Mental Health Struggles Are Normal and OK

From an outside perspective, it probably looks like my PhD has gone extremely well. I’m on track to submit in under three years, have had my first peer-reviewed journal article accepted for publication, and, amongst other opportunities, have been invited to share my research with Governments. I often use Twitter to share such achievements, and for most people, that’s all they see: short snapshots and updates on my success. I have never shared any of the struggles. So what most people don’t know is that last year I had days where I could barely leave my bed, as I had no energy or motivation, when going into a crowd or even getting the train would leave me in tears, and when my mental health was in such bad condition that I had to take myself to the hospital.

I want to share my story to let people know that you can get out of a dark place and turn things around. I have been open about my experience with colleagues and was surprised to find out just how many of us have struggled with our mental health during the PhD. If hearing my story will help even one person, then this post will be worthwhile.

I knew going into the PhD that I needed to look after my mental health. I had read blogs and other peoples’ stories, but I naively thought that they didn’t apply to me. I had never struggled with my mental health, had always enjoyed independence, and was confident that I would be fine. However, my struggles began in the second year of my PhD when, due to a complication in my funding, I had to undertake an unpaid part-time placement. The result involved me splitting half my time between London and Cardiff, worrying about money, and constantly living out of a suitcase. In the end, I broke down as I could not cope. I went to the doctors and was diagnosed with stress. I was instructed to take a few weeks off, and I did take some time off, but it’s hard with the time pressure of a PhD. It’s not like most jobs where someone will cover your work while you are away. It’s hard to switch off from a PhD.

I had pretty much recovered from the stress, and my mental health was getting a lot better when my grandmother, who I was extremely close to, passed away. At that time, I was living 4 hours away from my boyfriend and family in a city where I didn’t have many friends, and I lived quite far from campus with two flatmates who would regularly exclude me. One day, it all hit me; I was so sad and lonely and had no one to turn to, as everyone I trusted lived too far away. I had never experienced depressive thoughts before, so I didn’t know what was happening. My thoughts scared me to the point that I went to the hospital. At the hospital, I was diagnosed with reactionary depression, a form of non-chronic depression that occurs as a result of a trigger incident. I was assured that things would get better, and they did. It took time, some days even getting out of bed was hard, but things got better. I had counselling from the university, spent time with my family, and moved back to a city where I had a strong social network .

I’m now at the point where I am genuinely really happy and enjoying my PhD work. I have a far greater understanding of my mental health, I have got through what was possibly the hardest time of my life, and I am prepared for future challenges. The PhD still tests my mental health, with the pressures of writing the thesis alongside publications, conferences and the job market, however I now know how to look after myself. While I was suffering from depression, working on my PhD was extremely challenging, and I was worried that I would fall far behind. However, taking time off re-motivated me, and I have come back to it a lot stronger.

There are a three key things I’ve learned from this experience that I want to share with others:

Mental Health struggles are normal, and it’s ok.

When I was first diagnosed with depression, I felt ashamed and embarrassed. It felt like a weakness. However, I soon realized that it is an illness just like other illnesses that have physical symptoms. Speaking to others about my journey made me realize just how normal it is to struggle with your mental health and how beneficial it is to talk about it. Getting counseling at my university was crucial to my recovery and learning about myself and my mental health.

Put yourself first.

The thing that surprised me most from my counseling sessions was the realization that I never put myself first. I had always put others before myself to the extent that I was not looking out for my own wellbeing. I have learned the importance of learning to say no and to prioritise what I need. I have also learned the importance of treating myself.

The importance of a support network of friends and family.

When I was suffering from depression, I had no close friends nearby. Getting a train to see friends in a nearby city often felt far too difficult. It took the difficult times to make me realize just how isolated and lonely I was. Moving back to a nearby city where I have a large group of friends, events, and sports clubs to go to has made such a difference to my happiness.

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The Mindful Way

Meditation and mindfulness are buzz words nowadays. Be in the moment, stay in the moment, be present, wasn’t I present enough before? As far as I remember, I have been suffering from depression. It didn’t start with my PhD. Graduate school made it worse At the end of my second year, summer 2017, I reached one of my lowest points. I failed my annual review exam, I was breaking up from a difficult and toxic relationship, I had to move out from my old house and move to another lab. The situation was really bad and I was seriously thinking of dropping out from the programme. Despite the anxiety, I was wise enough to reach out to the counselling service at the University and took a break to visit my family in Italy.

