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Welcome to a special episode of PhD Career stories. Our guests today are Yorick Peterse and Maria Eichel, whom we met at this year’s Max Planck Symposium for Alumni and Early Career Researchers (#MPSAECR) in Berlin, Germany. At this symposium, Maria and Yorick conducted a workshop on Mental Health and also wrote an article about it on the blog of the Max Planck PhDnet entitled The Mental Health of PhD Candidates.
Today, Maria and Yorick will tell us how “normal” it is to encounter mental health challenges during a PhD, which sounds rightfully alarming. There are numerous preventive and coping measures that can ease the situation. Some of these lie in your own hands, some are – and should be – offered to you by the research institution.
M Lisa, (Nov 2017) […] for better Graduate Student Mental Health. Academic Mental Health Collective
P Yorick, (Oct 2017) The Mental Health of PhD Candidates. Max Planck PhDnet
A Teresa, (Oct 2017) When the going gets tough, let me counsel you to seek counselling. phdlife.warwick.ac.uk
P Kate, (July 2017) Is it still taboo to take a mental health sick day? BBC News
L Katja et al, (May 2017) Work organization and mental health problems in PhD students. Research Policy 46(4) 868-879, doi.org/10.1016/j.respol.2017.02.008
Yorick: I’m Yorick Peterse and I was a PhD at the Max Planck Institute of Psychiatry in Munich (Germany). Together with Maria – maybe you should introduce yourself first?
Maria: I’m Maria Eichel from the Max Planck Institute of Experimental Medicine and I’m still a doctoral student. I joined the (MPSAECR) event to meet new people, network and conduct this workshop about mental health.
Yorick: We wanted to propose a workshop about mental health work conditions and communication about mental health for this meeting. It’s been covered a lot in the media recently, the mental health conditions of PhD students and in academia in general. It’s an issue that is not discussed openly enough. Of course I work in psychiatry, so I have a bias towards this, but it’s really a problem. Speaking about mental health in general, it is not just for PhDs but for any type of employee or for any individual. We do not communicate openly enough about it in my opinion.
We just had a workshop about it with 12 individuals. They were interested in the topic and they probably know more about it than people in the general population. But most people don’t even know that one in three people – and that’s actually a conservative estimate – are affected by a mental health disorder in their life. This means that they are actually diagnosed with a psychiatric disorder. A lot more people are suffering from mental health issues which does not immediately mean that they are diagnosed, that they have a real illness.
Also, mental health disorders are increasingly causing a higher burden. The morbidity of suffering from a mental health illness is very high. It causes high disability rates which means that there is a high economic cost. People cannot work effectively or at all. For instance in the US, it costs around 200 billion dollars a year of direct treatment costs, in direct loss of productivity in the economy.
When you talk about mental health, a lot of people immediately think about depression. Just for the record, depression is not one disorder. There is major depressive disorder, bipolar disorder and unipolar depression. This is of course a very known example. There are also a wide range of anxiety disorders. Schizophrenia. Eating disorders. Substance abuse. Alcoholism is a widely spread disorder, which is not often enough recognized I would say.
If you speak about mental health in a work setting or in a PhD life setting, it’s more related to depression and anxiety because these kinds of disorders are stress-related. We know there is a relationship between the stress system, the stress hormone, the effect of this on the brain, which results in increased incidence and prevalence of psychiatric disorders. For PhDs, there is a recent study from Belgium (Levecque et al, 2017) which was really specific for PhD students. There have been previous studies for academia in general, or high schools. They found that 51% of PhD students have experienced at least two symptoms of mental health issues. It doesn’t immediately mean that it’s a huge problem. Mental suffering is normal. It gets more severe when you find that 40% have three different symptoms.
Jo: Can you give some examples?
Yorick: Yes, we’re talking about not being able to relax, having sleep deprivation because of worries related to work, not being able to enjoy the things that you normally enjoy, or feeling depressed. All those kinds of things. When you have four or more of those symptoms, you really have an increased likelihood of developing any psychiatric disorder. In this case, more likely depression or anxiety.
If 32% of PhD students match the criterion of having four or more of these symptoms, it’s the equivalent of the lifetime prevalence of having any psychiatric disorder. Just in a period of three or four years you have already reached this increased risk, which is quite striking I would say.
If you look at factors that people experience as stressful, it’s mainly work-family conflicts, high job demands, like having a high workload or having to work in the weekend or the evening, having to work huge numbers of hours or not being able to go on holiday. Family-work conflicts are the reverse. Job control, as a PhD student you’re usually not independent. You’re dependent on your supervisor and team, your institute, financing agency and so on. Leadership style. I think it’s a very common problem that managers are scientists. I think it’s almost self-explanatory that a good scientist doesn’t necessarily make a good manager. Often, they’re not very well trained in this.
Maria: That’s also something that really popped out during the workshop. The leadership problem and the supervision, that it’s really bad. Often, the situation is that the PhD students are in big laboratories with 10-15-20 students supervised by one group leader. It’s just really bad supervision and this of course goes with bad leadership style. That’s a huge factor.
Yorick: Yes, at least for the participants in our workshop. An interesting thing about this (Belgian) study was that they compared PhD students with people with an equivalent level of education, so people who did not go on to do a PhD but started working for a company. People were highly educated within society in general and also higher education students. They found that compared to people with the same education level in the general population or who had a highly demanding job, PhD students still have 2.4-2.8 (times) higher occurrence of psychiatric symptoms, so it’s not necessarily a disorder but symptoms. So there’s something specific about doing a PhD that causes even more stress than being highly educated and therefore maybe a more demanding type of job.
Let’s not go through the entire workshop, but one of the issues that we wanted to address is the importance of communicating about mental health. For instance by doing awareness month, a phenomenon in the UK and the US which is increasingly adopted in other countries. It’s not just focused on mental health. You have the LGBT awareness or LGBT history awareness month, black history month, women’s awareness week or month and you also have the mental health awareness month. It’s important that media and universities, companies and high schools focus on this topic for a while, so that people are exposed to the fact that this problem exists. We don’t talk about it very much, but it is important. Like I said, one in three people are affected by psychiatric disorders. People don’t know that, they might think that they are the only one.
Jo: Are there any best practices how to not let it occur so easily? Are there other institutes that you’ve heard of that have implemented activities or services?
Maria: There are actually some MPIs (Max Planck Institutes), not many, maybe two or three, that have implemented really good workshops on stress reduction. They offer massage, back pain training and other activities. There’s one Max Planck Institute in Düsseldorf that does a lot of seminars on this. They have an initiative within the MPS (Max Planck Society) which is called BGM, Betriebliche Gesundheitsförderung und -management (en: Workplace health promotion and management). They recently talked about including mental health and not only physical health into these topics. There are a lot of interesting things going on. They are discussing (whether there should be) psychologists in the institute or in regions where there are a lot of institutes. They are also talking about leadership courses, that the group leaders, directors and institute doctors are trained to handle these topics.
There’s one thing that was initiated this year. The (german) health insurance company Techniker Krankenkasse is paying for stress relief courses in each institute. You just have to get in contact with them. This is being organized within the BGM and the institute’s employees can get stress relief courses. It’s the first measure towards doing something. It’s important to communicate that there are opportunities to do these things and also include it in the journal Max Planck Research.
It’s why we did this workshop, because we both help out with The Offspring Magazine, which is a magazine from the Max Planck PhDnet. We are focusing especially on the awareness month, which gave us the idea of this workshop focused on mental health. We wanted to get alumni into the workshop speaking about their experiences, giving advice and suggestions to early-career researchers on how to handle and tackle this problem. We wanted to have best- and worst-case examples.
Yorick: Yes, it was an interactive workshop. People discussed in smaller groups and identified factors that were stressful to them during their PhD period. Like the lack of funding or secured funding, bad supervision and isolation in people who came as new students from abroad or even a different region within the country.
Maria: We have also seen that there are differences among the institutes. For instance in my institute, we have close relationships among the PhDs. We have monthly brunch clubs. You get a feeling and a community that you can grow with and rely on. Other institutes have a buddy system for the first month. If you come from a different culture or are new to the institute as a PhD, you get an (experienced) PhD who will help you get along. Then you have a first contact person. It’s important not to isolate yourself from society or community, because there are other people going through the same things as you.
Yorick: Yes, people came up with concrete ideas. Social isolation was one factor. If you come as an international student to Germany and encounter psychological problems, maybe you would like to have counseling. You might then run into the problem of not being able to find someone who can communicate with you in your language. Already finding someone who’s an English-speaking psychotherapist is difficult. But it’s not that hard to have a list in an institute where people can find psychologists that can work with people in a foreign language, whether it’s English, Polish or Languages from countries where a lot of foreign PhD students come from.
Another aspect was reducing the number of PhD students per supervisor; having a cap (maximum number) on this. Providing leadership courses was mentioned. Also, collecting data, we need to know how big this problem is in the Max Planck Society and elsewhere. Creating more awareness.
Jo: If you think that there’s one or two PhD students in the audience, among the listeners, who are currently struggling with mental health issues, is there anything you can suggest to them?
Yorick: Be open about it, which doesn’t mean that you have to run to your supervisor and say that you’re feeling depressed. But you do need to indicate that because of the stress you’re experiencing at or outside of work, it’s not going well with you. You need to find help. It doesn’t have to go through your employer although it’s important that conditions improve in the academic and professional world in general. But if you’re urgently not feeling well, get help and make sure you find a reliable psychotherapist that you feel comfortable with.
Maria: That’s also why we did the workshop. The most important thing for us is communication and creating awareness, so that the burden to talk to other people – friends, family, employers, maybe even your boss if you have a good relationship – decreases. It’s not bad, it’s not a problem if you can’t sleep because of stress and you’re unhappy. There’s nothing wrong with you.
Jo: As you mentioned, the statistics show that there’s quite a number of people actually going through this. There’s nothing to be ashamed of. It’s still a society stigma, but we’re working on it.
Maria: The best-case example that we presented was with this woman who wrote an email to the whole group where she wrote that she had to take two days off to focus on her mental health. The reaction of her boss was that they were really happy that she told them about it. That’s the way we hope these things will go on in the future.
Jo: Excellent! Thank you so much for sharing this with our listeners.
Welcome back to our next episode. In the meantime, feel free to share your experiences. We’re happy to hear from you on our social channels. You can also submit your own story to share with the global PhD community.