e20 System Update, and Some Thoughts on Mental Health

I’m sorry for not posting another update sooner, but I wanted to have a more firm schedule figured out before I made any more predictions about when I will finish the e20 System Evolved RPG Universal Rulebook.

Short version: The Universal Rulebook will be published no later than mid-December. Book printing will take a couple of weeks longer once the PDF is sent out to patrons and all who have pre-ordered, and my goal is to get the physical books in your hands before Christmas.

Want more details, explanation, and a little too much personal information? Keep reading. I apologize in advance if anything I share is a bit uncomfortable to read, but I feel that all of you who have supported this project have a right to full disclosure; I’ve tried to put as much of this as possible at the end of this post. (You can skip it entirely if you wish.)

Long version: After the disappointment of not finishing the book in time for Gen Con, I had what could best be called a complete nervous breakdown.

I have long been diagnosed with major depressive disorder, panic disorder (a type of anxiety disorder), and (the real kicker) severe attention deficit hyperactivity disorder. When I was laid off from my full-time job in December 2008 (I did online customer service for Wizards of the Coast), I lost my health insurance as well; COBRA was too expensive to maintain on unemployment, and it would have long since expired by now, anyway. I was able to afford to see a doctor and get the necessary medications for a while, but even that became too much too afford when I ran out of unemployment in 2010.

Once unemployment was exhausted, things started to become truly desperate. Freelance writing and editing jobs alone are rarely consistent enough to provide a stable income; even worse, these jobs were becoming harder to find because a lot of very talented and experienced game designers had been laid off by some of the larger game companies around this time. My only remaining lifeline was insufficient and getting weaker. This is part of the reason I started the e20 System project in the first place; I figured that if I couldn’t find enough freelance work to keep the lights on, maybe I could create my own work, publish it, and perhaps make enough to stay afloat.

Starting in December 2010, I no longer had any medication for depression, panic attacks, or ADHD. From that point on, my ability to work on this project was seriously impaired. When appropriately medicated, I can consistently produce 3,000 to 5,000 words a day, and when under deadline pressure I can manage up to 10,000 words a day for a short period before mental and physical exhaustion takes its toll.

Without medication, I’m lucky to manage 1,000 words on a good day, and on a bad day I might spend eight hours staring at and re-editing the same paragraph without even realizing how much time I’m wasting. On a really bad day, I have trouble even opening the manuscript, checking my email, or visiting my own forums without having a panic attack and sinking into a major depressive episode.

Unfortunately, without any medication at all, I’ve been having more really bad days than good days for most of this year.

Pretty early on, I figured out that I would have a lot of trouble finishing things on my own given how much my production had slowed, so I started lining up patrons who were interested in doing freelance work to do portions of the book. Editing is much faster than writing, so I thought this would get a complete manuscript done in the least time. Two of the most important chapters (Chapter 3: Classes and Chapter 4: Skills) were assigned a couple of months before the rest of the book was opened up to freelance work, and I hoped that this would provide a solid enough backbone to the rules system that everyone would be able to complete their assignments on schedule.

As I mentioned in this post, I overestimated how easily first-time freelancers would be able to adapt to the job. My perspective on this was obviously biased by how easily I took to my first writing and editing jobs; with very little instruction and guided primarily by my gut, I did well enough that I continued receiving freelance gigs for years. Certainly, there’s a big difference between working on an existing game system (as I was my first time out) and the core rulebook for something new, but I thought that the most recent e20 Lite PDF would provide more than enough guidance to keep people on track. Clearly, I was wrong.

Between that and how much I underestimated the difficulty of learning how to do layout for a complete book, things got way behind schedule pretty quickly. Deadlines passed, freelancers dropped out or turned in woefully incomplete assignments, and even those items turned in on time often needed substantial development and editing to get them up to par. A few patrons really went above and beyond, turning in exceptional work, but they were a small minority.

I feel horrible for not realizing how much trouble people were having earlier and for not figuring out how to provide the kind of guidance they needed; one of the things I most wanted out of this project was to help would-be freelancers get a shot at doing real game design work so they could learn the ropes. With my skewed perspective on how much help they’d need and my inexperience with managing a whole project (as opposed to “merely” designing, developing, or editing), I came up woefully short on guiding them through the process.

