My diagnosis is paranoid schizophrenia. I got sick a year after graduation. For 10 years I have been working in IT, now my position is a senior software engineer. I want to tell you what problems a person may face with a serious mental illness when building a career.
This is a practical article. In it, I almost will not touch my symptoms and describe my experience. There are a lot of such articles without me, and they also exist in Habré. There is a whole publishing house that specializes in books about schizophrenic experience.
Schizophrenia is present in 1 out of 100. The average IQ is 90 schizophrenic, whereas in a normal person it is 100. This suggests that there are fewer people who are smart enough for engineering work among schizophrenics. People like John Nash or Bobby Fisher (although it’s a debatable question whether there was schizophrenia) are especially rare. Only 25-30% of cases of schizophrenia does not affect mental abilities. Mostly they come under attack. And not everyone will choose the craft of a programmer by their profession.
Programmers and schizophrenics a little. On all reddit, after a long search, I counted a man of 15. On all of Habré there will be a man of 5. In general, do not be alarmed, it is unlikely that I work in your company. It is unlikely that you will even meet real schizophrenics on the labor market of qualified programmers (except, of course, in cases where the diagnosis can be clearly made on the resume).
We are very few, but we are. And schizophrenia is not a reason to give up life, to sit on a disability and sit in four walls.
Talk about diagnosis
Of course not to say, never, to anyone, and not under any circumstances. I work in enterprise development, on a foreign customer. Here, people are afraid to allow juniors to come to the rally with the customer, “what if he will blurt out.” And here is the risk. If it comes up, then maybe they will be fired, business is business. Well, or not fired, if you are lucky and you work in a modern progressive company. But, for example, will not be promoted. Or they won't raise the salary.
We, generally speaking, are not very happy. According to the survey, 38% of the inhabitants of Russia will gladly send me somewhere and isolate me. Anywhere, if only out of sight. In IT, however, the public is much more progressive than the national average.
Frederik Freese, who recently deceased, PhD in psychology with schizophrenia, advised: He added that if the atmosphere is more or less favorable, and you are a woman, then you may be treated simply as a person with a chronic disease. I would not advise a man to take risks.
Selection of drugs and side effects
I spent my third dozen jealously hating psychiatrists, refusing drugs, reading antipsychiatry and stories about the Big Pharma mafia. The result is three psychotic episodes, two hospitalizations. Every time I somehow had to change jobs, I sent strange encrypted messages to my friends during episodes. A lot of people stopped talking to me after that. Nothing good. Medicines must be drunk.
Terry Davis comes to mind immediately. Certainly, an intelligent and talented person who refused drugs and as a result spent his whole life in classes of dubious nature. So he can do, do he drink medicine? It is unlikely that he would become famous, but he would still be alive and worked somewhere as a programmer. Another example, of course, is John Nash, who never drank medicine. Schizophrenia has receded, so often with age. But do not forget that before this, John Nash spent 20 years talking to aliens. And only a miracle was not on the street. Few can afford this luxury.
In the fourth decade I want a calm and stable life.The main side effects of second-generation antipsychotic drugs were hormonal disorders, problems with the cardiovascular system, excessive sedation and weight gain. There are already drugs on the market that do not put pressure on the heart, do not cause strong weight gain and hormonal disorders. True, alas, not all of them fit. Try it worth it.
But there are other side effects. For example, the medicine I take destroyed my insights, "a-ha moments." I still understand different things, but the understanding is quiet and peaceful, without insights. I miss them. In general, medicines will definitely make life less interesting, vibrant and rich. But much more predictable and stable, generally tolerable.
Choosing a psychiatrist
For the selection of drugs and prescriptions will need a psychiatrist. Most likely not one. The psychiatrist imposed by the state is approximately equal in quality to a state lawyer. Here is what I heard from state psychiatrists:
“Work hard for you? So choose, or drugs, or work "
“Gain weight? So it's good! "
" Why do you need these new antipsychotics? Take haloperidol! They are all the same, only money pulls out of you ” (Haloperidol is an old drug with very bad side effects: double vision, muscle spasms, long-term use leads to incurable neurological consequences. In 2013, an article appeared that this drug neurotoxic)
Precinct psychiatrists, of course, do their job. They help patients receive some kind of medicine. They help to form a disability. They make sure that their players are not on the street. But if you want something more, you should contact a private specialist.
But a private specialist will be treated at best, based on statistics and averages. No trial and error is complete. In the case of a worse doctor will fall for the advertising, but again he will prescribe new fancy drugs - not so bad, the drugs are really getting better and better. In the worst case, they will be treated on the basis of "experience." As practice shows, experience is rather a negative phenomenon.
For example, the doctor refused to change the drug because she had a patient who had an aggravation on the drug. There were a lot of my arguments. schizophrenia occurs in all different ways. The world is full of people on this particular drug without exacerbations. Exacerbations are sometimes on stronger drugs. It is not a fact that this patient applied the drug correctly and on time. They all crashed against the wall.
When you hire a psychiatrist, he must act in your best interest. Your interests are not only to reduce the risk of disease, but also to minimize side effects, and return to full-fledged work. If the hired doctor does not act in your interests, you should part with him without any regret.
Exacerbations and Hospitals
Exacerbations happen. The drug is jealously taken every day, and still aggravation. The most frequently used technique for exacerbations is to raise the dose of drugs and watch. You may have to do it yourself. Perhaps with a trusted doctor. Well, if the dose increase did not help, then the aggravation should be stopped by more serious medicines. On the market there are drugs of prolonged action, the use allows you to arrest the most severe attacks. The main thing is to react in time.
