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Let’s talk about mental health

Authors: Inês Sousa Pereira & Laura Pintado

According to the World Health Organization (WHO), mental health refers to: “the foundation for the well-being and effective functioning of individuals (…) it is the ability to think, learn, and understand one's emotions and the reactions of others. Mental health is a state of balance, both within and with the environment. Physical, psychological, social, cultural, spiritual and other interrelated factors participate in producing this balance.” During our whole life, we are taught that we should exercise because it is good practice for your health. But rarely we are taught about the importance of taking care of your mental health. As the definition states, we need to have a balance of both the body and mind’s health. Sometimes it is actually imperative.

You may now wonder, how is this relevant for the purpose of this blog series? Well, a Ph.D. certainly tests your mental health. Actually, the WHO found in 2018 that 31% of Ph.D. students experienced signs of mental disorder, such as major depression, general anxiety disorder or panic disorder.

When you begin your Ph.D., it seems like the end is a long way off. You enter it with optimism, believing you can accomplish everything in your well-thought-out plan within the next 3-4 years, smoothly and “easily”. Let's be honest, we all think we have plenty of time to learn the new techniques and repeat your experiments until your hypothesis is accomplished…or at least answered.

So far, I know of no one who has ever experienced this idyllic situation. I'm not saying it isn't possible, just that I haven't come across an example.

And so, what is the reality? This question has many answers. Some projects are more detailed planned than others; there are labs with more equipment and better conditions; some groups may be more supportive or more competitive. Truth be told, we are many times supervised by negligent or even abusive “mentors”. And this just regarding the workplace, let's skip other realities we encounter in research such as the lack of rights, financial insecurity and temporary contracts in science, the pressure for publishing to even have a normal career and our fantastic working hours and conditions. Welcome to the toxic culture of overwork.

Clearly, countless reasons can be found. Yet, I find that many students have similar wonders and frustrations. In this "biological" field at least, some questions may arise: What is the next experiment? Why am I not seeing anything in this result? Why did my cells die during the experiment? Do I have to start over? How can I make these results a story and write a paper? Is the paper going to be accepted? Is my career over if I don't publish? Do I really only have 3 months left to finish?... Why did the planets align, and a pandemic happen at the same time as my PhD? In summary, we are full of questions and answers to those questions that hold the potential to affect our mental stability and well-being. Ultimately, the repercussion this rumination has on our mental health is broad, negatively affecting physical health, interpersonal relationships, academic output, and work performance.

Naturally, after feeling lost, we search for a reference, a guide. Therefore, we go to our supervisors with all these questions and MOST OF the time we get help and advice, other matter is the quality of these. However, we are faced with these questions 24 hours a day without the possibility to log out after we get home. During all these months our mind is working, and this is extremely exhausting. You would not think working out 24/7 is healthy, would you? Otherwise, I need your secret for long lasting energy.

In my personal experience, I find striking how more and more people are sharing these problems, and even more devastating is the fact of how normalized this is within science, in all of its levels. A recent survey from the university of Westminster in 2019 and published this year showed that just in the UK 40% of Ph.D. students believed that mental health issues are the norm with the same percentage of people admitting how other peers acknowledged having mental health problems.

Hence, you find yourself, a young Ph.D. student, asking for advice not only from your fellow colleagues, but from those who already passed this chapter. What is it that you find? Senior postdocs and young researchers who are still suffering this dysfunctional feeling, resigned and who have incorporated it within their job queries. Or even more encouraging (let's feel the irony), those who have left research due to the decadent conditions throughout their career. Indeed around 30% to 50% of Ph.D. students drop their programs.

In line with this, I would also like to tackle other questions with a slightly different nature. Let's start by introducing a concept that may help in understanding what I just said before: the Impostor Syndrome. Basically, this is defined as someone's own feeling of being a fraud among equally skilled colleagues and denial of our accomplishments. We find ourselves believing others may think we are not qualified enough or not good enough. We wonder if we are made for this, if we are smart enough, we doubt our own capacities and skills and we begin to develop a river of negative thought towards one that highly impacts our mental well-being. I don't know if you have ever suffered an anxiety attack but ever since I started my research journey I have. I didn't even really feel the overwhelming anxiety beforehand. The danger behind this is the fact that it can become a frequent episode and then it is referred, according to the DSM (Diagnostic and statistical manual of mental disorders) as a disorder.

