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TL;DR

In late summer 2023, I realized my mental health was the biggest barrier to achieving my goals. Over the next six months, I made it a priority, working with a therapist on CBT, adjusting medication timing, and developing healthier habits (like meditating and wellness routines). This resulted in a noticeable improvement in my clarity, productivity, and overall well-being, which positively impacted my work and leadership.

This post is part of an effort to post more :)

Background and Context

  • Late summer 2023: During a performance review, I realized my mental health was my biggest barrier to growth.
    • I had been diagnosed with depression years earlier and medication helped significantly, but I was still having breakthrough symptoms.
    • It was preventing me from achieving ambitious goals and handling important work decisions (like what my team should prioritize in the following quarter)
    • I made improving mental health a top priority in my personal development.
  • Early 2024: By my next performance review, my mental health had significantly improved.
    • People around me, (such as my direct report and husband), noticed the difference in my mood and decision-making.
    • My affect in meetings is better, and I am overall less reactive and more stable.

Nuance and Disclaimer

  • Still a work in progress: I have a long way to go in terms of mental health (and can still grow a lot in the things it affects like productivity and decision-making)
  • Just one example: I know many people have done better jobs improving their mental health and are much more productive and stable than I am. I am mostly just writing this as one case study of many.
  • Not universally applicable: Standard: what worked for me won’t work for everyone
  • Why I’m writing: I’m sharing this as an example of someone who’s made some progress, hoping it might resonate with others in a similar situation.

Some ways progress has affected my work

  • Fewer doom spirals:
    • I used to get caught in weekly (sometimes more) emotional breakdowns and thought spirals, which would take me out of action for hours.
    • These spirals would make me feel like I wasn’t doing well enough, wasting time, and letting people down (which in turn made it worse!)
    • Now, they’re much less frequent, less than once a month and when they happen, they are shorter/less severe
    • I have much more clarity when making decisions, and I’m not as overwhelmed by emotions.
  • Increased productivity:
    • I’m getting more done and feel less self-doubt.
    • I’m able to focus more on the work in front of me and consistently crank out productive days.
  • Leadership impact:
    • The improvements in my mental health have made me a better leader— I approach situations with more calm and focus.
    • I feel more capable of handling the responsibilities I have, which is critical when leading a team and making strategic decisions.

What Made a Difference (in my rough guess at level of influence)

There are a lot of other things as well! But these are the most notable:

Therapy (with the right therapist)

  • I tried therapy in the past, but it was a negative experience, often leaving me feeling worse and made me hesitate from trying it again for years Despite my hesitation, I gave it another shot, using the EA Mental Health Navigator to find a therapist who practiced Cognitive Behavioral Therapy (CBT).
    • I specifically wanted CBT because of its evidence base and effectiveness for people like me.
  • This therapist was incredibly helpful in identifying patterns of problematic thinking, reframing them, and suggesting practical actions I could take to help when I felt low (like making a “feel good” song playlist)
    • We worked on finding inconsistencies in my thoughts, reframing negative beliefs, and applying more productive ways of thinking. (The standard CBT stuff)
    • We really clicked, and I always left meetings with action points and feeling optimist/excited/much better
      • When I moved, I could no longer meet with her and have yet to recreate this.
        • I have tried ~4 or 5 different therapists since then and none clicked.
          • They were fine, but nowhere near as good - my guess is therapy relationships are very heavy-tailed.
      • I’m currently just using a free coaching program through my health insurance, which, while not as good, has been more effective than the other therapists I tried post-move.
    • Luckily, a lot of the effects continued and I am able to use the CBT tools I learned on my own (and with the help of books like Feeling Great)

 

Changing the time of taking medication

  • I switched from taking antidepressants in the morning to taking them at night.
    • This made mornings much easier, significantly improving my energy levels and set my days off to a good start.
    • And also has allowed me to become a morning person!
  • Unfortunately, this one is probably the least generalizable but had a big effect on me
    • But it’s possible, it’s worth talking to doctors about options like this

Meditation and Habit Tracking

  • I started meditating regularly and added it as a tracked goal in my weekly agenda with my manager. (I found the intro sequence to 10% happier really helpful)
    • I was asked, “Did you meditate four out of five weeknights this week?” which kept me motivated to keep up the habit.
  • For a period right after that performance review, I tracked my habits very rigorously:
    • Meditation, exercise, and other routines were strictly monitored weekly.
    • My manager held me accountable, giving feedback if I missed my targets, which helped me stay disciplined.
    • I tried making a Wellness Tracker to find correlations between sleep, exercise, and productivity and didn’t find much out.
  • When I stopped meditating for a period in the summer, I noticed a clear difference.
    • My control over my thoughts weakened, and the thought spirals and emotional overwhelm became more frequent again.
    • Regular meditation allows me to focus better and manage emotional responses more effectively.
  • Now I use the app “calm” instead of 10% happier.

