Opening the Dialogue on Mental Health in Grad School for MIAW

Inside Higher Ed's GradHacker blog posted about mental health yesterday in response to Mental Illness Awareness Week (MIAW).  Turley, who posted the blog, stated,

"I think that mental health issues are the biggest barriers to success among graduate students."

I have to agree.  I've stated on here numerous times that by the time we get to grad school, we are pretty much intellectually equal.  Time management and stress-management are the areas which either sink us or let us have success.  This is particularly true in times of high-stress such as comps!

I thought the post was well-done and brought up some important suggestions worthy of review.  And, since it is, MIAW and a large portion of this blog is devoted to helping those dealing with mental illness in graduate school, I thought I would tie this all together with a post about dialogue.

The suggestions Inside Higher Ed offered were mainly about dialogue.  I think this is an important point of note.  Why?  Well, as I posted about in "How to Talk to People with Mental Illness", a large part of the "puzzle" of "dealing" with the problems associated with mental illness are associated with stigma and a lack of awareness about resources.  I have been very open with my own struggles with bipolar disorder and how it has been the biggest challenge I have faced in grad school.  I have tried to show that most people deal with mental illness or face hardships associated with stress or anxiety in grad school whether it be prior to comps or specifically during the comps process.  Likewise, because I am a survivor of sexual assault and have also tried to be open about this, I have talked about the importance of being aware of the process of dealing with survivors and what comes "next" in the process of healing.  Most importantly, I have tried to open the dialogue on here and twitter in hopes that people would realize they aren't alone.  This was my most popular post this year.

I think people are starting to become aware on the blogosphere and on twitter of the reality of how prevalent mental illness is in grad school.  As I've said before, it's rather important to put this all into perspective.  I can think of few people who haven't seen a counselor.  And, in my opinion, most people who haven't seen one here, probably could have benefitted from seeing one at one time or another.  Whether it is just a "rough patch" or a legitimate disorder that needs to be diagnosed, the "treatment" is the same.  Thus, it doesn't matter what we call it.  Everybody's got something.  That's a thing I think we should emphasize.  While I deal with sometimes unique situations due to OCD, PTSD, and bipolar disorder, most of what I have been through is pretty relatable and standard grad school "fare" that is associated with stress and anxiety that MOST will experience in their time here.

That's why the GradHacker article is a good one, I think. It recommends three things:

1. "Graduate departments need to openly acknowledge the problem."2. "Academic advisors should receive training on preventing, recognizing, and addressing mental health issues in their students (and themselves too!)."3. "Graduate programs should offer (or even require) courses or workshops that teach yoga and mindfulness techniques."

Starting with number 1, I agree.  My department is not awful about this but there have been teachable moments here that I think have gone undiscussed.  In two instances, a grad student basically was a danger to themselves and another person.  I was the target of such a situation when a student basically became obsessed with me, stalked me, and then threatened to hurt themselves when I refused to help them do their homework. The student was eventually asked to leave the program for poor performance and the DGS reached out to this person.  He was more than helpful suggesting resources but the student either did not pursue them or did not get the preferred results.  In another instance, another student stalked a fellow cohort member, was a danger to herself, and the DGS admitted to WALKING her over to a hold.  Again, good for him.  He does look out for us.  However, in both instances, no more further discussion was called for.  These were moments the administration of the department could have used to bring us together, offer up resources, and possibly bring in a person from mental health to have a more open discussion.  Still, at least the administration hasn't ignored the problem here and is more than willing to LISTEN and help.  That's huge.

Number 2 is something I feel strongly about as a future academic and as a current grad student.  I do not doubt that my advisor is one of the best ones here as far as helping with this problem.  As I posted here, she has taken a personal interest in the unique problems facing female students trying to balance it all - school, life, and society's conflicting expectations. If I went to her looking for resources, I bet she would be able to help and would actively try.  However, I know others have not received the same level of support from other advisors or in other departments.  When a guy I was dating awhile ago admitted that the lack of sleep due to terrible lab hours was making him feel completely out of touch with reality, his advisor basically told him to suck it up.  We've talked since he graduated and got a job with a much better work-life-balance and he said that the last year here was the worst year of his life thus far.  The strangeness of being in a foreign country, having no time to even sleep or eat, and having no friends took its toll.  He now sees a therapist and is feeling much better.

