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MentalHealthError: an exception occurred

593 points| cool-RR | 10 years ago |kennethreitz.org | reply

186 comments

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[+] tominous|10 years ago|reply
This story struck a nerve because (in hindsight) I saw the same thing happening to my brother when he was about 19. He was suddenly interested in astrology, reiki, "tachyon energy disks", epiphanies, angels and demons, the vibrations of the universe.

At the time I thought it was a phase. My mother was always talking (tongue-in-cheek?) about her "parking angel" and burning incense, so I thought he had just picked up that part of her personality.

Turns out he had (and still has, many years later) schizophrenia so he was genuinely using his considerable intelligence to try and make sense of what he saw, heard and felt, drawing on any "truth" he could find.

It really put me off religion and spirituality for a very long time. If these concepts weren't out there and accepted by so many people, maybe he would have been diagnosed and treated sooner and be in a better place today. I don't know.

These days I do think some amount of religion/spirituality is positive, and I think in total it makes the world a better place, but if I ever felt that kind of epiphany personally I know I would head straight to the nearest mental hospital.

[+] jdietrich|10 years ago|reply
>It really put me off religion and spirituality for a very long time. If these concepts weren't out there and accepted by so many people, maybe he would have been diagnosed and treated sooner and be in a better place today. I don't know.

I'm a staunch skeptic, but I don't think there's a causal link. People suffering from psychosis invariably find something in their environment to create a contextual frame for their experiences.

For example, paranoia can manifest itself as a wide range of experiences. Someone living in rural Nigeria might describe being possessed by evil spirits, someone living in 1950s America might describe being followed by KGB agents, a European Muslim in the present day might describe being targeted by spy satellites and drones. After the release of the movie The Truman Show, psychiatrists saw a sudden emergence of patients who believed they were living in a reality TV show.

https://aeon.co/essays/a-culture-of-hyper-reality-made-paran... http://www.newyorker.com/magazine/2013/09/16/unreality-star http://news.stanford.edu/news/2014/july/voices-culture-luhrm... http://www.psychosocial.com/IJPR_10/Cultural_Demographic_Fac... http://bjp.rcpsych.org/content/193/2/168

[+] kruhft|10 years ago|reply
This is an interesting read on the difference of views between the Western and African views of 'mental illness' from an African (Witch) Doctor after visiting some western mental hospitals:

    http://www.wakingtimes.com/2014/08/22/shaman-sees-mental-hospital/
tl;dr: Most of what we view as mental illness they view as the birth or awakening of a 'healer' and should be treated that way for proper acceptance of the person into society and eventual recoverey.
[+] anaximander|10 years ago|reply
> ... if I ever felt that kind of epiphany personally I know I would head straight to the nearest mental hospital.

I can't say that you're wrong, but I would also ask you to consider that your sane and reasonable state of mind that's saying this now, is not the same state of mind that believes these delusions. What may seem right now to be a very clear and easy decision may be the last thing you would even consider in another mental state.

[+] spaceisballer|10 years ago|reply
This article describes my brother (minus the programming experience). The hard thing is you can never make someone get help if they aren't a threat to themselves or others. Being an all around a-hole isn't sufficient to make someone admit themselves to a facility (no matter the run ins with police or the diagnosis). He's lucky he went to a facility and followed through. My brother ended up in one and I felt like I talked him into staying. Then he calls me to try and get me to lie to his social worker. Then the social worker calls me and I don't lie (he wasn't staying with me and he didn't have a job). Social worker listens but then a few days later he's out. My only hope is that now that he went out to California the system out there can make him get help.
[+] protothomas|10 years ago|reply
A well written and brutally honest article - the author should be commended as this kind of honesty is what's needed in beginning to address mental health issues. I did feel the last throwaway point "don't date the crazy chick" let it down slightly - by his own hypothesis she too was suffering (bad) mental health issues and blithely shifting blame to her seems a little off.
[+] watty|10 years ago|reply
I'm curious what kind of drugs were involved. Crazy chick, traveling the world, doing shamanistic rituals (which often use drugs), sleep depriving oneself until hallucinating, etc.

He doesn't say it outright but had he not taken part in these damaging things, he may not have had the psychotic episode and wouldn't know he was bipolar.

http://www.elle.com/beauty/health-fitness/advice/a14193/ayah...

http://www.dailymail.co.uk/news/article-2521132/DMT-spirit-m...

[+] alva|10 years ago|reply
s/crazy chick/crazy dude/

Having a partner of either sex that also suffers mental illness (perhaps more severely than you do) can exacerbate un-healthy or unhelpful ways of thinking.

