Ask HN: Anxiety is limiting my enjoyment of a wonderful career. Can you relate?

Hey HN,

Here's the thing: I'm incredibly lucky. I'm working in a field I absolutely love (the intersection of technology and medicine), with a brilliant and compassionate group of people who I respect greatly, in an environment flowing in autonomy, doing work I find unbelievably interesting and impactful. There is nothing I would rather be doing, and (for the most part) no group of people I'd rather be doing it with. As someone who sought such a situation for a long time, that's not a statement I take lightly.

So what's the problem? Anxiety. So much anxiety. An onslaught of worry and fear, (quite literally) every minute of every day, all self-imposed and mostly centered on a fear of embarrassment. Do I know enough? Am I doing enough? What if I don't know the answer to that extremely basic question? How do I make sure that no one "finds me out"? Many imposter syndrome concerns: some of which are grounded in reality but none of which are helpful to me.

These thoughts fill up my mind in such a way that I don't have many brain cycles left for learning new ideas, solving problems or remembering details. (I have OCD, and these thoughts become obsessions that don't let up.) This creates a negative feedback loop: anxiety leads to decreased performance (in terms of learning/solving/remembering/accomplishing), which leads to anxiety about my performance, which further decreases my performance. As a result, I find myself becoming the imposter I'm trying to conceal, and am often unhappy.

Why am I writing this post? I'm seeking understanding, support, and related stories/situations. I'm not seeking a cure-all. I'm not seeking a pharmaceutical or therapeutic recommendation. Just support.

I'd love to hear from you all!

All good advice, but don't be afraid to try a medicinal remedy as well. I know people for whom Zoloft (frequently prescribed for anxiety) has worked wonders.

i can absolutely relate.

i have OCD, bipolar disorder, PTSD, and generalized anxiety disorder. i love writing software, but i struggle every. single. day. i totally understand the negative feedback loop. i worry that my performance will suffer, it DOES suffer because i worry so much about it, etc etc. and then there are days like today where i come in to work in the middle of a manic episode and have a million ideas that i can't extract from my brain because it's racing too fast. under less distressed circumstances, i could write something more eloquent for you, but getting just a few sentences out is a victory at the moment. suffice to say: you are not alone.

Very much so, so much so we built technologies to help measure and manage the physiology of anxiety/stress. I found that my physiology is much more manageable when I sleep well and exercise. From the perspective of the body, the autonomic nervous system is stress/anxiety, sleep/relaxation, and exercise. They are all the same bodily, interconnected system. Meditation and naps and mindfulness exercises work. So does simple, calming breathing exercise. All are a skill like anything else.

I know I'll never change how I respond to social settings and large crowds, and both are intimately involved in my job as a founder, but the physiological and contextual data has helped me to realize that the effects are manageable. Those effects are often common and one reason alcohol is likely such a popular sedative. But alcohol affects how well I sleep and so I gave it up. Nothing is more important in my life now than getting a good night's sleep.

I'm a neuroscientist by training and was not taught much of anything about the physiology of fight-or-flight versus rest-and-relax during my Ph.D. It's an entire area of medicine untouched by modern science. If you saw the equivalent of a therapist in 1880, opium and cocaine were the Prozac and Ritalin of their time.

At work, we all actually joke openly about this and I think it helps to know that everybody feels that insecurity to some degree or other.

All week long you'll hear self-deprecating remarks like:

"Oops, I suppose that bug exposes me as the mediocre hack that I am, haha"

"...but unfortunately I forgot to uncomment that section, because I am a complete idiot..."

In a way it helps keep your confidence up, because you're modeling the behavior of confident people. (Joking openly about one's own shortcomings)