After Aaron Swartz
Brilliant young hackers, striving to build tools to change the world, are killing themselves. Just last week: Aaron Swartz, co-founder of Reddit and fierce open access activist, took his life at 26. There have been other high-profile suicides in the tech world in recent years: Ilya Zhitomirskiy, co-founder of the distributed social network Diaspora, dead at 22. Len Sassaman, a highly-regarded cypherpunk who believed in cryptography and privacy as tools of freedom, dead at 31. Dan Haubert, co-founder of the Y-Combinator funded startup Ticketstumbler, dead at 25. If these young men were like the 100 people who kill themselves in this country every day, the biggest factor contributing to their deaths was likely under-treated depression.
We can readily come up with hypotheses as to why depression is a problem in the tech world. It’s a culture defined by ruthless pressure, high stakes, and risky gambles. Often hiding behind pseudo-anonymity, lightning fast criticisms are released online with bullet speed. Then there’s the “thrashing duck” syndrome: to survive in the start-up ecosystem you have to puff up your chest and show only how smoothly you’re gliding through the water; you don’t show how furiously your legs are kicking and struggling underneath. There’s also the hero archetype of the lone hacker: he’s coding through the night, living on red bulls, sleeping on a couch at AOL to save money, not thinking about short-term wealth, and surely not thinking about health, be it physical or mental.
As a clinical psychologist married to a hacker, I do not find this to be okay. On a human level, there is widespread pain and suffering lying silent and unaddressed. On a societal level, we are losing brilliant young minds, activists and role models with so much left to contribute to the world.
I am not saying depression and suicide are necessarily higher in this community compared to other populations; there isn’t enough data to say that. The rub to me is this: one of the most effective and scientifically-backed treatments for depression appears to be an incredible fit for hackers, and yet few people know about it. It’s called Cognitive Behavioral Therapy (CBT), and it has some of its origins in computer science.
Born out of the cognitive revolution of the 1950s, a key idea within cognitive psychology is that by studying how computers input, store, and process information, it becomes possible to make testable inferences about the nature of the human mind. Cognitive behavioural therapists (most typically clinical psychologists with research backgrounds) mirror hackers in how they see the world and approach problems. They share the same core values: an emphasis on problem solving as efficiently and effectively as possible, gathering data to test out what works and what doesn’t, using logic to debug a system, and implementing transparent methods that others can understand and replicate as opposed simply to putting your faith in a “magic black box.” CBT and hackers are long lost kindred spirits, yearning to be reunited.
To give a concrete example, a core concept within CBT is that when human beings are in high distress, our amygdala (the emotional/fear part of our brain) goes into high alert and overrides our prefrontal cortex (the part of our brain that uses logic to solve problems). In the midst of this emotional “hijack”, we are prone to hopeless thoughts (“my problem is unsolvable”) and a number of thinking errors that magnify our distress. As Cheezburger Network CEO Ben Huh wrote about his recovery from suicidal depression, “The reality is it’s never as bad as the insanity you’ve created in your head.” Through a process called cognitive restructuring, you work with your therapist to evaluate critically the thoughts that are contributing to your depression, similar to the process of debugging or critically reviewing your own code.
Given the striking overlap, why haven’t hackers found their way back to CBT? For starters, therapy has an image problem. There’s an assumption out there that therapy is some foofy practice of “self discovery” in which you talk about your mother for years on end and somehow magically end up better. Newsflash: therapy has made some remarkable advancements since the time of Freud.
To be sure, therapists – of which I’m one – have some significant hurdles when it comes to marketing ourselves. No one wants to Yelp their shrink. Due to the stigma that still shrouds mental illness, there’s no public and transparent method of rating therapists and personally sharing about what’s worked and not worked for people. But to buy into therapy, programmers need the hard data.
The data we do have is a large body of research showing that CBT is as effective as medication when treating mild to severe depression, and superior to medication in preventing relapse of depression. Not to mention it’s side-effect free.
Unfortunately, disseminating this knowledge remains a challenge. Academic and clinical psychologists have an ethical responsibility (as well as financial constraints) precluding them from pouring the billions of dollars into glib advertisements that we see pharmaceutical companies doing with such gusto. That aside, we need to be doing a far better job at explaining our methods so that there is greater public awareness about this tool that can quite literally save lives. We need to unleash our data from their academic ivory towers.
So psychologists, let’s fight to make our methods public and transparent, and let’s do so in an ethical and responsible manner. No blue birds singing and cartoon characters magically getting better like we see on the Zoloft commercials. Consumers, inform yourselves. Read up on evidence-based treatments for depression and other mental health problems. Share what’s worked in recovering from depression. Let’s use the Internet for what it’s good at: spreading knowledge.