Mental Health in the Work Environment.

Whether you love it or loath it, work is one of life’s inevitabilities. As you may expect, the entire experience is often littered with plenty of peaks and troughs. The highs of being offered a promotion contrasted with the lows of missing a crucial deadline. For the majority of us, we will experience both at least once. However, as with many of life’s experiences, the negative can dramatically decelerate and impede our abilities.

Unfortunately, work related stress often debilitates our executive capacity. This usually manifests as a self-propagating cycle, wherein stress can catalyse emotional instability and nervousness, which in turn further inflames stress and inhibits our concentration. For me, I often associate these feelings with being purely and utterly overwhelmed. Naturally, this can have disastrous consequences for our work life. For many of us, we may just accept this as part and parcel of a busy career. Externally, the term ‘suck it up and deal with it’ flies around more commonly than in should. However, do we actually have to deal with this as a condition of normality? No, we do not. 

Workplace stress is common and widespread, often aggregating prior to big presentations and important deadlines. It piles up on us as the workload gradually reaches a tipping point.

this is to be expected, especially for an intense work position. However, feelings of depression and anxiety shouldn’t be developing in these circumstances. If they do, we may need to take an important physiological and psychological health check.

At any given time, approximately 17% of working-age adults display symptoms associated with mental illness1. Women are disproportionately affected, being almost twice as likely to have a common mental health issue compared to men2. Further, around 20% of people are reported to take a day off due to stress, yet 90% of these individuals cite a different reason for their absence3. Thus, the fear of any judgement regarding poor mental health clearly remains. This is despite the fact that in the UK in 2019, stress, anxiety and depression were responsible for over 50% of all work-associated illness and 55% of all workdays lost due to ill employee health4. This likely correlates with 2019/20 estimates indicating that 828,000 UK based workers were affected by work-related stress, anxiety or depression4, which increased from the 602,000 reported cases in 2018/195. Why are these numbers so high? There are many potential obstacles which may contribute to these worrying statistics. 

A 2017 report highlighted that employees with a long-term mental health condition are twice as likely to lose their job than those who do not. In the UK, this equated to around 300,000 individuals2. While mental health awareness has been increasing considerably over the past decade, these numbers really underline an urgent need to amplify national efforts, especially due to the considerable health burden of psychiatric disorders. Salomon et al., first reported on this way back in 2013. In a study which was published in The Lancet, the authors asked over 60,000 participants from all around the world which diseases, injuries and disorders they considered to be the most disabling6. A disability weighing scale (0.00 to 1.00) was then curated representing the severity of the disease (1.0 being the highest). As per the report, the disorder with the highest disability rating was schizophrenia (0.778), with an untreated spinal cord lesion (0.732) and severe multiple sclerosis (0.719) following closely behind. Startlingly, severe anxiety (0.523) and depression (0.658) were considered to be more disabling than moderate multiple sclerosis (0.267), a moderate-to-severe amphetamine dependence (0.486), and severe chronic obstructive pulmonary disease (0.408). Further, moderate psychological problems were also reported to be considerably debilitating. For example, moderate anxiety (0.133) was reportedly more debilitating than a concussion (0.110), while the disability weighting for a moderate depressive episode (0.396) was higher than that for anorexia nervosa (0.224) and tuberculosis (0.333). Despite this worrying numbers, it is crucial to emphasise here that this data was based on general public surveys. As such, the data will display inherent variation. However, I do believe that the study underlines a clear association between mental health disturbances and our quality of life. 

What can I do?

Please do not allow the ‘stigma’ and previous cultural norms discourage you from seeking help. If our negativity and depressed feelings transcend both our work and personal lives, it is important to identify and/or actively seek out a supportive network. While discussing mental health within the working world is becoming more common, we can often worry about the opinions of others. Before speaking up, I was concerned that my colleagues would view me as incapable of successfully doing my job. A such, my anxiety was compounded by the paranoia of potentially being fired as a direct result of asking for help (despite this being illegal in many countries). Now, when my mental health inhibits my ability to work, I will immediately discuss it with my employer. After all, how can an employer adapt and adjust to our needs if we refuse to speak up? I appreciate this can be daunting, but it is absolutely crucial. If it concerns you, perhaps consider communicating with human resources instead. 

Developing a coping mechanism can also be critical. This could be anything easily employable to help you through a stressful workday. For me, I often go to the gym during my lunch break. Any negativity that I was dragging around due to a stressful morning is often eradicated following the exceptional endorphin hit I get from an intense workout. If that doesn’t sound enjoyable or you would prefer to just have some time to relax and unwind, then do so. I also sometimes find a quiet spot to read a book or go for a walk; both of which really help clear a busy mind for the afternoon ahead. Regardless of what you decide, I emphatically encourage you to take all of your lunch break. While this isn’t necessarily straight forward for some jobs, be strict with the time and make sure you give yourself that opportunity. 

If neither of these helps, I would also potentially consider seeing a therapist or psychiatrist. While some people report having bad experiences (myself included), this is often due to a clashing of personalities. This shouldn’t be surprising, as we will never fully connect with everyone we meet. I see a psychiatrist once a month and it really helps me put things into perspective. It can take some time to find a specialist which suits you, but it is often incredibly beneficial to supplement alongside some of your own coping mechanisms. 

If you feel as if all is lost despite implementing some of these strategies, consider finding a more supportive work environment. It is difficult to admit when a job doesn’t fit properly, but we will never be able to force pieces into place which are not meant to go together. Do you remember the last time you were happy at work? If not, perhaps it is time to talk to some friends and colleagues regarding your current situation. If others feel your work life hinders your happiness, perhaps it is time to move on.

In summary, while some individuals may gaslight us into self-blame, often spitting hateful thoughtless comments such as “we all get depressed sometimes”, or “be careful not to play the victim card”, the majority of people – including employers –  are empathetic, and they are there to listen to you. If any negativity comes out of you stepping forward, then perhaps that will provide you with an answer of what to do, regardless. 

References:

  1. Moran P, Rooney K, Tyrer P, Coid J. (2016) ‘Chapter 7: Personality disorder’ in McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital.
  2. McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital. 
  3. https://www.mind.org.uk/news-campaigns/news/work-is-biggest-cause-of-stress-in-peoples-lives/[Accessed 28th March 2021].
  4. https://www.hse.gov.uk/statistics/causdis/stress.pdf [Accessed 28th March 2021].
  5. https://www.hse.gov.uk/statistics/overall/hssh1819.pdf [Accessed 30th March 2021].
  6. Salomon JA, Haagsma JA, Davis A, de Noordhout CM, Polinder S, Havelaar AH, et al. Disability weights for the Global Burden of Disease 2013 study. Lancet Glob Heal 

Bullying, depression and suicide.

In 2016 the New York Post reported that Danny Patrick, a 13-year-old boy from Staten Island, took his own life after he was mercilessly bullied at Holy Angels Catholic School1. The following year Rosalie Avila, a 13-year-old girl from California, hanged herself in her bedroom after months of relentless bullying from her classmates2. In 2018, Amy Everett, a 14-year-old girl from Australia also took her own life as a consequence of cyberbullying3. Her father invited the bullies to her funeral, saying on Facebook: “if by some chance the people who thought this was a joke and made themselves feel superior by the constant bullying and harassment see this post, please come to our service and witness the complete devastation you have created.

