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What I Learned from a Stroke at 26: Make Time to Untangle

248 points| allsystemsgo | 9 years ago |nytimes.com | reply

99 comments

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[+] verisimilidude|9 years ago|reply
I spent several years in my mid-twenties working like the author, pretty much non-stop. At the lowest point, I fell into a weird sleep pattern: I'd crash as soon as I got home around 6:00 in the evening, then wake up around midnight and be back at work by 1:00 am.

It took an old friend's suicide to jolt me out of it. I saw a lot of my old buddies at the funeral and started reestablishing those friendships. We played a lot of video games. Xbox Live probably saved my life. The worst thing about overwork is that it becomes difficult to imagine yourself doing anything else when you're in the thick of it, like it doesn't even occur to you that you should be spending your time elsewhere; I wonder if any of you have experienced this. Thankfully, even something as inconsequential as Halo was enough to help me rearrange my priorities.

[+] throwaway28935|9 years ago|reply
For me it was the opposite. The whole time I was overworking I was aware and wishing I wasn't and very much imagining myself doing other things. Now I'm aware and wishing I was back to normal and working.

I spent about 4 years working flat out. If I was awake I was working, trying to keep the income coming after the recession hit. Then something snapped. The now ex-wife had to unwind the things I was part way through.

Since then I can't do anything productive. I spend all the time wasting time with tv, games and online. Or often literally just nothing. If I try and do something productive like finding work again, or even simple like tidying the house I seize up with a mental resistance I find hard to describe. The more effort and willpower, the more the resistance increases. Even if I get started I've dropped out to go back to doing nothing within 10 minutes. Most days start with a resolution and to do list, but end with another day wasted. It's wrecked my career, relationship and social life.

I've been to a few doctors, but I've never gotten anything even a bit helpful.

[+] gerbilly|9 years ago|reply
I've been thinking about this lately and I've concluded that a big driver of overwork is the misguided quest for fulfillment.

Not really fulfillment like we normally call it, I'd say more like acceptance.

Perhaps many of us are seeking love and acceptance from bosses and coworkers, and overworking ourselves to obtain it.

I believe that building your identity on anything that isn't yours is stressful. Building your ego on your job performance or on the positive feedback you get from coworkers isn't healthy.

It's like emotional sharecropping. You are building your ego on someone else's land.

People need to remember that work is the place where they have "human resource" departments, where they will make cut and dried decisions on who to retain and who to lay off the moment they want to adjust a budget.

[+] infodroid|9 years ago|reply
> many of us are seeking love and acceptance

I would go further than that, because I don't think this gets to the heart of the matter. The main driver of overwork is the promise of higher status that certain cultures bestow on those who pursue it [1]. The respect of bosses and the admiration of coworkers are just the consequences. As are the material benefits, like the increased salary and all the things it might buy.

Yet advising overworkers to stop looking to others for positive feedback is not going to work for everyone. A large proportion of people identify as extroverts, people who need validation from others in order to feel good about themselves. And it's unrealistic to expect extroverts to be happy with valuing their self-worth the way introverts do.

[1] Alain de Botton has a great book on this topic entitled Status Anxiety: http://alaindebotton.com/status/

[+] vlaskovits|9 years ago|reply
"emotional share-cropping" is a brilliant and moreoever, accurate term.

The writer of the piece, Jonas Koffler, is my co-author for Hustle.

In the book, we address the difference between 'renting your dream' (ie emotional sharecropping) and 'owning your dream' finding your personal meaning, momentum and money.

"I believe that building your identity on anything that isn't yours is stressful."

We couldn't agree more. We also describe how one should diversify their identity/ego into a portfolio of sorts.

https://www.amazon.com/Hustle-Power-Charge-Meaning-Momentum/...

[+] SmellyGeekBoy|9 years ago|reply
> People need to remember that work is the place where they have "human resource" departments, where they will make cut and dried decisions on who to retain and who to lay off the moment they want to adjust a budget.

Or looked at from another angle, this is one of the very reasons people want to be seen to be "going the extra mile" compared to their colleagues (not that I'm disagreeing - the point about seeking acceptance is a very important one).

[+] kafkaesq|9 years ago|reply
Not really fulfillment like we normally call it, I'd say more like acceptance.

