Luckily, during these past days, I have managed to recover a bit from the stressful weeks I experienced at work and from what I can now define depressive symptoms, and I would like to wrap up this topic of PhD and depression/anxiety by talking about anxiety during the PhD. So let’s start by the first important question:
What is anxiety?
Anxiety is defined as a feeling of unease and tension, worried thoughts or fear, and physical changes like increased blood pressure, that can be mild or severe. Anxiety is a normal and often healthy emotion, that allowed humans to survive predators since the earliest days of humanity. The approach of predators and incoming dangers used to set off alarms in the body (such as raised heartbeat, sweating and increased awareness of the surroundings) and allowed evasive action. The potential danger causes a rush of adrenalin, a hormone and chemical messenger in the brain, which in turn triggers these anxious reactions in a process defined the “fight-or-flight” response, that prepares us to physically confront or flee any potential threats to safety.
However, the duration or severity of an anxious feeling can sometimes be out of proportion to the original trigger. When a person regularly feels disproportionate levels of anxiety, it might become a medical disorder. The symptoms of generalized anxiety disorder (GAD) like a feeling of being “on-edge”, uncontrollable feelings of worry, increased irritability, concentration and sleep difficulties, might be normal to experience in daily life, but people with GAD will experience them to persistent or extreme levels, disrupting day-to-day life.
The exact cause of GAD isn’t fully understood, although it’s likely that a combination of several factors plays a role. The different factors might be environmental stressors (such as difficulties at work, relationship problems and so on), the genes you inherit from your parents, overactivity in areas of the brain involved in emotions, an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood. Many might occur at once, some may lead to others, and some might not lead to an anxiety disorder unless another is present. But also many people develop GAD for no apparent reason. Treatments include psychological therapies and medications. However, there are also many things people can do themselves to help reduce anxiety, such as going on a self-help course, exercising regularly, cutting down on the amount of alcohol and caffeine someone drinks and so on, in order to keep anxiety under control and eventually reduce the invalidating symptoms.
Unfortunately, during my PhD I am often feeling the need to push myself beyond reasonable or healthy limits, since I feel like my work in the lab and my research are the predominant measure of my self-worth. On top of this, stress and anxiety become normalized: everyone around me has experienced the same feelings, and it is often seen as part of the process of becoming a doctor – an initiation into the club. Having seen this, admitting the seriousness of my health difficulties feels like showing how fragile I am, and this feeling of fragility leads me to think I will be judged and defined mentally ill. I know, and I am sure, that the PhD is not the cause of my mental health problems, but the worst periods of mental illness I ever had in my life are definitely facilitated and exacerbated by its singular pressures. Yet, as I have already mentioned in my previous post too, public evidence of academia’s mental health crisis – and the external pressures that are driving it – is mounting.
Undertaking a doctorate comes with pressures enough in itself: isolation, long hours, financial worries, the lack of clarity and confusion surrounding your ideas, living with half-done experiments across an extended period of time. I kind of known, or at least, had an idea of this when I decided to become a Phd student, but the current institutional culture of academia is failing us PhD students in multiple ways. It is amplifying expectations to publish, to teach, to network and to undertake other professional activities. It does not provide training and payment for postgraduate teaching, nor tailored support and careers advice for the difficult transition period after completion, as you emerge and are left alone into a small and mostly closed academic jobs market.
When I first experienced these feelings and the first symptoms of my anxiety/depression, I felt reluctant to seek support: I felt like my own difficulties are not legitimate when placed alongside the problems that other people face, that these problems are “first-world problems”, or that my difficulties represent “cries of the privileged”. I was thinking that expressing my own distress would mean outweighing the (seemingly more important) problems of others, and admitting my relative weakness. So I kept on swallowing it, thinking that others are likely going through the same or worst things and it is all part of the process.
Luckily (or not so luckily), I recently bursted out and decided to reach out for help from a professional, that is helping me reflecting on how I am managing stress. As I have already written on my previous post, and I will not stress this enough, it is essential for universities and graduate programs to not only acknowledge and discuss the difference between acute stress, depression, anxiety, chronic stress, and poor coping skills during doctoral programs, but to also train faculty and staff to refer students to appropriate resources and create a supportive culture. I strongly believe that there does not have to be panic during a PhD program, and with open and supportive communication there could be health and wellbeing to the process of becoming a doctor.
Are these years of my PhD worthwhile? I still can not answer that. But definitely it is the best resilience training I could ever have and I think, and hope, it will really set me apart in the workplace.