These are three prolific cases of an increasingly common phenomenon: bullying, victimization and suicide. This increased emergence is a worldwide phenomenon, with research groups based in Chile4, Finland5, South Africa6, South Korea7, the United Kingdom8 and the United States9 all reporting associations between bullying, depression and suicidal thoughts in students. A more recent study published in 2020 examined the risk of suicidal behaviours in bullied students between the ages of 12 and 15 in 83 countries. Strikingly, the authors reported that the overall prevalence of suicidal ideation – defined as the formation of ideas or concepts surrounding suicide – suicidal planning and suicide attempts were 16.5%, 16.5% and 16.4%, respectively10. An increased prevalence of bullying was also associated with higher risks of suicidal behaviours. In Africa for example, the overall prevalence for suicidal ideation, suicidal planning and suicide attempts among students were 19.9%, 23.2% and 20.8% respectively, while bullying prevalence was 48%. These statistics were the highest for any of the 83 countries recorded. Why is something so unimaginable happening so frequently? Is there anything we can do about it? If we decipher the social and psychological factors responsible for the long-lasting consequences of bullying, we could successfully protect the Danny’s, Rosalie’s and Amy’s of the future. 

Of course, we all acknowledge that victimization is cruel and entirely unacceptable. However, do we truly understand the bully-victim dynamic? As you are likely aware, bullying involves aggressive behaviour and is associated with either a real or perceived power imbalance. This behaviour is often repeated over time and can take various forms, including rumours, threats, and verbal or physical attacks. It is crucial to emphasise that this kind of emotional manipulation and dysregulation can have serious consequences. For example, it is probable that prolonged reductions in one’s self-esteem due to persistent bullying is responsible for increased depression prevalence in adolescents11. However, depressive symptoms also appear to manifest in preadolescent children. A Netherlands based study of 1118 children aged 9-11 measured victimization associated with bullying alongside a range of psychological and psychosomatic – a physical disorder often made worse due to mental factors, such as stress – symptoms including poor appetite, bedwetting, sleeping problems, depression and anxiety. The authors reported that victims of depressive behaviours had significantly higher chances of developing psychological problems when compared to children who were not bullied12. In some instances, the psychosocial symptoms actually preceded bullying victimization, with children who already displayed depressive symptoms having a greater chance of being newly victimized. 

There is also a credible body of evidence which underlines potential life-long consequences as a result of bullying and victimization at a young age. In 2015, The Lancet published a study which analysed adult mental health consequences of maltreatment and bullying during childhood from two independent cohorts: the Great Smoky Mountains Study (GSMS) in the USA and the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK. Firstly, I should note here that a longitudinal study involves repeated observations of the same variables over a period of time. For example, monitoring weight loss or depressive symptoms over a 2-year period. In the GSMS, annual parent-child interviews were incorporated and bullying repeatedly assessed between the ages of 9 and 16. In contrast, the ALSPAC study assessed bullying with the inclusion of child reports at the ages of 8, 10 and 13. Overall, data from 1420 children in the GSMS and 4026 children in the ALSPAC were acquired for data analysis. The authors reported that children bullied by their peers were more likely to develop mental health problems as adults13. Even more startling, the development of mental health problems was higher in individuals who had been bullied when compared to those defined as being maltreated, which involved either physical, sexual or emotional abuse by an adult caretaker. What makes this study particularly pertinent is the utilisation of two independent cohorts from separate countries, emphasising that the association between childhood bullying and developing mental health problems as an adult is independent of differences in both social environments and cultural factors.  However, the correlation between bullying types, severity and mental health problems needs to be further explored. 

What about cyberbullying?

Comparatively, cyberbullying is a bit more difficult to define. While several definitions exist, Kowalski and colleagues succinctly defined it in 2014 as “the use of electronic communication technologies to bully others.14” Unfortunately, the global increase in social media presence over the last decade is directly responsible for the uncontrolled aggregation of cyberbullying which has also manifested. Unlike regular bullying which is often limited to school or college, cyberbullying is a constant barrier that many young people face. Further, because anonymity is easily attainable, more people may feel compelled to spit hatred towards others, knowing all too well it would be difficult to be punished for their actions. As a result, cyberbullying is why Amy Everett and so many others take their own life.

Research studies provide considerable evidence to the association between cyberbullying, mental health deficiencies and suicidal tendencies. For example, a 2018 meta-analysis – a type of study which examines data from a number of independent sources on the same subject to determine overall trends – of 26 independent studies identified that children and adolescents who have been victimized through cyberbullying were almost 2.5 times more like to self-harm, 2.15 times more likely to have suicidal thoughts, over 2 times more likely to display suicidal behaviours, and 2.5 times more likely to attempt suicide15. It wasn’t just the victims however, as bullies themselves were 20% more likely to exhibit suicidal behaviours when compared to non-perpetrators.

Perhaps unsurprisingly, cyberbullying appears to also correlate with substance abuse in adolescents. A longitudinal cohort of almost 3,000 students in Los Angeles completed surveys at the beginning of the study (10th Grade, mean age = 15.5), with a 12-month follow up also being incorporated. The study identified five cyberbullying roles at baseline: (1) no involvement, (2) witness only, (3) witness and victim, (4) witness and perpetrator, (5) witness, victim and perpetrator. At follow up, the investigators examined substance reliance over the last 6 months, including alcohol, marijuana, prescription stimulants and prescription opioids. Startlingly, over 50% of the students were involved in more than one of the aforementioned cyberbullying roles, with all four active roles being associated with increased odds of substance abuse at follow-up when compared to students who were given the ‘no involvement’ classification16. The study strongly stresses that cyberbullying can have detrimental consequences not only for the victim, but also the bully and even the witnesses.

Are there any data discrepancies?

With any data, it is crucial to examine both sides of the proverbial coin. As such, it is important to note that a few longitudinal studies have found no associations between bullying, victimization and depression development. One Finnish study examined the correlation between childhood bullying and suicidal ideation17. The study included 2348 boys, all of whom were born in 1981. Bullying information was acquired from the parents, teacher reports and the children themselves at age 8. Depression and suicide ideation were then assessed through participant self-reporting during their Finnish military call-up examination at the age of 18. The study reported that bullies themselves were more likely to be severely depressed and report suicidal ideation when compared to boys who were not identified as bullies during their childhood. Conversely, for boys who were only victimized, the authors did not report any increase in suicide ideation incidence17. While this might seem contradictory to other studies, I need to crucially underline here that self-reporting often opens the door to bias. Firstly, 10 year follow ups may result in participant memory bias, with individuals often choosing to selectively ignore negative experiences from their past. I know this is something I have done on multiple occasions. Further, as an 18-year-old man in 1999, when mental health discussions were still shrouded in stigma (especially for men), would you have wanted to openly talk about victimization and depression associated with bullying? In addition, would reviewing such a circumstance become an issue for the military selection process? Victims in this study may have avoided discussing these negative experiences due to fear of potentially being classified as unsuitable for military selection. There are many confounding factors here that the study does not take into consideration.

