We need to talk about Silicon Valley's mental health problems

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Bleary-eyed and frantic, I found perhaps the only hidden corner of the office and pulled my laptop closer. After a Mouse Trap-esque hunt through my insurance company’s webpage, I finally found my policy’s mental health services.

To get any sort of coverage, I’d have to call a hotline and explain why I was seeking therapy. If they approved my “condition,” my care would be subsidized.

Otherwise, ¯_(ツ)_/¯.

I was already uncomfortable with the fact that I had to seek help at all, but my long-simmering anxiety burnout was manifesting physically. I was barely eating, yet I was getting fatter and fatter. I’d developed full body rashes that got worse the more stressed I became. I cycled through stomach viruses and colds and flu for months, most of which were strong enough to make me bedridden.

Despite this, it felt like I was chasing ghosts. I was dwindling, possessed by some illness that was starkly out of place next to the cool job and great weather of Silicon Valley. Everyone else seemed to deal with their own stress alone, plastering their cracks with great dignity and fortitude.

I broke a tiny bone in my foot two years ago and was in and out of the doctor’s office for months. My specialist faxed them a form and I got a letter in the mail saying my treatment was approved. I didn’t call my insurance company once. Sitting in the thin-walled phone room with the phone number scribbled on a post-it, I was embarrassed for myself. I couldn’t believe it had come to this, begging an insurance agent to let me go to therapy. I couldn’t bear the thought of having an anonymous stranger finally tell me that my ‘condition’ was not legitimate.

Thankfully, I ended up going to therapy. I paid out of pocket, which was a small fortune, but one I’m grateful I could afford. I told almost no one, for fear that the rumor would get around that “Ash had finally gone off the deep end” and that I’d be fired.

Crazy people don’t work in the Valley.

Or do they?


When I revealed to one of my close friends that I was in therapy, she looked at my solemn face and almost laughed.

“Girl. Everyone’s in therapy. I’ve been going for years.”

As I opened up to other friends, I was shocked to learn who else was in therapy. People I thought were emotional rocks, fearless leaders — everybody had somebody. Even friends who were very conscious of their spending had that suspicious spot marked “busy” on their calendars.

Why the hell hadn’t we been talking about this for years? Why hadn’t I gone to therapy before I turned into the human pinecone? In a culture that shows male impotence commercials on network television, why are we so frightened of getting our minds fixed?

Harrowed royalty


Traditionally reserved for teachers, nurses, soldiers and other holders of high stress jobs, burnout has snuck its way into our privileged hacker dens. Despite free food and beer, most open office environments are akin to bougie sweatshops. There’s an expectation of distraction, an undercurrent of chaos that we choose to interpret as laid-back freedom. Crammed into close quarters, your average Silicon Valley worker is disrupted constantly in a parade of sensory overload.

80-hour weeks are a badge of honor. With all meals provided, showers and couches to nap on, people are discouraged from seeking outside stimulation.

Then, there’s the intense fear of failure. If you’re lucky enough to work for a company with millions of users, every act is an exercise in performance anxiety. Make a mistake and a zillion eyes will see. Even frankly frivolous mistakes are touted as life and death, as if a thousand people hitting a 500 error will tank the company and destroy an empire.

This fear of failure means we are hesitant to ask for help. It means we are afraid that the busting seams are a sign of character weakness. We enter this cycle of feeling insecure, being angry about being insecure, being sad that we’re angry about being insecure, feeling insecure for being sad when everyone else seems to be dealing.

Add in a dash of expectations shifting daily and a reverence for well-educated debate-club style bullying. This is a recipe for a mental breakdown.

How burnout affects the body

…recent research has found that burnout — and the related concept of “vital exhaustion” — increases the risk for cardiovascular disease as much as such well-known risk factors as body mass index, smoking and lipid levels. Specifically, burnout increases people’s likelihood of developing myocardial infarction, ischemic heart disease, stroke and sudden cardiac death. Studies also point to an increased likelihood of type II diabetes, male infertility, sleep disorders and musculoskeletal disorders among those with the extreme physical, mental and emotional fatigue.
…other potential pathways between burnout and health problems could include poor health behaviors, sleep disturbances, the metabolic syndrome and difficulty breaking down blood proteins that contribute to clotting.
— D. Smith Bailey, American Psychological Association

TL:DR, extreme stress is as bad for you as smoking or being fat. Not to mention the toll it takes on your personal relationships or energy levels. When all you want to do is rage and eat popcorn facedown on the couch, you’re not going to win any awards for Ideal Human Specimen.

How might we fix it?

Silicon Valley recruiters love to sell their perks. Shuttle service two blocks from our houses. Masseuses who play Enya and work out the kinks in our backs. Beautiful free food that is plated and garnished and allergy conscious, in-house barristas who dab foam art on lattes. Gym memberships, to keep the free food from making us fat. Free tampons if you’re lucky.

I appreciate the sentiment behind these lordly gifts. Employees are expected to work hard and that’s not without consequence. Bodies get pudgy, necks get tight. But despite leading the way on perks and maintaining a concerned chatter about standing desks and gluten-free options, Silicon Valley, like the rest of America, hasn’t given much attention to mental health.

Some ideas on how companies can help:

Match gym memberships with mental health perks. Give folks a yearly stipend for therapy and coaches. If stress is as dangerous as smoking and a high BMI, it stands to reason that talking to a pro is as valid as sweating it out on the treadmill. Pros help people plan their careers so they’ll have something to look forward to, as well as give them skills to deal with stress in productive ways. Arguably this is more relevant than being strong enough to climb a mountain.

Stop glorifying work hour martyrdom. Thank people when they work hard, but do not put the hours on a pedestal. Look, we all have to take one for the team once in a while, but consistent and forced long hours are rooted in fear (If I don’t, they’ll fire me; if I don’t, my company will die) or some mismanagement (poor project scheduling/resourcing, epic system failures and inefficiencies). Sane hours of smart, focused work signal that your company understands its mission and is in it for the long haul. We blame Millennial flip-flopping for short tenures in Silicon Valley, but I strongly side-eye burnout.

Enforce vacation far before it’s needed. Ah, the burnout vacation, precursor of quitting, destroyer of teams. Unlike happy proactive vacations, burnout vacations often remind us that work has become a thing to escape. Sitting on the plane before even leaving SFO, we already have anxiety-dread about returning and decide it’d be great to never have to go back to the office. Why not have a minimum vacation policy as well as a maximum? Why not offer a few discounted hotel deals with hip chains like The Standard or the Ace to encourage people to explore?

Silicon Valley leads the nation in perks, innovation and openness. It’s part of why people are fleeing finance and academia for the golden hills of Northern California. It’s part of why people accuse us of entitlement. There’s an opportunity to hack mental health for the entire nation by making it a priority in the Bay. Imagine a universe where we talk about our brains openly and treat getting help like a vital part of wellness, not a character flaw. Wouldn’t it be wonderful if the press talked about our extravagant concern over mental health, rather than free soda? As creators of the overshare, we are the perfect candidate to lead the way for this change.

Ash Huang is an independent designer, illustrator and writer. She’s done work for Dropbox, Designer Fund, Pinterest and Twitter. This essay was originally published on Medium, and is being republished with permission.

Ash Huang is an independent designer, illustrator and writer who has done work for Dropbox, Designer Fund, Pinterest and Twitter.

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