Guest post: Life as an anxious grad student

Note from Meg: This guest post (which starts below the break) is a follow up to my post on life as an anxious scientist, where I talked about having an anxiety disorder and some of my strategies for managing it. The post below was written by a graduate student who wishes to remain anonymous. It summarizes that student’s experience with an anxiety disorder, and includes information that I think will be useful to students and advisors. My plan is to have a follow up post in the future with more thoughts on the topic.

Disclaimer: I’m not a mental health professional, I’m not a doctor, but I know how it feels to be a grad student living with generalized anxiety disorder (GAD). I feel qualified to talk about things that helped me finish grad school and I’m hoping my story helps others in need.

I’ve lived with GAD for 9 years, it triggered right after my first semester as a Master’s student. My family was going through an emotional roller coaster and I would put an average of 75 hours of studying in a week. My program was really demanding, 15 people started just four of us finished. My “free” morning in the week was a Sunday, and consisted of doing laundry, grocery shopping, cooking, and hearing my parents cry after another week of emotional distress. After 6 months of this routine I ended up in the ER with horrible stomach pain, a doctor rushed me into surgery, gall bladder out! Okay, I should be great after this right? Well, eight more months without a gall bladder and the same stomach pain, zillions of pills and tests that weren’t improving my condition, just left me thinking that I had a horrible condition that no doctor could detect and that I was going to die. I had panic attacks everyday, slept an average of three hours, and lost about 50 pounds. I developed phobias against doctors and medicine, and was afraid of traveling (after a panic attack I had during a flight). Many nights I had to call a friend or my mother to come over to my place and stay with me, because I was scared I wouldn’t make it to the next day.

As a student I was very good, I loved what I was learning, and it was the only thing that kept me going. I did everything I could for professors and classmates not to notice that I was going through hell. At the end of the day I didn’t want to ruin the only thing that was good in my life. However, the lack of sleep and food were making it harder to learn, write, and be a good grad student.

Finally, after one more doctor switch, I was asked if I felt at peace everyday, the obvious answer was no. Dr. N, the latest physician in the case of my strange stomach pain, opened up and he said as a resident he went through a lot of emotional distress with his family, and the hours and workload left him feeling like he was going to die. He never mentioned GAD but referred me to a psychiatrist. I’m grateful for scientific curiosity, otherwise I wouldn’t have dared to put a foot in a psychiatrist office. Dr. S, the psychiatrist, was very relatable, he seemed like a confident PI. He understood academic life perfectly. First thing he did after I explained my symptoms was grabbing a thick book and opened in a specific page and gave it to me. He said “you like research and evidence right? This is a book about the latest mental health research, read these pages in front of me, how many things do you identify with?” Right in front of my eyes I discovered that I was a textbook case for anxiety, and that there were specific treatments for it, most importantly, it was very common for people who suffer from anxiety disorders to go through a 100 physicians before finding one that actually understood the condition. The search was over, I was relieved to be diagnosed. The treatment involved medication and cognitive behavioral therapy (CBT) but to be completely honest, neither of them were easy. Medications made my brain foggy, made it harder for me to learn and to focus, made me gain weight, gave me sugar cravings. CBT was also hard; having to talk about hurtful family history and recognizing triggers for anxiety takes a toll in your day, it leaves you physically and emotionally exhausted.

What was the price I paid during grad school?

I continued being a student, finished my Masters, and moved to a PhD program with the same advisor but at a different university, which also involved switching psychiatrist and therapist. I was fortunate that my new university had a very professional counseling center, but it took time to find the right counselor there. It also took more effort to better organize my days to be able to keep up with teaching, research, and health appointments. I had many unproductive days, where I couldn’t read or write since it was impossible to focus. Reading a paper would take 3 times more than usual. I would fall asleep due to the medication, and about 5 times during my PhD I went to the ER feeling that I was choking and I couldn’t breath during a panic attack. Next month, I would be worry about paying the $500 ER co-pay out my $800 paycheck. So the price I paid was time, money, and research quality.

What were the positive changes that helped me through it?

