Mental Health in Academia: “No one likes to see friends suffering”

I first experienced mental health difficulties when I was doing a research project for a year as an undergrad. It was not so much a problem that was caused by research, as research making a pre-existing problem much, much worse and tipping it over the edge. In this case, I was in a relationship with an abusive partner who managed to take away my entire social support network in my first year of university. I don't think I have ever felt so lonely in my entire life. I’m still so angry at the people in charge who were supposed to be protecting students, because they failed me. Looking back on it, I don't know how I made it out without being sectioned. But I got through it using medication, which worked very quickly. I got an extension, graduated with everything I needed, and that was all fine.

The researchers who were supervising me, or the other academics and administrative staff, they couldn't fix the problem, but they were at least treating me with respect. The postdoc who was looking after me, if his students were looking tired or starting to nod off during a meeting, he would pick us up, march us out and say: "Right you lot, go home, sleep, come back tomorrow." This sounds very small but even just getting one decent night's sleep is enough to get you on track sometimes. And just the feeling that there is somebody who's looking out for you is absolutely priceless. It can often be enough, even if they don't necessarily do a lot. They don't have to do a lot.

I had a circle of friends and colleagues that were fantastic, so I was a bit blindsided when my mental health took a dive halfway through my PhD. I think it was mostly physiological: work pressure, lack of sleep and just the physical stress of a job that requires you to work evenings and nights because this is what your experiments dictate. I think that, once you have fallen into a cycle of depressive thoughts, it is a lot easier to relapse. So, I was medicated again then took myself off that gradually.

If you're in the middle of a depressive episode, you don't have the energy to really enjoy things. Even if you did have any energy after getting up in the morning, you probably wouldn't want to anyway because your reward pathways are killed. You are physically incapable of enjoying new things or even thinking back to happy memories. It kills that as well. There are different cycles of thoughts and different emotions that go along with each episode, depending maybe on what triggers them, what else is happening in your life and the long-term pressures that you're under. But most of the time, you feel completely worthless - at least I do - and there is no logical way to deal with this because your own mind is telling you this. I think my depression also latched onto the uncertainty that comes with academia. I think, this is a thought experiment obviously, if I was practicing in a stable job that I knew was going to feed me, and pay the bills, and bring… a measure of respect and the feeling of being useful to others... I don't think it would have been as bad.

No, I carried on. I had to. Because research doesn't stop. My co-authors needed those results. What are you going to do? There's absolutely no blame to be put on my supervisor. If you want to take holiday, the answer is always: “Yeah, okay, get out, I don't want to see you for a week.” But I didn't ask because I honestly don't know where I would have been able to slot that time in.

I felt comfortable enough to knock on their door and say: "Heads up, this is nothing to do with you, and nothing directly to do with lab work, but I have been diagnosed with moderate to severe depression. I have been more tired than usual, I may be more tired than usual for a while, I am on medication, I'm getting help, this is the medication I’m on. I'm telling you in case I sleep until 12:00 every day of the week, or you notice something that's different. Or, you know, in case I have a reaction to the medication.” And they have been phenomenally supportive.

If I needed to dump everything and just stay home for a couple of days, I wanted to know that they didn't think I was slacking off. I obviously wanted them to keep it confidential and not mention it to any other lab members unless I did or said it was okay. I wanted flexibility when it came to lab work and the many and varied extracurricular parts of research like showing up to seminars or tackling the next conference. And all of this was fine.

Not everybody knew what the diagnosis was, and not everyone knew I was on medication, but it became obvious I was struggling. They almost literally scraped me off the floor once. This was both spectacular and just incredible in how practical and how caring people in a research group were. They didn't have to be.

This was during a long stretch of intense work that really screwed with my head. I was sitting in the office, but I could not sit upright, and it was as if reality had basically slipped sideways. I think any medic would just have diagnosed it as nervous exhaustion. It was terrifying. Everything was just wrong. And there was the small fact that I was toppling sideways off my chair. My colleagues bundled me up in a cab and made sure that I made it home. For the next few days, they monitored me, fed me, took me on walks. That is practical support. Afterwards, I felt mortified, but they weren't awkward. That was incredible.

I wouldn't quite say my labmates helped keep me alive, that's over exaggerating, but they certainly helped keep me going. It’s knowing that if, God forbid, something similar happened again, I will not just be left alone quietly to expire on the floor of the department. These are people that you can call. Even just knowing this is sometimes enough to get you through. You don't always have to pick up the phone and say “yeah, I'm not okay, I'm melting down, I'm coming over”.

Our lab manager wasn’t yet in post when I had my very large dose of very practical support, but this is now the person to whom people turn to if they have any questions, or theories about life other than “oh god, how do I get my next grant”. This is somebody who is genuinely interested in other people's perspectives, and likes being supportive. The graduate administrator at my department, she was also amazing: she is one of those people whose office you can walk into and immediately feel better. She understands the headache that university bureaucracy can cause and the tricks to deal with it, for example if you need to intermit. Admin staff who are not connected with the research grind, who don't have a vested interest in your supervisors’ publication record, they are a safe place. You know that they are not going to use what you tell them to scoop your next paper, or force you to come into the lab half an hour earlier every morning.

Day-to-day support are very much small things, like “oh this person is having a very rough day, let's maybe just leave a chocolate on their desk, or some fruit for the vegans”. For what it’s worth, I have never seen male students do this, not in these small, concrete, everyday forms. Most of the supposed support I've been giving has been letting the student next to me rant and just occasionally nodding or picking up the chocolate and sliding it over. For some people, and it seems obvious maybe, but taking them out of the lab, and getting coffee somewhere out of the office, just changing the environment, sometimes that is almost enough when they are stressed. But support depends very much on the person. It comes down to paying attention to them and working out what they might need. Obviously you ask before you do anything that's too out there: I'm not just going to walk into somebody's house, commandeer their stove and start cooking freezer meals for them. Otherwise, you are going to do something that might stress them out even more, or annoy them, or embarrass them. And a lot of people are embarrassed being helped – hello, exhibit A here.

I am really bad at talking about feelings – I’m from one of these “stiff upper lip” cultures after all! But it's worse if you don't, so the logical thing is to do it. I'm fairly blunt when it comes to it, to the point of going: “Do you want to rant about this feeling, or do you just want for me to shut up, or shall we talk about something else completely irrelevant?” I'm more practical; there's no point going “pat, pat, there, there” if at the end of the day you know they’re going back to a flat with an empty fridge or they have to stay late to take care of their experiment.

Some people, even if they can’t tell you what they need during a crisis, they can at least say: “I'm not ok, I’m coming over.” So, you just draw the curtains, make some tea, put out a snack with some sugar, and prepare a fainting couch. But some people are unable to ask for help, and very good at hiding when they are under a lot of stress. For them, the amount of help they want is probably far less than the amount of help they actually need. Offers of help stress them, so you feel a bit powerless. Sometimes, all you can do is to be very quietly approachable, to show that you are somebody who – I don't know if enjoy is the right word – but you are somebody who is happy to be a sounding board for other people.

Labor as in very hard work, sometimes yes. But most of the time it is not difficult to do yet it clearly makes a difference to the person. It matters to me. I know what it felt like to be completely abandoned by peers during my undergrad, and I do not want anyone who's at all close to me or has helped me in any way to have to go through that.

I think it made me better at it. Perhaps that's just projecting, because I know what I would have wanted, so I’ll try that first. Or perhaps I am somehow slightly better at spotting red flags. I’m not sure, I'm also very bad at reading people! But I know how bad it can get. If you have not gone through mental health issues, these experiences are not on your radar. This means that you might not notice when somebody else is going through them. You are incapable of understanding fully exactly how low a person can get, and how cruel other people can be.

... maybe most in need of it? Or who have had a hard time in the past and maybe need some more space to recover?

No, thank God it didn't. Because I don't think I could have done it. There was just not the space. Oxygen mask principle: you take it in turns. It's hard enough for one person to break the loop without having somebody else saying everything's terrible. The supporter should be someone who is at least on an up rather than a down.

I don't think so, but it could have been a very different story if I didn't work in a multidisciplinary, very collaborative, very supportive, very friendly group. You knew that if you had to stay late looking after somebody else's experiments, you could go home early in a few weeks' time and they would shut down your instrument.

Absolutely. If you're taking more time to help somebody psychologically or you're leaving early because you're going to have drinks with the poor chap who has failed his experiments three times in a row, there are others who will gladly absorb your slack. Because you will have done the same for them, or they know that if they need help they can ask. This would not work in a research group where, for example, the boss is having multiple people compete on the same question.

Yes, and we have a very thorough and possibly unusual vetting procedure for that, where everybody in the lab gets to meet new applicants, and give their feedback to the PI. If enough people say “no, God, no” and can justify it, even if it's just because their personality is completely wrong, our PI won't hire them.

Absolutely. Selfishly, when one is feeling incredibly low and completely worthless, it is concrete proof that, no, actually you aren't worthless because you were useful in this circumstance. But mainly, no one likes to see friends suffering - anything you can do to stop that. That comment you made, about how being a collaborative group allows individuals in it to be supportive, I think it works the other way around as well. In the long term, a culture of support makes a research group, or an institution on any scale a far better place to work, for everyone: people do their best work when they feel valued, and respected, and are treated like humans.

Do you know someone in academia who struggles with their mental health? Have you provided support to somebody? We are interested in hearing about your experiences so we can understand how to better help supporters.

Interview conducted by Elsa Loissel, Associate Features Editor, eLife.