80k podcasts on mental health

  • The 80,000 Hours Podcast has some really nice mental health episodes (example)
    • I especially enjoyed the episodes on 80k After Hours, like the one on free will, which helped me embrace the idea that I can’t control everything.

Physical Routines

Exercise

  • It was super important to find a routine that was fun and enjoyable.
    • For me, this is specific workout classes with really good fun music and getting involved in social sports (ie: by joining a social/beginner recc league or attending meetup group events)
  • I also have in my weekly check-ins “did you workout >3 times this week”?
  • Physical activity, especially when combined with a social element, is especially helpful for maintaining energy and positive affect

Sleep:

  • I have always enjoyed sleeping, typically my issue was sleeping too much instead of too litte
    • I became strict about my daily routines, trying to wake up within 30min of the same time every day, even on vacations (but taking more naps on those vacations).
      • I am a lot worse on weekends and sometimes shift later but will schedule in obligations/workout classes as a way of forcing myself to get up after a reasonable number of hours of sleep.

Final Thoughts

  • In six months, I went from frequent emotional breakdowns and decision paralysis to a place of more clarity, confidence, and emotional stability.
  • This journey isn’t finished, but the changes I’ve made have had a profound impact on both my work and personal life and my guess is that other people can achieve that too :)
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Thanks for sharing and glad you feel better! I had a very similar experience recently. I also agree that the right therapist can make a big difference. My coaching was with Overcome. https://www.overcome.org.uk/ I don’t have depression but I had pretty severe anxiety. Interestingly I also had spirals but with consistent help they are gone and it is easier and easier to deal with setbacks, which for a leadership role was big game changer. What I found most useful about my new coach is not any specific techniques they used (it was a mix of ACT and CBT which work really well on me) but the fact that they had experience and understanding of what my role is like (charity founder) and what it’s like to be an EA trying to make an impact. Also my coach has a similar cultural background to me which was a cherry on the top!

So glad you've found ways to significantly improve your wellbeing!!

I switched from taking antidepressants in the morning to taking them at night.

Can I ask why you think this helped so much? 

Different medications get metabolized at different rates. If you were taking one that peaks after ~8 hours (like extended-release venlafaxine), evening timing might work better.

The first antidepressant I tried gave me nausea for much of the day when I took it in the morning. Taking it at night helped a lot because I slept through the part where I felt sick. This is how I learned "complain to your prescriber if you're having side effects" because sometimes they have simple ideas that help.

Thanks! I have this nausea problem, so I'm going to try taking mine at night :) (checked and it seems fine/safe)

Worth a try! Different meds are activating (make you more alert / awake) vs sedating, so it's also worth noticing if an evening dose makes it harder to sleep.

Thank you! And thank you so much for your podcasts - like I mentioned in the post I found them really helpful and relatable and am grateful for you sharing so much!

I'm on buproprion xl and generally they don't recommend taking it at night because it can cause insomnia but I'm really lucky and have never really had problems with that. Instead, I just found waking up in the morning extremely difficult - I often woke up sad and just wanted to stay in bed and keep sleeping (even if I had slept a really long time). Due to the extended release, taking it at night means that peak effects are now happening in the mornings when I was most sad / low motivation before. So that was honestly just really great for me.

So nice to see & thank you for sharing! If you’re ever interested in picking up habit tracking again, I’ve been through the ringer with apps and settled on Bearable; they have a lot of the more correlative stuff you were looking for (i.e. you can set up unlimited inputs & outcomes and it will correlate between them in a simple way).

But, also, I’ve been using habit/factor trackers for years and I’ve never gotten anything useful out of their analysis tools because there are too many confounders. I mostly find them useful as a habit that causes me to be more mindful about those things, which is valuable in and of itself. (And also I have chronic pain so can specifically keep an eye on my flare-ups for my rheumatologist).

I use bearable for 3 months at a time to get a picture of what is currently working. You can track effect sizes of supplements in sleep quality for example if you also have a way of tracking your sleep. 

Funnily enough, I noticed there were a bunch of 80/20 stuff in my day through using bearable. I found doing a cold shower, loving kindness meditation in the morning and getting sunlight in the morning were like a difference of 30% in energy and enjoyment so I now do these religiously and it has worked wonders. (I really like bearable for these sorts of experiments.)

This is super interesting! How do you do the experiments? Do you change one thing at a time and track?

I just did different combinations of the sleep supplements, you still get the confounder effects but it removes some of the cross-correlation. So Glycine 3 days, no magnesium followed by magnesium 3 days, no glycine e.t.c. It's not necessarily going to give you a high accuracy but you can see if it works or not and a rough effect size

Thanks! I actually also was using bearable for a while there and had a similar experience of "it's hard to find out info because of confounders but this is generally useful for being mindful of my wellbeing". I don't use it any more but might look into it again :)

I remember thinking it was super cool when I found it

Love hearing stories like this! I went through a similar journey both mentally and physically and realised sometimes the professionals don't know how to solve my issues and then I have to jerryrig my own solution (with a doctor's oversight). 

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