I thought long and hard about whether or not to write this post. Certainly others have already written about the subject far more eloquently than I ever could [See here, here, and here]. And there are no shortage of news articles about the “rising mental health crisis” in academia, which you can read here, here, or here. Furthermore, I’m no expert in the field of medicine or psychology. But I realized as I was talking with my students the other day that there is still a major stigma against mental health in the world at-large, especially in academia. Those in academia, whether students or faculty, often feel that if they suffer from some sort of mental health related issue—whether temporary or a permanent part of their life—that it means they’re weak or “not cut out” for the demands of academia or that they’ll never “make it.” So I’m not going to wax philosophical about large-scale solutions or attempt to “fix” the issue in this post. But I want to contribute to the conversation as we seek solutions by offering my own personal experiences and maybe suggest some starting points.
Often when we talk about mental health, we do so as if it is entirely separate from our physical health [further stigmatizing it in many ways]. But the reality is, our mental health is intricately tied to our physical health—whether our mental health impacts our physical health or vice versa. Just yesterday, a student of mine developed sudden onset chest pain and collapsed before being rushed to the emergency room. Knowing this student as I do and based upon our many conversations regarding school, work, and life responsibilities, I have no doubt that this was a physical response to an often hidden, internal war we rage with ourselves. I know it because I suffer from that internal battle myself.
My First Diagnosis
I have always been something of a perfectionist. I’m notorious for editing my papers as I write them (which, I’ve been told, is absolutely terrible for productivity), for reading over emails ten times before I send them or having legitimate mini-panic attacks if I find an error, and for berating myself for never being productive enough. Mental health issues run in my family: ranging from severe clinical depression to anger management issues to opioid dependency to general anxiety disorder. So it wasn’t a surprise to my mom when, at the tender age of 13, I was diagnosed with clinical depression and general anxiety disorder. I was treated with a barrage of medications as doctors sought one, or any combination, that would “even out” my hormones, serotonin levels, or mood/emotion neurotransmitters. I tried Prozac (which increased my suicidal thoughts), Wellbutrin (which caused my 105 lb frame to lose nearly 15 lbs in less than a month), Lexapro, Zoloft, Celexa, Cymbalta (which worked for a short time), and Effexor, just to name a few. Nothing seemed to “work.” In spite of this, by all accounts I appeared “normal.” I was an active kid who played on the soccer team and was a (albeit “nerdy” and “unpopular”) cheerleader and played softball. I had friends and I took AP classes and was in honors programs. But I suffered from severely low self-esteem and took to self-harm in the form of cutting from the age of 15 until 20. When my mom found out, I just found new ways to hide it. Cutting was the only thing in my life I felt like I had control over.
When I went to college, I decided to quit trying new antidepressants and did my best to manage my mental health issues on my own. That really meant that I tried to suppress them as I took course overloads nearly every semester of 18-21 credits while working part time and trying to maintain some semblance of a social life. I suffered from frequent headaches (sometimes to the point of migraines), neck pain, back spasms and pain, dehydration, irregular sleeping patterns, anemia, and poor eating habits (affecting my energy, which often felt non-existent). I was ALWAYS tired. Even though I tried working out or being active to help counter some of these issues, every time I was the least bit active, it felt like my heart was going to explode out of my chest. I generally attributed those feelings to the asthma I had been diagnosed with as a child, but my inhaler was no longer effective in treating the symptoms. So I became less active, which freed up time for my academic work, but did nothing to improve my physical (or mental) well-being. I wanted to be the woman who did it all. I wanted the 4.0 GPA and stellar recommendations and perfect hair and a fit physique and beautiful handwriting and to be artistic and adventurous and travel and publish, etc.
My friends in college were supportive and we helped each other through those struggles. Having that safety net, I think, was one of the major contributors to my sanity during those years. So when I graduated a year early and had the choice of staying at the same college for grad school or going to another local college nearly 3 hours away, I stayed so that I could stay with my friends while they finished their degrees. I couldn’t bring myself to leave that sense of security. And while in grad school, I made new friends in that program who filled the void when my undergraduate friends all graduated and left. I coped with my mental health issues in my Master’s program by consuming copious amounts of coffee (I’m talking, quite literally, 12-18 cups a day), binge drinking, and developing unhealthy attachments to my significant others at the time. Looking back on those days, I appeared like a disaster waiting to happen. I clearly couldn’t “do it all” and I clearly wasn’t actually addressing my mental health issues. A total breakdown seemed inevitable. I am fortunate that such a breakdown never came to pass and I’m still not quite sure how I avoided that scenario as I headed into the PhD program.
While in my PhD program, I really had to come to terms with the fact that I hadn’t been successfully coping with my mental health problems at all and that if I didn’t make some sort of change, I would be bound for collapse. Unlike the MA program, which allowed a high level of sociability, I found the PhD program to be much more isolating. Not only had I moved a solid 8 hours away from my friends and family in North Carolina, but this time I had no roommate, no significant other, and no real connection to the area. I made friends in the program, to be sure, but it wasn’t the same. I think part of that is because we knew that as colleagues at this level, we were—in many ways—in competition with each other. Competing for fellowships and research grants and travel awards and conference slots and the best classes to teach as part of our assistantships and publishing opportunities. And I’ve found that academia—especially the humanities—can be an isolating place. Unlike some fields, collaboration still feels fairly taboo and viewed with skepticism within the field of history. Even outside of graduate school, the competition for ever-dwindling resources causes many to keep their peers at arm’s length. And bringing up any perceivable “weakness” like mental health problems felt like putting a target on your chest. The same things I’d struggled with earlier carried over to the PhD program: headaches, general body pain, nerve sensitivity, poor sleep, lack of energy, frequent illness, etc.
