Mental Health and Graduate School

A note about the author: Ryane Logsdon is a Ph.D. Candidate in the Animal Behavior Graduate Group at UC Davis. She has dealt with generalized anxiety for most of her life, with bouts of depression throughout her undergraduate and graduate career.

May is Mental Health Awareness month and while May has passed, the conversation about mental health should be ongoing. First, let’s clear up what we mean by “mental health.”

WHAT IS “MENTAL HEALTH”?

According to mentalhealth.gov, created by the US Department of Health and Human Services, “mental health includes our emotional, psychological, and social well-being.” This includes, but is not limited to, diagnosing and treating psychiatric disorders (e.g. depression, anxiety, panic disorder, eating disorders, etc.), our capacity to handle stress and relationships, and our moods, behaviors, and choices. A person with poor mental health may not be able to work as productively as they’d like, handle stress healthily, maintain meaningful relationships, or even maintain good physical health and immune function (1). The primary difference between poor mental health and a mental health disorder is the impact that your mental state has on your life; poor mental health may prevent you from being your most happy, successful self, but mental health disorders are those that impact your daily functioning.

Conversely, having good mental health does not just mean being free from the negative symptoms of poor mental health, but includes the presence of positive mental and emotional characteristics. People with good mental health generally feel content with most aspects of their lives, can handle stress and setbacks in a healthy manner, are able to find enjoyment and have fun, and have self-confidence.

Mental health rarely has a single direct cause. More often, it is influenced by a multitude of factors. Genetics and brain chemistry, personal experience, and environment (physical, social, economic, etc.) all interact to determine the current state of your mental well-being.

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SOME STATISTICS

Mental health in graduate school is an especially important topic, as graduate students are at a high risk of experiencing a mental health disorder.

According to a recent large-scale, international survey, approximately 40% of graduate students suffer from moderate to severe anxiety and/or depression, as compared to only 6% of the general population (2). Take that in for a moment: the average graduate student is over six times more likely than a member of the general population to deal with anxiety or depression. While this is the most recent study (as of writing), multiple studies have found similar results – 30-60% (with some surveys finding as high as 87%) of graduate students experience a common psychiatric disorder, a much higher rate than the general public (3, 4, 5).

Additionally, many psychiatric disorders (particularly anxiety, mood, and substance disorders) typically emerge during the early 20s (6); the same time many individuals are starting graduate school. So, it’s not just that graduate students are undergoing more mental health distress than the average population; we are often experiencing these issues for the first time. Poor mental health can even exacerbate the ever-present imposter syndrome (the feeling that you are unqualified or don’t belong in your academic program).

On top of the high rates of psychiatric disorders in graduate students, and the overlapping age-of-onset, graduate school is generally a highly stressful environment for most people, and thus it’s an extremely important time to take care of your mental well-being. While some stigma still exists about mental health issues in academia, these conditions are far too prevalent to ignore.

ASSESSMENT TOOLS

If you are wondering where your mental health currently stands, there are a plethora of resources available online, and some self-assessment tools are listed below. Please note: these resources should not be relied on as professional advice; they are primarily informational. For a diagnosis or professional opinion, please consult with your primary care physician or appropriate mental health-care provider. However, these tools can provide a good starting point to help you assess your current mental state.

Some common symptoms that serve as indicators that your mental health could use a boost include:

Trouble sleeping (too much or too little)
Change in appetite
Change in mood
Reduced energy and trouble performing simple tasks
Reduced enjoyment in socializing and other activities

Self-assessment tools for common mental health issues here and here.

Self-assessment for depression and anxiety here.

Self-assessment of work-life balance here.

A general well-being checklist here.

I WANT TO IMPROVE MY MENTAL HEALTH…NOW WHAT?

Most schools have on-campus, mental-health resources freely available to students. However, this can range from a single consultation to fully-covered* therapy throughout the tenure of your school career.

*usually by your school’s internal insurance or a comparable outside insurance.

Some generally accepted ways to improve your mental health include:

Get enough sleep; doctors often suggest 7-9 hours/night, depending on the person
Maintain a healthy, well-rounded diet
Incorporate physical activity into your life
Take time to do an activity that you enjoy (whether with friends or alone)
Spend time out in nature (Nature Deficit Disorder is real!)
Switch up your daily schedule
Journal or track your moods and feelings
Develop healthy coping skills for stressful situations (perhaps meditation, or these one-minute stress relievers)
Seek outside help when needed

TIPS AND RESOURCES

First, if you feel you might already be in a mental health emergency or crisis, please see the resources below:

Emergency/Crisis Resources

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Lifeline Crisis Chat (online messaging)
National Hopeline Network: 1-800-SUICIDE (784-2433)
Crisis Text Line: text HOME to 741741 within US (or RELATE, if you are a UC Davis student) to get connected to a counselor within 3-5 minutes, for text-based crisis support. NOTE: this system is especially helpful because it will not only guide you through a crisis, but can offer assistance if you’re supporting someone else in a crisis.
TREVOR Crisis Hotline (geared towards LGBTQ individuals): 1-866-843-7386

However, if you are not in crisis, but think you might need some outside help, the first step in the process is typically scheduling an appointment with your primary care physician or a therapist. They can help guide you towards the next step. Scheduling an appointment to speak with someone is not a sign of weakness or defeat – it’s often a step towards self-care and improving your mental well-being.