First, I became more organized. I needed time for everything, including free time. So I organized my schedule better. I tried to be stricter about working hours and also had to have free time. I wouldn’t work on the weekends; I would come home and cook a healthy dinner at night with enough left overs for lunch next day. I would bike or go to the movies; I would go camping because my brain needed it. Second, I learned how to talk to my advisor about expectations. I would be very clear about timing, and the amount of work I needed to do in order to achieve those expectations. It took a lot of fine-tuning to achieve goals because I was always hoping I could do more, but finally realized that my brain was working differently and I needed to adjust to my new reality. Third, I never quit therapy, it is hard, many times it doesn’t make sense and makes you angry, but there is a point where things start clicking and strategies work in your favor. I’m happy to say that I’ve been two years without a panic attack and 1.5 without medication. Fourth, I formed a supportive network, a small group of friends who I could talk directly about my feelings. I had my extremely patient husband and two incredible friends who shared good and not so good times during grad school. My two friends also attended the counseling center so we felt free to discuss mental health without judgment.

What would I do different? How could my advisor help?

I wish I could have talked to my advisor more directly about GAD. He knew I had health issues and that I needed time for medical appointments, but he never knew about the suffering or ER visits. I never felt confident to speak directly about my feelings, I didn’t want to appear weak. It would have been great if he had asked about my mental health, or if he had training from the university about these topics, a lot of professors are not aware of the symptoms. Also, one of the most difficult things of being a grad student with anxiety is dealing with uncertainty. My advisor was not the greatest at keeping up with our appointments or commitments, so that produced a lot of distress and worry in my grad student life. It would have been easier to have an advisor that was more consistent, but at the same time, this situation gave me an opportunity to confront the difficulties of an academic career and achieve more scientific independence. Again, it was through the support of my counselor and my network that I managed to survive this period. Sadly, many professors are unaware that their failure to provide on time feedback or keep up with appointments directly hurts the mental health of their students. If you are an advisor do not hesitate directing your student to counseling/therapy centers, they have wonderful resources and people that have seen it all.

What are the challenges ahead? How do I feel today?

I am still working through my anxiety and fear. I actively work on detecting anxiety triggers, although everyday is easier after few years of practice. I am still working to overcome my fear of long flights and getting sick in a foreign country, so for now those wonderful conferences in other continents have been out of the question. I deal now with the uncertainty of postdoc life and job applications, but I mostly focus on what is constant and important in my life: my husband, my son, and my pets, they all need me to remain calm and positive. I also set goals that are attainable within time frames that I can commit to. I am nowhere close to having a Science paper but I feel extremely strong and brave, I survived hell after all, how many scientists can put that on their CV?

11 thoughts on “Guest post: Life as an anxious grad student

      • Thank you so much for sharing it! I think it will help a lot of students and their mentors.

  1. Thank you so much for sharing. It is very important to talk about mental health in Academia. I experienced a rather severe concussion this year after a bicycle accident and have been going through quite a few mental health problems related to it. I tried to hide the symptoms but I was an emotional wreck on the inside. It was only until I told a friend about one of the symptoms and then started to see a doctor that I actually started feeling like I was in control of my life again. I really want to reiterate that it is so important to seek professional help when we need it. Because academia is all about thinking, there is something about the job that made it feel especially shameful to admit something was wrong with my brain. I hope others read your story and it encourages them to seek some help when they need it and I am so happy to hear about your improvements. It is truly an uplifting story!

  2. Thanks for sharing your story! You mentionned that you would have liked to have spoken more directly with your PI about this, is there anything that your PI could have done to facilitate this? Do you have ideas about appropriate or thoughtful ways a PI could ask this kind of question?

    • Yes – thanks for sharing! I’d also like to add is there any way a supervisor can recognise GAD if a student doesn’t want to open up (or doesn’t appreciate they suffer from it)? Sounds like many students develop (temporary/partial) coping mechanisms that may mask issues from others.

    • I don’t think there is an easy way for a PI either to ask or to recognized GAD or other mental problems since most of them do not have training in these issues. However, I think if your student is asking you for a lot of time for medical appointments, is having trouble understanding/ focusing then don’t jump immediately to conclude that he/she is lazy, not working enough, or “just sick”, it might be a big symptom of a mental problem.

      Three things that definitely can help are

      1. Do not judge or say it will improve. One of the most horrible things for a person with GAD is having someone without GAD telling you ” I understand what you are going through, that’s how grad school is”. The experience of grad school with anxiety is definitely not the same to the experience of a regular stressed person. A great PI is a person who listens rather than a person that “understands everything”.