As Gen Con approached, the only thing that kept me going was a single-minded dedication to finishing the book on time. I was working 12 or more hours a day, every day, to try bring it in for a landing, and I was pushing myself right up to my breaking point. When Gen Con arrived and it still wasn’t done, I even stayed up all night in the hotel room to try to finish it off so I could burn CDs with copies of the PDF to sell in my exhibit hall booth. It was so tantalizingly close, but the list of items I’d have to cut and save for a later project was growing longer and longer.

In the end, it wasn’t enough, and the bitter, soul-crushing despair of failing to reach that goal made all the physical & mental exhaustion I’d been pushing down come over me all at once. I completely collapsed after getting home, and I sunk into a major depressive episode where I couldn’t do much of anything. I spent weeks trying to recover and get my bearings again, but even looking at the manuscript was triggering massive panic attacks. My depression- and anxiety-flooded mind was telling me that I would never work again, that my whole life had just ended and this book would be my tombstone: “Here lies a colossal failure who couldn’t finish what he started.”

I’d reached a point where I could hardly open my email without a panic attack: I saw one too many messages asking politely about the status of the book, but in my mental state a pleasant and friendly inquiry felt like an angry denunciation. I don’t think I really managed to start recovering until the middle of September, when I received a very touching and concerned email from one of our patrons who I’d met just once in late 2010; given that I was having so much trouble even looking at my inbox, let alone reading actual emails, it was rather remarkable that I saw it at all.

It was the first line in the email preview that caught my eye: “Are you doing OK?”

Yes, he talked about the project and the need to post an update, but the part that really stood out was that he was asking me how I’m feeling. Many of my own friends couldn’t tell how bad a place I was in because I, like most people with severe depression, had learned to hide it under a mask of false pleasantness for a few hours at a time. (I’ll discuss this more below.) Somehow, it reached me, and knowing at least some people were worried more about me than the book started to pull me out of it.

It took a few weeks to recover and start to really do inventory on the manuscript, figure out what was wrong with it, and plan exactly how to fix it. In retrospect, I’m very happy that I didn’t manage to “finish” the book in time for Gen Con; in my delirious haze of nonstop work and little sleep, I had been overlooking far too many details that would have made the game a hideous wreck.

More importantly, I just managed to get about two months’ supply of medication for the first time in almost a year, so I’m finally feeling like myself again and tearing through manuscript pages at a furious pace. The medication isn’t quite what worked best for me, but it’s a huge step up after going so long without anything at all.

Now, the end looks like it’s really in sight, and I can see all the intermediate steps to get there. It looks like I’ll even be able to squeeze in a last-minute round of playtesting online with our patrons to find and squash any remaining mechanical bugs before sending out the final PDF to patrons and the printers.

So, for the first time in far too long, things are looking up.

* * *

The following isn’t directly related to the above, and you can skip it entirely if you don’t want to read anything unrelated to gaming. It’s just a bunch of stuff I’ve always felt the need to say about some of the disorders I’ve had to deal with; it’s cathartic for me, and I hope that it will help someone, someday.

* * *

A Brief Discussion of Depression, Anxiety, and ADHD: If you don’t have any of these disorders, count yourself as very lucky; they can have an absolutely crippling effect on your ability to manage your day-to-day life. They have a high rate of co-morbidity (i.e. someone with one of them is fairly likely to have another) and their symptoms often overlap, mask, or feed into one another, so at times it can be difficult to diagnose them correctly. Many people have them but have never been diagnosed; they’re particularly common among creative types (writers, artists, etc.), and to some extent they seem to actually contribute to creativity. Seeing the world in a foggy haze of overlapping thoughts, random moments of blood-curdling terror, or the shattered fragments of dripping sadness apparently means you’ll have some unique ideas floating around in your head.