What about the bully?

Most of the studies available which analyse the association between bullying and depression focus on the depressive symptoms of the victim. However, there is an increasing concern regarding the mental health of the perpetrators. Multiple cross-sectional surveys have reported elevated depressive symptoms amongst adolescents who report bullying their peers9,18. Cross-sectional studies incorporate a type of analysis which is taken at a specific time point; for example, at a particular age. Interestingly, in another study which compared self-reporting and teacher reported bullying status of students, self-reporting was associated with increased depressive symptoms whereas teacher reported bullying was not19. This study is particularly important, as it suggests that self-identification of bullying behaviour could result in the manifestation of shame, self-blame and guilt, all of which could be instrumental into catalysing an emotional spiral towards depression.

An increased risk of depression and suicidal thoughts appears to be particularly pertinent for teenage girls18. Research by Brunstein and colleagues identified that girls who reported bullying others more frequently may be at a higher risk for depression and attempted suicide when compared to boys18. This perpetrator-depression link appears to also hold true in children, although a study from the Isle of Wight reported that the probability of presenting psychiatric disturbances were highest amongst male bullies, presenting a 9.5-fold increased risk, followed by male bully-victims (7.9-fold) and female victims (4.3-fold)20. The study also reported that children who bullied others had a 5-fold increased chance of being in contact with mental health services compared to non-bullies. A more recent study by Dr. William Copeland and Dr. Elizabeth Costello from Duke University provides additional credence to these findings, wherein they repeatedly examined 1,420 children between the ages of 9-16 over several years, determining whether bullying could predict psychiatric issues and suicide. The authors reported that both victims and bullies alike had an increased risk of depression and panic disorders, alongside behavioural, educational and emotional issues21. Thus, social interaction and development may have stark implications for the development of mental health difficulties associated with the bullying-victim-perpetrator dynamic.

Summary

I wanted to emphasize here that bullying has devastating consequences, with mental health problems often manifesting for both the victims and the perpetrators. In many circumstances, bullies themselves undergo episodes of considerable unhappiness, frequently resulting to substance abuse and suicide, not dissimilar to that observed in victims. As a community, we need to identify this and help educate the youth of our society so they can learn become the best of us. It is time that we helped them learn from our mistakes. We owe it to ourselves to help them do better.

If you yourself want to learn more about the presence of bullying, depression and suicide within the youth, the CDC have an informative online booklet which is easily digestible. It provides insights into what school personnel can do to help, alongside providing links to further information for those who seek it22.

References

  1. https://nypost.com/2016/08/13/staten-island-boy-takes-his-own-life-after-ripping-school-bullies-in-suicide-note/
  2. https://abcnews.go.com/US/family-13-year-california-girl-committed-suicide-months/story?id=51820650
  3. https://www.bbc.com/news/world-australia-42631208
  4. Fleming L, Jacobsen K. Bullying and symptoms of depression in Chilean middle school students. J Sch Health. 2009;79:130–137. 
  5. Kaltiala-Heino R, Rimpelä M, Marttunen M, Rimpelä A, Rantanen P. Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. Br Med J. 1999;319:348–351.
  6. Liang H, Flisher AJ, Lombard CJ. Bullying, violence and risk behavior in South African school students. Child Abuse Negl. 2007;31:161–171
  7. Kim YS, Koh YJ, Leventhal B. School bullying and suicidal risk in Korean middle school students. Pediatrics. 2005;115:357–363.
  8. John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, Lloyd K, Hawton K. Self-harm, suicidal behaviours and cyberbullying in children and young people: systemati review. J Med Internet Res. 2018: 20: e129.
  9. Fitzpatrick K, Dulin A, Piko Bullying and depressive symptomatology among low-income, African-American youth. J Youth Adolesc. 2010;39:634–645. 
  10. Tang JJ, Yizhen Y, Wilcox HC, Kang C, Wang K, Wang C, Wu Y, Chen R. Global risks of suicidal behaviours and being bullied and their association in adolescents: School-based health survey in 83 countries. EClinicalMedicine. 2020;19:100253.
  11. McLaughlin K, Hatzenbuechler M, Hilt L. Emotion dysregulation as a mechanism linking peer victimization to internalizing symptoms in adolescents. J Consult Clin Psychol. 2009;77:894–904.
  12. Fekkes M, Pijpers F, Fredriks A, Vogels T, Verloove-Vanhorick S. Do bullied children get ill, or do ill children get bullied? A prospective cohort study on the relationship between bullying and health-related symptoms. Pediatrics. 2006; 117:1568-1574.
  13. Lereya ST, Copeland WE, Costello EJ, Wolke D. Adult mental health consequences of peer bullying and maltreatment in childhood: two cohorts in two countries. Lancet Psychiatry 2015;2:524-31.
  14. Kowalski RM, Giumetti GW, Schroeder AN, Lattanner MR. Bullying in the digital age: a critical review and meta-analysis of cyberbullying research among youth. Psychol Bull. 2014;140:1073-137.
  15. John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, Lloyd K, Hawton K. Self-harm, suicidal behaviours, and cyberbullying in children and young people: Systematic review. J Med Internet Res. 2018; 20:e129.
  16. Yoon Y, Olivia Lee J, Cho J, Bello MS, Khoddam R, Riggs NR, Leventhal AM. Association of cyberbullying involvement with subsequent substance use among adolescents. J Adolesc Health. 2019;65:613-620.
  17. Brunstein Klomek A, Sourander A, Kumpulainen K, Piha J, Tamminen T, Moilanen I, Almqvist F, Gould MS. Childhood bullying as a risk factor for later depression and suicidal ideation among Finnish males. J Affect Disord. 2008;109:47-55.
  18. Brunstein Klomek A, Marrocco F, Kleinman M, Schonfeld I, Gould M. Bullying, depression and suicidality in adolescents. J Am Acad Child Adolesc Psychiatry. 2007;46:40-49.
  19. Wienke Totura C, Green A, Karver M, Gesten E. Multiple informants in the assessment of psychological, behavioral, and academic correlates of bullying and victimization in middle school. J Adolesc. 2009;32:193–211. 
  20. Kumpulainen K, Räsänen E, Puura K. Psychiatric disorders and the use of mental health services among children involved in bullying. Aggress Behav. 2001;27:102–110.
  21. Copeland WE, Wolke D, Angold A, Costello EJ. Adult psychiatric outcomes of bullying and being bullied by peers in childhood and adolescence. JAMA Psychiatry. 2013;70:419-26.
  22. https://www.cdc.gov/violenceprevention/pdf/bullying-suicide-translation-final-a.pdf

Bullying: a victim’s perspective and experience.