I have talked about the need to be aware of resources for both general stress and anxiety and for sexual assault crisis.  We are faced with problems that our students bring us even as grad students.  I make myself aware of the mental health and counseling resources on campus as well as the sexual assault crisis resources.  This particular school has EXCELLENT resources.  If I was advising grad students in the first semester of grad school or teaching an introductory seminar, I would like start that first seminar or meeting off with a general overview of what stress is like in grad school, that it is "the norm" and that how you deal with it is what matters.  I wish more people did this.  The more open we are about the problem - not just in closed-door settings - the more likely we are to solve the problem.

In regards to number 3, I agree with the idea of offering mental health seminars or cohort meetings for first year grad students.  This is proactive.  If a counselor was brought in once every other week for drop-in meetings and open discussions with a cohort in a conference room somewhere, good techniques could be gained in dealing with stress and anxiety.  Likewise, students would not feel as isolated.  Eventually, if you manage to get through semester one, you will realize that everyone is dealing with the same damn thing.  But you have to get there first!

The counseling and mental health centers on campus offer a variety of stress-mangement, sexaul assault recovery, and mindfulness resorces here that I think are very valuable.  However, few are grad-student specific.  Because I am aware of stigma and the perceptions of undergraduates as well as my age, I am reluctant to join any group that is not grad-student specific. It would be a conflict of interest to have a student or future student in there.  But hey, at least some grad-specific things exist and there are sexual assault survivor groups, which is more than I can say for my undergraduate school.  And, there, everything cost a lot of money.  Here, 90% of these resources are free and if they aren't, they take insurance.  Indiana did not take any form of insurance, which was a huge barrier to poor grad students seeking treatment, I'm sure.

All in all, I look forward to having more dialogue on this blog in the future (in the comments) and on twitter.

Big takeaways that I think we should focus on is that we need to provide resources to students before things get hairy.  Provide the resources to deal with stress and anxiety first rather than just react to the problem.  And as future academics or current academics, we should be aware of what resources are available and work actively to smash stigma.

General Tips For Passing Comps and Saving Your Sanity

So, I passed my comps.  I did so with surprisingly little fanfare on behalf of my bipolar disorder or OCD - two things that have, typically, made me feel shitty for every finals week in history minus the last two.  Comps is the juncture when most of my friends have ended up seeing a therapist and shrink and/or getting put on meds.  I fared ok, though, thanks to their advice.  Had I not had an immense amount of support from my family, friends, and therapist, I would have been fucked.

I think our department, historically, is pretty open with advice and support of those of us suffering through this exercise.  It's not seen as a competition between members of cohort or a cutthroat situation.  We all help one another.

But, not every department is similar.  And not every situation works out this way.  The cohorts before mine were rather large and studied together.  My cohort has 4 people - only 2 of which were taking comps this time around.  So, we were really too small to do anything together.  It felt lonely but I made my own support network and worked it.

Here are some general tips that may be helpful...

1. It's a marathon and not a sprint.  There is a good reason for this.  I had all summer to study.  In reality, you can probably take a month off of everything and study your ass off and pass but you will lose your life and mind in the process.  Make it easy on yourself, give yourself time to adjust, give yourself time to get confident and feel comfortable rather than cram.

2. You can't read everything or prepare everything.  You just can't.  You will feel like, even on the last day of studying, that you still have SO much to do but you can't do anymore.  It is time-dependent and, yes, you could study for all eternity.  While it is tempting to study for another semester, you are better off just to take your exam.  It's key that you do as much as you can and then let it go.  This was excellent advice I was given by friends.

3. Making comps a "job" is much better than freaking out and trying to cram it into every hour of every day.  I'm a sucker for a schedule and when I go into "work" to get things done, I generally do them.  If I stay at home, nothing gets done.  I took a summer class mainly to ensure I was in the office every day.  It was the best decision I made.  I went into class in the AM, did a bit of work for that, and then studied from 1-5 PM for comps daily while doing that scheduled.  Then, it was a 9-5.  It worked.

