Ruminate with Me

An update on my mental health

Behdad Esfahbod
4 min readJan 15, 2024

Between 2020 and 2022 I offended a lot of people in my industry, because of my deteriorated mental health. I think I have recovered now. Here is an update on what happened as I currently understand it.

Bipolar Disorder (BD) comes in two flavors. Bipolar II, like the one I identify with, is rather mild. But Bipolar I is serious business. Four years ago I experienced Bipolar I-like mania first hand, and this is my story.

I was born in 1982. It was not until 2019, at the age of 37, that I learned that I might be Bipolar. At first it was my therapist who suggested it, and later my reading on the subject convinced me that I exhibit Bipolar II traits: Periods of super-high energy, followed by months of depression. So I sought a psychiatrist and in December 2019 I met one in Seattle. He asked me to fill out a short questionnaire and then scored it. After some talking, he concluded that even though I might show some Bipolar traits, because it doesn’t affect my life, they will not diagnose it. And by “my life” he meant my education and career.

Until it did affect my life. In January 2020 I had a traumatic experience when I was in Iran to visit family. I was arrested by the Islamic Revolutionary Guards Corps (IRGC) and kept in solitary confinement and interrogated daily for a week. I spare you the details, which I have written about before, but when I finally left Iran later that month, I found myself paranoid and suffering from Post-traumatic stress disorder (PTSD). My wife abandoned me. The pandemic made me even more isolated. I was on medical leave at work, but decided that working might make me feel better, so I ended the leave. Yet I could not get work done.

Months passed. In June I went back to my psychiatrist and said: “I think I have ADHD (Attention-Deficit / Hyperactivity Disorder), can you give me some pills to help me get work done?”, this time over video chat during the COVID isolation. Again, he had me fill out a single-page questionnaire. This time, he diagnosed me with ADHD, and prescribed Adderall to me.

Adderall made me into a monster. I became manic. Super manic. I started experiencing everything in a new way. I started smoking marijuana and drinking Diet Coke and no food for days at a time. I lost a lot of weight.

I lost a lot of weight.

I heard voices. I was overwhelmed by the volume of ideas attacking my mind at any moment. I felt like I had new knowledge without knowing where it came from. Things became black & white. Either right or wrong. I started seeing wrongs everywhere I looked. The context would not matter to me. If it was wrong, I had to call it out. And soon I started calling people out. I literally spent ten hours one night writing a ten-page opinion and posting it on the internet. I attacked and offended many of my industry colleagues.

Finally, in an act of defiance, I quit my lucrative job at Facebook and decided to move back to Canada to live near my sister. I met with the psychiatrist again. He asked me if I got any work done. I said “No! But I quit my job and am moving to Canada to live with my sister!” He agreed I have made “good progress” and refilled my prescription!

It took another two weeks before I realized that it is the Adderall that has transformed me into a new person. I stopped Adderall, but the mania remained. I engaged in risky behavior. I got into trouble with the law. I even attempted suicide, a common act specially during a so-called manic-depressive episode; that is one that you are both manic and depressed at the same time.

I was lucky enough to book an appointment with a psychiatrist at the Mayo clinic in Rochester, Minnesota, who confirmed that I am indeed Bipolar II. But even they did not realize that I am manic on Adderall. I moved to Edmonton, Canada. It took me nine months to find a psychiatrist to treat me. It took another year of trial and error, to find the right cocktail of medication to stabilize me. Some drugs made me paranoid, others anxious. Or left me depressed.

It took many tries to find the right medication to treat me.

I have been stable for almost two years now. In this period I felt a lot of shame about my actions during the mania. As time passed, I reached out to people I have offended the most and apologized. Most accepted my apologies.

My first psychiatrist should have known that ADHD medication and Bipolar II do not mix. But since he was dismissive of the Bipolar diagnosis earlier, it did not occur to him.

I still feel anxious most of the time. But otherwise I am currently in a controlled hypomanic episode (a revved up mood, but not manic), where I restarted travel and felt back the creativity I used to feel during my past hypomanic episodes. I attended conferences and was for the most part welcomed by the community.

There we go. That was the gist of my mental-health breakdown and recovery. I lost acquaintances, but was supported by many friends.



Behdad Esfahbod

I don't know what to do. HarfBuzz author . Fonts/text rendering Open Source software developer. Ex FB/Google/RedHat #WomenLifeFreedom 🌈