Take a second to close your eyes and visualize your life, from childhood right up until this morning. Try to focus on your most principle experiences, associating these specific events with particular feelings and emotions. Now, what did they mean to you? What feelings do you cling onto the most? It is sadness? Happiness? What about regret? Upon reflection, it is often easy for us to linger on the negative. During our childhood, this is especially true if we were plagued by bullying. The innate ability of our peers to manipulate the direction of our social development and emotional stability is really quite impressive, many times cultivating a negative mentality not dissimilar to an overgrown weed. A pest, often too difficult to remove.

Overall, my childhood was pretty good. Until around the age of eight, I lived in a small street called Church Leys in Harlow, Essex. I was pretty lucky in that many other families in the neighbourhood had kids around my age. This was before the development and widespread accretion of the internet, cell phones or social media. Thus, the other kids and I would usually spend the majority of our spare time together, trading Pokémon cards, playing football, or glued to the Nintendo 64. A distant time, void of any pertinent obstacles. 

Unfortunately, negative emotions often cloud positive thoughts. My experience with secondary school and sixth form was the parasitic catalyst for this prolonged negative outlook. Many days were unpleasant, and the emotions associated with those moments often mean I forget to appreciate the enjoyable experiences in my past and present. Retrospectively, I often forget how enjoyable both my childhood and my peers could actually be. Instead, I attached myself to the disapproval I was relentlessly fed by others. This was a direct outcome of persistent peer-associated bullying.

I was an incredibly introverted and pretty weird kid. As such, I was probably an easy target. Slightly overweight, I was fat-shamed practically every day. I also had long curly hair similar to Slash, the guitarist from Guns N’ Roses. As cool as I thought it was, I was often coined the ‘yeti’ or ‘sasquatch’. Otherwise, ‘tramp’ would resonate in the days someone wanted to shake up the name-calling schedule. Eventually, these insults metamorphosized into commonplace nicknames. Understanding that resistance would likely result in further ridicule, I attempted to wear them like a badge of honour, despite being necrotic in nature. 

Eventually, I was gifted a reprieve. I managed to make some of my bullies snigger during an English class, while my teacher glared at me with absolute distain. It was a lightbulb moment. While quite depressing in reality, I realized my way out of constant victimization and shame presented itself before me; position myself as the class clown. My agenda? Disruption, disobedience and disorder. My goal was to ruin every fucking class for the teacher so the popular kids would hopefully view me as three-dimensional and interesting. While it didn’t stop the bullying entirely, it put a muzzle on it for a while. As you might expect, this shift in behaviour resulted in educational penalties. I was switched into lower class sets because my teachers thought I was apathetic about my tutelage. To their credit, that did appear true. In actuality, because my mental health and self-esteem were so devastatingly damaged, my interests aligned with being in favour of my bullies rather than developing my academic abilities.

I almost ruined my education because of this manipulated mentality, all because a few insignificant bullies were flinging their own mental health and insecurity problems towards me. I adapted to fit into their crowd of callous clowns, attempting to avoid further harassment. Not dissimilar to a chameleon, I blended into my new social surroundings, but the ramifications were severe. Peer-pressure got the better of me. At the age of fourteen, I ended up being rushed to hospital due to alcohol poisoning. To impress my bully-perpetrating peers, I decided drinking a bottle of vodka would make me look dangerous, daring and most of all, sufficient. The worst thing about the entire experience? It wasn’t even these ‘peers’ that dialled for an ambulance. Instead, it was a stranger in the street who witnessed me repeatedly collapsing at a local park. I will never forget that feeling of utter loneliness and isolation upon understanding a stranger cared more about my health and safety than the people I associated myself with. I was rushed to hospital, wherein I woke up the next morning. Informed that I spent the majority of the night before throwing up on the nurse, the doctor explained how lucky I was to be alive. The hammer hit home for my mum when he turned to her and explained the situation would have been considerably worse if I was smaller in size. After this declaration, it should have been a turning point. Instead, the notion of being a smaller kid reverberated around my head. Irrationally, I extrapolated his conclusion to mean that I was obscenely overweight. The socially developing brain, huh? What a fun fucking ride. Hey, what did it matter? Nearly killing myself got me in their good books! As an insecure, vulnerable and lonely kid, I managed to turn this into a twisted positive. 

Obviously, this ‘respect’ didn’t last long. In fact, the harassment expanded. In my later years at secondary school (I’d say between the ages of fourteen and sixteen), I was bullied in my morning and afternoon registration group, and the prospect of a reprieve appeared bleak. After about twelve weeks, I identified a way out. For the majority of my childhood, I lived alone with my mum. I used this to my advantage and started bunking off school. My mum would often leave for work after I left for school, so I began hiding in the nearby woods until I witnessed her drive off into the distance. My truanting lasted for approximately two weeks before my brother dropped by to collect something. Because I lacked any real ability to provide a show stealing performance in lying aptitude, he quickly put two-and-two together. 

I became so mentally disenfranchised that I gave up on the entire education process. As a result, I coasted through my penultimate year, often attempting to nullify my chronic negativity through self-harm and emotional withdrawal. I began to disrupt practically every class wherein a potential bully was also present. Talking, throwing stuff and swearing at the teacher were all commonalities in my troublesome approach. The result? About 180 detentions in a single academic year. I think I received five or six a week on average, surmounting to an hour each day after school. I intentionally skipped out on the majority of these, resulting in extended ninety-minute detentions instead, as was the rule if you missed any. Clearly, I wasn’t making the wisest of decisions at the time. Looking back, I find that entire detention process infuriating. Teachers could have allocated detention time to force students to carry out class activities focused on the core fundamentals: English, Maths and Science. If standard protocol, perhaps I would have identified my passion for the latter far earlier. 

Eventually, a lifeline presented itself in the form of my drama and performing arts teacher. Patrick Walker was always cool, calm and collected. His approach commanded authority, but in an unthreatening and empathetic way. Dedicated to helping his students’ development, he understood that belittling someone would only result in revolt and rebellion. My mum and I were called in for a meeting with him once, as he also had a crucial role in the senior leadership team. He emphasized that I was at an inflection point. The choices? Continue on my current path, ruining my life as a result, or actively apply my academic ability towards bettering myself and my future. As a direct consequence, I began to focus on my classes, rather than my bullies. While the victimization continued, I learned to ignore it for the most part. My newly found focus towards education helped me realize I attained genuine enjoyment from science, performing arts and computing. This alone was the spark responsible for a miraculous turnaround; I developed a hard-working mindset. But despite this newly discovered surge of motivation, I was unable to reach the goal I desperately set myself; an A grade in science. In fact, I mostly received C grades across the board. As such, that prospect of a better tomorrow rapidly mutated into uncertainty, depression and inescapable self-doubt. 

I scraped into sixth form. By this point, the feeling of negativity and worthlessness felt permanently engraved into my brain. Instead of thankfulness and pride due to acceptance, I assumed the school took pity on me. I felt inadequate and expected to fail. While my hardworking mindset remained, my insecurity was rife. Life became study-centric. I did have friends during my time at sixth form (many of which remain my friends today), but I didn’t actively see them all that often outside of class. Because my mentality was infected with so much rotten self-doubt and paranoia, I never allowed myself to enjoy some of the better moments during those years.