I don't think the writer was placing entire blame with the partner, but actually making a good point earlier about the psychological reinforcement from being around them

[+] nnq|10 years ago|reply
Side note on the "mystic flavor" yoga (as oppose to plain "mindfullness meditation" and "yoga for back pains") and other "eastern" spirituality things: I think there's a reason why there are so many initiation ceremonies and tasks that one was/is traditionally put to do before going-off-the-deep-end, and why ancient hindus saw being a yogi as a path for one that was of a certain age and already had a family and proved itself capable of functioning in society - to weed out anyone with preexisting mental health conditions. You even see this pattern in the story of Buddha's life - he was a socially capable young prince born in a loving family and had no frustrations and most material needs fully satisfied. And also for the zen philosophy attitude of "but don't take these things too seriously" - to prevent people from actually "drowning" in these mystical visions and loosing any contact with reality.

Overall I think that a lot of people would benefit from the occasional mystical perspective on life. It's awesome for creative problem solving! And most people have become a bit too secular and boring. But if they go on and apply the "work hard on it and take it seriously" pattern to spirituality they'll just go and OD on it.

The "westernly refined eastern spirituality" seems as close to the original thing as purified cocaine is to chewed coca leaves: very different concentrations, very different use scenarios. How can it not go wrong for the more psychology sensitive individuals among us?

People should go and read/listen some of Allan Watts' book/recordings. You can try starting with this: https://www.youtube.com/watch?v=8130_-3d3PA . He had some good ideas on how to use an occasional mystical perspective to enrich one's life, without taking it too seriously and completely loosing it. Mind it, I don't agree with most of his ideas, but they are still better than what others are selling.

[+] yahyaheee|10 years ago|reply
Upvote as well. My personal mystical experiences have been very positive in my life. My friends and I call it "cleaning out the cobwebs" and do it a couple times a year. And yes this stuff is not good for people with mental illness, but let's not throw it away all together. Psychedelics have an incredible promise to heal, and have helped me substantially with my own trauma. However they should be used in chorus with a certified therapist. Beyond that I get a little agitated when people feel that none of it is of any substance and we already "know" reality. I think we are actually very far from understanding the nature of reality and these experiences may hold legitimate truths in them. Let's not be reductionists and keep an open mind
[+] dfraser992|10 years ago|reply
Upvote, and especially for the metaphor (cocaine versus coca) - it summarizes what I've seen in the New Age-ish subculture over the years.

I've had experiences with kundalini - quite definitely. And some woo-woo ness I can't possibly explain unless one is already familiar with the terminology and understandings. Ken Wilbur is a useful read - it's not all garbage.

But "I" was still "I" and understood what was going on and never forced it by heavy duty 100% immersion into the subculture (aka dating the crazy chick). No instances of mania, etc - always came down, after learning some inner stuff. The focus was always on the inner world and self-knowledge, not solving the problems of the universe. The universe can take care of itself.

It's when you go into "inflation" and think "you" are the embodiment of God and all that is where everything goes sideways (aka no sleep for 10 days). To think all the concepts are -literally- true is a sign of a less sophisticated understanding or of schizophrenia, etc - like not understanding the myth of the dead and reborn god is a metaphor, not an actual historical event (people...! really?) but once that metaphor becomes properly understood, then the universe becomes a little more interesting.

Someone with an undiagnosed bipolar disorder is pretty guaranteed problems eventually. I'm glad he's back to normal.

[+] flatline|10 years ago|reply
> ancient hindus saw being a yogi as a path for one that was of a certain age and already had a family and proved itself capable of functioning in society

This was the case with the Western mystery traditions since the Greeks, but I wasn't aware of it in the East. Buddhist monks are often accepted at a very early age. In Tibet in particular they learn advanced yogic practices, although the more rigorous training does not start until the teenage years. Foyan, an 11th Century Chinese Zen monk, comments that there is no point studying past the age of 30 because you are too old!

[+] wife2715|10 years ago|reply
Almost the exact same thing happened to my wife recently. As somebody who experienced this from the "other side" it is truly frightening. It nearly tore my family apart.

Even now, months later, not everything is back to 100% normal. My wife still occasionally shows signs of her episode and is on medication (although we have transitioned to a low dosage of a more forgiving drug). The most obvious problem is a stubborn insistence that what is going on in her head right now is the only reasonable option and any discussion otherwise is an active attempt to undermine her (i.e. a conspiracy against her). This transcends normal disagreements. She also still has trouble sleeping.

