Rebroadcast: this episode was originally released in May 2021.

Today’s episode is one of the most remarkable and really, unique, pieces of content we’ve ever produced (and I can say that because I had almost nothing to do with making it!).

The producer of this show, Keiran Harris, interviewed our mutual colleague Howie about the major ways that mental illness has affected his life and career. While depression, anxiety, ADHD and other problems are extremely common, it’s rare for people to offer detailed insight into their thoughts and struggles — and even rarer for someone as perceptive as Howie to do so.

Links to learn more, summary, and full transcript.

The first half of this conversation is a searingly honest account of Howie’s story, including losing a job he loved due to a depressed episode, what it was like to be basically out of commission for over a year, how he got back on his feet, and the things he still finds difficult today.

The second half covers Howie’s advice. Conventional wisdom on mental health can be really focused on cultivating willpower — telling depressed people that the virtuous thing to do is to start exercising, improve their diet, get their sleep in check, and generally fix all their problems before turning to therapy and medication as some sort of last resort.

Howie tries his best to be a corrective to this misguided attitude and pragmatically focus on what actually matters — doing whatever will help you get better.

Mental illness is one of the things that most often trips up people who could otherwise enjoy flourishing careers and have a large social impact, so we think this could plausibly be one of our more valuable episodes. If you’re in a hurry, we’ve extracted the key advice that Howie has to share in a section below.

Howie and Keiran basically treated it like a private conversation, with the understanding that it may be too sensitive to release. But, after getting some really positive feedback, they’ve decided to share it with the world.

Here are a few quotes from early reviewers:

"I think there’s a big difference between admitting you have depression/seeing a psych and giving a warts-and-all account of a major depressive episode like Howie does in this episode… His description was relatable and really inspiring."

Someone who works on mental health issues said:

"This episode is perhaps the most vivid and tangible example of what it is like to experience psychological distress that I’ve ever encountered. Even though the content of Howie and Keiran’s discussion was serious, I thought they both managed to converse about it in an approachable and not-overly-somber way."

And another reviewer said:

"I found Howie’s reflections on what is actually going on in his head when he engages in negative self-talk to be considerably more illuminating than anything I’ve heard from my therapist."

We also hope that the episode will:

1. Help people realise that they have a shot at making a difference in the future, even if they’re experiencing (or have experienced in the past) mental illness, self doubt, imposter syndrome, or other personal obstacles.
2. Give insight into what it’s like in the head of one person with depression, anxiety, and imposter syndrome, including the specific thought patterns they experience on typical days and more extreme days. In addition to being interesting for its own sake, this might make it easier for people to understand the experiences of family members, friends, and colleagues — and know how to react more helpfully.

Several early listeners have even made specific behavioral changes due to listening to the episode — including people who generally have good mental health but were convinced it’s well worth the low cost of setting up a plan in case they have problems in the future.

So we think this episode will be valuable for:

• People who have experienced mental health problems or might in future;
• People who have had troubles with stress, anxiety, low mood, low self esteem, imposter syndrome and similar issues, even if their experience isn’t well described as ‘mental illness’;
• People who have never experienced these problems but want to learn about what it’s like, so they can better relate to and assist family, friends or colleagues who do.
• In other words, we think this episode could be worthwhile for almost everybody.

Just a heads up that this conversation gets pretty intense at times, and includes references to self-harm and suicidal thoughts.

If you don’t want to hear or read the most intense section, you can skip the chapter called ‘Disaster’. And if you’d rather avoid almost all of these references, you could skip straight to the chapter called ‘80,000 Hours’.

We’ve collected a large list of high quality resources for overcoming mental health problems in our links section.

If you’re feeling suicidal or have thoughts of harming yourself right now, there are suicide hotlines at National Suicide Prevention Lifeline in the US (800-273-8255) and Samaritans in the UK (116 123). You may also want to find and save a number for a local service where possible.

Producer: Keiran Harris
Audio mastering: Ben Cordell
Transcriptions: Sofia Davis-Fogel