If you’ve decided to start therapy, here are some things I’ve learned through my personal experiences: first and foremost, don’t be afraid to switch therapists! The fit between you and your provider is important. There are a lot of different therapeutic practices, and every therapist has their own take. It’s important to find one that works for you. That being said, be ready to share. This is basically a doctor’s office – it rarely helps to lie to your dentist about how often you floss, and the same applies when talking to your therapist about how often you feel stressed. If you aren’t honest with your symptoms, it makes it more difficult to get help. Additionally, be aware that mental health changes come slowly; don’t expect immediate results. Therapy can be extremely uncomfortable at first; do your best to just push through the awkwardness.

However, if in-person therapy isn’t for you – either for personal or logistical reasons – there are now many mental health resources available that are more flexible. Online and app-based therapy (such as Talkspace, BetterHelp, or MyTherapist) are great options for those having trouble fitting regular appointments into their chaotic academic schedule. Most of these also make it easy to switch therapists, so you can “shop around” a bit and find a therapist you connect with. Additionally, these resources are often cheaper than out-of-network therapists not covered by your insurance. If you want to remove the therapist altogether, there are also online platforms that can offer self-guided therapy (e.g. MoodGYM).

Another option that can address your mental health needs is medication. While therapists don’t have prescribing power, psychiatrists do, and most therapists work with a doctor or nurse practitioner to determine an appropriate medication regime for their clients. The specific type of medication prescribed will depend on your personal mental health needs, but SSRIs (selective serotonin reuptake inhibitors) and MAOIs (monoamine oxidase inhibitors) are common. These medications, like any other, vary by person in their effectiveness and their side-effects, and it is common to have to try out a few different medications before finding one that works well for you. This can be extremely frustrating, as you often won’t notice any impact of the medication for a few weeks. The side effects can sometimes be significant, especially in the beginning, and this can be especially difficult to balance with graduate school. Like with therapy, persistence is key in finding the right fit, and sometimes switching is the right tactic. I personally recommend working with a therapist any time you are changing your medicinal routine, as it is beneficial to have an outside resource to help you monitor the changes in your mental state. Again, remember that mental health is often determined by biology – taking medication to address mental health concerns is just as valid an option as taking medication to handle any other health issue.

Lastly (and perhaps the least discussed option), you might consider taking a temporary leave-of-absence from your program. Most schools have the option to take a temporary leave (at UC Davis it is called the Planned Educational Leave Program – PELP), often up to a year. Even if your school doesn’t have a program like PELP, many departments are willing to work with students to schedule a medical leave. Only you know if taking a temporary leave is the right choice for you, but it’s important to remember the option exists. The feasibility of conducting your best research is slim if you’re fighting a daily battle with your brain.

BALANCING MENTAL WELL-BEING IN GRAD SCHOOL

If you aren’t in graduate school yet, you may want to consider the mental health resources available at your prospective school during your application process. Of particular importance is understanding what your potential school’s insurance (or your outside insurance) will cover in terms of therapy, psychiatric consultation, and prescription medications. These resources are worth knowing about even if you never have to use them – you may have just the knowledge a friend needs!

Once you are in graduate school, there are some things you can do to help maintain positive mental well-being. Here are my personal recommendations.

First, engage in good mental well-being practices early and often. Learn to prioritize your mental health alongside your school obligations. Treat your time as the limited resource it is, and find activities that energize your mental state – these include any activities that bring you relaxation and joy. Remember to schedule time for these activities!

Maintaining a degree of work-life balance is a struggle for many graduate students, but this balance is highly correlated with positive mental health. When you’re striving to find this balance, be aware that it will look different for everyone. What works for your advisor or lab-mate may not work for you! Additionally, what you personally need to maintain good mental health, as well as the demands of graduate school, is constantly shifting, so try to be flexible when creating this balance. To recognize these changes in demands, both emotionally and academically, you need to be aware of your own needs. This hyper self-awareness often is not a natural skill, but it is something that can be developed through effort and persistence. Journaling and therapy can help increase your self-awareness.

Both mental health and graduate school are journeys with lots of high and low points. Unfortunately, sometimes the low points coincide and it’s important to have systems in place to lean on when you need extra support. This can include developing social connections that you trust and having knowledge of what mental health resources are available to you, whether they be through your school or elsewhere.

Just remember, your health – which is both physical and mental – is more important than your degree. If you put in the effort and time to maintain your health, you will be in a much better position to succeed in both graduate school and beyond.

Sources:

Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M.R., & Rahman, A. 2007. No health without mental health. The Lancet 370:9590, 859-877.
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.
Levecque, K., Anseel, F., De Beuckelaer, A., Van der Heyden, J., & Gisle L. 2017. Work organization and mental health problems in Ph.D. students. Research Policy 46:4, 868-879.
Panger, G., Tryon, J. & Smith, A. 2014. Graduate Student Happiness & Well-Being Report. http://ga.berkeley.edu/wp-content/uploads/2015/04/wellbeingreport_2014.pdf
http://www.apa.org/gradpsych/2012/01/heal.aspx
Kessler, R.C., Amminger, G.P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T.B. 2007. Age of onset of mental disorders: a review of recent literature. Current Opinion in Psychiatry 20:4 359-364.