This paper is a reflection on Peter Railton’s keynote speech at the Central APA in February 2015, especially on his disclosure of his struggle with clinical depression. Without attempting to deny the significance of Prof. Railton’s outing, we want to draw attention here to something that did not prominently figure in his speech: structural features of the philosophical profession that make people sick. In particular, we focus on the “ideology of smartness” in philosophy and how it creates a pathological double-bind (...) for those that come into the discipline from the margins, or find themselves in its margins. (shrink)