Many of the bullies at my secondary school performed poorly in their exams, decided to take a different career path, or both. I didn’t see them again. Instead, I exposed myself to new bullies: the cool-intelligent crowd. Do you remember that kid that always got straight A’s despite never paying attention in class? All while taking the piss out of how hard you worked or how weird you were? Yeah, that came to ahead here. Around the same time, emotional withdrawal became second nature, but I considered it a positive thing. Facilitating me to work non-stop, it helped me to shrug off the snide comments from others. The work ethic I developed helped me attain the grades I needed for acceptance into a top-tier university. However, the social sacrifice was severe, and feelings of insufficiency aggregated once again.

My experience with university was better. Upon arrival at my dorm, feelings of acceptance and belonging really took over. On the most part, I met a range of different individuals from all walks of life who shifted my world view significantly. Regrettably, a small number of privileged students would often make snide comments, but fortunately they were located in a separate building. I recall that prior to moving in, there was a Facebook group set up by the university for the different accommodations located around London, so all incoming students had the opportunity to engage with others prior to arrival. For someone as timid and shy as I was at the time, this was a social security net. Though, I remember some individuals mocking me for my apparent eagerness on the group. While university is often distinguished as a potent primer for maturation towards adulthood, this association was clearly lost on some. Instead, they ridiculed me for being lonely and wanting a fresh start.

My first year as an undergraduate student made me realize that anyone has the ability to become a bully, regardless of their previous circumstances. I also began to understand that chronic bullying often results in long-lasting consequences, with depressive experiences in both childhood and adolescence resulting in life-long effects. For example, I still feel overweight to this day despite exercising four times a week and eating healthily.  The consequences of fat-shaming during my adolescence really came to a head during my first year at university. I decided that my body was unbearable, so I employed a crash diet. I think my daily food regime was two slices of brown bread, a tin of baked beans and a roasted chicken breast, which is far from ideal for an active university student. The result? I dropped around 5 stone (70 pounds) in as many months. I was underweight and unhealthy.

After that initial year, things changed. I was selected to participate in an exchange program for my second year, wherein I decided to study at the National University of Singapore. The experience was the catalyst for priming the development of who I am today. It flipped my preconceptions and assumptions about myself, fuelling endless ideas of what I could potentially be. I still suffer with body confidence issues, but now I understand where it stems from. I take the time to rationalise my insecurities, target their original source, and remind myself that those feelings often manifested due to negative situations. While it remains to be completely effective, this approach to acknowledgement and acceptance helps me to rationalise my issues, allowing escape from an otherwise inescapable chokehold. 

For this topic, I wanted to highlight my own personal experiences with victimization and bullying to really drive home that it can have immense implications. To this day, I still find it difficult to accept a compliment, and this had negative implications for previous relationships. For me, it was primarily due to bullying. Today, the only compliments I can really recognise are based on my previous successes. For example, I can accept the notion of someone referring to me as articulate, based on the fact I managed to navigate the PhD process and emerge with a doctorate. However, I still find it difficult to accept compliments associated with my appearance, my cultural taste or my social skills. Thus, I just hope that people become more aware about the consequences of long-term bullying, whether in childhood, adolescence or adulthood. There is a fine line between good-hearted ‘banter’ and just being degrading and hurtful. Locate the line, be mindful of it, and it will have long-lasting benefits for the mental health of yourself and your peers.

Please, always remember that random acts of kindness are far more rewarding. 

Social isolation and mental health.

Humans are social creatures. If there was any doubt in that before, the current isolation that many are facing solidifies this fact. We only need to look at chimpanzees, or the relationship between a mother and her child for verification as to where this characteristic manifested itself from. It is unsurprising then that isolation can have severe negative connotations. Currently, with the unprecedented global COVID-19 pandemic, scientific experts and the majority of world leaders are highly recommending that everyone practice social distancing. This means staying approximately six feet away from others not within your household, alongside keeping public trips to an essential minimum (i.e. to get food if you cannot get it delivered). Whilst this may be an inconvenience to many, it is necessary to reduce viral transmission, protect the physically vulnerable and reduce the pressure on international health services. However, social isolation may have detrimental effects to those who are psychologically vulnerable; a category that I myself unquestionably fall into. 

Social isolation has definitely led to serious consequences. However, in psychology the term ‘social isolation’ is difficult to define. What matters the most is whether an individual actually feels lonely. Scientists have coined this ‘perceived social isolation, which can have negative effects both physically and psychologically. In young adults (18-27 years of age) for example, loneliness has been associated with poor sleep habits, depression and suicide. In addition, social isolation may increase the risk of illness and death due to cardiovascular disease. In the United States and United Kingdom, heart disease is one of the most prevalent killers of middle-aged and elderly individuals. At first glance then, these alarms should raise considerable concern.

However, things are never that straightforward. Researchers determined that isolated mice (which are highly social animals) have an increased risk of obesity and the development of type 2 diabetes. In some people, psychological distress can be associated with particular eating habits. For example, a bad diet is often associated with an increased risk of depression. This often results in a self-propagating cycle: depression facilitates a poor diet, and self-hate manifested as a consequence of this diet can fuel the fire towards further negativity.  

So, could this become a serious problem during viral-induced self-isolation? Should we be worried about people who are living alone, and for people with a history of mental health problems? Yes and no. From my perspective, I feel a bit stir crazy. However, I am otherwise fine. I have suffered with major depressive disorder for my entire adult life. I have lived on the razor’s edge for many years, attempting to take my own life on several occasions. As you can imagine then, my mind is often akin to a bag of f***ing cats. Despite that, my mental health during isolation has been relatively manageable. It is important to note that I do live with my long-term girlfriend. Nevertheless, I often prefer being entirely isolated. Many people who go through depressed episodes often want to be left alone. So being in close-quarters with the same person for so long with no reprieve could be considered as quite the challenge. That is partially true. I think the one thing for me which has helped me rationalize the situation and keep my mental health in check is pretty obvious: there is a global pandemic. We are all affected by the current situation. Because I can appreciate that, I think it removes some of the stress and self-destruction that would have otherwise lingered. I am not isolating and hiding away whilst others are out and enjoying themselves (unless you are being a selfish p***k). All of my friends and family are doing the same thing: watching terrible television and investing in toilet paper as their new international currency. 

In association with this pandemic, if you do not suffer with a pre-diagnosed mental health condition, please do not try and raise your arms up in solidarity with those who do, declaring you ‘now totally understand’ the difficulties associated with psychological illness. From a personal standpoint, it is patronizing beyond explanation. A few months of isolation is not even remotely comparable to the years of self-disregard and harm (whether physical or psychological) that many people may have (or currently are) dealing with. I am not taking aim at anyone specifically here, either. I just believe true empathy is more helpful to those in need. For me, I prefer it when people show genuine care. Talking about your mental health revelation on social media doesn’t help anyone. If you truly empathize and you believe someone is in need, why not call them? What about sending them a surprise gift in the post? Knowing that someone is thinking about me through direct displays of affection reduces that ‘perceived social isolation’ quite remarkably. 