That's exactly it -- people strive for "fulfillment", but find it to be at best a nebulous goal, ever out of reach. So they settle its poor imitations - acceptance and recognition.

[+] RankingMember|9 years ago|reply
> It's like emotional sharecropping. You are building your ego on someone else's land.

Nicely put.

[+] cesarbs|9 years ago|reply
I'm 28 and have severe hypochondria, so this article was a terrifying read. Having a stroke is my #1 fear. But reading it makes me feel good about having shifted my attitude to work after I got married. I don't think I'll ever be the workaholic that I was in my early 20s, because my priorities have shifted so much after getting married and I've become especially frightened of the idea of stressing myself out to the point of suffering something like a stroke. The last thing I want in my life is to burden my wife with having to take care of a disabled me.

In fact, I don't think it's only work that can lead to bad health issues caused by stress. I have my whole routine designed to have a low stress life. I avoid bringing in anything into my life that might be a major source of stress. I keep everything as simple as possible.

On the symptoms side of things though, I now have to go to the doctor. Again. Reading about the buzzing in the right eye and the tingling was terrifying because I've been feeling something similar for the past few months. So onto my 4th brain scan in the past few years... Sigh. Hypochondria is a bitch.

[+] dav-|9 years ago|reply
I struggled with severe hypochondria for about two years.

I had been feeling tingling/numbness/buzzing all over my body, coming on in waves and lasting anywhere from minutes to over a week at a time. I was ~~worried~~ convinced that it was MS.

My (awesome) doctor told me that it was super unlikely to be something as serious as MS, and that it was most likely my anxiety. I had always avoided medications in the past; even though I knew I had anxiety, I thought I could continue coping with it on my own. I finally took his advice and started taking an SSRI (Paxil) and my very physical symptoms disappeared almost immediately even at the lowest dose, after lingering for months.

Before I started on the medication, I was unable to read the news or search Google about anything health related because the simple mention of any random disease would send me into a near panic attack. Now, I can research any disease in depth and feel zero anxiety.

Oh, and did I mention that prior to being worried about MS, I was convinced that I had some type of heart defect. My doctor at the time was not nearly as good as my current one, and she indulged in my anxiety and we went through the whole battery of tests: EKG, Holter monitor, echocardiogram. Everything came back normal, but my worry just shifted to a new thing.

I guess my experience has led me to two conclusions: treat your anxiety first, and try to find a great doctor.

[+] daeken|9 years ago|reply
> On the symptoms side of things though, I now have to go to the doctor. Again. Reading about the buzzing in the right eye and the tingling was terrifying because I've been feeling something similar for the past few months. So onto my 4th brain scan in the past few years... Sigh. Hypochondria is a bitch.

I really hope you find a way to handle this that doesn't involve very expensive reassurance from doctors. I experience something very similar when I read about heart conditions; I go into a spiral of anxiety where I believe my heart is failing, even though countless doctors have assured me that I'm perfectly fine there. Isn't the human brain just a ton of fun?

[+] M_Grey|9 years ago|reply
You might be better served by seeing a doctor who can help you with your hypochondria, or otherwise seek some means to manage your anxiety. Some means of recognizing thoughts you're having which are excessively rooted in fallacy, obsessive thoughts and the like, not to mention learning how to redirect your attention and calm yourself is a good idea.

After all, the result of that will be that you're under less stress, and less likely to have some kind of cardiovascular event.

[+] Zelphyr|9 years ago|reply
Check Acceptance Commitment Therapy (ACT). It's a form of CBT that has been particularly successful in treating anxiety-related issues.
[+] reitoei|9 years ago|reply
> So onto my 4th brain scan in the past few years

You really, really need to talk to a different doctor.

[+] tluyben2|9 years ago|reply
Same experience in the early 2000s at 28; worked like a maniac in a fast growing company (co founded by myself); we had huge clients and made bucket loads of money (Deloitte fast 50 for years) but we were understaffed as our hiring did not keep up with the growth: I worked 7 days, 8 to 10 and usually more after getting home. I came in one monday went to the toilet when suddenly my arm fell down next to me, I stumbled, remember a crackling sound in my head and not much more after that until many hours later in the hospital. Unlike OP, I had to spend 1 week (esp the first 24 hours as they are crucial) for observation and tests in a special stroke ward. They could not find any cause. I know there is not much proof for the stress having to do much with stroke or high bloodpressure but I am sure that was the cause anyway. I remember that choking feeling of thats stress and pressure. I packed up and moved to Spain with my wife; started working sane hours from home.

