Wednesday, October 24, 2018

Mental health crisis: in the middle of the storm

By Jai Ranganathan

“I don’t deserve to be here.”

“I am the stupidest person in my lab.”

“Everyone can clearly see how idiotic my work is.”

“I am a joke.”

Does any of this sound familiar? When I was getting my doctorate in ecology, phrases like these formed the spinning center of a nonstop interior dialogue of sorrow and self-recrimination.

And, unfortunately, I wasn’t the only graduate student who felt this way. Recent research has shown something that almost everyone connected to academia knows: there is a mental health crisis among graduate students (REF 1 at bottom).

Treatment resistant depression. Anxiety disorder. Imposter syndrome. We have invented an almost endless supply of words of clinical and bloodless terms to describe the ways we can silently suffer in our own minds. But none of them can truly describe the searing experience of actually being in the middle of a mental health hurricane.

If you’re a graduate student (or anyone really) in the middle of the mental storm, it is really easy to blame yourself for being in the maelstrom to begin with. It’s really easy to think of yourself as fatally flawed, somehow intrinsically undeserving of being anywhere near academia.

But of course, none of that is true. Mental health concerns, even severe long-lasting mental health concerns, don’t have to prevent highly successful academic careers. In her book Lab Girl, ecologist Hope Jahren talks in detail about how she navigated academia even with her bipolar diagnosis. And Kay Redfield Jamison’s entire career as an extremely prominent psychologist at Johns Hopkins University has been closely tied to her own long-standing mental health issues (her book An Unquiet Mind is a classic memoir of living an academic life with mental illness as a constant companion).

Author Jai Ranganathan, of SciFund Challenge, bringing
scientists together to build a more science-engaged world.
So, if you’re in the middle of the storm, the key question is surely: how do I get out? Just speaking from my own experience in the storm (and not as a mental health professional, which I’m not), I can say for sure that the number one thing is to not ignore it. Like attempting to run a marathon while ignoring a broken leg, ignoring your own mental health issues in the middle of your graduate career is likely to turn out poorly and with lots of unnecessary suffering.

So what should you do? We all know the general advice. See a counselor. Take medication. Go to a support group. Take better care of yourself. Etc.

But here’s the thing that they don’t tell you. Many of those mental-health-improvement things won’t work in your specific case. It happens all the time. A particular medication makes all the difference in the world for a given person but yet, for another person with the exact same condition, that medication is not effective. For one person, going running daily is the key to mental health improvement, while for another going running is the sure-fire path to more misery.

Unfortunately, the solution to mental health issues for any particular individual is almost certainly going to be idiosyncratic and individual. If you are trying to get out of the mental health storm, there simply is no substitute for trying a million things out, knowing that some of them (most of them?) are going to fail. And the fact that there is a high failure rate in the things that you try to help yourself doesn’t mean you are doing it wrong - it’s just the nature of the process. It’s also just like trying to find a pair of pants that fit really well - it would be pretty unlikely that the first pair that you try on in the story truly fit. But if you just keep trying on more things, you’ll get there eventually - so long as you keep trying.

So, where do you get started? In my own particular idiosyncratic case, I have found to be particularly helpful the program known as WRAP (Wellness Recovery Action Plan). Through WRAP, you’ll find a ton of ideas for things that you can try.

And what if it isn’t you in the storm, but instead a friend, colleague, or family member? What can can you do to help them out? The good news is that there is a lot you can do. Research indicates that social support can make a gigantic difference in mental health recovery. This is true even for conditions like schizophrenia, which in the past had been considered to be treatable chiefly through medication-only approaches (REF 2). If you are trying to figure out how to approach someone who seems to be struggling, here are two resources to check out (1, 2). If the person that you are concerned about is someone with whom you share a close connection, I would strongly recommend attending a support group meeting intended for those with mentally ill loved ones. These groups are truly lifesavers for so many and are commonly held as community meetings. If you are in the United States, you can find your closest support group via the National Alliance for Mental Health. In Canada, a great place to find a support group is through your local branch of the Canadian Mental Health Association.

[KC: for more on mental health issues in grad school, see this great  2-part series by Sarah Klain, Ally Thompson, Karina Benessaiah, and Verena Seufert]

1. Evans, T.M., Bira, L., Gastelum, J.B., Weiss, L.T., Vanderford, N.L. (2018). Evidence for a mental health crisis in graduate education. Nature Biotechnology (36) 282–284.
2. Kane, J.M., et al. (2015). Comprehensive Versus Usual Community Care for First-Episode Psychosis: 2-Year Outcomes From the NIMH RAISE Early Treatment Program. The American Journal of Psychiatry 173 (4): 362-372.


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