4. You need days off - plenty of them.  This a million times over.  Again, if you make it into a marathon pace, you can afford to take the time.  Take your time and finish strong.  I told friends and family that their job was to distract me when I was off the clock.  Yes, you will still wake up and have a full on conversation about Street Level Bureaucrats at 3 AM with your SO but, for the most part, you can get them to help you ignore comps and start fresh the next time you pick up a book.  Weekends were KEY for me.

5. Talk to your advisor - he or she will most likely be helpful.  My advisor was awesome during the entire process and so were other committee members.  Everyone gave me good advice and I was talked off the ledge a couple of times by faculty members.  It was good.  Don't be afraid to reach out.  They have all been through this and talked a number of students through it before.

6. Talk to friends that did it before you and take their advice seriously.  My friends were really helpful.  I found an officemate and friend who was much like myself in terms of stress behavior, OCD, and past experiences with school to be particularly helpful.  Even if they have no clue what you are preparing, how much they are preparing, etc. even a strong word of encouragement will help you keep pushing.  Hang out with these people, listen to their stories, it will help.

7. Ask for past comps notes.  Either study with your cohort and trade notes or ask for them from the people that have come before you.  I just handed my stash of notes off to the people in my cohort taking comps next semester. I am sure some of what I did will be useless to them but a lot of what I was given was helpful so use it!  People aren't generally shy about sharing.  After all, you just took a shit ton of notes that you won't use again until you need to make a syllabus, right?

8. Read over past questions before you get too involved in studying to help you figure out what matters and what doesn't.  Before you freak out, it may be helpful to look at past questions just so you can say "yes I can answer this".  When my roommate was taking comps the semester before I did, I read over past questions with her and found that I felt a lot better about my own chances of passing after reading them.  She said they helped her as well.  We have very different approaches to studying but that was one thing that worked for us both.

9. Stop studying well ahead of when you need to take your comps or defend them.  I stopped almost a week before I took my writtens to go swim in a pool.  I couldn't feasibly do anymore.  I didn't do any prepping after that point.  I focused on getting sleep, hung out with my boyfriend, and didn't do a whole lot more.  It was good.  I went away the weekend before my defense and brewed beer.  Believe it or not, there isn't much you can do but take them.  About 2-3 weeks before you take your comps, you will feel like there isn't much more you can REALLY do. You are probably ready at that point to take them even though you would like to prep indefinitely.

10. Get mental health support and get it often if you need it.  Almost every department has a stress or panic attack nightmare to do with comps in recent history.  My advisor told me REPEATEDLY over the course of comps that the only real fear she had about me was my stress derailing me about 4 weeks before my written exams.  I took 4 days off, started fresh, and calmed the fuck down.  I also upped my dosage of valium, something I take for sleep.  My shrink and therapist were there every step of the way.  I impressed them in the end with my ability to stay on target but it really was just doing all of the things I'd been doing before.  If you are feeling completely out of control, go see someone!  Honestly, I slept 8 hours before my writtens AND orals because of life-saving meds that kept me from being manic.  I felt like I was cheating in one way but the reality was, I would have failed without regular behavioral modification and medication.

I didn't experience true hypomania at ANY point on my comps journey past the initial stress of trying to study while taking care of a very sick roommate.  This is the longest I've been stable.  I didn't let that first experience color my ability to pass, either.  I listened to my gut, went home for a couple days, studied there, and then got back on track.  Take care of yourself and be kind to yourself (as my therapist tells me).

Feel free to include your rec's in the comments....

Mental Illness and Grad School: You aren't alone

As I bind up these various articles, notes, and papers  into neatly-made subject-specific binders for my comprehensives, I am left to reflect on past  years and the struggles I have had.  Currently, I am not even half way done with my courses and the tower of binders is higher than our coffee table.  My roommate faced a similar situation in January while studying for her comps.

But it gets me thinking.  There's a LIFE in there.  There's my academic life- the good, the bad, the awful, the REALLY good.  There's a student just on the verge in there and an academic ready to publish in there.  Well, on that last part, I can dream, right?

