I opened a spreadsheet to calculate when I would die
Misdiagnosis nearly killed me
Not in a dramatic, self-destructive way. In a project-management way. I had just been approved for a disability pension, diagnosed with Bipolar II after decades of treatment, and I did what any analytical psychologist with a grim piece of data might do. I went to the literature, pulled the mortality statistics, split the difference between the studies, and ran the numbers.
Seventeen years. That was the projected remainder of my life.
So I planned accordingly. Finances. Relationships. Output. What to build and what to abandon. Everything reverse-engineered from an estimated date of obsolescence.
Years later, I deleted the file. Not because I recovered, but because the diagnosis was wrong.
This article sits at the intersection of three books, three ideas, and one uncomfortable realisation. Misdiagnosed is the forensic account of how a psychologist can spend three decades being treated for the wrong condition. It’s the Circumstances reframes mental distress as an environmental mismatch rather than a defective brain. The Augmented Psychologist asks what happens when a burned-out profession finally uses machines to protect its humanity rather than replace it.
They are not separate projects. They are one argument viewed from three angles.
Misdiagnosis is not a clerical error
For years, my life was organised around the assumption that I had Bipolar II disorder. The evidence seemed persuasive. Cycles of exhaustion and shutdown. Periods of intense productivity. Crashes that looked like depression. Bursts of energy that looked like hypomania. Medication regimes built around stabilisation.
From the outside, the pattern made sense.
From the inside, it never quite did.
Psychiatry relies heavily on observable behaviour. That is both its strength and its vulnerability. Many different internal causes can produce identical external presentations. A clinician sees lethargy and records depression. Sees bursts of productivity and records hypomania. Sees social withdrawal and records mood disturbance.
But behaviour is a surface language. The same sentence can be spoken by entirely different underlying systems.
What was labelled as depression in my case was, more often, masking exhaustion. Running a neurodivergent operating system in an environment designed for neurotypical expectations consumes extraordinary cognitive energy. Every conversation requires translation. Every social cue must be reverse-engineered. Every response calibrated. The processor runs hot. Eventually it shuts down.
From the outside, the machine looks broken.
From the inside, it is overheating.
What was labelled as hypomania often turned out to be ADHD hyperfocus. Not chaotic, grandiose, or scattered, but directed. Purposeful. Locked onto a specific domain. Productive in a way that mania rarely sustains.
The outward behaviour matched the diagnostic template. The internal mechanics did not.
So the system did what systems do. It treated the template.
Pharmacological furniture
Medication did what it was designed to do. It flattened the peaks and softened the troughs. It reduced volatility. It made me, in many contexts, easier to manage.
It also made me beige.
Functional. Upright. Acceptable. But dulled. Observing rather than inhabiting my own life. Attending conferences, running businesses, speaking to people, and feeling like an anthropologist embedded among a species I could study but not quite join.
I call this pharmacological furniture. Not because medication has no place, but because when it is applied to the wrong architecture, it stabilises the appearance while degrading the system.
The deeper damage was not only pharmacological. It was existential. If treatment does not work, the assumption becomes that the patient is failing. Non-compliant. Resistant. Complicated. Broken in ways that are hard to fix.
Identity slowly reorganises around the idea of being a problem.
The spreadsheet reinforced that identity. The mortality statistics were treated as fate. The diagnosis became a countdown.
The moment curiosity returned
The turning point did not arrive as a test result or a clinical breakthrough. It arrived as a question during a late-life conversation with a psychologist friend who had known me for years.
“Has it occurred to you that you might be neurodivergent?”
Not framed as a declaration. As curiosity but a loaded question she already knew the answer to.
That question reorganised decades of data. The shutdowns, the hyperfocus, the exhaustion, the masking, the sense of operating through translation. The patterns aligned differently when viewed through an autism-and-ADHD lens.
Nothing magical happened. There was no instant cure. But the frame shifted from defective mood regulation to mismatched operating system.
The spreadsheet stopped making sense.
The diagnosis that had structured my life began to dissolve.
It’s the circumstances
After that conversation, something else happened that I could not explain.
I had moved to Vietnam.
The decision was practical. I was living on a pension. The cost of living in Australia was punishing. Đà Lạt offered something more sustainable. The move was not framed as treatment. It was logistics.
Within three months, the “treatment-resistant depression” that had defined thirty years of my life lifted.
Colour returned to my photography. The music I was writing for my own amusement was no longer ‘music to slash your wrists by’; it was funk-metal. Energy returned to my days. The background heaviness receded. Not entirely, not permanently, but unmistakably.
This was not the novelty effect of travel. It persisted.