      2. Have a one-to-one meeting where you offer your help and ask how you can help. Also reassure your student you want her/him to succeed. My PI was supportive but hearing it out loud would have been much better for my anxiety than just assuming that he was supportive. In the meeting, you always have the opportunity to direct your student to counseling resources, suggest him/her to first go to group meeting in the counseling center (like a meditation class) especially if the student or you are unsure of his condition.

      3. Follow through. We had meetings where my PI committed to do things and then he forgot to do them. Uncertainty is the big monster for a person with GAD, it makes you desperate nervous and leads you to have more catastrophic thoughts. Having a consistent PI makes a world difference.

      In my experience No. 1 would have helped me to open up, but I can see that this is not necessarily true for other people with GAD.

      • Question re: your #1. As a supervisor, it’s difficult or impossible for me to tell the difference between someone with GAD and someone without GAD who’s going through the stresses every grad student experiences. Which makes it difficult or impossible for me to tailor advice to the individual student, doesn’t it? I mean, if a student without GAD is going through the sort of stressful episode that every grad student experiences, it might well be quite helpful for them to hear that I have some understanding of what they’re going through (having gone through it myself), that they’re not alone, that every student goes through those episodes. (Aside: this doesn’t just apply to students. Here’s an anecdote from a prof who was going through a very stressful time and was greatly helped by being told everyone goes through the same stress, it’s normal: So, how can a supervisor draw on their knowledge and past experience to best offer individually-tailored advice/suggestions/perspective, given their necessarily-imperfect ability to truly know what anyone else is feeling and going through?

        Honest question–I completely accept that as a supervisor often it’s your job just to listen, and not pretend that you can totally understand what any of your students is feeling or going through. But I do think that, after listening and asking questions, you will often want to offer *some* sort of advice/perspective/suggestions/etc. Besides “Have you considered seeing the university counseling service?”, which of course might often be a good suggestion.

      • Hi Jeremy, I should be more specific about #1. Empathy is very good, offering advice and directing students to counseling is great, I’m totally in favor of professors that share their experience because grad school is stressful for everybody.
        I should clarify better what I meant with “understands everything” type of professor, in an effort to answer your question “how can a supervisor draw on their knowledge and past experience to best offer individually-tailored advice/suggestions/perspective, given their necessarily-imperfect ability to truly know what anyone else is feeling and going through?”
        For me “understands everything” type of PI is a professor that talks over you, that minimizes what you are trying to say. For example student says ” I haven’t slept well, I am afraid of my prelims” and the professor immediately responds with “that happened to me too, it is normal/ that happens to everybody don’t be afraid”. Although it is a completely reasonable response, when dealing with a person with anxiety this kind of answer is perceived by the anxious student as a minimization of the experience, and it is internalized as a complete failure to deal with the situation producing more anxiety. A better response from the professor can be “how long have you not been sleeping?, can I share my experience when I went through it? maybe we can figure from there some useful strategies for you feel more confident”, that puts you in a more empathic position and also gives you the opportunity to detect a key feature of people with GAD, anxiety is sustained for long periods. Most of the grad students experience anxiety during the program but it is truly a problem when 1) it has been sustained for months 2) interferes with the ability to focus, or perform activities like presentations or writing.
        As I said, I’m not a mental health professional but I’ve seen many times professors minimizing their students concerns regardless of their anxiety status, an it is very hurtful.

  3. THANK YOU SO MUCH FOR WRITING THIS! I just finished my M.S. and I had been suffering from mysterious severe stomach pains through my degree. Every time I go to the hospital they tell me the same condition is causing the severe pain, but can’t explain the cause. I will be venturing to PhD-land this coming semester and this post definitely provides ease in knowing that I can do it. Great advisers help too! I still share the same fears as you do (traveling far away, long flights etc.). A dream is to study in Spain for a summer…that dream preserves positive thoughts that I will be able to stay healthy for it in the future.

    • Hi Joe, I’m glad you will venture into the PhD, I’m sure you will accomplish your goals it is important for you to take control over your dreams. Find a very good PI, someone that is very structured is key. Stomach problems are strongly correlated with anxiety and there are many studies that have found this link, so might be good to check if anxiety is manifesting that way. You can definitely travel, I went to teach a workshop in Asia and I asked my husband to go with me and support me during the trip. I must say the long flight was the hardest part, once I was in the location I had a wonderful time, my anxiety and stomach were not a problem. Now I am working through doing these long trips by myself without any support, because it is the next challenge and that would help my career. Maybe you can start by going to Spain with someone that supports you, I’m sure you will love it and you will feel very good.

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