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Paying Graduate School's Mental Toll

Like nearly all science graduate students, chemistry blogger See Arr Oh was no stranger to stress. But one afternoon during his third year of a Ph.D. program in organic chemistry, as he sat in his car, he decided the stress might actually be killing him. "All of a sudden I would just be blurred out and tense all over. Everything just seemed to rush at me at once," he says. He went to the emergency room and was told he was suffering from panic attacks.

Looking back, he says he isn't surprised that the stress and anxiety finally got to him. His adviser had refused to write recommendations for postdoc positions and fellowships. His research projects had stalled. His personal life hardly existed, and his diet was abysmal: fast food, coffee, and the occasional beer.

About 60% of graduate students said that they felt overwhelmed, exhausted, hopeless, sad, or depressed nearly all the time. One in 10 said they had contemplated suicide in the previous year.

When he tried to find help, it wasn't there. "There was nothing available at the university to help me," he says. "There were lots of resources for undergrads but nothing really for graduate students."

See Arr Oh isn't alone in suffering significant mental health problems during a science graduate program. According to a report from the University of California (UC), nearly half of graduate students said that a mental or emotional problem had interfered with their academic work in the past year. Yet, little is known about the mental health problems that affect graduate students, including those in science. "There's the assumption that all college students are college students. They all experience the same thing," says Tammy Wyatt, a psychologist at the University of Texas, San Antonio. "But our work has shown that this isn't true."

In one of the few studies on the subject, Wyatt and colleague Sara Oswalt compared responses to mental health concerns from the nearly 28,000 undergraduate and graduate student participants in the American College Health Association-National College Health Assessment II. Although the undergraduates reported more psychological issues and specific psychiatric diagnoses than graduate students did, the levels among graduate students were still high. Nearly 40% of graduate students reported feeling hopeless during the previous year, 78.5% said they had felt overwhelmed, 27.2% said they had felt depressed, and 54.5% said they had felt stress over the past year ranging from “more than average” to “tremendous.”

A 2006 report from UC paints a similar picture. About 60% of graduate students said that they felt overwhelmed, exhausted, hopeless, sad, or depressed nearly all the time. One in 10 said they had contemplated suicide in the previous year.

Although many graduate students might like to seek help for their issues, they aren't always able to access the help they need. In the 2006 study, a quarter of graduate students said they were unaware of on-campus psychological help, and just 27% utilized available on-campus resources. Jerald Kay, a psychiatrist at Wright State University in Dayton, Ohio, and an expert in mental healthcare at colleges and universities, says that some university counseling centers won't even see graduate students.

Meanwhile, according to recent studies and reports, nearly all directors of college and university counseling centers are seeing an increase in the demand for their services and the severity of the psychological problems they see. Most of these reports have focused on undergraduates; it isn't known whether these same trends are affecting graduate students, but it probably is. "More and more students are matriculating as undergraduates with a history of significant psychiatric disorders," Kay says. It's likely, he continues, that some of these students go on to graduate school with the continuing need for mental health care.

Will the Affordable Care Act (ACA) make a difference in the accessibility of mental health care for science graduate students? Kay says it isn't yet clear. Under ACA, young adults will be able to remain on their parents’ insurance until they are 26. The act also requires, in theory at least, mental health coverage that's on par with medical and surgical coverage.

John Guthman, director of student counseling services at Hofstra University in New York, says that some of the issues facing graduate students are very similar to those facing undergraduates. Both groups face academic stress, relationship issues, financial problems, and social transitions, as friends frequently graduate and move away. Students from abroad—much more common in graduate school—also must deal with language and cultural issues, Guthman says.

But See Arr Oh and other graduate students say that graduate students aren't just older undergraduates. Graduate students have bigger responsibilities and weightier, longer-term commitments. They have to worry about funding their training and research, publishing papers, and finishing dissertations. The small, short-term deadlines common to undergraduates are replaced in graduate school by more serious, longer-term deadlines.

Graduate students are more likely to have spouses and children who share the impact of their successes and failures. Graduate students are expected to practically live in the lab for several years. They're embarking on a challenging, high-risk career path. Yet, many of the universities that do offer mental-health support to graduate students offer them the same support they offer undergraduates, and that support may not be appropriate to their circumstances, Wyatt says.

