Mental health is not a choice

You don't get to opt out of your mental health the way you opt out of a Pilates class.

You have a brain. It is doing things whether you "prioritise" it or not. When you say you've chosen not to prioritise it, what you actually mean is that you have, so far, been lucky enough to get away with ignoring it.

That is not a strategy. That is a privilege. And privilege has a habit of running out without warning.

I know this because mine ran out in October 2008.

What happened on the trading floor

I was on the US shares sales trading desk at Goldman Sachs in London. It was the financial crisis. I was in my late twenties, working the hours you work in that job, in that year, and I had a relationship at home that, to put it carefully, was not helping.

I had my first non-epileptic seizure on the trading floor.

I went home and tried to pretend it hadn't happened. Because that is what high performing women do when their bodies try and rebel.

It happened again. And again. By late summer 2009 I had a diagnosis: NEAD. Non-epileptic attack disorder. A condition where the brain, under sustained stress and unprocessed psychological pressure, starts producing seizure-like episodes. It is what happens when the load you've been carrying becomes louder than your ability to ignore it.

I had been "unwaveringly unbalanced" too. And then my brain, very politely, took the decision out of my hands.

What the VC actually meant

I want to be fair to him, because I think there is a real point buried under the swagger.

Building something significant requires unusual focus. It requires saying no to things other people say yes to. It requires giving up some balance for some seasons. That part is true. I am the head of EMEA at a Series G company. I have a book coming out. I have had to work really hard for both things.

But that is not what he said.

He didn't say "there are seasons where you go all in." He said he has not prioritised his mental health for ten years, and he listed his stress-induced physical conditions like medals.

What "having it all" actually means

The "you cannot have it all" line is one of the laziest in business. It is usually deployed to make the person saying it sound serious, and to make whoever is listening feel a bit pathetic for asking the question.

Nobody, in any season of their life, has all of everything. That isn't a women's issue. That's a being alive issue.

What I've actually found is this. You can have a great career and a life you recognise. You can be ambitious and well. You can build something significant and also know what your children, partner, friends and dogs are up to this weekend. You can work like hell in some seasons and pull back in others. The bit you can't have is all of it perfectly, all of the time, on full throttle. Which is not the same thing.

The framing matters

When a public figure with a platform says "I chose not to prioritise my mental health and you should too," he is talking past two big groups.

The first is the people whose mental health was never a choice. People with depression, anxiety disorders, PTSD, eating disorders, bipolar, OCD, the whole spectrum. For them, what he's calling "discipline" is actually a luxury they don't have. To frame mental health as a thing you can simply decline is to say, without realising, that you've never met it on its own terms.

The second is everyone who hasn't met it on its own terms yet. Including, statistically, a fair number of the young founders who are reading his post and absorbing the lesson.

We don't hear from the founders who burned out and quit. We don't hear from the ones whose marriages ended. We don't hear from the ones whose bodies, like mine in October 2008, simply stopped agreeing to the deal.

What I wish I'd been told at 28

That the cost of "unwaveringly unbalanced" is real, and the bill comes in eventually, and it tends to come in at the worst possible moment.

That working hard and looking after your brain are not opposites. They are the same project.

That the women I most admire in business are not the ones with the most impressive lists of things they've sacrificed. They are the ones still standing, still sharp, still able to recognise themselves, ten and twenty and thirty years in.

That a body sending you signals is doing you a favour. Listen the first time.

And finally

It was Mental Health Awareness Month when he posted this. I'll leave that there.

To anyone reading this who is in their version of October 2008 right now, I want to be clear about one thing.

The version of success that requires you to ignore your own mind is not a version worth having. There is another one. It is harder to build because it doesn't come with a ready-made narrative of sacrifice. But it lasts. And you get to be there for it.

Mental health is not a choice.