Burn Rate summary

Imagine you’re 20, you’re partying hard, you’re drinking, taking drugs, and you’re in love. Of course you’re a bit agitated and jumpy! Of course you’re somewhat euphoric! And why would you need to sleep? You’re bursting with energy!

So, how would anyone – including yourself – notice if there’s actually something wrong with you? 

The doctor tells Andy he has bipolar disorder, type I – maybe. Bipolar disorder type I is a condition that causes extreme mood swings, including emotional highs and lows and full manic episodes. The doctor explains that if he doesn’t relapse in the next five years, it could just be a one-off; perhaps it was caused by the drugs he was taking, or even his heavy acne medication.

Andy clung to that idea. So did his family of medical professionals. Maybe it was a one-off.

Andy moved on as if nothing had happened. After a couple of years working in private equity, he went to Stanford Graduate School of Business – a place where anything is possible and you’re encouraged to dream big. It’s there that he met Brian Spaly, an ambitious, confident young entrepreneur with a particular obsession: pants.

Andy didn’t really have an obsession. He played with the idea of starting a falafel chain, or importing Guatemalan rum, or maybe carving out a niche in South African cured meat. None of the ideas gained traction. But Spaly’s did.

The two young entrepreneurs made an unexpected deal because Spaly wanted to go back and work in private equity for a while. Andy would be CEO and cofounder of Bonobos, and Spaly would chip in during evenings and weekends.

Unaware of Andy’s ghost, all Spaly saw in his friend was a driven, hustling young entrepreneur who could be trusted to get his company up and running. And he was right, more or less.

Andy came close to mania in these early days in NYC, but his sister, Monica, pulled him back. 

His family never talked about his diagnosis, but in an attempt to prevent it from happening again, they started monitoring Andy more closely. Monica spotted the signs – his elevated mood and grandiosity – and made sure he got some decent sleep to break the dizzying upward spiral.

People assume that the swings of bipolar disorder are sudden: you’re up one minute and down the next. But it’s more like a sine curve that gradually unfurls in cycles. You can feel the same way for weeks – and then suddenly flip.

Andy’s depressive episodes alternated with periods of elation, but he hadn’t had another fully manic episode yet. In fact, he was still clinging to the idea that his college experience was a one-off. Perhaps his current depression was just the result of a stressful job – how can you say what’s illness and what’s just life?

The future looked bright for Bonobos, but building a company while VCs are watching you is tricky. Plus, Andy’s new leadership style – instilling fear among employees – was under scrutiny. A pattern was emerging of him enthusiastically embracing new senior hires, and then firing them within a year. 

But he kept on at a tireless pace. The company dashed forward, wildly innovating. Though its initial hook was to be online-only, it started opening physical stores where customers could try on pants for home delivery. Andy tested countless other ideas too; he even wanted to launch a tech product to help other online vendors, as Shopify would eventually do.

The low period ends when Andy starts seeing Manuela. She’s beautiful, intelligent, grounded. She’s perfect, and he falls in love immediately – which, when you have bipolar disorder, can be dangerous.

Andy’s on another flight to Vegas, and this time he becomes convinced that the plane is going to crash. This isn’t a hunch; he’s absolutely certain. He spends the flight preparing for his approaching death.

After that episode, Andy regained some semblance of control and realized he needed to quit his job. He found a new CEO for Bonobos and took on a board chairman role instead.

He and Manuela went on a trip to China, where she had some business to take care of. During the trip, his mood dipped as low as it had ever been. He couldn’t function. He literally couldn’t find the energy to leave the bed, even when he desperately needed to pee. But hitting rock bottom created space for something important to happen – Andy finally opened up to Manuela. She listened, offered her compassion and support, and stayed with him.

Back in the US, Andy’s energy is up again. Things start well. He’s learned from some of Bonobos’ previous mistakes and focuses on profitability this time. They’re back to the classic startup aim: sell the company, or go public. 

Things are good with Manuela too, and he secretly puts down a deposit on an engagement ring. Exciting.

Andy is committed to Bellevue Hospital, and it takes him days to come down. But he gets there, and one day Manuela is allowed to visit.

They play cards together. He notices some bruising around her eye. He feels a deep sense of shame. She stares at him and tells him it didn’t hurt.

Even with regular therapy and balanced medication, things can go down quickly in the absence of sleep. 

Andy was excited about his engagement to Manuela and had already skipped a night of sleep when his parents visited one day. Out shopping, he suddenly lost focus, flung his mom off his arm, and ran down the street. His dad managed to catch him. There was no more denial – it was immediately treated as a psychiatric emergency. Dr. Z took care of Andy and upped his dosage permanently.