This is a post I have been considering writing for a while now as I feel it is an important topic. I have been avoiding it because talking about depression (or other mental health issues) can feel self-indulgent, like you are having a pity party for one but allowing other people to watch. It can also be intimidating because you always want to present the best version of yourself, but an open dialogue is essential in removing the stigma around mental health and it’s also something I know almost every PhD student I have met has faced at some point in their studies, so I expect my experiences are somewhat universal.
When I started my PhD all new students were given advice about how to handle the PhD process. There were warnings that periods of intense anxiety, loneliness, stress, and depression were to be expected and were a natural part of being a PhD student. ‘Oh that’s fine’ I thought, ‘I’ve always coped with those things before, I’m sure this will be no different’. What no one can prepare you for is just how intense these feelings can become. I am approaching the final months of my PhD and lately I have been reflecting on my mental health journey as well as my academic one. I have learned hard lessons in keeping myself mentally well and sometimes I have failed, despite my best efforts. It seems strange, but I am only now realising just how depressed and anxious I have felt over the past few months. Depression isn’t like a light switch. It’s not like one day you’re fine and the next you’re recognisably depressed. Instead it is more like a spring day – in the sun you are warm and happy, but then a cloud slowly moves across the sky. You notice it’s gotten a little darker, but you wait, knowing the sun will return. The normal ebb and flow of life. But sometimes, the clouds don’t move on and instead get darker, all the while you get colder. After a while, you open your eyes and realise the sun is gone and you are far more than just cold, you are shivering. Of course, eventually the clouds move away again and you can bask in the sun once more, but it takes time and even after they are gone it takes a while to feel warm again.
I am very grateful for all the support I have around me. I know my journey has been made easier by the people I love and the understanding they have shown me. I am also able to write this because for the first time in a long time I feel like I am basking in the sun again. I would like to share some of my thoughts on stress, anxiety, and depression specifically, as this is what I have most experience of, but it is worth noting that academics may also have other mental health conditions: anorexia, OCD, schizophrenia, personality disorders, amongst others, and they should not be dismissed. What I think is most important in discussing mental health is honesty and not accepting that being mentally unwell, in any way, is ‘part of the experience’ of being a PhD student. The things that follow are those that I have focused on or learnt throughout my process, thinking it was just ‘a funk’. In hindsight, I should have sought more help than I did.
1.Mental Health Can Have A Physical Effect
What I have learned the hard way is that stress, depression, etc. can have a very real and tangible impact on your physical health. I have friends who started their studies in good health, but ended it with cystic acne, severe hair loss, alopecia, and/or debilitating anxiety and depression. Some of these conditions disappeared again as they transitioned into work, flaring up only occasionally, but others took a more permanent toll. For me, my physical problems began in my second year of PhD studies. I began to get constant crippling stomach ache mixed with crippling period pain. After a couple of weeks I went to the doctors and to cut a long story short, it took a full year of near-constant pain and debilitating fatigue to get a diagnosis of endometriosis*, which was and is exacerbated by stress.
I had to have a laparoscopy (keyhole surgery), which after a few weeks of recovery has (for the most part) lessened my pain, with only occasional bouts of intense pain. But there is a clear correlation between periods of intense stress and intense pain. Stress means that my ability to deal with my pain also plummets and it is at these points that I really have to concentrate on looking after myself, starting with my mental health. Do not underestimate how your mental well-being can affect your physical health.
2. “Self-Care” Is Not A Bad Word
‘Self-care’ is the carrying out of small acts that help you feel calmer, more relaxed, and help reduce your stress/anxiety/depression. In essence it is permission to be a little bit selfish for a short period of time every day. This can be difficult for someone who has a lot of demands on their time or is already plagued with guilt about not ‘doing enough’, whether or not this is true. The vagueness of the term ‘self-care’ can contribute to it seeming a bit of a weird, hippy thing, but all it requires is to take some time out of your day to concentrate on yourself and your own well-being. Whether that’s 5 minutes, 10 minutes, or an hour or more, it all contributes to a healthy brain and a healthy you. It won’t fix everything, but it will help.
There are lots of different ways to exercise self-care. Some of them cost money, some do not; some of them are big things that you can only motivate yourself to do at a certain level of ‘wellness’ or when you have enough time, and others are little things you can do at any time.
Here are a few of the things I do to help myself. I don’t do them all consistently and everyone is different so what works for me, may not work for you. As Adriene Mishler says: ‘find what feels good’.
- Breathing – when my anxiety is high, I find that being mindful of my breath helps, even if only for 10 seconds. Sometimes it can be all I need to go psych myself up to do a piece of work that I’m dreading. Other times it is not as effective, but it still helps calm me down or makes me realise how much I’m tensing or gritting my teeth. Mindful breathing is also an important one if you suffer from panic attacks.
- Exercise – Exercise is fantastic for depression and anxiety, but it’s often the last thing you want to do. I have found exercises that I enjoy doing – I hula hoop and I have recently started an aerial silks course. Otherwise I try and make good choices like walking to the shop instead of driving. The most effective thing for me is to exercise with a friend who can help get me out the house when I’m feeling too low to motivate myself.
- Bath– my number one indicator of being depressed is not wanting to shower, so when that ‘I can’t be bothered’ attitude sneaks in, I make an extra effort to keep up good hygiene. Equally, a hot bath with some essential oils and an audio book is good for relaxation (and eases muscle pains from desk-sitting/exercise/endometriosis).
