more manageable, I became dumbfounded. I realized only after feeling much better that the one question I recall none of the health professionals asking me from 2005 all the way up until 2011: what was I actually eating?
Food for Thought (and Energy!)
If I try to remember what my meals looked like when I started working professionally in 2003 (and to some extent all the way back to 1999 at GaTech) up until a year and a half ago:
Breakfast
Cereal w/ milk, muffin, or bagel w/ peanut butter or almond butter; pancakes or eggs, bacon on the weekends
Lunch
Usually Mexican/Indian/Thai food (varied over the years depending on where I was working), burger w/ fries, occasional salad, sandwich with chips
Dinner
If working late, then whatever food was brought in if the company catered; otherwise, whatever food was close around (likely the same places I ate at during lunch); or skipping dinner and eating some kind of snack at home later in the evening (usually another bowl of cereal or PBJ or whatever could be made quick)
When not working late – frozen pizzas or pre-packaged food that could be warmed up (sometimes in microwave, sometimes in oven, sometimes in saucepan); pasta w/ tomato sauce; mac and cheese; thai/indian take-out
Fluids
Orange juice in the morning
Coffee many times throughout the day, which also killed my appetite
Very little water if none at all (would drink water during workout sessions)
Occasional soda
Certainly anyone can look at this and say, yeah, that doesn’t look like the healthiest diet, but at first glance I wouldn’t think someone would say there was anything particularly wrong with it either. However, there is one thing that is missing in significant quantity – vegetables. There would rarely be any sort of vegetable or green on my plate unless it snuck onto the plate (luckily, Thai or Indian food usually has vegetables).
Fast forward to today and I now consume the following:
Before breakfast
10 oz. of carrot juice (used to buy this in the store and then decided to simply buy my own 5 lb bags for the week and get a juicer); I recently started juicing the leftover stalks of whatever green I’ve been eating in addition to the carrot juice
Breakfast
Two eggs, parsnips w/ cinnamon or seasoned cauliflower / rutabagas w/ diced onions + some sort of green sauteed in butter (chard, spinach, kale, or collard), two slices of toast
Before lunch
I usually try to drink 1-2 quarts of water before lunch. I have a stainless steel water bottle that is close to a quart that I keep filled at my desk. I don’t usually have any liquids when I’m eating a meal to aid in digestion. I’ll drink something before or an hour after my meal.
Lunch
Usually, this is some form of leftover from dinner the previous night(s) that I bring to work and warm up in a toaster oven. Occasionally, I eat something from around the office, but this was difficult initially because I find that most places don’t include fresh vegetables or greens with a good sized portion of protein
Dinner
Two small lamb loin chops (pan-fried, then broiled) w/ brussel sprouts (sauteed)
Ground lamb and sweet potato (steamed and mashed w/ butter) tacos w/ onions, garlic, and chard, collard greens, or kale (sauteed) in a brown rice or corn tortilla + additional sweet potato, onions, garlic, and greens on the side
Turkey burger w/ broccoli, cauliflower, beets (both gold and purple), or whatever else I have left in the fridge
Seasoned, baked chicken breast w/ blanched and then sauteed green beans
Turkey meatloaf w/ kale chips, baked cauliflower or turnips/rutabagas
Miscellany
Occasionally, I mix whole grains in: brown rice, quinoa, millet
I’ll eat fish and beef occasionally
Dairy products come and go in my diet and when I do eat them I go for the whole fat, raw versions when available (or at least vat or low-heat pasteurized)
I’ll have fruits occasionally as a dessert or a snack
All of these meals are makeable in about 30 minutes. When I am eating later than I like or have to run to Whole Foods to pick up groceries, then I’ll usually grab stuff from the hot food bar — again, loading up on vegetables; including ones that I don’t buy regularly, such as bok choy.
The key here is that I eat vegetables now in significant quantity due to the mix of vitamins and minerals present. Two-thirds of my plate will be vegetables and only a third will be a hand-sized amount of protein/fat (some vitamins that come from vegetables need fat to be absorbed) and occasionally some starch such as brown rice or quinoa. If I’m eating out somewhere, I’ll usually request for them to double whatever vegetables come on my plate.