That is what I want to accentuate. Just because someone is physically isolated, does not mean they have to become emotionally and psychologically isolated, too. Talk to your family and friends regularly. Organize an online pub quiz, play video games together with some headsets. How about sending pictures from the last time you saw each other? Perhaps even make plans for the end of the year when you can see each other again. Start preparing things you can look forward to. 

I do appreciate the concern for people struggling, but I also fully understand the risks if social distancing rules are not followed. Unfortunately, I have lost all my grandparents. I know the heartache. I would not want to see that happen to anyone close to me, but this virus appears to be particularly fatal in the elderly. Strikingly, of the people who were hospitalized in the New York City area, around 88% of patients on ventilators have died due to COVID-19. For some, this solidifies the virus as being a death sentence. Is isolation comparable to this for those who suffer psychologically? No. Just because I am unable to physically interact with the people I love does not mean I am unable to communicate with them. I am pretty isolated right now, geographically speaking. I live in the United States, whilst my family are back home in the United Kingdom. If one of them were to get sick, I would not be able to fly home due to flight and VISA travel restrictions. Whilst that is upsetting of course, I am determined to keep to a routine. I stick to activities that I know make me feel good: exercise daily, make music and of course, write these articles. 

I do acknowledge that some individuals may be particularly fragile during this time, such as a recovering self-harmer, alcoholic or drug addict, all of which may find self-isolation unendurable. These are the people that we must prioritize; protecting those most vulnerable in our community. This is no time for a ‘ME’ mindset. Selfishness is not needed or warranted here. It is time everyone started to develop a ‘WE’ mentality. With that in mind, please focus on the health of yourself and your loved ones during this difficult time. However, do so with some physical distance. If you stand in solidarity with those who suffer with mental illness, I would like to say thank you. Nevertheless, please do not paint everyone with the same naïve brush.

The science behind SAD.

Because I am British, it probably comes as no surprise that I unequivocally understand the heartbreak of traditional rainy weather. An indestructible stereotype of the UK, bad weather has never really manifested the ability to catalyse happiness during the morning commute. Whilst the occasionally odd shower is often welcomed, consistent wind and rain provokes noticeable negativity in people – have you ever been in central London during commuting hours? Yikes. Why then, for many of us, does our mood shift in association with the weather? Interestingly, science may have the answer! This discussion is dedicated to what has been coined seasonal affective disorder. Here I will survey some of the evidence surrounding the condition and describe what we may be able to do to fight back against it!

Seasonal affective disorder: what exactly is it?

Seasonal affective disorder is a form of depression otherwise referred to as SAD or seasonal depression. As you may have guessed, people who suffer with SAD tend to experience mood changes and symptoms similar to depression. These symptoms appear to correlate with the changing seasons, primarily beginning in the autumn and winter months, before alleviating during the arrival of spring. With this in mind, it is important to note that SAD is more than just “winter blues”. The symptoms can be distressing, debilitating, and can significantly interfere with daily functioning. Nevertheless, various treatment options are available.

Causes

Unfortunately, the biological cause(s) of SAD is still relatively unknown. However, some evidence suggests that it is related to the body’s level of melatonin, a hormone secreted by the pineal gland. Melatonin regulates the sleep-wake cycle, and darkness is known to stimulate its production, preparing the body for sleep. Because more melatonin is therefore produced during the winter months (when sunlight hours are diminished), people tend to feel sleepier and more lethargic. 

In addition, research suggests that some people who develop SAD may produce less Vitamin D. Interestingly, Vitamin D has been suggested to play a role in serotonin activity, a key mood regulating neurotransmitter which is reduced in some depressed patients. 

Treatments

Interestingly, human clinical trials have identified that both cognitive behavioural (e.g. talk) and light therapy improve the symptoms of SAD, wherein the latter may be more effective for reducing four key signs of the disorder: early insomnia, anxiety, hypersomnia, and social withdrawal. So, if you needed a sensible reason for an expensive winter holiday to the Bahamas… you are most certainly welcome. However, more practical approaches to tackling SAD symptoms include taking care of your general health and wellness, which involves (yep, you guessed it…) regular exercise, good nutrition and getting enough sleep. Spending time outside and rearranging your office space so that you are exposed to a window during the day may also be of benefit.

Does blindness contribute?

From a scientific perspective, there are many interesting questions arising from SAD research. For example, is it more common in people with serious visual impairment? Does the likelihood of developing SAD increase as eyesight progressively degenerates? What about people who are blind and have been since birth; do they develop symptoms of SAD? These are all interesting research avenues which are currently being investigated.

It is important to seek help

Whilst it is thought-provoking topic to discuss, please remember that If you feel like you or a loved one has experienced depressive symptoms for an extended period of time, contact your nearest doctor for support.

Is Grief a Mental Illness?

Image from Pixabay

For the majority of us, grief is an inevitability. 

If you have ever experienced grief, you may be familiar with questioning your own sanity… ‘Did I just fleetingly see my loved one wade through a crowded street?’

In some circumstances it can even result in us questioning our own reason for living. Whilst disturbing, these thoughts usually diminish over time, becoming less consuming and intense. However, sometimes these thoughts can pass the line into pathology, wherein treatment may be required to help alleviate and remove the developing problems. 

Pathological grief disorder (PGD) is a condition which is a fairly new addition to what has been dubbed the ‘bible’ of psychiatric disorders – referred to as the Diagnostic and Statistical Manual of Mental Disorders (DSM). This disorder is commonly known as traumatic or prolonged grief, wherein it typically lasts for longer than six months. However, the addition of the disorder to the DSM has been a fairly controversial one. The reason for this being because it allows for medical treatment of grief related depression within the first few weeks following a bereavement. Diagnosing someone with depression so quickly after a significantly traumatic event is, in my opinion, not the correct decision. 

Grief is a natural response the naturally diminishes over time. This is particularly pertinent to individuals who believe the ‘strong’ and ‘stable’ approach for other family members following a fatality – primarily being men. In 2017, Prince William discussed the destructive nature of the ‘stiff upper lip’ mentality, admitting that it had taken a devastating toll following the death of his mother, Princess Dianna. Thus, relying on medication to potentially numb the emotion of someone in grieving may only exacerbate the issue, especially when the medication is eventually withdrawn. If that was me, I would probably start to believe that prescription drugs were the essential crux for any potential happiness. Whereas in actuality, any recurring negative emotions would have likely reemerged due to not having sufficient time to process the death prior to pharmaceutical intervention.

Whilst immediate medication is not advised, it is crucial to identify signs of chronic psychological distress following a bereavement. Here are a few PGD symptoms to be aware of:

  1. Concentrating on little else apart from the deceased loved one
  2. Extreme focus on reminders of the loved one or excessive avoidance of reminders
  3. Intense believing that life has no meaning
  4. Inability to enjoy life or reminiscence on positive experiences with the loved one. 
  5. Wishing to die to be with the loved one.