Interestingly, Imposter Syndrome does not discriminate, and students to scientists at the top of their academic careers can suffer this, supporting what I previously exposed. Moreover, it has been observed how some personality traits are characteristic in those more prone to suffer from this. People experiencing self-efficacy struggle or perfectionisms are examples. But in more detail, neuroticism as one of the big 5 personality traits plays part of it. Therefore, those with a tendency towards depressive thoughts, anxiety and self-doubt particularly experience this syndrome. But caveats! Neuroticism exists on a spectrum, that is, there are people who may just present more rigid traits than others. Interestingly, competitive environments can also lay the groundwork for this. And here competitive is a word I would love to highlight as this is the proper definition of what a PhD is.

I feel there is a huge gap and a big stigma regarding mental health born from misinformation. Certainly, we need more (in)formation about what is in our hands to improve and safeguard our mental health. As we all know, knowledge is power, and not only on how to perform a single cell analysis, but on how to identify and manage our intrusive thoughts in the work field. According to this, I do think it is more a matter of learning basic psychological terms to actually realize that these feelings are other but normal to then go and apply some tools to improve our situation. This implies breaking some stigmatized beliefs about what psychological help means.

Fortunately, there are new figures appearing in academic research like the research integrity office (RIO), made to ensure the quality of the research work or the introduction of tutors to whom go in case personal problems appear. Despite these small steps, the problem still remains that people simply are not even aware of the existence of such or they normally are useless due to how rooted the institutions are in old ways. However, these figures, if properly working, are particularly important considering that many times, the advice you receive from others when presenting your concerns are things such as to ignore it and focus on your work or to not be concerned as those feelings are normal, without providing any type of lesson on how to form constructive criticism to improve. Moreover, last year a Ph.D. survey was published in nature in which it was shown how 36% of responders searched for help and still 18% of those who sought help at their institution did not feel supported. I hear a bell ringing somewhere.

This right here saddens me. I hope that now, with the global visualization mental health has, we could find a more feasible place to openly discuss it. The benefit of talking to your colleagues and supervisors about what can be done to efficiently perform your work, and how to come to productive solutions could minimize the helpless feeling we often have before a complicated situation. Because let's face it, we are often left alone and problem-based learning may be a good approach that many universities in Europe apply. Nonetheless, when in a research Ph.D., we encounter very formative years in all of our life spheres and proper mentorship is not only required, but mandatory. We are not only learning several techniques and soft skills that, in one way or another, we`ll apply for the rest of our lives. We are learning how to get introduced into a working environment, how to cooperatively work within a community, how to develop critical minds (not only regarding science) but especially, and I hope that after today, we include the fact that we learn how to talk to ourselves when dealing in a constantly frustrating and competitive field.

Because the goal is not only to accomplish a Ph.D., but to make the most of it, with a healthy mind. We have our heads full of questions when the real and big concern we all should have is: at which cost do I want to obtain my Ph.D.

So, big questions arise. What can I do in order to improve my mental health? How can I learn to deal with frustration after learning to expect excellence for so many years to achieve this position? These can be perceived as subjective topics as everyone of us has our own idiosyncrasy of what works better for us. However, I do dare to leave you with some tips that have been helping me:

1. Psychological therapy/coaching. What better suits you. I went coaching for a few months in the middle of my Ph.D. and it was game changing for me. I got to understand the root of my problems and come up with solutions. And let's get straight here, this is constant work, as you are training your brain to respond differently to stimuli that sometimes we don't even consciously identify. Long story short: one session is not enough. Also, eventually you could meet in a group session as it helps with the feeling of loneliness. You can actually realize you are not alone with your emotions. Talking and relating to others about our common problems, asking for opinions, giving advice and setting goals is crucial. The aim here is not only to learn how to identify all emotions we may have, but how to manage and respond to them. Therapy aims to teach us how to change the inner speech we have by paying more attention to our cognitions and its impact. We might realize we are not being comprehensive nor compassionate with ourselves.

