In recognition of Mental Illness Awareness Week (MIAW), GradHacker will be publishing articles on Graduate Students' Mental Health all this week. Want to join the conversation? Comment below or tweet using #ghmiaw.
Editorial Comment: This article was originally published on September 2, 2013 on Nash Turley's blog and is republished here in its entirety. Nash Turley is a Guest Author at GradHacker who is currently a PhD Candidate studying evolutionary ecology at the University of Toronto. You can follow Nash on twitter at @NashTurley and on his blog at nashturley.org.
There is an abundance of comics and writings online that poke fun at the tortured graduate students, anxious and overwhelmed, complaining about grading and research and the next frightful meeting with their advisor (e.g. PhD comics and this recent buzzfeed post). Graduate students consume and propagate these memes because, oh! how we can relate, and oh! how easy it is to make fun of people with emotional problems. And those outside the graduate school loop seem confused why grad students are so sensitive and mentally unstable. As these ideas migrate across the Internet and across our hallways I worry our collective community is masking its real concerns about mental health behind laughter.
Undergraduate and graduate students alike often suffer from anxiety, depression, and other mental health issues (1, 2). Many students move to new cities or countries to start their degree and thus lack social connections and support, commonly feel overwhelmed by teaching and research loads, and often have persistent fears of failure and inadequacy. These and other causes can lead to anxiety and depression that drain students’ creativity and motivation. In one study of over 3,000 international graduate students, 44% said they had mental health issues that “significantly affected their well-being or academic performance” (3). In addition, these can lead to graver health concerns, most dramatically suicide, which, among college students across 10 universities, was found to be highest among graduate students (4).
From these studies and my personal experiences and observations, I think that mental health issues are the biggest barriers to success among graduate students.
Graduate departments are supposed to provide resources to help their students succeed, but what do graduate programs offer to prevent or deal with mental health problems? It seems typically little to none. Most universities offer counseling programs that can be helpful but this is a reactionary solution, an approach that patches leaks in an already damaged vessel. What can graduate programs do to help create robust fleets that can successfully navigate the perilous waters of graduate school? There surely are many ways to work towards achieving this goal, but here are some suggestions:
Graduate departments need to openly acknowledge the problem. If mental health issues are barriers to success then this should be a prominent topic in grad student orientations, student handbooks, initial meetings with advisors, and other places. It needs to be clear that departments recognize this as an important concern. Mental health issues are often poorly understood and stigmatized, both of which can prevent people from seeking help when they desperately need it. For example, when someone is seriously physically injured they typically seek immediate help, but that same person suffering terribly from depression or anxiety may not seek any help because of denial that they have a serious issue or because they are ashamed. These are large and complicated problems that have roots in the way our societies as a whole perceive mental health, but the simplest first step to addressing them is making mental health part of the conversation in our academic communities.
Academic advisors should receive training on preventing, recognizing, and addressing mental health issues in their students (and themselves too!).Professors often don’t receive much, or any, training on being mentors or supervisors, which can leave them ill prepared in guiding their students towards success. The primary and most clearly articulated role of an advisor is to provide assistance and guidance in purely academic endeavors: understanding concepts, shaping ideas, teaching technical details of research, writing, etc. However, a greatly under-appreciated role of effective advisors is to provide psychological support, guidance, and assistance to students who are often working through some of the most difficult periods in their lives, both personally and professionally. The amount of involvement advisors have in the personal lives of students is a matter of choice, but if they choose not to take an active role in helping students with mental health issues they at least need to know how to recognize problems and have resources to point students toward.
Graduate programs should offer (or even require) courses or workshops that teach yoga and mindfulness techniques. Yoga and mindfulness provide concrete techniques to promote mental health. This is not just a personal anecdote (although, it is that as well) but also rather something supported very robustly by decades of research. Take this study with 28 young men and women (mostly students) who were experiencing symptoms of anxiety and depression. Half of them took two one-hour yoga classes a week for five weeks. After five weeks the treatment group had a 70% reduction in symptoms of depression and a 20% reduction in anxiety. There were no clear changes in the control group (5). The physical health benefits of yoga are very robust and supported in a review of over 80 studies (6); the mental health benefits of yoga specifically are less studied but reviews on both depression (7) and anxiety (8) suggest general support for effectiveness of yoga as a treatment.
The positive effects of mindfulness (AKA meditation) on mental health are well studied and strongly supported. A meta-analysis of 20 studies found a positive effect size of around 0.5 for both mental and physical health (9). That means that groups partaking in mindfulness treatments had 0.5 standard deviation units higher scores for health metrics. Another meta-analysis of seven randomized controlled studies showed that mindfulness treatments reduced stress by 1.4 standard deviations (10). That’s quite large for a standardized effect size! (Yet another meta-analysis from 2010 found similar results (11)).
In most university environments there are already places where students can receive training in yoga and mindfulness, often on campus even. This is great. However, availability is not enough, departments need to commit to making these services available and actively encourage students to participate. Courses could be arranged that are offered to graduate students and could even be taken for credit. Workshops could also be arranged with invited instructors that are highly encouraged or even required. Finally, if only private courses and workshops (i.e. not free) are available then departments could offer full or partial compensation for students taking them.
These are just some suggestions, and I am sure there are many other potentially promising options. Another that comes to mind is encouraging or requiring students to visits with a student counselor once or twice during the course of a graduate degree, just as a check-in to see how they are doing and if they are potentially suffering any mental health issues that they themselves may not be aware of.
Alright, some final words: in academia, and throughout our societies, mental health issues drift around like a light fog, ever present, clearly a bit pesky, but easily ignored. The haze can become particularly thick for graduate students as we climb our way upwards in our research and our careers. But perhaps it is time for a stout breeze, leaving a fresh new atmosphere in its place. An air where we can openly acknowledge that mental health is an issue to be dealt with. Perhaps with this increased visibility we can see and be open to new solutions to old problems.
What resources have you found helpful in improving your mental health? What helps? What hinders? Leave your thoughts in the comments below.
[Image used with permission from the author.]References
1. Bayram N, Bilgel N (2008) The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric Epidemiology.
2. Dyrbye LN, Thomas MR, Shanafelt TD (2006) Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Academic Medicine.
3. Hyun J, Quinn B, Madon T, Lustig S (2007) Mental health need, awareness, and use of counseling services among international graduate students. Journal of American College Health.
4. Silverman MM, Meyer PM, Sloane F (1997) The Big Ten Student Suicide Study: A 10‐Year Study of Suicides on Midwestern University Campuses. Suicide and Life-Threatening Behavior.
5. Woolery A, Myers H, Sternlieb B, Zeltzer L (2004) A yoga intervention for young adults with elevated symptoms of depression. Alternative therapies in health and medicine. 10:60–63.
6. Ross A, Thomas S (2010) The health benefits of yoga and exercise: a review of comparison studies. Journal Alternative Complement Medicine. 16:3–12.
7. Pilkington K, Kirkwood G, Rampes H (2005) Yoga for depression: the research evidence. Journal of affective disorders.
8. Kirkwood G, Rampes H, Tuffrey V (2005) Yoga for anxiety: a systematic review of the research evidence. British Journal of Sports Medicine.
9. Grossman P, Niemann L, Schmidt S, Walach H (2004) Mindfulness-based stress reduction and health benefits. Journal of Psychosomatic Research. 57:35–43.
10. Chiesa A, Serretti A (2009) Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. Journal Alternative Complementary Medicine. 15:593–600.
11. Hofmann SG, Sawyer AT, Witt AA, Oh D (2010) The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology. 78:169–183.