At the time she had her breakdown she constructed an elaborate and paranoid fantasy inside her head that everybody was out to get her (including close family members and myself). This was tightly wound with inscrutable religious imagery and governmental conspiracy.

It was terrifying and I had her committed to the psychiatric unit (this is what nearly destroyed our relationship).

The most frightening aspect of the whole thing is that she was 100% convinced she was right at the time. Her logical reasoning facilities simply broke down. There was no reasoning with her. In fact, if anything, trying to talk to her using logic and reason aggravated the situation.

Even now, when she looks back, she can see how strange it must have been for everybody else, but she's still struggling because her brain is telling her she was "on the right side" of this problem the whole time.

This can happen to anybody, and it's nobody's fault. Sometimes, shit happens. Nobody should be ashamed of this. Take care of yourselves and others. Most of all, get a good night's sleep and eat well!

[+] cmrx64|10 years ago|reply
> Sleep is really important.

This cannot be overstated enough, I think, beyond just the effects of severe sleep deprivation. It's very true in my personal experience with major depression as well.

Also good to do: eat well, get exercise, get sunlight. Minds don't exist in isolation from the body, it's all the same sack of chemicals.

[+] hacker_9|10 years ago|reply
It's interesting to me it has to be stated at all to be honest. When I don't sleep my productivity plummets, and it's pretty easy for me to make the link. Even the difference between 7 hours and 8 hours makes a noticeable impact.

I sometimes wonder if these kind of first hand experiences are something that should be a part of the education system, such as depriving yourself of sleep and recording the results, or exercising on and off for several weeks and recording your mood, etc. I find this kind of self experimentation highly informative, and these days I can easily 'feel' the effects of drinking/smoking/dieting/exercising/etc on my well-being and mood, which in turn gives me a lot more willpower to see things through when I can logically infer the cause of bad feelings/moods and know they are temporary.

[+] IndianAstronaut|10 years ago|reply
I wish we would stop praising or making light of sleep deprivation. We need to stop thinking that sleeping a lot is a sign of laziness.
[+] krylon|10 years ago|reply
I agree completely.

After my last depressive episode, I have fallen into a fairly rigid sleeep-wake-rhythm, which has served me pretty well. When the depression rears its ugly head, irregularities/changes in my sleep cycle are usually the first observable symptom.

And I have not met a single person suffering from major depression who has not in some way had his/her sleep pattern affected by it.

[+] dghughes|10 years ago|reply
I used to work shift work and thought it was great to wake up late and stay up late when working then go to bed even later after winding down when I got back home. The occasional overnight project that would span several nights (you waste two days as one day).

Then I went back to an 8am to 4pm schedule and wow what a difference I didn't realize I was a walking zombie all those years.

Yes sleep is important but consistent sleep is the key.

[+] arca_vorago|10 years ago|reply
My main scientific interest is in how much of this kind of mental problem is genetic, and how much is not. In particular, I have felt for quite some time now that those who are raised very religiously are much more likely to have mental issues and have problems thinking fully rationally/logically.

I am a combat vet with mild ptsd, but I was very religious before the war. I am now not just an athiest, but I am antithiest, and during what I call my "descartes reset" I had to relearn many things I thought I "knew". I eventually realized that while in general I was fairly smart, there were entire areas of life that being raised religious effectively neutered any logical thinking. As a result, I feel like I am intellectualy a teenager, because so much of my early years were wasted with this religious indoctrination, and to me the key is that in many/most cases, forcing children into religion is very mich indoctrination. I recognize some of the techniques the military uses in theirs!

Of course the genetic angle is an important one that I hope cheaper and more broadly available sequencing can help with, because some people arenpredisposed to these kinds of mental breaks and can be told they are at higher risk if they do drugs, dont sleep, etc.

That being said, living in the bible belt, the connection between religion and mental health interests me just as much.

[+] majewsky|10 years ago|reply
> "descartes reset"

I love that word. Especially because studying Descartes in high school has also shaped my world view very strongly.

[+] auvrw|10 years ago|reply
> Sleep is really important.

so true. remember it's cumulative, too, so you can't miss a bunch of sleep, sleep 8hrs one night and then be alright.

>This can happen to anyone, even you.

not as concerned a/b this, but i s'p so.

>Don't date the crazy [person]!

totally date the person you feel a connection with, and don't worry a/b labeling them, yourself, or anyone else w/ such a gross, pejorative label as "crazy". do remain true to yourself under any & all circumstances. travel, in particular, can be tricky, depending on the time of year, especially.

> That is unlikely to happen again

this is a catch-22: it's as unlikely to happen as one is convinced that it could happen and remains vigilant.

thanks for Requests and stay safe!

