Something Better Than This
Why do I always feel so terrible?
H asks: I just turned 31, and 30 was probably the hardest year of my life. Your book really helped me reflect on my twenties. I realized that I'm definitely more of a Meaning type, but thought I should be a Stability type all through my young adulthood, hence the constant feeling of being unable to 'fit' into my own life. I moved from full-time office job to full-time office job to a mental health breakdown, to a part-time office job, babysitting, grad school, back to full-time office job, then a psychiatric hospital, and somehow jumped right back into my full-time office job. I felt like a failure every time I left a job. Each time, making moves felt like the hardest decision in my life, with huge stakes, but I kept leaving because it felt. . . just wrong, deep in my body. But with a history of depression and anxiety in my family, it was just all chalked up to that. I've been on every type of medication, starting at age 14, but nobody encouraged me to go to consistent therapy until I went on my own at age 25.
Even though I've recently found myself in a well-paying, remote position in an area of interest, I spend a lot of days crying, overwhelmed with the feeling that it's just still not quite right. It feels like a personal failing to not be able to find the right thing for me again and again and again. I know that I'm also entirely overwhelmed by the state of the world. I'm trying now to focus on finding joy and fulfillment outside of work, realizing that I barely have hobbies, and certainly don't have passions beyond 'make the world a better place.' But I don't even know where to start in finding my own passion and joy.
Oh gosh, I’m so familiar with wanting to be a person who can just work a job “like everyone else” and not be miserable doing it. As anyone who was friends with me in my early twenties can attest, I was always burning out from jobs and having big or little emotional breakdowns. I tell one of these stories in my book, but there were plenty of others. I’d feel like I was trying my absolute best to be “good” or “normal” in some way but I would reach a point of misery that just couldn’t be reconciled and I’d suddenly quit or give notice. I also barely understood the word “hobby” and was (I mean, still am) endlessly overwhelmed by the state of the world. Let’s just say: I relate. In my case, working for myself has been a game-changer. As an astrologer once told me in a birth chart reading: “You’re a terrible employee.” She’s not wrong. No matter how hard I’d try to be a great employee, I am just much more suited to work for myself. So, this is a bit simplistic (and I have a lot more to say below), but I did wonder upon reading your letter if the same might be true for you. Would you be happier pouring your creative energies and compassion into your own work? Would this be possible?
I also wondered if you might feel some resonance with The New Yorker profile by Rachel Aviv called “The Challenge of Going Off Psychiatric Drugs,” about a Quarterlifer who was diagnosed and medicated constantly throughout her 20s. It’s a painful read, so brace yourself if you choose to go there. It really demands a reckoning with how we fail to attend to developmental psychology in America when modern psychiatry is built on diagnosis and medication versus developmental struggles, let alone incurred trauma, systemic stressors, family systems issues, gender confusion, and more.
This is all to say, I’ve thought a great deal about how best to respond to your inquiry. Ultimately, over and above the questions of work or meaning and stability in the abstract sense, I found myself wanting to address the question of your fundamental well-being.
I have a hunch that there are some underlying issues that may have been overlooked in favor of psychiatric diagnoses and medications. I’m going to focus my attention on one broad area in particular: your blood sugar, nutrition, and hormonal health.
Why am I going here, and so quickly?
It’s a combination of things: the age of onset of difficulties, the length of time you’ve battled with these feelings of instability despite many attempts to change things, your mention of family history, the degree to which you have struggled, and the specific form of anguish that I felt while reading your email (edited down). My hope is that there may actually be a quite specific solution to what you’re feeling and that it’s not being addressed.
So let’s jump back to when this all seems to have started for you, around the age of 14. Did anyone explore your hormonal health back in the day? Were you placed on birth control? Has anyone talked with you about this since?
For a variety of reasons, puberty is frequently a turning point for young women, and a negative one. It doesn’t all have to do with hormonal health—there are so many social forces that objectify and traumatize girls, teach them that they’re objects, and silence their voices—but what you wrote just made me wonder if you may have chronic blood sugar and/or hormone imbalances that began with puberty and continue in some form to this day.
