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?