After years, I finally took the pill...

March 25, 2024

Hey everyone,

If you're new here, welcome to Never Enough - where I share some of my best recommendations.

Today's edition is brought to you by Write of Passage.

I’ve made some pretty good investments in my career, but publishing my ideas online is arguably the best investment I’ve ever made. Most of the opportunities I’ve encountered over the years have come from interesting people reading my writing and reaching out. It’s how I’ve met some of my best friends and business partners.

If you want to follow suit, I recommend following David Perell on Twitter (X). He has a lot of great content on this topic, but I’d get started here. He calls it: How to Build A Personal Monopoly By Writing Online.*

  • This is a bit weird to admit, but I’m an incredibly anxious person. I constantly expect the worst, obsess over it, and planning is my way to calm my anxiety.

    Over the past two decades, this anxious planning has helped me grow my business and be successful, but a few years ago it got to the point where I was making myself miserable and actually causing problems at work. I couldn’t even watch a movie without pausing multiple times to fire off an email I was stressing about. I wasn’t present during family vacations and was irritable in meetings. I lived in the future. A terrible, anxious nightmare where all of my companies were failing, my kids had suffered horrible accidents, and everyone hated me.

    I tried just about everything. Yoga. Meditation. Sauna and cold plunge. Exercise. The only thing that worked was alcohol, and we all know how that ends (I almost entirely quit drinking about 10 years ago).

    Finally, I gave up and asked my doctor to prescribe me an SSRI (Serotonin Reuptake Inhibitor), but I couldn’t bring myself to take it. The pill pack sat beside the sink for months, taunting me.

    I was scared. While I’d heard incredible testimonials from some friends who took them, I’d also heard horror stories from others. I worried it could turn me into a zombie, devoid of emotions. That it might take away my fire.

    Of course, my anxiety problem continued, so I did a deep dive into the science behind their side effects and found a paper about how different people metabolize SSRIs. It turned out that certain people have a genetic mutation, where some SSRI drugs spike to crazy levels in their body, causing far worse side effects. Odder still, my doctor wasn’t aware of this, nor were many of my friends who had experienced bad side effects. I ran my 23andMe genetic data through an analyzer and found that I was an SSRI “slow metabolizer” and likely would have suffered these side effects.

    I found a new drug that was metabolized on a different pathway called Vortioxetine. It's the newest class of anti-anxiety/depression medications and works differently from medications like Prozac and Escitalopram. Not only does it not spike drug levels in slow metabolizers (people whose bodies break down certain medications more slowly, leading to a buildup of the drug in their system and potentially causing more severe side effects), but it doesn't appear to cause sexual side effects.

    Three years ago, after almost a year of deliberation, I gulped and took the pill.

    To my surprise…I didn’t turn into a zombie. In fact, the opposite. Slowly, over the course of a few weeks, I felt my anxiety abate. It didn’t go away, but it felt like the volume had been turned down 50%. And a few months later, when I thought about some of the things I’d been anxious about before, I laughed them off. It felt like being reminded of being insecure in high school or something: “I can’t believe I was so worked up about that!

    Taking Vortioxetine has had a profoundly positive effect on my life. I’m a far happier person now and enjoy my days so much more. Rocks feel less like boulders. Things feel manageable and I’m more present. Don’t get me wrong. It’s not a panacea. I still get stressed and experience anxiety, but it’s just way less overwhelming. Best of all, I haven’t experienced any major side effects. Occasional nausea if I take it on an empty stomach.

    Maybe an over share, I know, but I wanted to share my experience for three reasons:

    1. I know so many people who suffer from crippling anxiety, but are scared of taking a pill. I thought maybe sharing my story would help them consider it as an option. *Do your own research. I’m not a doctor.

    2. Nobody seems to be aware of this slow metabolizer issue. If you have 23andMe, check this part of the test to find out if you’re a slow metabolizer. If you are, you might want to consider Vortioxetine (brand name Trintellix/Brintellix).

    3. There is so much silly stigma against talking about this. For some reason, if you have seasonal allergies and take an antihistamine (which affects your brain too), nobody thinks twice about it. But when it’s for anxiety, you’re weak or insane. F that.
  • I just got back from an amazing week on the north shore of Kauai, Hawaii. I had previously only been to The Big Island and Maui, but Kauai absolutely blew me away. Easily one of the top 5 most beautiful places I’ve been.

    A few spots/activities I loved:

    - Java Kai for coffee and breakfast
    - Nourish for lunch (great acai bowls)
    - Bar Acuda for dinner (try the lamb chops)
    - Zip-lining at Koloa
    - E-foiling lessons (sans Zuck sunscreen face mask) - yes, I went full Tech Bro™
    - I stayed at 1Hotel Hanalei. Great rooms and service, but I’d go elsewhere for food. Easily the nicest view I’ve ever experienced from a hotel.
  • Years ago, when I was thinking about selling one of my old companies, I had no freaking clue how to get started. I didn’t even know what an investment banker was. Someone who works at the bank??? What are the options? Who do I talk to? How will someone value the business? What I really wanted was security. I wanted to have enough money in the bank that I could pay off my house and buy a nice car, but I thought that meant selling my whole business.

    Now I know there’s a gazillion options. Everything from raising equity, to dividend recaps, to even selling the business to your employees with management buyouts.

    But even today, I want to tear my hair out when I talk to investment bankers: “What can you do for me???” I want to scream (but don’t). I wish they’d just show me a menu showing me all the options and explain it in layman's terms.

    Finally, Chris and I got frustrated. We met Louis, a young investment banker who was…shockingly normal and nice. A lot like us. The three of us partnered up to start our own investment bank. It’s called Tenzing and it’s built by founders, for founders.

    If you’re thinking about de-risking and taking money off the table, selling your company, raising debt, or even a management buyout (selling to your employees), then you should email him: louis@tenzing.co
  • Anytime Bill Gurley talks, I listen. Well, now he's talking a lot. He and Brad Gerstner (another super smart VC) just started a new podcast called BG2. Yes, I know, another tech podcast. But this one offers some of the sharpest commentary I've heard on AI, self-driving cars, and chips. I highly recommend checking it out.
  • Quick music rec: I’m a huge fan of RAC. He just released a new EP called Hyper (Spotify), which is really good.

That’s all for this week…but one more thing. If you’re enjoying this, can you do me a favor and forward it to a friend? Thanks.

-Andrew

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