- A Cuppa – I like tea. I like coffee. I like herbal tea. Whatever my flavour of the day is, I make sure I consciously take a second to appreciate it.
- Little Treats – when I’m feeling low I buy myself little, inexpensive things that won’t clutter up my flat. Things like a magazine, a new type of herbal tea, a branded coffee, or even a cheap bunch of flowers. Anything that will boost my mood a little.
- Mindfulness/ Meditation Journal – people often mistake depression as ‘feeling sad all the time’ but it is more usually a mix of lots of different emotions: anxiety, numbness, sadness, lethargy, tiredness, a dislike of socialising, de-motivation. Trying to work out how you feel and why can be worthwhile, especially when trying to work out which act of self-care you need that day. I have a notebook that I write in. I write my goals, what I’m grateful for, how I’m feeling, sometimes I just write a letter to someone that I don’t send. It helps me direct my thoughts more positively and to keep a record of the little victories, which can make all the difference when everything feels like a failure.
- Take Care Of Your Physical Body – sleeping and eating well can be the hardest things to do when your mental health is suffering, but it is so important. For me this also includes listening to my body when it signals it is struggling with fatigue or pain. Sometimes I have to leave that piece of work because I need to lie down, or I shell out on that 30 minute massage because it helps alleviate my back pain. Taking care of the physical body helps your mind.
3. Socialising Is Necessary
PhDs are lonely things. No one in your life is doing exactly what you do, not even fellow PhD students. Your friends and family love you, but they don’t know your project inside out; they can’t write that tricky paragraph that you’ve written and re-written ten times over; they’re not balancing essay marking, article writing, research, and public talks on top of trying to write your thesis. There is also a dangerous assumption in academia (and probably true in other jobs too) that you should be working 24/7. Social media is a fantastic tool for networking with other academics, but hashtags like #academicweekend can make you feel guilty about having time away from the computer screen/books. Especially when your work is so portable, you can work anywhere and so leaving it “at work” becomes harder. But getting out there and being with friends is a great way to refresh your brain. I find I gain perspective – everyone has their own stresses, their own projects, their own balancing acts. I have a laugh – which is, and always will be, the best medicine. I may even have a drink (alcohol or tea, either works) that helps me relax that little bit more. It’s time away from work, but it’s important for the holy-grail that is a work/life balance. It’s also a really good chance to check in with how you’re feeling – my Mum often notices my signs of depression before I do, for example.
4. Seek Professional Help
It’s a weird thing, mental health. When my endometriosis symptoms began the first thing I did was turn to a doctor. It was a physical problem that needed a remedy. However, when my mental health suffers I am reluctant to seek professional help, which is hypocritical of me because it is the first thing I recommend to my friends when they are in need of some extra help. People also talk about the stigma of seeking help: for me, this is not so much worrying about what other people may or may not think, but it is difficult to admit to myself ‘you can’t cope’ because it feels like failure.
However, during my year of physical investigations, I did seek counselling through my university, which was incredibly helpful. Discussing what was happening with a third party meant that I had an unbiased opinion about my situation, how I was dealing with it, and I could be honest about how I was really feeling. I am proud of myself for facing up to my struggles and I am incredibly grateful for the counselling service. It was worthwhile experience that I should have taken advantage of more.
There is also medication and this can and should be used when necessary and prescribed by a doctor.
5. Be Honest With Your Supervisor
This is one that is PhD specific, but could also apply to a manager at work. I have found my supervisors to be incredibly supportive of my struggles and they have directed me with good advice. If my anxiety is work related they help me by discussing specifics about my project, what’s worrying me, and what can I do to get a grip on ‘x’. They have also allowed me time off when I have needed a break, and at other times they have helped me to organise/manage my workload so that is not so overwhelming.
Saying ‘I’m fine’ all the time, even when you’re at breaking point, helps no one. If you don’t get on with your supervisor or fear they may not understand, seek a colleague who you can be honest with. I don’t tell my supervisor every little detail, but he has a general understanding of how I’m feeling, but most importantly how I’m dealing with my PhD project, even when the answer is ‘I’m not’. These times don’t last forever and to a certain degree are part of the ups and downs of working on a huge project that is taking up 3-4 years of your life. Equally, doing a PhD doesn’t have to be soul-destroying and a good supervisor will help make sure it’s not.
6. Be Kind To Yourself
I once heard that you should treat your consciousness like your best friend. If a friend spoke to you the way you speak to yourself, would you still be friends? Being kind to yourself, being understanding, and being aware of your language can all help. It can also give you the permission you need to carry out the points above.
*A note on my condition:
Endometriosis (pronounced en- doh – mee – tree – oh – sis) is the name given to the condition where cells like the ones in the lining of the womb (uterus) are found elsewhere in the body. Each month these cells react in the same way to those in the womb, building up and then breaking down and bleeding. Unlike the cells in the womb that leave the body as a period, this blood has no way to escape. It is a chronic and debilitating condition that causes painful or heavy periods. It may also lead to infertility, fatigue and bowel and bladder problems. Around 1.5 million women in the UK are currently living with the condition. Endometriosis can affect all women and girls of a childbearing age, regardless of race or ethnicity.