At that time, my new housemate who became my new boyfriend after a few weeks, told me about meditation as a way to treat depression. He taught me this technique called transcendental meditation, in which you repeat a word in your mind for 20 minutes. I noticed a quick improvement in my sleeping and breathing but the effect was short. Unfortunately, after all that happened in the first year of my PhD, I had lost all my confidence and passion for my research and I struggling a lot with being focused on the lab activities. I used to blame myself for every single mistake and all the things that went wrong. I struggled to balance my life, being a good student in the lab, having a social life, being a good girlfriend and I wasn’t taking care of myself at all.

I reached out to the counselling service again and I then decided to start taking medication. I was initially on a low dose and after 6 months of taking meds, anxiety was still there and I went back to my initial and depressed state. I decided to double my dose of meds and I have been feeling much better since. Although medication helps in reestablishing serotonin levels in your brain, they aren’t a long term solution. I had no intention to keep increasing my dose and rely on meds forever, I needed a more permanent solution.

Luckily, my social media presence helped me reaching out to loads of brilliant and like-minded people. I am glad of all the conversation about self-care, meditation and mindfulness because all the little things suggested have been making a significant difference in my life.

I started by sticking to a self-care routine which means making myself presentable every morning, go out once a month, making nice meals, reading books and walking a lot. I do yoga 3 times every week and I practise it early in the morning so that I don’t feel the pressure of leaving the lab before 6pm while everyone else is still working.

But the best thing happened recently is reading the book, “The Mindful Way through Depression," a guide through mindful meditation. It taught me to accept my experience present and past no matter how pleasant or unpleasant some situations or feelings can be. It taught me how to breathe with my pain, that the way I feel is the way I feel and this is okay. It taught how not to be judgmental with myself and look at thoughts as mental events rather than being carried away by emotions and sensations triggered by these thoughts. The best part is that you don’t have to stay seated or doing anything special, mindfulness is something you should apply to every activities of your life. Brushing your teeth, walking to work, watching TV, talking to a friend or a stranger, whatever you do, do it with intention and stay present in the moment. Care about it by noticing all emotions, feelings, thoughts and sensation related to a specific action.

Image: “The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness” by Mark Williams, John Teasdale, Zindel Segar, and Jon Kahar-Zinn

Image: “The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness” by Mark Williams, John Teasdale, Zindel Segar, and Jon Kahar-Zinn

Practising meditation every day really improved my mood, I am a lot calmer and focused at work, I enjoy the lab and every moment of my life. I accept and live my experience moment by moment, breath by breath. I was back in Italy for a few days over Christmas and my family was surprised to see how different I was. No longer stressed, snappy, anxious, aggressive, complacent, not fun to be around with. I think of life and my job as a gift, not a burden anymore.

Thanks to all the awesome people who directly or indirectly join this journey starting from Susanna, Prasha, Katherine, the people behind some of my favorite Instagram accounts @ph_d_epression, @herstemstory and @grad_selfcare. All my Instagram friends that despite don’t talk about this are a massive support, my friends in Nottingham and Italy and all those who constantly send me messages of support, because it really means a lot!

To remind yourself of daily self-care try this bookmark. It can be purchased from https://www.etsy.com/shop/PhdToSuccess

Image: Knit bookmark that says “selfcare”

Image: Knit bookmark that says “selfcare”

Dedication - Sara Beck

A story on "Dedication," in two meanings of the word. I couldn't concentrate on writing my dissertation until after first writing this dedication to my late partner of 9 years, fiancé of 5 days. Written in December of 2014.

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To Ed.

When I decided to go to grad school, Ed jumped right in alongside me. We spent Thanksgiving, 2005, in my townhome, studying for the GRE together, taking practice tests in between cooking a massive turkey dinner for two and camping overnight by the fireplace. It was one of my favorite Thanksgiving memories. Ed already had a Master’s degree, but thought he might get another, or else maybe a Ph.D. in medical physics or mechanical engineering. Why not?! Driving home for the holidays that year, we missed a turn somewhere in West Texas, distracted by my vocabulary cards. It gave us an extra hour to cram. Three days before Christmas, we sat side by side at the GRE testing facility. The questions were getting harder and harder and eventually easier, which meant we were getting them wrong. We both seemed to be squirming in our seats, tempted to decline our scores. Ultimately, we did just fine. We tied in math. Ed beat me in verbal and I beat him in the writing.

Georgia Tech

Two weeks later, Jan 2006, I started my Master’s through a Distance Learning Program at Georgia Tech. I’d watch recorded lectures after work and submit my homework by fax. Come exam time, my bosses would proctor my tests and fax them from wherever I happened to be at the time: Johnson Space Center in Houston or the Mission Control Center near Moscow.

            Balancing school with work was challenging, especially during Space Shuttle missions. School interfered with our evenings, as well, but Ed had his own evening schedule: ice hockey on Sunday nights, Crossfit and climbing on Tuesdays and Thursdays, sailing and ultimate on Wednesdays. School interfered with our weekends, as well, and I skipped plenty of climbing trips to Austin or Potrero Chico, Mexico to stay home and study or catch up.

Environmental engineering was also challenging! I had an aerospace and art background so I lacked knowledge in biology and chemistry and had to teach myself concepts I had either forgotten from high school or never learned in college. When I was struggling in my Biological Processes class, in particular, Ed tutored me given what he happened to remember from AP Biology, 17 years earlier. “Ed. How do you know this stuff?” “Eh. I don’t know,” he shrugged “I just remember it.” His knowledge retention was incredible.

After three years of grad school at the slow pace of one class a semester, I took a leave of absence from work to finish. We packed my Toyota Carolla full with a futon mattress, a papasan chair, a bike, and some clothes, and drove to Atlanta where I spent the summer taking my last four classes. My backpack was falling apart at the time so Ed cleaned out his and gave it to me the night before we left; I still use it daily. We Skyped almost every weeknight. He flew out to visit over 4th of July and we met halfway in Alabama for a climbing trip. Three months later, he flew out again and we made the long drive home together.

I didn’t attend my commencement ceremony so when my diploma arrived in the mail, I asked Ed to hand it to me. He downloaded Pomp and Circumstance on his iphone and called my name out loud; I walked across the ‘stage’ that was our living room, in between the couch and the TV, shook his hand, accepted my diploma, and smiled for invisible photographers. I told Ed he had to repeat the ceremony and mispronounce my name in the process. He was wearing boxers at the time, or nothing at all; I honestly cannot remember, but I do remember laughing and thinking “I love this.” I could not imagine a more perfect commencement ceremony.

 

CU Boulder

The following January, 2010, Ed and I were once again on a road trip, this time to move me to Boulder for my doctorate. He planned to join me after the Space Shuttle program ended ten months later. Unfortunately, the final three Shuttle missions were delayed. Ten months became almost two years. His coworkers left the group; he stayed. His coworker had a baby and worked part-time; he stayed a few extra months to make up for her absence.

To keep the long distance relationship going, we Skyped or talked almost daily and visited often. Six weeks was too long, so we made the effort to see each other every 5 weeks, splitting time between Colorado and Houston, or meeting for other events in Orlando, San Francisco, L.A., Germany, or Spain. I watched other grad students lose their long distance relationships, but we managed to make ours work. It was an investment.

“Ok, how long do we have in the bank?” he asked after a particularly perfect weekend together. “What do you mean?” “When should I come visit you before we lose this?”

Ed worked the Space Shuttle program through until its end; we watched the final landing together, side by side, from the bleachers at Kennedy Space Center. A few weeks later, he left NASA and a career he had held for 15 years to join me in Colorado.

In Boulder, Ed supported me even more. He was genuinely interested in my research. Since I study ultraviolet disinfection, he started ordering us UV gadgets for the house: a UV water purifier, UV toothbrush sterilizers he found on sale. When I bought a deuterium lamp for some of my experiments, Ed constructed a wooden lamp housing for it as a fun side project to keep him busy. Once or twice, he joined me in the lab to help count colonies, the last task before a trip to the mountains. He suggested gifts for our lab’s white elephant gift exchange (soaps in the form of Petri dishes with glow-in-the dark bacterial colonies). He proofread some of my grant proposals and scholarship cover letters. He listened to me rehearse my conference presentations and, not only that, but he was able to ask intelligent questions about a subject completely outside of his specialty. Before long, he was also doing work for my advisor, redoing our lab webpage.

            I biked or walked the two miles to campus and Ed often picked me up from the lab late at night or when it was raining or snowing. We always had the same conversation: “Thanks for getting me,” I’d say. “I didn’t for-get you!” he’d respond. Every. Single. Time. The two times I walked home with a flat tire late at night, he surprised me by meeting me halfway to walk me home. He protected me.