Some do get the help they need. With the help of a counselor, See Arr Oh was able to start making changes in his life to reduce his stress. He improved his diet and began taking walks. He shifted his priorities to include adequate sleep and some leisure time. "There's a lot more to life than just your job," he says today.

Science Careers talked with other science graduate students who have experienced mental health issues. Each of them offered some advice for current sufferers:

You're not alone. Nash Turley, a Ph.D. student in ecology and evolutionary biology at the University of Toronto, Mississauga—he moved there with his adviser from North Carolina—thought he was the only one in his old department who was struggling. But as he improved and gained a sense of perspective, he realized that depression, anxiety, and other problems were common. "It's probably why no one in my old department wanted to hang out," Turley says. "There was this atmosphere where everyone was sad and stressed out all the time."

<p>Nash Turley</p>

Nash Turley

Courtesy of Nash Turley

Turley knew it was time to get help when he began to have thoughts about hurting himself. He found the number for a therapy hotline and was put in contact with an on-campus therapist. "I made a commitment to try and do better. There weren't any magic tricks," he says.

Many people are afraid to seek psychological help, Turley says. Although people are becoming more open about engaging in psychotherapy, there's still a lot of stigma around mental illness. Turley now tells other graduate students to seek help sooner rather than later. "Get over the stigma. Going to see a therapist is OK. It's just like seeing a doctor when you're sick," he says.

Beware of perfectionism. Ever since she was in high school, Yichelle Zhang has struggled with anorexia nervosa. Zhang, now working toward her Ph.D. in psychology at the University of New South Wales in Australia—she is studying eating disorders—has slowly begun to address her own. "The time and energy I devote to my disorder is often like a full-time job. I frequently sacrifice sleep, and my productivity and quality of work suffers," she says.

Because she was aware of her issues going into graduate school, she had established a strong support team that consisted of both professionals (including a therapist) and friends. Zhang avoids discussing the issue with people in her lab because she doesn't want to be treated differently.

Zhang says that the most important thing she has learned is to beware of perfectionism. "I have to remind myself to take a step back and cut myself some slack sometimes. I don't need to give 110% all the time," she says.

Zhang has begun practicing yoga and mindfulness meditation, focusing on the present moment, and removing judgment about feelings and experiences. These practices have given her a better perspective on her eating disorder and her work.

Amanda Traud

Amanda Traud

Courtesy of Amanda Traud

Group hug. When Amanda Traud, a Ph.D. student at North Carolina State University, began her program in biomathematics, she was convinced she had gotten in by mistake. It was only a matter of time, she thought, until her adviser and colleagues figured out that she wasn't as smart or talented as everyone thought she was. Traud was suffering from what's known as imposter syndrome, a psychological phenomenon in which people feel like frauds. Their successes, they feel, are due to luck, not skill or hard work. Imposter syndrome is especially common in female graduate students.

Traud's imposter syndrome led to depression and anxiety, which weren't helped by the added pressure of having a husband in law school. "Things tend to get worse around deadlines. Unfortunately in grad school there aren't lots of little, tiny deadlines like you might see in undergrad. There are just these big, looming deadlines," Traud says.

When Traud sought counseling at NCSU, she noticed that about 80% of the people she saw in the waiting room were graduate students. (Graduate students make up about 28% of the NCSU student population.) Individual counseling helped, but what Traud found most useful was her dissertation support group. "Every week we meet and just talk about what's been bothering us and offer advice or empathy," she says.

Go informal. Not all types of support need to be in the form of formal support groups or organized therapy. Regular gripe sessions with other graduate students in her program, Traud says, help her blow off steam. She also makes an effort to chat with other graduate students, providing a source of support.

Professors, pay attention. Both Turley and Traud note that most professors are unaware of the amount of stress their graduate students are facing. Traud believes that if professors were more aware they could refer students to counseling and other programs. The problem, they note, is that even when such support systems are available, they aren’t advertised well, and professors don't know that they exist. Turley and Traud urge graduate students to ask around at both counseling and academic support centers for resources that may be able to provide emotional or practical help.

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