It was while I was in the PhD program, though, that I met my husband. He wasn’t in academia and he provided me with an outside perspective and clarity that forced me to really reflect on what I’d been doing to myself for the last several years. He recognized that I was running myself into the ground and that it was affecting me physically. My husband encouraged me to take frequent breaks, would remind me to eat and to drink water and to reduce my coffee intake, and tried to keep me from staying up to all hours of the night working. I wish I could say that I managed to turn everything around immediately; that marriage was my cure. But the fact is, that’s not how this works. I’m still a work-in-progress. But in meeting him, I’ve made some important discoveries about my mental and physical health that may help me learn how to more effectively manage my own issues and maybe help my students find ways to address their own. Because there is no one-size-fits-all approach.
The first major breakthrough was the fact that some of my physical issues were the result—not of asthma—but of an undiagnosed heart condition (that took 2 years, countless stress tests, 3 echocardiograms, a Holter Monitor, 1 transesophageal echocardiogram, and 4 cardiologists to discover) called Ventricular Septal Defect. Knowing the issue and finding treatments to address the symptoms has helped me to regain some activity in my life. I know, now, that I have to limit my cardio exercise (so I save it for hiking) and can focus on things like strength training and yoga in my general day-to-day. Additionally, I can no longer have the excessive amount of caffeine I once consumed in my younger years. I’m sure that my 12-18 cups of coffee a day in grad school really took a toll on my heart health and I potentially put myself in a very dangerous position without realizing it at the time. Finding the energy to be active is still difficult and I often use my lack of “free” time as an excuse to not be physically active. But yoga is having some small therapeutic effects on my mental health.
The second major breakthrough was when my current physician diagnosed me not as having clinical depression with general anxiety disorder, but as having Biopolar II disorder. The treatment process is different for Bipolar II and there are new options for me to consider in consultation with my physician. The tricky part is recognizing when I’ve slipped from my personal “normal” into a hypomanic episode or a state of depression. My husband can clearly tell when I’m in a hypomanic episode because I exude confidence, express a more positive outlook, and often have difficulty focusing because I jump from task-to-task much like someone with an attention deficit disorder. Those episodes are easier to recognize and often last for a very short amount of time. The more difficult to ascertain is when I’ve slipped into a state of depression, because it tends to resemble my personal “normal” initially. But I begin to realize when I’m in one of these states because my thoughts become more negative, my self-esteem drops, I lack the desire to do basic tasks (like showering, putting makeup on, brushing my teeth, or even moving my body at all), and I become even more tired than usual. When I thought I suffered simply from clinical depression, I couldn’t understand why I couldn’t just always feel as good as I did in what I now know was a hypomanic episode. I would beat myself up for not being able to maintain those positive emotions and outlook.
Whenever I meet my students for the first time each semester, I always include these 2 facts in my “introduction.” Several people have expressed to me that they think this is a bad idea because it makes me vulnerable, whether to attacks or manipulations from students or to repercussions from the administration where I work. I’m aware of the risks associated with being open and honest about my diagnoses. That it’s too personal. Certainly my personal life and details are still mine and I don’t “overshare” with my students. They don’t need to know that I cried in the shower for 45 minutes last night for no real reason. But I find that most of my students develop a new sense of respect for me as a result of my honesty about my general diagnoses because so many of them are struggling with their own mental and physical health issues. And when you know you aren’t alone, or that there’s someone who has managed to achieve success in various aspects of life, it provides a sense of hope that they can do it too. It has led to several students feeling comfortable enough to share with me their own struggles and I can point them in the direction of local or campus resources that can help them. Because too often they are either unaware of or afraid to seek out those resources. But with support, they’re more likely to take advantage of what’s available to them. And hopefully this means they’ll be less likely to suffer physical/mental breakdowns, fail classes, or drop out entirely.
There are still things that I struggle with in terms of finding “balance,” in my work and life, especially when I’m feeling particularly isolated in my new location and job. I still have trouble sleeping (but my two loveable Boxers try to help with the best puppy cuddles ever). I don’t eat as well as I should (Repeat after me: cheese is not a food group). And sometimes I forget to eat entirely or I overeat. I often have to force myself to be active (paying for a yoga membership helps) and schedule time to call friends and family (a huge shout out to those friends and family that stick with me, even when I feel like the world’s worst at keeping in touch). Although I try to stick to a sleep schedule, I end up working 16+ hour days and sleep too long in the mornings. I feel immense guilt if I don’t finish something right away or if I don’t spend ALL day working. I tend to answer my email immediately and at any time if I’m awake, even on weekends. And I overextend myself with commitments to committees and volunteer opportunities and conferences and projects. But I’m taking baby steps. And hopefully I’ll get better at saying “no” to things that matter less so I can start saying “yes” to things that matter most. Some of the things I’m trying to implement (some more successfully than others):
- Eating breakfast
- Drinking enough water
- Not answering emails after 8pm during the week unless it’s an emergency
- Limiting my answering of emails on weekends
- Attempting social media-free weekends
- Doing yoga at least 3 times a week
- Creating a schedule to set time specifically for class-related work, research, and committee responsibilities to prevent too much emphasis in one area
- Reducing my commitments
- Allowing myself some down time each evening without guilt
Hopefully in time these will become habits, not just attempts. In the world of academia where I feel a constant sense of competition, grapple with imposter syndrome, and have an overwhelming schedule, it’s even more important for me to recognize the limits of my mental and physical well-being and to not overextend myself. And I want to encourage my colleagues and my students to develop self-awareness and set their own limits. Until we can talk more openly about our struggles without fear of repercussion or admonishment or shame, I worry more of my students and colleagues will find themselves on the verge of mental and physical breakdowns.
Enjoy this picture of my dogs and one of my attempt at sociability with colleagues for a belated Galentine’s Night: