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Q&A: Why discuss mental health in academia?

Despite increased awareness and discussion around mental health disparities in academia, there remains an urgent need to resolve the conditions that cause these issues. 

Zack Burton, PhD '20, stands alongside The Manic Monologues cast during the Stanford premiere of the show. The Manic Monologues is a play showcasing true stories of mental illness to disrupt stigma. (Photo credit: Frank Chen)

 

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Stanford Earth transitioned the Office of Multicultural Affairs (OMA) into its Diversity, Equity, and Inclusion (DEI) initiative in 2020. As part of an effort to celebrate and discuss identity, five Stanford Earth community members talk about how mental health has informed and impacted their careers.

“My life course was forever changed in the weeks leading up to my qualifying exams,” says Zack Burton, PhD ’20, who lives with bipolar I disorder with psychosis. “I entered a quickly escalating state of mania, which culminated with me climbing to the top of a campus parking garage desperate to end what had become full-flung psychosis. While I survived the experience, I was hospitalized for weeks and lived in an alternate universe for months, completely devoid of any sense of self.”

Widespread mental health issues

Nearly one in five Americans will experience a mental illness in a given year. In their lifetime, more than 50% of Americans will be diagnosed with a mental illness that might include depression, anxiety disorders, bipolar disorder, eating disorders, schizophrenia, or misuse of alcohol, drugs, or other substances.

In academic settings, approximately 15% of undergraduate students and 13% of graduate students suffer from anxiety or depression, with those in doctoral programs being particularly susceptible. In a 2009 study of 26,000 students from 70 universities and colleges, 4% of graduate students reported that they have “seriously considered attempting suicide” in the past 12 months.

While mental health issues are complex and take many forms, all of them interact negatively with high levels of stress associated with being a student. In a 2014 survey of 790 graduate students at the University of California, Berkeley, almost half of PhD students met the criteria for depression, including up to 46% of those who identified as part of biological and physical sciences.

Mental health in context

While these issues are incredibly widespread in academia, mental health issues don’t affect all students equally. Certain students may be more susceptible to certain mental health issues, like anxiety or depression. Students who happen to be womenLGBTQIA+, have disabilities, or come from a racial or ethnic minority may face additional challenges with discrimination, harassment and assault, microaggressions, and conscious or unconscious bias – all of which are made more challenging if they also struggle with mental health issues. Mental health also has worsened for a few other groups during the pandemic, like postdoctoral fellows or those who are parents/caretakers.

Among those in academia, one aspect of the problem sometimes lies in the academic power dynamic, in which students may feel that they shouldn’t reveal their need for accommodations to advisors who seem to be the sole gatekeeper of their career. The prevalence of mental health issues in academia is, at least partially, a consequence of an excessive focus on conventional success measures – hours worked, papers published, funding acquired – all while students often operate with little certainty about their future careers.

Widespread mental health issues can hurt the science, too. A National Academies report found that dropout rates for students with diagnosed mental health problems range from 43% up to 86%. According to a 2019 Nature survey of 6,300 early-career researchers, more than one-third of respondents said they sought help for anxiety or depression caused by their PhD studies. The top two concerns that arose in the survey: difficulty maintaining a work-life balance and uncertainty about job prospects.

Mental health in the COVID era

Mental health has taken a particular toll since the global pandemic. More than 42% of people reported symptoms of anxiety or depression in a December 2020 survey by the U.S. Census Bureau, an increase from 2019’s 11%.

The same trend can be observed in academia. In a poll of 1,122 U.S. faculty members, almost 70% of respondents said they felt stressed in 2020, double the number in 2019. More than half of the people surveyed said they would consider a career change or early retirement. According to a survey of 15,000 graduate students and 30,000 undergraduate students at nine U.S. research universities, signs of depression and anxiety have doubled in graduate students during the pandemic.

During the COVID era, all of the usual coping mechanisms have been restricted – going outside, interacting with friends, going on trips, and even seeing a therapist. This rise in need has led to a disruption in mental health or therapeutic care for many individuals. Throughout the pandemic, mental health care has transitioned toward digital methods. However, this option isn’t available to all students because many students have been living out of state or out of the country. As many therapists are licensed to practice only at the state level, this makes it tricky for students to get the care they need during an especially high-demand period.

Globally, there is ample evidence indicating the spread and increase of xenophobia, racial violence, and discrimination during the pandemic. As more light was shed on anti-Black and anti-Asian racism in 2020 and 2021, students, staff, and faculty have been under increasing stress that may contribute to their ability to manage mental health issues.

Mental health resources

According to a study of 6,300 early-career researchers, more than one-third of respondents said they sought help for anxiety or depression caused by their PhD studies. And of those who sought help, only 26% responded that they received “real assistance” from their institutions.

Despite increased awareness and discussion around mental health disparities in academia, there remains an urgent need to resolve the conditions that cause these issues. Depression, anxiety, periods of intense stress, burnout, imposter syndrome, and so many more mental health stressors are all too common in academic settings.

At Stanford, a wealth of mental health resources are available to students, but navigating these tools can be difficult. A few good places to begin are Stanford Counseling & Psychological Services (CAPS), the Bridge Peer Counseling Center, the Stanford Earth peer wellness liaisons, or the Stanford Earth graduate student wellness page. Regardless of location, students can call CAPS 24/7 for urgent support: 650-723-3785.

Stanford Earth transitioned the Office of Multicultural Affairs (OMA) into its Diversity, Equity, and Inclusion (DEI) initiative in 2020.As part of an effort to celebrate and discuss identity, five Stanford Earth community members talk about how mental health has informed and impacted their careers. Professor of Geophysics Simon Klemperer; PhD students Karissa Pepin, Nicolette Meyer, and Kelsey Foster; and alumnus Zack Burton, PhD ’20, discuss their hopes for the future of diversity and inclusion in the geosciences.

How would you describe your identity?

Zack Burton
Zack Burton, PhD ’20, studied marine oil, gas hydrate, and sedimentary systems of the Late Cretaceous and Cenozoic via geochemistry, computational modeling, and global synthesis. While at Stanford, Burton co-created The Manic Monologues, a play showcasing diverse true stories of mental health and illness to disrupt stigma. The Manic Monologues premiered at Stanford in May 2019 and has since traveled as far as Los Angeles, Iowa, Florida, and Maryland, and has recently been adapted into a virtual format.

BURTON: I live with bipolar I disorder with psychosis. I was born in San Francisco but grew up in the Canary Islands and Germany, and am of European and Indigenous Mexican descent. My mom grew up in rural Northern California, and my dad was born in Uruguay and grew up near Manaus, Brazil.

FOSTER: I think my natural reaction is to just say I’m a scientist, but my identity is more than just that. While I am a scientist, I am also biracial (half Filipino and half American), I am a dancer, I am a daughter and a friend.

PEPIN: I am a White female scientist from Minnesota. I experience anxiety and depression, which have worsened since starting my PhD.

MEYER: I am Asian (Chinese) and white cisgender woman from Singapore and Switzerland.

KLEMPERER: Older white male scientist and parent. Although I don’t consider it part of my identity, my history includes several extended periods with a clinical diagnosis of depression, typically triggered by exogenous circumstances, and treated both chemically and by cognitive therapy.

Share a formative experience related to your experiences with mental health.

Nicolette Meyer
Nicolette Meyer is a PhD student in Earth System Science who investigates bacteria and archaea that live at the bottom of the ocean. She studies what they do, and their role in cycling climate-warming greenhouse gases today and in the geologic past. She is also a 2019-21 ​​​​​peer wellness liaison for her department and a community associate in graduate residence.

MEYER: One of the challenges I faced in graduate school was a 2-month expedition on a research vessel. The 12-hour day shift work without any weekends, the lack of privacy due to the tight quarters, and sleep deprivation were cumulatively extremely tough to handle. Most of the usual ways I unwind, i.e. spending time with family and friends, hiking, etc., weren’t an option. The grueling hours took a toll on my mental and physical wellbeing. Although I still enjoy fieldwork, and would love to go on another expedition, I’m now more realistic about the difficulties I will face.

KLEMPERER: Like many academic scientists, I am hugely invested in my work and allow my work to take priority in my personal “work-life balance.” This choice isn’t a problem until it is a problem. The inevitably close identity with one’s academic grouping (department, school, Stanford …) is only recognized as too close when ruptures, actual or threatened, within that grouping lead to serious mental distress.

PEPIN: I have cried in front of almost every single professor I have had at Stanford. In these experiences, I never received negative feedback that warranted tears, but the fear of being a disappointment to my advisors/superiors so overwhelms me that I often live at an emotional threshold, teetering on the edge of a breakdown. Thus, I’m pushed over the edge at the slightest hint of perceived disapproval. About a year ago, it became apparent that this is an unsustainable way to live and that these emotions get in the way of my learning and research. Reaching out to CAPS led to my most recent bout of treatment for anxiety, which has helped me control the crying a little. However, I’m coming to realize and accept that this stress response may be a part of me that never fully goes away. In that case, what helps the most is being surrounded by people who accept this aspect of me – my advisors, professors, and friends have always listened to my fears and supported me and my research, which has helped me persevere in the face of my mental health barriers. Acceptance of mental illness (and its symptoms) is perhaps the single most important thing we can do for ourselves and others.

BURTON: Following an episode of psychosis and mania that threatened my life, I was hospitalized for a few weeks on campus. It was only thanks to my house full of geology roommates (plus one geophysicist who somehow snuck in), my then-partner, my family, a whole gang of loving friends and peers in Geological Sciences and the school at large, and tremendous advisor Steve Graham that I could slowly rebuild and recover in the months that followed. It may seem strange to say, and is an utter privilege to say, but I now feel incredibly thankful for my experience with mental illness, because my continued work with The Manic Monologues and other mental health organizations has truly lent my life purpose and hope.  

Do you feel like mental health is discussed openly in your field and at Stanford?

Simon Klemperer
Simon Klemperer is a professor of geophysics and seismologist who is interested in the structure, tectonics, deformation, growth, and composition of the continental lithosphere. For nearly 30 years he has studied Tibet and the Himalaya in China, India, and Nepal. Though most of his teaching and mentoring is of graduate students, he also helped institute, and has continued to be faculty lead of, the Stanford Earth Summer Undergraduate Research Program that places and mentors two dozen Stanford undergrads in research opportunities each year.

KLEMPERER: As scientists we largely live a life of the mind and our success is often measured by our intellectual achievements, so it is inevitable that acknowledging mental health issues seems to be acknowledging a likely diminution of current or future success. Just as it’s important to recognize that a physical incapacity may be temporary (a broken leg limited my ability to work, until it healed), it’s also important to remember that many mental health issues are temporary (depressive episodes also pass). Over time, our community has become much more open to discussing mental health, but conversations about both physical and mental health are only initiated after a visual indication of changed health or a verbal allusion to a chronic condition or potentially triggering external event. As a result, we all have a duty of care to our colleagues and students by being alert to such signals that might signify changed health.

FOSTER: I believe people at the school and in my field broadly discuss the importance of mental health, but there is less discussion around what that looks like in practice. We all know taking care of our mental health is important, but I think if students don’t see their advisors, mentors, etc. modeling what it means to prioritize mental health in academia, it can be difficult to figure out how to prioritize their own mental health. That being said, Stanford does have a lot of resources. I know that sometimes it can be hard to find the right resources, but the peer wellness liaison program has been a great way for me to learn about the resources at Stanford and share those with others. 

BURTON: I am hopeful because, for the U.S. as a whole, there have been some discernable shifts these past few years in the openness with which we discuss mental health conditions and mental health difficulties. And this discussion is in part being thrust into the limelight due to the unprecedented burden of the global pandemic and its impact on isolation, anxiety, depression, and burnout as well as on access to care and major disruption of services. But there remains much work to do in combating the shame, stigma, and discrimination to which those living with such conditions are subjected. On an institutional level, there needs to be more effort in facilitating openness, conversation, and acceptance, but also in caring for “our own.” As long as students are dying by suicide, there is a big, BIG problem. Structural changes, action by leadership and those in positions of power – these are critical in effecting systemic change. With mental health, as with any effort in truly furthering inclusion and equity, the onus should not be on the individual.

PEPIN: The open discussion of mental health/illness has really only come to the surface since the wellness liaison program started (Thanks, Ann Marie Pettigrew!), at least in Geophysics. Now we’re at the point where we recognize and value the struggles with mental illness that many students/faculty/staff/postdocs face. Stanford provides many resources, and I think more professors are reaching out to their students to make sure they are okay, not just the research. However, nothing is really being done to fix the source of the problem. We need to ask ourselves: Why do so many people in academia suffer from this? Why are so many people in need of therapy that CAPS can’t keep up with the demand? The ultimate question needs to be, “How do we change the way our system works to 1) prevent mental health problems, and 2) make those who have mental illness feel welcome in this space?” The answer will likely demand changing our views of what makes a scientist valuable.

How does your mental health intersect with your research, your workplace, your field?

Kelsey Foster is a PhD student in Earth System Science who studies the ability of vegetation to take up carbon from the atmosphere and how its ability to do so is changing. She also serves as a 2020-21 peer wellness liaison for her department.

FOSTER: I think my mental health impacts every facet of my life. It’s all interconnected. I’ve learned that the more I prioritize my mental health, the more I am able show up fully for my research and all other areas of my life. It’s important to take these facets of our identities into account because they interact with our science. More recently, the violence against the Asian community has had an impact on me. I often think about why these attacks are happening and how my mom or my relatives could be the subject of this violence, but not me because I am white passing. Making sense of the privilege of being half white and white passing has been on my mind a lot recently. I’m learning how to accept where I am in the present moment and progress in my research as best as I can but it’s not always easy to do.  

PEPIN: Many of the symptoms of anxiety and depression are at odds with life in academia. How can you work 60-80 hours a week when depression makes you tired all the time, lose concentration, and have little-to-no interest in activities you love? How can you publish consistently or ask good questions when anxiety makes you believe that nothing you have done is good enough or that you are a fraud/imposter? I don’t want to portray people with depression/anxiety as helpless beings that can’t do amazing work, because we often do. The issue is that what makes us who we are prevents us from fitting the model of a typical scientist, which makes it hard to feel like we belong in science. It’s a constant battle between the desire to be perfect and the need to be human.

BURTON: I’m not a big fan of generalities, but there’s plenty of research that explores intersections of bipolar disorder and creativity – and creativity is certainly important to me and my love for scientific inquiry. And maybe bipolar disorder can come with certain superhuman abilities – I would never want to experience full-blown mania or the terrors of psychosis again, and I stay on my meds religiously, but do still find myself popping out of bed after 2, 3, 4 hours of sleep, captivated by some sort of gusto and electric eagerness to dive back into the life I left behind a few hours prior.

MEYER: Maintaining my wellness and mental wellbeing is essential to living and working. Research, especially lab and fieldwork, sometimes demands long work hours, which can lead to burnout. I find that maintaining a work-life balance needs constant recalibration, conscious effort, and I still struggle with it. I try to surround myself with people who set boundaries with their work, and to tune out the glorification of overwork.

Why do we need to make space to discuss mental health in the workplace?

Karissa Pepin
Karissa Pepin is a PhD student in Geophysics whose work focuses on the use of interferometric synthetic aperture radar (InSAR) to study Earth’s subsurface response to fluid extraction and injection. She served as a peer wellness liaison for her department from winter 2019 to winter 2021 and as a Graduate Student Advisory Committee representative from spring 2018 to spring 2019.

PEPIN: Even as I write my responses for this story, I struggle with the knowledge that future employers may stumble upon this article and it will negatively affect my job prospects. The fact that this worry exists underscores that we need to be open about mental illness so advisors/employers do not think that its occurrence devalues our potential productivity and/or contributions. It is often the fear of being misunderstood or rejected because of who we are that exacerbates the symptoms of anxiety/depression. We have a long way to go in DEI, but discussions like these make me feel like there is light at the end of the tunnel.

KLEMPERER: We all need accommodations at different times in our lives, for different reasons. We are fortunate to work in departments that are very accepting of temporarily diminished capacities for work, but accommodations can only be made when a need is apparent – the challenge to all of us who are used to being outwardly successful (as who is not who is at Stanford?) is to be willing to express our needs. There is a lot of generosity available for the asking, in spirit and in kind, and I hope my statement that I have both received and offered such generosity will encourage others to seek and offer support.

BURTON: Central to the oft-touted trope “The best geologist is [the one] who has seen the most rocks” is the assumption that diversity is important. I’d have to think that if we want to be better scientists and team leaders, advisors and faculty members, lab mates, and contributors and collaborators in the private sector, academia, and government, we can only benefit from diversity (very broadly defined); the creation of welcoming, inspiring, inclusive spaces; and equitable policies to ensure both influx of new perspectives and access to this field we love. Any scientist who thinks that ideas are important would be a fool not to realize that diverse, equitable, and inclusive environments are more beneficial to ideas – to the pursuit of innovative, impactful science – than homogeneity.

 

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This story is part of the #StanfordEarthCelebrates series hosted by Stanford Earth Diversity, Equity and Inclusion. Continue to read the rest of the collection here. 

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