In there, I manage to see that even during the worst times of my life, I've managed to take good notes and keep it relatively together.  There have been points when I honestly didn't feel like living was the best option in my life.  Most of those points were pre-grad school but my first year here was hellacious.  It was wrought with financial difficulty when the university made an accounting error and granted me no money for 3 months.  It was full of more financial difficulty and physical pain after an emergency surgery left me with a $3500.00 hospital bill in the middle of my second semester.

And yet, here I am.  I'm the strongest I've ever been.  It hasn't been an easy week, after all.  My roommate is dealing with tough shit, too.  Everyone is.

Recent talk of mental illness on twitter got me thinking about things.  Several people have been talking about this on my feed.  One commenter noted that she was dealing with problems that seem to be similar to issues that I have with OCD but didn't want to be "labeled" or have it reported back to her supervisor.  Grad students worry about such things.  Hell, I worry about this blog labeling me in some ways but I think the blog shows that there is far more to me than OCD or bipolar disorder.

Most people wouldn't see me and go "yep, she's got a mental illness".  A lot of people are surprised to find this out if they ever get to know me well enough.  I certainly don't TRY to hide it.  If someone is to ask me, I cop to it because I want to show people I'm NOT afraid.  And that's a personal prerogative   Not everyone has to be so open.  But I don't appear any different.  I do well in my program.  This year is a year that has been rough because I have been diagnosed with something new.  PTSD is now the new word.  Another diagnosis - oh, joy!

But my therapist said something to me that stuck.  How many people can you think of that you would label as being "OCD" or "bipolar"? "No one," I replied.  But then he asked me how many people I know have mood or anxiety disorders in academia.  I counted in my head for quite some time.  He then asked me how many people that I had known had had panic attacks.  I counted some more.  There were more people than I could count on fingers and toes.  And, while these disorders may be "labeled" something, I don't label the person that.  I doubt that anyone else does the labeling thing, too, despite a high prevalence of mental illness and anxiety disorders among academics.

It's not a surprise that many of us have such similar issues.  Grad school is incredibly stressful.  It can be down right impossible.  You work 80 hour days, you take your work home with you, and the only people you generally hang out with live with you, work with you, research with you, and share your interests.  It's a giant, stress-induced fishbowl of epic proportions.  We're talking The Hills for smart people sort of drama!

I work in an office with 14 of my colleagues - basically all in one big room.  We know WAY too much about one another and boy have I seen a lot of panic attacks.  I've talked people down and they've done the same for me.  So I know many people who suffer from similar illnesses.  But they are still just people I know, respect, and talk to on a daily basis.  They are friends and colleagues.  And no one judges them for it - or they really shouldn't.  That'd make them terrible people.  As long as you do your job and aren't a total ass, no one cares.

But that doesn't mean you should suffer.  And labels only matter if you let them.  I don't think of myself as bipolar, for example.  I, like many people in my family, suffer from the disorder but I am still probably the most functional diagnosed person in my family.  That's a source of pride in some ways.  I'm NOT the disorder I was so afraid to be labeled as.  I did not want to suffer the way I have seen other family members suffer.  I did not want it to be this ugly mark on my record.

But, you know what?  It's not.  As long as I don't let it.  It's not easy to do that.  It's easy to get sucked in and scared.  I'm not saying that it hasn't taken a long time.  It's taken three years of intensive therapy, maintenance, and drugs to get me to this point but that success is on me.  A lot of other people do the same and you'd never know.

And really, everybody's got SOMETHING.  If it's not mental illness, it's a death in the family or something major.  One of my colleagues lost his father last year.  His father was dying while he was taking comps.  I have had friends that have suffered from really bad illnesses themselves while dealing with the stress of grad school.  Some people have families or start families.  Everybody's got something that makes things hard.

So, don't feel alone.  Just feel like you have the right to be stressed and you have the right to talk to others about this stress - especially medical professionals that CAN help.  And feel that no one has the right to define you with a stupid label, sure.  But get that help and hold your head high.  The only other choice is to throw your hands up and give up.  Fuck that.  You're a grad student.  You came this far partially because you ARE crazy for wanting to do this to yourself and partially because you are insanely motivated and WANT this.  Don't let anything take that from you.  You are a million, billion times stronger than that.