Exacerbation is fraught with entry into the hospital. Everyone is afraid of this. They go to a mental hospital for a long time, at least three weeks. The hospital is like a prison. With regards to the staff: nurses, nurses and doctors are, of course, not monsters and not sadists. But these are embittered people. Tired, burnt, cynical and indifferent. Which pay very little for very stressful work. It is also terrible that for a sick-list with a stamp of an institution, they can be fired from work to an easy one. Here it is necessary to get out.Perhaps the hospital should not be taken from there at all, but look somewhere on the side.
Sometimes the aggravation is first noticed by the patient himself. Sometimes close people. Therefore, it is good to live with someone. In one study, this fact increases the risk of recovery. I do not see anything bad in coming together with my parents for a while. This will reduce the likelihood of a successful personal life, but honestly, a successful personal life with such a diagnosis does not really shine. In women, everything is true, better. The same role, of course, goes to the spouse. Or a therapist. In general, someone should be.
Exacerbations are a slippery subject. It is better, of course, not to allow. Without tablets, the probability of exacerbation is about 80% per year. In any case, you must be ready to pack your bags and look for a new job. It is possible that in another city.
A few years ago, cognitive behavioral therapy was considered the standard of treatment. The recommendations wrote that medications are obligatory, but without psychotherapy, in addition, it is direct anywhere. Now the mood has changed and they look askance at psychotherapy. I went to cognitive behavioral therapy. There was little confusion. I can’t say that they were directly “pumping out money”, there was a person sitting there who was listening to me and offering something. But it didn’t work out well, we didn’t agree with the therapist on the characters.
However, I find psychotherapy helpful. As soon as the crisis is over, there remains a huge amount of fear. And how will I live? Can I do it? What if there is an aggravation? But I had a hole in the resume, what will I say at the interview? There are real problems behind these fears. They can work with a therapist, just don’t have to look for causes in childhood injuries, or use NLP technology, you just need an educated and emotionally uninvited interlocutor. Before going to the therapist, you must first clearly articulate all their problems. Time there resource is expensive. It is necessary to choose a psychotherapist more intelligently, you should not focus on specific schools and methods, but of course the psychoanalyst and NLPist will hardly fit here.
Psychotherapy is often presented as a magical place where miracles happen. Rather, it is an optional supplement to improve the quality of life. It is worth walking when the state has stabilized and there is money, which is not so pitiful.
Another tough question. 80-90% of schizophrenics smoke. Allen Carr, in his book, claims that cigarettes create anxiety and interfere with concentration. Studies, I speak here only about studies conducted on schizophrenics, show that cigarettes can cope with anxiety, and improve concentration. Cigarettes help with schizophrenia.
On the other hand, the harm from smoking is well known. If possible, if finances allow, it is worth giving up cigarettes and switching to other methods of obtaining nicotine, be it a patch, gum or vape. Absolutely refuse it - well, I do not know.
In psychology, for some reason, it is considered to be avoiding a bad, nasty adaptation strategy. Probably, when avoidance reaches the size of agoraphobia, it is something bad. For example, I am very easily overworked and react painfully to stress. I see nothing wrong with taking care of avoidance.
For example, I go to shops only in the dark. There is a huge list of people with whom I prefer not to intersect. A friend of mine, a schizophrenic, turns off the color on a computer, and works behind a black and white screen, avoiding unnecessary stimulation.
Most of the evenings I study technology. Partly because of my fears of losing my job and not staying. But largely because I don’t know what to do with the evenings. So I avoid a full-fledged rich life.
I try by all means to make excuses from business trips, I feel very anxious when traveling. But in the end, I feel good, and I have no desire to somehow change in these areas of life.
Being a bad programmer
Schizophrenia forces temper their ambitions. If earlier I was chasing money and interesting projects, now I choose a quiet and calm corporate unfinished business. In this you learn to find your charms. You see how the system develops over the years, as a result of this or that design decision. You have the opportunity to take on a large piece of functionality and gradually grow it and develop it. In general, programming moves from the killing of dragons to something gardening.
I have a very vulnerable and vulnerable nature. Any conflict of interest is alarming. Basically, on the project I am “Yes man”, I can brace myself and object, but I easily give up and accept the point of view of the authorities. In general, not a fighter. Before my illness, I scornfully treated such people.
It’s very hard for me to refuse a person to the review code, I’d rather ask carefully if you really wanted to, or maybe you meant something else. It hurts me when I click on the “Needs work” button. I understand that it is unlikely that a person will be mortally offended and will take revenge. But I will still be nervous.
I'm not sure about myself. I constantly advise either with stack overflow, or with the team. I'm afraid to delay the deadlines and anger the authorities. This is often the reason for overtime. This is “what if they say?” To overtime in the evenings and on weekends I agree easily. Work calms me down. I distract from my sad thoughts and problems.
It is hardest for me before releases, when something broke and needs to be fixed. When several people are constantly writing to the chat and waiting for action from me. I am quickly overloaded and very nervous. I run away from the computer, I smoke until I calm down, come back.
In my work a lot of fear-driven development. Being tolerant of people has become more important than being right and right. I do things quite differently as experienced professionals advise.
I'm a bad programmer, I got used to it for a long time. And yet, their own peace and comfort ultimately triumph over the desire to be a tough guy and do everything right.
Schizophrenia is not only its own tragedy. Willy-nilly you plunge into the whole sea of another's grief. The pain is completely pointless, accidental, and not at all deserved. Sadness and sometimes even suicidal thoughts are normal. This, too, must be calm.
List of books that helped me recover:
The author thanks the community/r/schizophrenia for the warmth and support that he received in the most difficult moments.
- Elyn Saks. The Center cannot hold
- Milt Greek. Schizophrenia: A Blueprint for recovery
- Kurt Snyder. Me, myself and them
- Ann Olson. Illuminating Schizophrenia