Attention Deficit Hyperactivity Disorder is probably one of the most misunderstood; lots of people think it only affects children, and many of them think that hyperactivity and inattentiveness are just bad behaviors that would go away if you discipline the child (“Sit down, shut up, and pay attention!”). That simply is not the case.

ADHD is caused by a general lack of the neurotransmitter dopamine, which plays a critical role in the “reward center” of your brain. Essentially, your brain is wired to give you a reward when you perform biologically important activities (e.g. eating, mating, etc.), and it’s the reason that food tastes good and orgasms feel even better. (It’s not a coincidence that people might compare a particularly decadent slice of chocolate cake to sex; they both use the same reward mechanism.)

Dopamine ultimately reinforces behaviors that become tangentially associated with these basic biological needs. For example, you learn to seek attention, praise, and approval very early on because you associate that with your parents taking care of your most basic needs; it’s no different than Pavlov’s dogs learning to associate the sound of a bell with food. Over time, you begin to receive dopamine rewards for doing activities that are related to attention, praise, etc., even when the primary (biological) stimulus is not present, and otherwise boring tasks unrelated to biology start to become their own reward. This function is how you reinforce behaviors to learn new things and motivate yourself to perform tasks that don’t relate directly to survival of the species. It’s also how many addictive drugs work, stimulating your brain with the same reward normally reserved for meaningful activities.

Now, try to imagine that this fundamental reward function doesn’t work correctly. Your reinforcement is always less than it should be, so you’re essentially constantly lacking the dopamine that your brain is wired to seek. Food, sex, and even the most stimulating diversions feel only a fraction as good to you as they should, and everything else feels like the most boring thing you can imagine, like being trapped alone in a featureless room for hours doing nothing but watching paint dry.

So what does your brain do? It wants more of everything that’s even remotely stimulating. It will make you pursue the tiniest diversions to get just another tiny hit of dopamine, whether that’s by overeating, engaging in promiscuous sex, using illicit narcotics, or even seemingly minor things such as subconsciously fidgeting in your chair for the extra sensory input or latching on to any passing thought or ambient sound just to fill the happiness void inside you.

These last two things are self-stimulating behaviors, and they are why hyperactivity and inattentiveness occur in people with ADHD. They’re the brain’s desperate attempt to find something — anything — that provides a split-second of that sweet, sweet dopamine fix. As you can imagine, an inability to sit still, listen to a single voice, or focus on a single train of thought can cause serious problems with learning and developing life skills. Your brain grabbing onto every tiny passing stimulus is like being in a room with a hundred TVs covering every wall, each on a different channel and at maximum volume.

Many people with ADHD don’t know they have it and they self-medicate; overeating, promiscuous sex, and drug abuse are very common coping mechanisms. Drug abuse, by the way, isn’t just illicit narcotics; it can include tobacco (nicotine) and caffeine, both of which are mild stimulants, and this is what I did before I was diagnosed. (Going through an entire 12-pack of soda in a day was usually the minimum I had.)

In fact, the best treatment for ADHD is a stimulant medication that fills the gap left by insufficient dopamine; the best ones use some extended-release mechanism to keep its levels steady for a long period, allowing you to function like a normal person while they’re on. (The same effect can be achieved if you drink a ridiculously unhealthy amount of caffeine, but it’s such a high amount that it will usually cause nausea, rapid heartbeat, etc., which I found out the hard way.)

If you think someone might have ADHD — constant fidgeting, interrupting, forgetting details, extreme procrastination, often “zoning out” when you’re talking to them, especially if a TV or other distraction is in sight, etc. — medication is really the only way to fix it. Yes, there are some cognitive behavioral approaches that can help, but in my experience they don’t quite get through that mental fog; ultimately, the problem is a lack of dopamine, and it needs to be addressed directly.

Get help for them earlier rather than later; a very smart child might be able to make up for ADHD and still get good grades for quite some time, but eventually it will catch up with them and start to cause problems. (In my case, this didn’t happen until I was working on a Ph.D., and every day I wish it had been caught when I was in elementary school.)

Panic Disorder: I think the best way to explain a panic attack is to tell you to imagine what it feels like in that split-second before a car wreck, that gut-wrenching fear that floods your brain as you realize that something horrible is about to happen.