To be clear: number of working hours have not much to do with stress levels: I sometimes still work long hours but since I never felt anything like that kind of pressure I had then. And I never will; it was silly and unproductive but as my first big company and successful startup (which gave me financial freedom early on), I did not have many history to fall back on and the advice around me was of a 'do not stress so much' kind of unhelpful level.

It took me years to get over the anxiety of getting another stroke and my speech is still not what it was before; I cannot pronounce some English words correctly even though I know how to and used to be able to. But it does not impair my life or work: people seem to like that Dutch English accent while my previous English was more perfect.

[+] lostlogin|9 years ago|reply
Could you clarify - did you have a stroke? Your post says you were observed and no cause was found. Do you mean that no cause for the stroke was found? Or no cause for the symptoms?
[+] hourislate|9 years ago|reply
I gave way too much to more than one job when I was young. As I transitioned into my 30's I began to think very differently about work. It wasn't my #1 priority anymore. By the time I coasted into my 40's I was just looking for somewhere I could become a number and disappear. A good paying Corporate job or contracting.I like environments where a huge bureaucracy exists to slow things down. Ride it out to retirement. It's working out well for me. Don't have a lot of piss and vinegar left. Like to enjoy my family, my cars, travel, quiet times. I can piddle a whole day away just messing around in the garage and it feels so rewarding. I think it is the Spanish who have a saying....."It's nice to relax after a day of doing nothing".
[+] ams6110|9 years ago|reply
This is what a lot of 25 year olds who say "I can't imagine ever not working, not learning new stuff" don't understand. Of course they can't imagine it. I couldn't either when I was 25. But when you're 50, you can really feel like there are better things to do than work your ass off for someone else's benefit or entertainment.
[+] germinalphrase|9 years ago|reply
I teach high school. I love working with the kids, but then I look at my 50hrs+/wk (yes, really) and can't help but feel like pushing into business for the pay bump - or find a desk job for the same take home and have my evenings/weekends to myself.

Always greener pastures elsewhere...

[+] dasmoth|9 years ago|reply
38 here, and while the way I think about work has changed somewhat, the "bureaucracy to slow things down" aspect remains, if anything, more soul-destroying. If I have to spend time at work, I really, really, don't want the feeling it's just a burned offering to the gods of process. Still time for this to change, but I'm starting to doubt it will.
[+] infodroid|9 years ago|reply
It's sad that the author effectively blames himself for overworking and the resulting stroke. It might be the more socially-acceptable explanation, but there is more to it than that. He wouldn't be clocking 70 hours a week and bearing "self-imposed tortures", while ignoring the symptoms of exhaustion, unless his peers and the wider society rewarded it, as part of a self-destructive feedback loop. And we are all complicit in it, since we keep praising people who successfully "hustled ... up the chain of command", "managed to survive layoffs", and are now "leading development and marketing for a team" after only a few months. Overworking is nothing to celebrate and it shouldn't be a role model for anyone. We shouldn't reward this behavior when we encounter it.
[+] randomacct44|9 years ago|reply
What the?

"When I was discharged from the hospital late the next day, the cabdriver asked me, “Where do I take you?” I couldn’t remember the name of my street. I handed him the discharge paperwork with my address on it, arrived home and slept for a long while."

How does someone who just had a stroke get discharged from hospital the next day, to a taxi?

[+] tluyben2|9 years ago|reply
I felt invincible at that age and I did not feel the need to have insurance really; in NL insurance is mandatory but I had the cheapest of the cheapest. After a major event like a stroke, you usually cannot move, ever, from your insurance (at least not 'up'). Also, you cannot get income protection insurance after that, which, of course, now you will see the use of.

I wish I had forked out the cash for international health insurance, the largest package, before I had a stroke, but I did not as I felt nothing would happen to me. Now that I live in another country and I travel a lot, I get bitten by that naivity a lot. I would recommend, if you are healthy and have enough $ to take an international health insurance package as you will never know what happens.

[+] Xiol|9 years ago|reply
I found this line particularly shocking.