Pathological mourning is not a new concept, with publications discussing its commonality and treatment options in the 1980s. The primary problem is that the DSM does not discriminate PGD from intense ‘normal’ grief, thus likely yielding huge false-positive diagnoses from psychiatrists. This is likely to cause additional stress to an already vulnerable individual.

A major reason for this is because the signs between PGD and ‘normal’ grief are practically identical. However, in PGD the symptoms are considerably more prolonged, debilitating and intense. Numbness and detachment can last for over six months, and perhaps extend considerably longer. It is in considerable contrast to feeling sensitive after being exposed to emotional triggers of that loved one – for example, videos and photos or anniversaries.

Nevertheless, ignoring any type of grief is potentially an extremely hazardous choice. The severe consequences of losing a loved one can, without intervention, manifest in post-traumatic stress disorder (PTSD). Whilst primarily associated with individuals who have worked within the military, PTSD is common amongst various groups, including the bereaved. A recent study looked into the rates of PTSD in 132 people who had lost a close relative due to cancer. Strikingly, at one month 30% of the volunteers were rated as having PTSD, with another 26% displaying pre-clinical signs of the disorder.

Interventions for pathological grief disorder

Because the diagnostic criteria for PGD is lacking, many suffers are instead diagnosed with major depressive disorder and are ‘treated’ with antidepressants. Whilst this is sometimes beneficial for the patient, evidence is lacking as to whether this is successful for PGD sufferers. 

On the other hand, grief counselling is available. Therapists for this type of support are widely knowledgeable and understand that each experience of grief is entirely unique, complex and emotional. Your culture, personality and individual experience will all affect the grieving process. A ‘one size fits all’ approach in terms of medication is unlikely to help the majoring of us. Grief counsellors on the other hand will intricately tailor treatment to meet your specific needs. 

I would strongly recommending reading about grief counselling if you believe there is a loved one who requires it. Communication with health professionals (alongside loved ones) is absolutely crucial for healing and recovery. Unfortunately, grief is a normal and upsetting part of life. Instead of immediately jumping towards medication as a potentially damaging crutch, take the right initial steps following a bereavement: Emote and communicate with friends and family. But remember, never be ashamed to seek guidance and support if you think you need to. 

Social anxiety and loneliness.

Image: Pixabay.com

Fearnounan unpleasant emotion caused by the threat of danger, pain, or harm. 

Does that sound familiar to you and your experiences? Perhaps it may. Anxiety is often coined to be a particular type of persisting fear, wherein we worry about potential future outcomes associated with specific events. In fact, the way we feel when either frightened or anxious are extraordinarily similar, because the basic emotion for both remains the same. So, despite not being in any immediate danger, anxiousness can result in similar symptoms to that of fear: increased heart rate, feelings of sickness and/or dizziness, and a loss of appetite. For many, new social situations can be a common trigger of these symptoms, often termed as social anxiety. 

Social anxiety: what is it?

Also labelled as social phobia, social anxiety presents itself as a long-lasting fear of being humiliated or scrutinised by others. It is sometimes (and incorrectly) compared to general shyness. However, whilst shyness often manifests for many prior to an unfamiliar situation, this usually dissipates following exposure to the new social situation. This is not the case for social anxiety. The latter often manifests during adolescence, when the opinions of friends and peers become increasingly important. This impairment can continue into adulthood, wreaking havoc on a wide variety of important life events. Separating social anxiety symptoms from those of general shyness is thus essential before discussing management and treatment options. 

The symptoms

Symptoms of social anxiety (as with any form of anxious behaviour) can be wide ranging, and it is unlikely that any one individual would experience them all. All anxiety disorders can be associated with the symptoms mentioned previously. However, common identifiers for social anxiety usually include the feeling of dreading everyday activities, such as starting up conversations with strangers, speaking on the phone to unfamiliar people, or even going into work. As a consequence, social anxiety can result in the avoidance of many social activities such as eating out or going to parties.

Can social anxiety effect my health? 

Because of the primal need for social interaction between humans, the consequences of social isolation on both physical and emotional health can be catastrophic. A recent meta-analysis – a statistical approach which combines data from multiple studies – identified that a lack of social connections can heighten health risks as much as smoking fifteen cigarettes a day or having an alcohol consumption disorder. The analysis suggested that social isolation can significantly increase the risk of premature mortality, with the magnitude of risk exceeding that of other common leading health threats. A recent study in 2019 analysed the data from more than 580,000 adults, finding that social isolation increases premature death risk for every race.

The negative impact on both mental and cognitive health is also apparent. Evidence supports a link between social isolation and adverse health effects including poor sleep quality, depression and accelerated cognitive decline, the latter of which is associated with problems in memory, language and judgement. A 2018 study also discovered a clear association between loneliness and dementia, increasing a person’s risk of developing the latter by up to forty percent. Examining data from more than 12,000 U.S. adults aged fifty or older, participants rated their loneliness and social isolation alongside completing a battery of cognitive tests every two years for up to ten years. 

Do you think this applies to you?

As reported by a 2018 survey, loneliness levels have reached an all-time high. Of the 20,000 U.S. adults approached, nearly half reported feeling alone, with the youngest generation being the loneliest of all. However, isolation is also well characterised in the elderly. According to Age UK, over two million people in England over the age of 75 live alone, with over one million stating that they go for over a month without conversing with a friend, neighbour or family member10

It is essential to determine whether social anxiety and/or loneliness applies to either yourself or a loved one, and then take appropriate action. It is important to try and communicate with friends and family where possible. However if this is hindered, it is imperative to seek out advice from a qualified medical professional. 

The Tale of the Academic Black Dog.

Image: Matej.

The idea that mental health issues are more common amongst university students has gained traction in recent years. Identifying this problem has led to the much-needed development of support systems for students whilst they study towards furthering their promising careers. However, psychological distress is running rampant at a much deeper level within our university culture, wherein the urgency cannot be understated. 

I am talking about the academics – the pillars of higher education. Yet, despite their obvious essentiality to students’ success, they are often overlooked by the people they teach. Comparatively to their students, research into the poor mental health of academics has received little attention, despite its clear importance. As with any individual, if you suffer in silence, understanding that you aren’t the only person with a seemingly unshakeable black dog can provide a form of release from some of the distress you may be feeling.

Acknowledge the Academic

During my undergraduate degree, I inevitably looked towards my lecturers as sources of extensive knowledge. I was always fascinated by their research and scientific interests. Yet, I never considered the amount of stress that they were likely under, and the personal impact associated with this. In many scenarios, the increasing workload of academics, alongside the lack of job security and the extensive demand to publish, has led to many academics suffering with some form of mental health disorder. A 2017 survey highlights this, wherein it was identified that 43% of academics (including senior and principal lecturers) exhibited symptoms of at least a mild mental health disorder1. This is nearly twice the level of prevalence in comparison to the general population. An Australian study further validates this, finding that the rate of mental illness amongst academic staff was up to four times higher2

Suffering with mental health difficulties will predictably hinder professional performance. Nevertheless, the support options available for academics remains rather limited. Many universities offer mental health services, but these are primarily aimed at students. Some services are available, such as the option to see an occupational nurse, but information regarding these services are often obscure and difficult to find.