2. Organization. I’m not saying you should become one of those people who loves lists and weekly planners. But I do feel that weekly planning provides you with some control about work that has to be done, I would even say that by doing this you’ll have a rough idea about what is monthly needed. So, just decide whether to pick a weekday or do it on a daily basis to plan the to-do list. Set some goals and think about what needs to be done. This will make you more productive and relaxed, especially on Mondays when getting to work.

3. Stop comparing. I know the urge to compare is strong, and that even your own boss might already have done it for you. However, he/she might not be updated on how society is transforming and that nowadays the basis of organizational psychology and “healthy” positive psychology are emerging. There is a body of studies showing how a healthy organization (company, institute, laboratory…) leads to a healthy and successful outcome. Therefore, try to build a critical perspective of the situation when receiving bad feedback or when you feel things are out of control and falling apart (drama queen). In other words, “hike your own hike”, is the motto commonly used in the hiking community, which means that you should focus on following your own plan in a way that you can enjoy, without trying to follow someone else’s steps. Be aware that this is something not only you do, Amy Summerville, a behavioral scientist, published a study in 2008 showing how over 10% of daily thoughts were regarding some type of comparison. And this automatic pattern needs to be detected and CONTROLLED the same way as you do your cells/animals. Your inner dialogue referring as to the way you compare, may bias your own perception about your skills and experience. And here I would like to highlight that many jobs will demand you to be updated and to recycle continuously, so it is indeed a constant learning process, so come to the realization that you cannot know everything.

4. Critical Perspective. Following the previous point, and once you are able to detect your really nice thoughts regarding how useless you might be, you could find another perspective (and here therapy might be helpful). In clinical psychology there is a whole line of research regarding human suffering, and an important concept, other than empathy and altruism, pops out: compassion. This is an emotional response when perceiving suffering. My point is we need to develop compassion towards ourselves. So, when you receive a NOT constructive criticism, by your boss or that senior from the lab whose social abilities are lacking, you might question whether that person is right, or whether you have to assertively speak out and defend your work. In the end a PhD is in essence, a defense of your work.

Another example that comes to mind, and is quite frequent, especially in the beginning is when we make mistakes. We didn’t choose the best control, or not control at all. We might have forgotten some reagent, messed up a whole experiment costing money or killed our cells. Who knows all the shenanigans there are? You feel STUPID, useless. Again, stop the bully inside you and put things into perspective as this work many times consists of this in order to learn or who knows, even discover that protocols are not always that rigid. Which goes with another advice: develop cognitive FLEXIBILITY. Not everything is black or white, nor gray. There is a damn rainbow in this world, so besides reading the 34869 paper about the same topic, try to see the different alternatives interpretations of things.

Overall, during your career you do need to develop a sense of criticism. As a scientist you need to question everything to get to the best answer. Having said that, let's apply the same principle to other spheres of our life.

5. Disconnect. This tip can be easier for some people, but I feel it is necessary. Try to find a hobby you really love and dedicate time to it frequently when you are not working. You could read other than science stuff. You can train, join a painting group, go hiking, go for a walk or bike. Try to find things that will help you disconnect besides Netflix and buying stuff on the internet, we do not earn that much. So, once you are finished for the day, you could grab that dusty book and read for a bit with a nice cup of win…tea. It could help you forget work and focus on another universe.

6. Socialize. This again depends on your personality and unfortunately not everyone works in a healthy environment, but I find it essential to have someone to confide with, share my thoughts and frustrations and also, why not, have fun with. It does not do any good to spend all the time complaining about our Ph.D., even if we are right. However, we risk putting ourselves in a position of victim by doing so and take away the power to change what is leaving us frustrated about our work. Of course, not all things that happen are in our control and it is good to acknowledge it. But I recommend that after you complain about your day, you try to see if there is something you can do tomorrow to improve it. If not, well just forget the problems for a moment, take the initiative and enjoy your social time by grabbing a beer with some colleagues.

I hope in some way my words helped you to understand the importance of a healthy mind and place during a Ph.D.. If you have not done a Ph.D., maybe you could understand us better. If you are doing it, know your feelings are quite common and we can help each other out to improve our health.

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