My cupboard is bare for the most part – no more cereals, potato chips, dry pastas, crackers, etc.
My fridge is full of organic vegetables and meat.
I’m mindful of sugar.
I cook with butter usually for breakfast and olive oil (on low/med heat; there are better oils for high heat) for all other meals.
I drink lots of water (3 quarts) and usually only water during the day (occasionally a kombucha or decaf tea) — not during meals.
I use a rice-cooker w/ a steam basket to steam most of my vegetables (quicker and easier than the stove top) – I bought one from a Japanese food store
I still enjoy an occasional coffee, sweets, pasta, pizza, etc. from time-to-time, however, the key is that I keep none of that in the house.
My grocery bill for the workweek is roughly $75 with some carry-over to the weekends. The most expensive items are meat, eggs, and carrots (because I’m buying those in 5 lb bags). Vegetables are for the most part cheap in their individual quantities.
I didn’t eat this way before because I considered food to be a nuisance. Even though I had enjoyed great meals in restaurants or cooked by others, I treated that as a luxury. My relationship with food was that I needed to be doing something else other than preparing a meal or taking time to enjoy it calmly. So, when I was hungry, my intention was simply to eat something as quick as possible and get back to what I was doing. One way I could characterize my prior understanding of food is that I could eat anything and produce anything. My new understanding is garbage in == garbage out. Now, that’s not entirely true because I know that I was still able to develop working code under extreme stress even though I was not eating well. However, I also know now that I was not producing at my optimal performance.
I see food as potential energy. Whatever food I am taking into my body is, ultimately, a stored form of energy from the sun. It goes through millions of chemical processes to reach the stage that it is at when I ingest it. That potential energy gets used either for physical or creative work. To me, a calorie is no longer a calorie and I don’t view things in a simple “bad” food vs “good” food dichotomy. I choose organic because I’m looking to maximize the nutrients in my food, not simply because non-organic is “bad” (and yes, I’m aware that the term “organic” is prone to abuse in efforts for companies to make more money). I choose specific foods over others for the same reason. I prepare my food and use whole ingredients because I like knowing what I’m putting into my body.
Summary
I could go on about a lot more things, such as how the body needs healthy levels of certain amino acids and minerals for the optimal functioning of the brain, the glycemic index, or what foods are nutrient rich. However, the most valuable guiding strategy that I have learned from all of this is that nutrition is more about how I feel and less about how I look, which is why I misunderstood and took no interest. I knew that eating healthy was important; however, I had never experienced first-hand the effects, nor did I have a reason to. I think that nutrition is even more important than exercise and that physical activity comes naturally as an effect of having more potential energy in my body. My invitation to you is to find out what works for you. Become the patient observer. Pay attention to how you feel after meals. Notice what improves your moods. Take time to prepare your own food and enjoy it stress-free, so you can maximize the nutrients you are taking into your body. What motivates me to continue is twofold: I don’t want to go back to feeling the way I used to feel and, more importantly, I want to see what’s possible.
I’ll also add that everything isn’t perfect today. I get irritable at times. I wake up on the occasional morning and feel sluggish. I still battle with anxiety. I’m exhausted sometimes at the end of the day. I’m frustrated occasionally with the performance of my own work or with what we’re doing as a team. However, all of those things are blips now where before they were part of my routine, daily experience. Having a programming background, I simply see this as an optimization problem to figure out what can be done better. However, optimizing the human body is a bit more difficult than shaving cycles off of a routine. Maybe in a cyber-augmented posthuman world of the future, we’ll have the equivalent of a software profiler for the human body.
In the final article, I’ll shift focus to the changes I’ve made that impact how work gets done both at a studio and individual level, talk a bit about what I’ve changed in regards to sleep, some practical things I do to conserve willpower throughout the day, and tie up any loose ends with this series.
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