If you were my client, I’d want to work with you to find one or several very competent, feminist endocrinologists, nurse practitioners, Chinese medicine specialists, or naturopathic doctors with whom to explore your hormonal health we well as your relationship to food. I think talking with several different practitioners is important because this is an area that, despite being massively important, is poorly understood and often misdiagnosed.
If you were my client, these are things I’d want you to explore:
Have your B-vitamin and iron levels checked and, if they’re in any way suspect, consider taking daily supplements ASAP, and follow the recommendations of your healthcare professional. Being low on either of these can lead to a host of issues including unrelenting existential despair.
Begin eating a protein-rich breakfast in the morning, with cooked veggies if possible, and always before coffee (if you drink coffee). There’s competing research on this, but I’ve learned to do this from female practitioners whom I trust deeply and I swear it has changed my life and changed the lives of many women I know. Your blood sugar is much more likely to remain balanced throughout the day if you do not drink coffee before food and if you are loading in protein first thing in the day.
If you’re vegetarian or vegan, the above two points are hugely important.
I’d be curious how caffeine, sugar, alcohol, and other substances may be affecting you. Wheat too. Different people have different levels of tolerance to everything, including some allergies that manifest more as mood disorders than anything else.
Is there any family history or possibility that you have PCOS, endometriosis, or any problems with your thyroid?
Are you getting enough sleep? Are you sleeping deeply? Has there ever been a concern about sleep apnea?
Are you on birth control? Do you have any concerns about how birth control has affected your moods?
I encourage you to explore these questions and more with qualified medical professionals from various backgrounds. Chronic mental and emotional health issues are too often treated as symptoms to be eradicated rather than as problems to be solved. We need to get to the root of what has been happening for you all these years!
I so deeply want you to feel better. I want you to know that you can be alive in this world—this world—and feel at peace more often than not.
Finally, because I can’t help myself, I want to say one final thing: I do hope you’ll also explore at least one non-rational, impractical, entirely unnecessary, “what’s-the-point?” activity. Just because. Just because they exist and something calls you. Ask your soul what she wishes she were doing and then spend time doing that.
Maybe it’s dance or swimming. Walking in the forest. Painting. Drawing. Ceramics. Interior design. Sewing. Gardening. Flower arranging. Baking. Pasta making. Piano playing. Novel reading. Novel writing. Poetry. Sexual expression and play.
Rather than try to find a “hobby,” which just strikes me as just another painful problem to solve, see if you can make the goal of finding and making beauty. That’s it. Just lean into beauty. Explore your sensual self in the coming months. Make it a goal or a task if you have to. Just make pointless beauty a non-negotiable priority.
xo,
Satya
Do you have a question for a future edition of “Something Better Than This”? Just respond to this email!
Live Book Talks!
The paperback edition of Quarterlife comes out July 4th and I’ll have the honor of reading at a few of my favorite bookstores. I would love to see you there! Come say hi and bring your friends!
Wednesday, July 5th, 7pm | Powell’s City of Books, Portland, Oregon
Thursday, July 6th, 7pm | Elliott Bay Book Company, Seattle, Washington
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Hi there! I know this post is old but I wanted to follow up; I am the person who submitted this question. Since submitting and seeing Satya's answer, a lot has changed in my life! I did get hormone levels checked and all appeared normal. changes include - being diagnosed with inflammatory bowel disease (ulcerative colitis) and starting treatment for that, starting to take iron and a daily vitamin; switching from coffee to green tea, and eating breakfast before or with my tea (breakfast with ideally a bit of veggies and/or a good amount of protein), eating less red meat. moving to a new city (!!!!), taking a pottery class and being awful at it but still having fun, exercising with weights, walking in the woods a lot and trying to get at least a little fresh air in morning and at night, etc. I'm not a brand new person by any means, and a lot of things haven't changed that much, but I'm also no longer crying a majority of the days, I'm feeling that awful pit in my stomach a lot less frequently, and generally feeling less bad overall. I'm also better at sitting with some uncomfortable feelings without spiraling. Life-changing stuff even if it didn't like...change my whole life and get rid of my anxiety, etc.