When my mum suffered a stroke, she was hospitalised for 7 months and had a team of occupational/speech/physiotherapists around here helping her recover as much as possible (which wasn't much, to be fair).

But socialised medicine is evil, and the NHS death panels could've taken her.

[+] nkozyra|9 years ago|reply
Exactly my thoughts. I've heard of a week or less stay discharged to family, but not throwing someone in a cab the _day after a stroke_.
[+] callmeal|9 years ago|reply
Welcome to America.
[+] digi_owl|9 years ago|reply
Not having the life insurance to cover a long term stay?
[+] WhitneyLand|9 years ago|reply
Related info:

Compared to people with the lowest psychological scores, those with highest scores were:

86 percent more likely to have a stroke or TIA for high depressive symptoms.

59 percent more likely to have a stroke or TIA for the highest chronic stress scores.

More than twice as likely to have a stroke or TIA for the highest hostility scores.

http://newsroom.heart.org/news/high-stress-hostility-depress...

[+] austinjp|9 years ago|reply
Yep, although:

"One thing we didn’t assess is coping strategies...it’s possible that positive coping strategies could ameliorate some of these associations or effects... We did not inquire about coping. I would say that’s one of the tasks for future studies."

[+] jdimov10|9 years ago|reply
Don't make time to untangle. Stay untangled. Live your life. Enjoy it. Have fun. If you have any time left after that, then may be do some of that inconsequential stuff like earning money or achievements. These are nice, if you enjoy doing them, but are not important. Unlike what you've been brainwashed to believe, your life does not depend on those things. Your well-being does not depend on those things. The well-being of your family and children does not depend on those things. It's the other way around.
[+] fiatjaf|9 years ago|reply
Have you actually passed two days without any money in your pocket?
[+] sotojuan|9 years ago|reply
Many people in this thread lamenting overworking in their youth. Maybe I've been lucky but at 22 I'm very happy with my decent 9-5 type employments. I've never felt the ambition necessary to sacrifice my free time for work—I'm satisfied with what I have.
[+] kajjffkk|9 years ago|reply
Many people seem to work solely to earn income. I feel like this is a common work arrangement.

Others work to make income and intellectually and emotionally satisfy themselves. Perhaps you're in this camp? If so, I'm with you on that one.

Granted at some point of income, a certain amount of income without personal fulfillment is preferable to me due to the delayed gratification possibilities.

[+] Animats|9 years ago|reply
"Being so young, I had not even considered that having a stroke was a possibility. But I have since learned that they are on the rise among younger people."

Uh oh. Does anybody keep stats for YC companies?

[+] coldtea|9 years ago|reply
>My doctor did not directly link my stroke to overwork, but said it could have been aggravated by stress, overexertion and exhaustion.

Could he put it any more directly?

[+] agumonkey|9 years ago|reply
I had an accident that led to cardiovascular / brain issues that reminded me of this, although less critical at first, but lingering. Since I do not need to be hospitalized, I could reflect on it, and it was like knowing how it felt to be handicaped, suffering debilitating diseases or even what old age could feel. It sheds a strong light on the life of others and yours, how fragile health can be. That said it's also sad how impossible it is to know this beforehand (if you're between child and old, many doctors will just handwave over some symptoms).
[+] BigJeffeRonaldo|9 years ago|reply
It's not complicated to understand. If you work hard, you need rest. Your body, if you don't derange her with stimulant drinks and cocaine, she will tell you, "I need to rest!" So just listen! It's not that hard. Just listen to your grandma instead of being a techno nerd who drinks red bull until he is deranged with permanently lowered IQ from sleep deprivation and a weird disease. If you work hard, you need a rest.
[+] dsfyu404ed|9 years ago|reply

[deleted]

[+] rjtobin|9 years ago|reply
Kind of shocking lack of empathy in that last sentence. Don't get me wrong, I hate the "you shouldn't say anything offensive" brigade, but equally, no reason to be so caustic. Overwork is a big part of tech culture sadly, posts like these are helpful, even if they are only reminders of things we already know.
[+] copperx|9 years ago|reply
You haven't met my famous Russian professor who works 7 days of the week and seems pretty happy with his life.
[+] kajjffkk|9 years ago|reply
>Humans don't last long at a 100% duty cycle.

I dont disagree, but do you have a source on that?