[+] djhn|10 years ago|reply
Calling sleep cumulative is slightly dangerous, you can't recover lost sleep or stock up on it. But Sleep deprivation and its adverse effects could be describe as cumulative, with a slow rebound.
[+] throwaway172648|10 years ago|reply
Im very happy to see this on the top of hn. I had a very similar experience but do not talk about it at all because the stigma is so strong.

A major problem with the conversation in mental health is that having thoughtful or well formed opinions about the subject can incriminate you. I have a tremendous respect for anyone that is willing to talk openly about it. I am no that brave.

[+] joepie91_|10 years ago|reply
Serious question: have you considered publishing it anonymously?

If you've run into issues with that idea (like being concerned about unintentionally revealing hints about your identity, or how/where to publish it, etc.), I'd happily try and help out - my e-mail is [email protected].

[+] davycro|10 years ago|reply
A courageous story. I felt the author captured the pace and psychotic features of a manic episode. Call me a terrible person, but I chuckled when I read about the "Dynamo algorithm to replicate life". I can imagine the author wandering around the hospital with the whitepaper in hand demanding that doctors read it.
[+] w_t_payne|10 years ago|reply
I already hold Kenneth in great esteem because of his work on Requests and Clint, both of which I make use of and admire.

This post amplifies my respect for him as a human being.

I welcome posts like this (and there seem to have been quite a few recently) because I really want to be able to talk openly about mental health to gain clarity and understanding.

I am particularly interested in issues around arousal, focus and mania, since these affect our profession so profoundly. (I wonder how many of us in this forum owe our professional skill and aptitude to a predisposition towards hypomania and intense focus).

It feels like our society is moving in a positive direction here -- a move which I applaud and welcome.

The mind is powerful, wonderful and strange, and we need to treat it with respect and understanding -- something that can only come about by being open and honest.

[+] michaelwww|10 years ago|reply
This is an excellent article and I applaud Kenneth for writing it because it will help someone who reads it. Coincidentally, after reading this I came across another article about bipolar illness and how it has wrecked the life of a once famous woman:

The best African American figure skater in history is now bankrupt and living in a trailer (Debi Thomas) https://www.washingtonpost.com/local/social-issues/the-myste...

[+] mooseburger|10 years ago|reply
I am oddly disappointed. I thought the article would be about more "relatable" mental problems like depression or low self-esteem, rather than a full on psychotic break. Sometimes I wonder if programmers are afflicted with the above plus anxiety more than the average. It certainly has affected me as someone who grew up nerdy and bullied, but most of my coworkers seem pretty happy.
[+] Confusion|10 years ago|reply
You probably also look 'pretty happy' to your coworkers. They experience you as you experience them: without any knowledge of what goes on in their minds. Conversation is required to probe deeper. There may be many that have, or at least understand, your problems.
[+] raverbashing|10 years ago|reply
I would say that the description of the Psychotic episode helps to raise awareness of that mental problem
[+] the_mitsuhiko|10 years ago|reply
> It certainly has affected me as someone who grew up nerdy and bullied, but most of my coworkers seem pretty happy.

I can very much relate to this. But you grow out of it and I never really considered it a psychological problem. Everybody has his or her thing growing up and for me it was just lack of self-esteem and not fitting into the lifestyle of people around me. But growing up I learned to just ignore it and that made me happier and more confident in the process :)

I don't think it only affects programmers. But when I was at school it was just not particularly common to be interested in computers and that's certainly a factor. Group pressure is a big thing when you're young.

[+] dclowd9901|10 years ago|reply
That's interesting. I also was nerdy and bullied a lot, but I consider myself a pretty happy person now. I've grown far more adept at handling social issues (more self confidence, better at taking social cues, etc), I've become fairly successful, and (ashamedly) I take joy in knowing the people who bullied me growing up are either the opposite of those things or dead (of their own consequence). Even if that wasn't the case though, I get the sense that the reason I have become successful socially and professionally is because of what happened to me growing up. You can't not be who you are, ya know?
[+] mycroftiv|10 years ago|reply
Threee years ago I experienced a very similar manic episode with delusional thinking, but in my case, it was absolutely the best thing that ever happened to me. The creative energy and imaginative thought patterns I experienced then transformed my life in a positive way. I know this is an atypical experience and I was lucky to dodge many possible negative consequences of actions based on delusional belief systems. For me, the key was maintaining my social connections and using the perceptions and reactions of other people to keep myself connected to shared reality.
[+] mystikal|10 years ago|reply
A lot of people think that believing you're Jesus is some kind of grandiose delusion, but in the case of manic psychosis, it's simply the logical conclusion of all the super intense messages from the universe you're receiving.