The explanation that eventually made sense sits at the heart of It’s the Circumstances. In Australia, I was embedded in a culture with dense, implicit social expectations. Nuance mattered. Small talk mattered. Subtle interpersonal choreography mattered. Masking was constant and exhausting.
In Vietnam, I was visibly foreign. Expectations shifted. Social errors were forgiven. Oddness was contextualised. The pressure to perform neurotypicality relaxed. In Vietnam, I was a foreigner and all foreigners are weird, aren’t they.
The masking load dropped.
If relocating across cultures dismantles decades of “biological depression”, the problem may not have been neurochemistry alone. Person-environment fit matters. Context shapes physiology. Chronic mismatch can look indistinguishable from illness.
The circumstances changed. The system stabilised.
Contaminated statistics
The spreadsheet assumed that Bipolar II shortened life expectancy. The literature supported that claim. The numbers were not invented.
But misdiagnosis introduces a question that psychiatry rarely confronts directly. If diagnostic categories are porous, and if neurodivergent presentations are routinely funnelled into mood disorder labels, what exactly are those mortality studies measuring?
Are they measuring the lethality of the condition?
Or the lethality of decades of mismatch, chronic stress, and pharmacological regimes applied to the wrong architecture?
If large numbers of neurodivergent people are misclassified within mood disorder datasets, the statistics become contaminated. The reduced lifespan may reflect the cost of misdiagnosis, masking, and environmental misfit rather than the intrinsic trajectory of the disorder.
That is not an academic concern. It is a survival one.
The administrative avalanche
The natural reaction to such a story is to ask how clinicians could miss it. The temptation is to frame this as a failure of compassion or competence.
That explanation is too simple.
Modern clinical practice is saturated with administrative load. Notes, letters, risk assessments, insurance documentation, compliance frameworks. Cognitive bandwidth is consumed by logistics. Curiosity becomes expensive. Pattern recognition narrows to what fits the checklist.
When cognitive load is maxed out, clinicians default to efficiency. Behavioural clusters map to familiar diagnoses. Treatment pathways follow established routes. There is little space to step back and ask whether the architecture itself has been misread.
Burnout erodes empathy. Not because clinicians stop caring, but because caring requires energy, and the energy is being spent elsewhere.
This is the entry point for The Augmented Psychologist.
AI as scaffolding, not replacement
The reflexive fear is that artificial intelligence will replace clinicians. The deeper risk is that clinicians continue drowning in administrative work and lose the very human capacities that define the profession.
The argument for augmentation is pragmatic. Offload the mechanical tasks. Draft letters. Structure notes. Organise data. Reduce the friction of starting. Free cognitive resources for interpretation, curiosity, and presence.
AI functions as scaffolding. A second brain for logistics. A starter motor for executive function. A mirror for blind spots.
It does not feel. It does not grieve. It does not sit in silence with a terrified client and share metabolic risk. Those remain human domains.
But it can write the summary that allows the human to go home and sleep.
Used carefully, augmentation restores the clinician’s humanity by protecting the energy required to deploy it.
The WEIRD problem
Augmentation introduces a new risk. Most AI systems are trained predominantly on Western, educated, industrialised, rich, democratic datasets. Their assumptions skew individualistic. Their relational advice often privileges assertion over harmony.
In cross-cultural contexts, this can be dangerous.
Advice that reads as healthy boundary-setting in New York can detonate relationships in cultures built around face, hierarchy, and collective balance. The output sounds confident. The cultural mismatch is invisible unless the clinician actively translates.
This friction is instructive. It forces engagement. The clinician cannot autopilot. Cultural awareness becomes an active process rather than a background assumption.
The tool’s imperfection sharpens the human.
A trilogy of thought
Viewed together, the three books map a progression.
Misdiagnosed documents the personal and systemic cost of reading behaviour without understanding architecture.
It’s the Circumstances reframes distress as an interaction between person and environment rather than an isolated defect.
The Augmented Psychologist proposes a structural response: reduce administrative burden, restore cognitive bandwidth, and use technology to protect the conditions under which curiosity and empathy can survive.
The through-line is simple and uncomfortable.
Brains are not failing in isolation. Systems, environments, and expectations are interacting with those brains in ways we do not yet fully understand.
After the spreadsheet
The spreadsheet is gone; in its place is a different question.
Not when will I die, but how many people are currently living inside diagnostic frames that do not fit, environments that exhaust them, and systems too overloaded to notice.
The profession is not short on intelligence. It is short on time, bandwidth, and structural support. Misdiagnosis thrives in that gap. So does burnout.
We tend to ask whether AI will replace us; a harder question sits underneath.
What if the real danger is not that machines become more human, but that humans remain trapped in systems that prevent them from functioning at their full humanity at all?