Graduate Mental Health and Me
Ask any graduate student their thoughts on wide-spread mental health crises in higher education, and many of them won’t be surprised. Researchers have found that roughly one third of students are at risk of psychiatric disorders1 and experience generalized anxiety disorder and depression at rates six times higher than the general population2. More than half report tremendous amounts of stress per a University of Arizona survey3. Suicide is one of the leading causes of deaths in medical residents4. It’s not difficult to figure out why this is happening.
Trainees have been workhorses for academia for a long time. At my graduate institution, for instance, students taught over 50% of the credit hours offered by the university. The National Center for Education Statistics reports a 41% increase in postbaccalaureate enrollment between 2000 and 20185. Meanwhile, grant funding for institutions like the National Institutes of Health has decreased in the same period6. For students, this translates to fewer opportunities, more competition, and a constant struggle to make ends meet7. The prospect of becoming a professor is impossible for a larger and larger proportion of students. The average age at which a researcher receives their first major NIH grant has increased from 36 to 42 between 1980 and 20088, meaning trainees can expect to work an average 6 years longer than their own mentors to reach the same point professionally. Add on a global pandemic that has limited productivity, eliminated access to coping mechanisms, and increased uncertainty, and we have trouble on our hands9.
I was unable to escape this trend myself. Hints of generalized anxiety disorder appeared throughout my life, but it wasn’t until I went through the absolute ringer of Ph.D. training that my illness fully developed. Constant tension headaches, mood swings, and an ugly mix of imposter syndrome and paranoia became every day realities. I felt I had to grin and bear it, trying to deliver coherent presentations and quality data through thunderous racing thoughts. With the stress and immense pressure that graduate students already feel, I had no idea that my inner tumult was not normal.
It all finally came to a head in early 2018. I was hyperfixated on escalating tensions with North Korea, discussing the possibility of nuclear assault to anyone with ears. My sleep schedule was destroyed. I was forgetful despite my obsessive note-taking habit. Never one to shy away from volunteer opportunities within my program, I was trying to ease my mind by keeping myself too busy to think that if I died, everything would be easier. And I broke. I had my first major panic attack sitting at my desk in the lab. As waves of nausea and crying washed over me, my quick-thinking lab manager pulled me into a private room and hugged me until I calmed down. I felt a deep, burning embarrassment. Why was I struggling while my peers seemed to flourish?
I finally accepted that what I needed was professional help. I visited a therapist, and eventually a psychiatrist. Honestly, I should have thanked my medication, Lexapro, in the acknowledgements of my thesis. Maybe it’s the years of therapy talking, but these days I’m trying to weaponize my anxiety. Instead of thinking of it as a burden, I try to make it a tool. What is my anxiety trying to tell me? What can I do that’s constructive rather destructive?
· “I’m going to screw this up because I’m a failure.” I know this means “this procedure makes me nervous,” so I should prepare a clear work plan, take good notes, and work slowly.
· “I have no idea what I’m doing and everyone will find out that I’m stupid.” Being unsure how to proceed doesn’t mean I’m stupid. Who can I ask for help to make sure I’m on the right path?
· “If this doesn’t work, then I won’t be able to accomplish any of the things I have planned in the future.” This one is just a lie that my illness likes to peddle. Focus on the task at hand. It’s time to take a break and regroup when I’m able to present in the moment.
I was able to get better because I had resources. I was lucky to be at a university that offered a limited number of free counseling sessions and health insurance that covered my psychiatric care. Many of my peers had no idea what mental health resources were available to them, and I still get asked for advice post-graduation. My program director thanked me for my candidness in sharing my experiences and has now integrated wellness into the student training plan. It’s vital that moves like this become ubiquitous. In addition to a planned study by the Council of Graduate Schools, individual institutions must develop methods for supporting students’ emotional health. Studies suggest that these should include promotion of careers outside of academia, developing a healthy work-life balance, and establishing supportive mentor relationships. When I started my postdoctoral work, I made sure my mentor knew about my diagnosis and what warning signs he should look for. When he could tell that I was struggling he reminded me, “You can’t shut down! Tell me what you need to help get you back on track.” Feeling heard has made it possible to keep moving personally and professionally. Neither academia nor mental illness will ever be easy, but trainees’ suffering can be eased by remembering to treat us like people, and not research machines.
1. Katia Levecque, Frederik Anseel, Alain De Beuckelaer, Johan Van der Heyden, and Lydia Gisle, Work organization and mental health problems in PhD students, Research Policy, Volume 46, Issue 4, 2017, Pages 868-879, ISSN 0048-7333, https://doi.org/10.1016/j.respol.2017.02.008.
2. Evans, T., Bira, L., Gastelum, J. et al. Evidence for a mental health crisis in graduate education. Nat Biotechnol 36, 282–284 (2018). https://doi.org/10.1038/nbt.4089
5. https://nces.ed.gov/programs/coe/indicator_chb.asp
6. https://fas.org/sgp/crs/misc/R43341.pdf
8. Matthews KR, Calhoun KM, Lo N, Ho V. The aging of biomedical research in the United States. PLoS One. 2011;6(12):e29738. doi: 10.1371/journal.pone.0029738. Epub 2011 Dec 28. PMID: 22216352; PMCID: PMC3247288.
9. https://escholarship.org/uc/item/80k5d5hw