Now, try to imagine that this feeling hits you frequently and unpredictably; sometimes you can figure out a stimulus that triggers it, but sometimes they seem to come out of nowhere. Suddenly, your brain is screaming over and over at you, “You’re dying! You’re dying! You’re dying!” The fight-or-flight response kicks in, but there’s nothing to run from.

Personally, I suspect that this has high co-morbidity with ADHD and depression because of that “happiness void” I mentioned; if you’re not getting enough stimulation that tells your brain that everything is OK (plenty of food, well-rested, etc.) so it will release dopamine, eventually your amygdala gets the idea that something is horribly wrong. I’ve never seen research to back this up, but it does seem to fit with my experience; I’ve never had one while fully occupied and entertained, but they come on very easily in quiet moments. At the very least, I think that this chronic under-stimulation can condition the amygdala to be on a hair trigger, like with post-traumatic stress disorder.

Even worse than the panic attacks themselves is that you eventually become terrified of the idea of having one; you avoid anything that seems to trigger them, and it’s even possible for your fear of having a panic attack to actually cause a panic attack. Once this sets in, you have very significant trouble functioning until you get medication (e.g. Clonezapam) to control it.

Major Depressive Disorder: Like ADHD, this one is definitely based in neurotransmitter deficiencies (including dopamine), so it makes sense that they often occur together. Some people mistakenly think that major depression is just sadness, but it’s much more than that. I’m going to try my very best to describe what it feels like.

Depression is feeling your soul rotting inside an animated corpse. It’s drowning in a bottomless pit of sorrow as a mountain of ice-cold water crushes the breath out of your chest. It’s such an utter, overwhelming despair that you can’t even cry. It’s absolute emptiness, a hollow inside your being, a hole so deep you can never fill it — and sometimes you look into that abyss and you long to throw yourself in, just to escape, just to feel something, anything, other than pain, regret, and sorrow in that moment as you disappear into oblivion.

Depression is when your brain tries to kill you.

Please, please take depression seriously. About 3.4% of people with major depression ultimately commit suicide (accounting for up to 60% of all suicides). You can’t be talked out of depression, and you can’t just cheer yourself up. In fact, people with major depression often do a very good job of hiding it from friends and family, and the shame of the social stigma of depression just feeds into it, making it worse.

Obviously, you don’t want to be dismissive and tell someone with depression to get over it, but you also don’t want to start handling that person with kid gloves and walking around on eggshells. Though meaning well, it feels like condescending pity and it reinforces feelings of shame and worthlessness.

Just talk with them. Be there for them. A lot of the time, just a voice reaching out can pierce the wall of darkness around them. (It’s what an email from someone I’ve met only once did for me.)

If you’re afraid they might have suicidal thoughts, keep them talking and it will usually pass. If it feels like they’re actively planning to kill themselves, keep them talking but get help (911) as soon as possible. It’s good to keep the number for the National Suicide Prevention Lifeline — (800) 273-8255 — in your phone in case you’re having trouble getting through or thinking of what to say.

If you’re depressed, seek help. Go to a doctor who specializes in this; it does get better — sometimes completely! — with the right medication and/or therapy. Spend more time with friends and family, and don’t be afraid to open up.

Most importantly, keep that suicide hotline number in your phone just in case you need it someday. Everyone you know will be happy you did.

One Response to “e20 System Update, and Some Thoughts on Mental Health”

  1. avatar Nateal says:

    I wanted you to know that I understand what you went through.

    I have Major Depressive Disorder, Generalized Anxiety Disorder, and Borderline Personality Disorder. I understand how all-consuming it gets. I’ve been so low that I’ve failed out of an entire semester of college and was unable to go back for over a year. I struggle with my issues every day. I’ve gotten help and am supposedly now better equipped to deal with them, but that doesn’t make it easy or even doable some days.

    I’m very glad you got back on track. I feel like I want to say more, but I feel like I can’t put the words together as well as I’d like.

    So from one struggling creative soul to another, Keep on Swimming.

Leave a Reply