To outsiders, it used to seem as though running a startup was just a matter of hanging out with your friends while raising tons of venture capital funding. And that view isn’t all wrong. But in the decades since the Silicon Valley craze began, critics have been working to give both insiders and onlookers a reality check.

“There’s something delicious and hypnotic about being all in it together and counting on each other,” Kate Losse, who wrote the tell-all The Boy Kings about her time as one of the first customer service representatives at Facebook, told Forbes. “It’s maybe why people these days are fascinated with startups.” Gideon Lewis-Kraus’ No Exit, from earlier this year, chronicled a startup in the midst of Silicon Valley’s “modern gold rush” that ends up being more trouble than it was worth. As former Google programmer Michael Church once wrote in a blog post, “The best and worst companies tend to be startups. The worst ones don’t usually live long enough to become big companies, so there’s a survivorship bias that leads us to think of startups as innately superior. It’s not the case.”

So what are some of the downsides amid the free food and swag? Recently, I used a Silicon Valley developer’s Secret account to post a question: “What’s the worst part of working in a startup?” Relying both on the replies on Secret and in follow-up conversations with anonymous startup vets, I found that the responses tended to cluster around a handful of themes.

Startups are at once all-consuming and unstable. Many responses made reference to endless labor in return for a tiny chance of success. One person bemoaned “the likelihood of working very hard for something that has [a] 98% chance of never being a thing.” Another put it this way: “Give it all to the company you have a fraction of a percent of or GTFO.” Others cited “the lack of respect, regard, trust and support internally,” “uncertainty,” and “getting repeatedly screwed over by people you thought you could trust.”

Work-life balance is impossible. The concept is “actively shunned,” according to one Secret respondent. I spoke with one Silicon Valley developer who said that while the idea of “work smarter not harder” gets thrown around a lot, in reality, managers measure commitment based on how much time an employee spends at work. “The mindset, at least in Silicon Valley, is that if you want to coast, you join a big company—startups are where you’ll work hard,” said a developer from a data-management startup. One Secret response invoked a girlfriend “who most likely will need to be deleted if you’re going to succeed.” Though many of the developers I talked are in relationships, almost all of them said they’ve known others who “put dating off” while trying to make it in startups.

You’re at a disadvantage if you’re not on drugs. “I’m kind of a turd in that I worked like six-hour days because I’d just be Adderall-ed up and work for six hours like a monster and then peace out,” said one programmer at an advertising startup. “Modafinil is an essential tool in the arsenal of any active start-upper,” declared a commenter on a Hacker News thread. “Get it.” The San Jose Mercury News recently took a deep look at Silicon Valley drug use, attributing it to “newly minted wealth, intense competition between companies and among their workers, the deadline pressure of one product launch after another and a robust regional black-market drug pipeline.”

Mental-health issues such as depression are common yet taboo. In July, Catherine Shu of TechCrunch collected anonymous interviews with six startup founders who have struggled with depression. Concealing these struggles, one said, “helps to show you are strong, that you can handle everything. A lot of the projects we work on are collaborations with other digital agencies/developers. If they thought we were melting down as entrepreneurs then perhaps they wouldn’t want to partner or share as much risk with us.” One long-term startupper told me, “I’ve been very depressed for a lot of my life, and I would say actually that that my worst depression has been in my own company.”

There’s immense pressure to conform to company culture. “People start putting requirements on their co-workers that are more based on their personal preferences of who would make a good friend,” said one developer. Especially because startups begin as small, close-knit groups, subjective “likeability” factors play a disproportionate role in hiring and office culture; most notoriously, it results in white or Asian twentysomething men hiring other white or Asian twentysomething men. Women aren’t just excluded; when they do work at startups, they are often bullied, exposed to “brogrammer” culture, sexually harassed, or undervalued. (Worse, startups generally don’t have HR departments that can mediate complaints.)

The overall bias can lead to an almost obsessive interest in youth and sameness—one programmer likened it to a “medieval obsession with virgins.” (Recently a rash of tech companies have published diversity reports in an attempt to be more transparent about the racial and ethnic breakdowns of their employees.) “At the end of the day, you just want to work with people like you,” one developer told me when I asked if he thinks startups have an ageism problem. “Let’s say I drop out of college. I work at a startup for three years. I’m now 23. I know literally everything about that [startup]. And then we bring in some 40-year-old dude to interview. Does he work under me? Do I work under him? I know more than he does, and he’s going to ask for two to three times what I’m making because he’s older. I am strongly dis-incentivized to hire him.”

You might end up sleeping in a utility closet and wake up in need of medical attention. Not a trend, but this story must be told. “I’ve done 28-hour stints, sleeping on the floor in my office, stuff like that,” a developer told me. “Once I asked my manager where I could take a nap and he suggested the utility closet at work. So I did and I woke up with mild acid burns from the cleaning agents in the closet. That actually happened.” Only in Silicon Valley.