Ed also doubled as my IT specialist. He fixed computer problems before I even had them. “Where’s your laptop? I’m upgrading your RAM.” “Hey, I’m gonna upgrade your operating system.” “Hey- I got you a new hard drive” “Hey! I got you a trackball mouse to help with your carpal tunnel.” When my computer screen shattered three days before my preliminary exam, Ed replaced it in a 4-5 hour procedure on the kitchen table. When I thanked him, genuinely, he said “Babe. These are the moments guys live for! To be the hero for the girl.”

            “We’re a team!” we would say, and we meant it, but I often think I got the better deal.

As a grad student, I brought my work home in a way that Ed never did. So many times, he listened to my frustrations and reminded me why I was pursuing this degree. He cheered me on – quite literally – with phrases like “Ra! Ra! Sa! Ra!” or “The future of water everywhere depends on you!” or, my personal favorite: “You’re gonna do great! And don’t let Sara tell you any differently.”

When my friend graduated, we watched her commencement ceremony at Macky Auditorium one December. Ed mocked the announcer who repeated over and over in a strange accent: “Doctor of PHEElosuPHEE civilengineering.” “Doctor of PHEElosuPHEE civilengineering.”

During 8 years of grad school, Ed supported me, without hesitation, in more ways than I could ever imagine or describe. I don’t think I ever adequately thanked him enough nor came close to returning the favor.

Ed died in September of 2013 in a fall at Grand Teton National Park.

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Finishing my doctorate without him by my side proved to be tremendously, tremendously difficult. I had to battle an enormous amount of lethargy and apathy. Who cares about work when your life has been turned upside down with zero warning at the happiest time of your life? Who cares about research when you’ve lost your past, your present, and your future, overnight, in the span of 3 seconds? Who cares about water disinfection when your best friend and life partner was reduced to a ceramic on the kitchen counter next to that UV gadget he once bought you? Who cares about DNA and protein damage when you feel like someone carved out your heart with a butcher knife, shoved it still beating into a blender, and pureed it before repackaging it back in back in your chest cavity? What do you begin to work on when your dining room table is covered in stacks of estate paperwork and decisions you never imagined were possible? How do you write a dissertation when your brain is wound up in one giant knot and simply will not let you concentrate? How do you prioritize something that has fallen several notches on your newfound spectrum of significance? How do you work toward a finish line when every time you envision that finish line without your partner, teammate, and number one supporter, you sob?

I went back to work in November, revised a manuscript, and then got slammed by the holidays and Ed’s birthday. I went back to work in February, conducted an experiment, and then got slammed by the 6-month anniversary of his death, my birthday, and the arrival of Spring. I went back to work in April and then got slammed by the triggers that inevitably came when I had to repeat in the lab every single thing I was doing in the lab the week before he died. I was living in an alternate reality where nothing made sense and nothing was right. And I was forcing myself to work in that alternate reality that everyone else pretended was normal, oblivious to the fact that the world was actually upside down and my pureed heart was actively dripping out of my chest cavity. It was bizarre. And maddening.

I went back to work in May and then got slammed by the arrival of summer. I went back to work in June, finished a manuscript, and then got slammed by the date of the wedding we had planned for our 10-year anniversary. I went back to work in August and then got slammed by the one-year anniversary of his death and a visit to the site of his accident. I went back to work in September, set a defense date, did some experiments, revised a manuscript, escaped to Siberia, wrote non-stop, and defended to a caring committee, an incredibly supportive advisor and a small group of colleagues, friends and family.

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Nine years after Ed and I sat side-by-side taking the GRE together and squirming in our seats, I participated in another December commencement ceremony at Macky Auditorium. This time, the man with the strange accent announced “Doctor of PHEElosuPHEE civilengineering” and pronounced my name – correctly – as I walked across a stage larger than our living room and received my diploma from a fully-clothed man. My advisor, Karl, hooded me, catching my chin in the process, and after eight years of unwavering support, Ed was not there to watch it.

Ed, this degree is as much yours as it is mine. We’re a team! You helped make every single part of it possible and I am indebted to your encouragement, your selflessness, your patience, and your sacrifice as you put your career on hold and moved to another state to support mine. I hate so much that you’re not here to close out this chapter that we started together, to cross the finish line with me, and to start writing the next chapter, as always, side by side. You liked to read books out of order so that you always knew the ending. I wonder if you read your book out of order and if you already knew the ending, and, if so, whether you would have wanted to rewrite any of this chapter. I miss you, my love.

 

 Ra! Ra! Sa! Ra! The future of water everywhere depends on me.

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