Enlightenment is hell.

[+] kenneth_reitz|10 years ago|reply
Exactly! It is the inevitable truth you are being constantly presented with. You are forced to accept it.
[+] enkephalin|10 years ago|reply
my thoughts exactly, during a similar event. i was just trying to make sense of things, and due to the gravity of the unfolding events, being jesus or god was a possibility i just couldn't ignore, despite being in full possession of my mental faculties at the time.
[+] astazangasta|10 years ago|reply
We're all suffering from grandiose delusion all the time. Each one of us believes we are the most important thing in the universe - and we ARE, in our own solipsism. But this belief (the ego) is buried deep within us, and the constituent (spiritual, emotional) elements of our universe are built around it. Psychosis merely brings it to the front. Of COURSE you are Jesus, the most important thing in the universe. If not you, who is?
[+] fishnchips|10 years ago|reply
I personally found out that coding before sleep is a horrible thing for you - your mind keeps working on problems long after you close your IDE.
[+] Xc43|10 years ago|reply
He is lucky. All of you without mental problems are quite lucky.

Kenneth, if you are reading this: I feel you man.

I had a similar experience to you. Similar fleeting views... without a crazy chick. I was the crazy one. What I did not say so far is that I too am lucky. My psychiatrist said that I was in the 1% of the 1% (I am not sure of the percentages). Those who recover among those who suffer from schizophrenia. Now, 4 years later, it seems that I made a full recovery. Yet I lost 2 years of my life to it. Two years of my life where I did not take medication. You are older than me, you accomplished so much more. I still have to get my C.S. degree. I am in my last semester. I now somewhat look up to you. Before reading this article, I had no idea of your existence. Now I found an inspiration I can relate to. Thank you for sharing.

[+] TrevorJ|10 years ago|reply
>A breakthrough occurred when I slipped the doctor a piece of paper containing the URL to this website. This gave him a really good idea of who I actually was, and was a very useful tool in helping him diagnose me.

Is it expecting too much of our health care professionals to assume that they should be I don't know, spending five minutes on google looking for this information themselves? What about interviewing family and friends? How do you expect to treat a mental health patient without a baseline in the first place? This tidbit did not instill any confidence in me whatsoever.

[+] josscrowcroft|10 years ago|reply
This brings to mind something I read by Ken Wilbur, about "Waking Up" vs. "Growing Up".

In a nutshell, as I understand it: Waking Up without Growing Up - like spiritual bypass - can lead to delusion, psychosis, inflicting unconscious wounds on ourselves and the world... Advancement in Waking Up, which I suppose we need for ultimate fulfilment, doesn't by itself cause progress in Growing Up, which we need to function as part of our world...

I've seen friends who started earnestly seeking spirituality around the same time as me go deep into madness (with spiritual names), for example dealing with 'entities' they claim to be real, yet are not part of shared reality, and I suppose failing to see that their experience is actually mirroring their inner state.

My own brief touches with psychosis triggered by intense - and arguably premature - spiritual work have emphasised for me the importance of remaining grounded in the daily life of being human, doing that basic work first to become emotionally literate, calm, healthy and self-nurturing.

What concerns me is that people throw the baby out with the bathwater when they stifle or medicate their spiritual longings due to fear of (or experience with) mental illness. Mental health seems like it could be a prerequisite for facing the challenges of sincere growth, but not a reason to avoid spirituality.

I believe Ram Dass said "You gotta be somebody before you can be nobody."

[+] exizt88|10 years ago|reply
Could this have been prevented? Is there a reliable way to check on your mental health status?
[+] teamhappy|10 years ago|reply
Psychosis is pretty hard to hide I think. Basically any doctor should find out that "there's something going on" simply by having a conversation with you. The same is probably true with family (they may notice you're "acting weird/different" or something like that). If your friends are very spiritual they might think this is normal of course, so maybe stick with professionals/family.

I'm not sure about bipolar disorder and similar diseases, but I suspect they're much more difficult to diagnose (but also a lot less scary than psychosis).

[+] truebosko|10 years ago|reply
Talk to friends about your feelings. Sometimes it can be hard to see how deep you've gone when it's just yourself.
[+] DanBC|10 years ago|reply
There's a lot of work happening around early diagnosis and early intervention for first episode of psychosis. We know that early intervention is important across a bunch of measures for psychosis (amount of medication; amount of hospitalisation; ability to stay in work; etc).