Wanted to share this here instead of just emailing Satya in case this is helpful for anyone else. It's clishe, but a lot of the basics that everyone is always on about (breakfast, walking) really made a huge difference for me : )
Oof, I can relate to a lot of what the letter writer shared here. Even one of my favorite jobs I held in my early 20s was marked by months worth of "not rightness" at the beginning of it! Looking back, there were a number of factors going on - including imposter syndrome, waay too much caffeine, and not having developed a good groundwork for rest and the emotional space for outside of work interests. This is something I am generally still trying to figure out (the work part)...so I'm afraid I don't have much to contribute here about that piece. I would be curious to hear from others who have made their own path in various ways if they are here! I find it relieving to hear those specific thoughts and feelings related to not having a good fit with certain environments and what environments people have found more fitting (like Satya sharing her own experiences). I can say that pursuing strong interests with the overall goal of learning more and enjoying them has been something that has greatly enriched my life - especially when I can enjoy them in some form of community.
I did find myself relating to a lot of Satya's advice about the importance of the physical health and nutrition side of feeling well. I have been feeling crappy most of my life and it's been a long process of figuring out some of the pieces. One example: I didnt realize until my late 20s that stopping at one cup of coffee drastically reduced my anxiety levels throughout the day. I used to chug god knows how much and feel no hunger until lunch, eat a late lunch, and then want to sleep for a year straight. Eating before coffee does seem to help me feel more level energy as well.
Finally addressing some unresolved health issues has also helped so much in the last few years! I so so second the advice of getting lab testing done. I found out I often have low hemoglobin that seems to dovetail with fatigue, and I have to keep an eye on my vitamin D for the same reason (mostly in the winter). Some of this stuff can fairly easy to alter with dietary modifications and/or supplements. I also know of people who didn't find out they had a thyroid issue for a long time because they thought everyone else was bone-dead tired all the time...so they didn't "complain." We get so used to certain things sometimes we don't realize that we can maybe feel better.
If you have access, I would add that finding a provider/doctor who has good ratings and reviews for specifically being a *good listener* and *takes time to answer questions* makes getting testing for specific symptoms so much easier - I was prompted to do this after a misdiagnosis in my late 20s that missed a serious infection. I found it useful to make a list of symptoms as they occured over time (and their relative frequency/duration) and brought them in to discuss with my new provider.
Unfortunately I've found in the past that sometimes certain symptoms get dismissed as psychological due to a history of mental health concerns like anxiety or depression. One example that comes to mind is someone I knew years ago who initially got diagnosed with anxiety. Later testing revealed their symptoms were likely due to a non-lethal but funky structural heart issue causing feelings of chest flutters and lowered oxygen (not to say that's letter writers issue - but that sometimes the physical side of symptoms is overlooked in favor of emotional causes). I think a good enough doctor will often want to work with people to rule out more physical possibilities if they haven't been already ruled out.
And I agree with Satya's advice to look into hormonal stuff if it's relevant for you. Since I got my period (about 2 decades ago) I've had heavy periods and cramps that can leave me bed bound at times. It was until last year when I started getting the bad cramps and pain outside of my period that I found out I had endometriosis. I'm very used to it at this point pain-wise so when I had to go to the ER for near passing out levels of pain last year I knew something was really wrong. I was actually concerned my appendix had burst and the ER doctor initially thought that might be the cause as well. The testing showed it was cysts causing the pain! That finally led to seeing a specialist, testing, and then a diagnosis. It seems some of my lifelong GI issues may be have been interacting with the endo too...some different various health pieces definitely came together. PCOS was also something we tested for and ruled out as well.
In any case, I am so rooting for the letter-writer to get to feel some relief, both existentially and emotionally/physically! And curious to hear from anyone else that related to the letter or Satya's response :)