The Stigma Survives

In 2014 a survey was carried out to determine the attitudes and experiences of students and staff surrounding mental health problems, which included the completion of a “stigma scale”. The study highlighted that “silence” surrounding mental health issues permeates throughout the university culture, impacting on help seeking behaviours alongside the support and recovery of affected individuals3. It is not surprising then, that only 6.7% of academic staff in the United Kingdom have ever opened up about a mental health condition4.

The Guardian online have a blog entitled Academics Anonymous, whereby academics can discuss work difficulties without disclosing their identity. One such post in 2015 suggested that HR departments within many universities remain unsympathetic and often fail to recognise a mental health disorder as a legitimate illness5

Overworked and Underpaid

Clearly more needs to be done to support our academics. Structural changes are desperately needed to address many of the factors associated with poor mental health, such as job security, pay and work load. Unfortunately, these changes are unlikely to happen quickly. The high costs of education put many institutions under extraordinary pressure to satisfy students and their parents with educational excellence, with this putting further stress on academics. In one example from 2017, some “overworked” lecturers at Queen Mary University London were caught sleeping in their offices overnight, before being threatened with disciplinary action6 – which would only result in further psychological distress.

Supportive Strategies

Like the work currently used to support the wellbeing of students, academics need more information surrounding mental health to help change their attitudes towards seeking support. One study emphasises the benefit of exercise, where academics were more likely to report lower levels of distress if they undertook 150 minutes of moderate to vigorous exercise per week1. Thus, the creation of physical activity options for staff, such as free exercise facilities and subsidised cycle to work schemes may provide some benefit.

Regardless of the strategies selected, we all need to be aware of the non-selective nature of mental illness. It affects men and women from all backgrounds, in all professions, and at all stages of life. We need to understand this before working together to provide strength and support when it comes to fighting back against mental illness. For students, I have previously written an article on the BPS blog talking about my personal experience of battling with mental illness whilst completing my PhD, which can be accessed here.

There is a heavy cost to getting a PhD that nobody talks about.

Image: Tim Gouw

Embarking on a PhD is a journey of epic proportions. Initially filled with excitement and enthusiasm, students are compelled by the idea of pushing the frontiers of human knowledge.In time, this enthusiasm can fade. Devoting three to five years of your life to such a tiny subject niche has the ability to do that, even to the most devoted of individuals. Unfortunately, the long and winding road takes both a physical and psychological toll. Stress management will inescapably take centre stage, and your ability to manage it will be extensively tested.

In 2011, a study carried out by the University of Texas found that 43% of their graduate student participants reported experiencing more stress than they were able to handle, with PhD students expressing the highest levels. This likely explains the high attrition rate. In 2013, it was estimated that 30% of students who embark on a PhD in the UK leave university without finishing. This statistic was worse in North America, where in 2008, almost 50% of students left graduate school without their doctorate. However, research has shown that the majority of students who enter doctoral programs have the academic ability to successfully complete the degree. Therefore, it is likely that the culture of PhD programs are to blame.

My personal experience

I have suffered with depression for my entire adult life. Worryingly, the stigma surrounding the subject remains rampant. Enough so that it doesn’t come into the majority of people’s conversations unless a suspected suicide hits the news. In academia, the silence is even more deafening. For myself and many other PhD students, our thesis hovers over us like the sword of Damocles, even in supposed moments of rest.

For me, paranoia proliferates. I become so fixed on what my supervisory team think of me and my thesis progression that I sacrifice most of my outside interests. Now, I feel guilty when I take time off, regardless of how essential it is to avoid physical and mental exhaustion.

For a long time, I assumed that I was expected to maintain a false illusion of mental stability and confidence when interacting with others within the faculty. Not only emotionally taxing, it was isolating – something which is already an inevitability as a PhD student.

Further, none of my closest friends or family have been previously exposed to what a PhD entails. Of my immediate family, I am only one of two who went to university. Of course, they have been nothing but supportive.  But in the majority of cases, the advice they have provided has unfortunately fallen on deaf ears, and has sometimes further contributed to my anxiety.

Luckily for me, my supervisory team are fantastic. With their extensive support, providing advice through personal experience, they are helping me through the PhD process. But this isn’t the case for everyone. As an alternative, talking with other PhD students can also help alleviate mounting stress. For me, the latter has been the greatest way to help break the chains of isolation, as the more students I talk to, the more I began to realise that I am far from alone.

We need to break the silence

Why does the stigmatisation of mental health still exist, when approximately 1 in 4 people experience a mental health problem each year? Poor mental health within universities is an escalating problem. Not just because it affects how students learn, but it can also significantly contribute to whether students actually finish their degrees.

Disturbingly, in 2017 the All Party Parliamentary Group of Students found that 69% of students have felt depressed within an academic year, while 33% of students had experienced suicidal thoughts. The actual recorded suicide rate of students within higher education in England and Wales within 12 months ending in July 2017 was 4.7 deaths per 100,000 students, equating to 95 suicides. Although a relatively small number, this has increased on previous years.

Across the UK, universities are taking positive steps to help combat this growing problem. For example, the University of Bristol has spent £1 million on a new wellbeing service for students, following seven suicides within a six-month period. Such initiatives are to be welcomed, as are signs of coordinated leadership nationally, but much more still needs to be done. Hopefully raising awareness of students’ mental wellbeing, alongside emphasizing communication and increasing support can prevent the loss of life of more talented young people.

Keith Flint.

Keith Flint, The Prodigy

Keith Flint.

In my opinion, the king of the misfits. I was introduced to The Prodigy when I was still in nappies. My brother has always mentioned to me that I used to dance around like I’d been possessed every time he played one of their records. Their influence on my life has stood the test of time. I have listened to the band practically every day for approximately twenty years. From ‘Music For The Jilted Generation’ and ‘The Fat Of The Land’ through to ‘Always Outnumbered, Never Outgunned’ and ‘Invaders Must Die’, their music has always been an instrumental part of my life, helping me pave my own path going forward. 

I remember seeing the Firestarter video when I was a kid. Keith wearing that oversized United States styled t-shirt. By societies standards, he was this freak. But to me, it helped me understand and conceptualise that being a bit different is more interesting and exciting than being like everyone else. That alternative look is probably why I never gave a shit about what others thought I looked like. Perhaps that is why when I grew my hair out to the point I looked like an unwashed willow tree, it still didn’t bother me.

As you may have now guessed, I was a fucking misfit in school. Alternative as hell, and not particularly liked as a consequence. Likely due to how weird I was… probably. When school became unbearable, music was both my defence and release. The Prodigy were the guys who topped that list. Often music that helped me lash out against the intolerable, it kept me focused on the bigger picture. As of right now, that focus has become slight overcast in shadow. Liam Howlett (Producer/Engineer of the band) has informed fans this afternoon that Keith killed himself. If I was in water, I think I would have sunk sixty feet. Keith, this enigma that I always considered to be larger than life, has now been engulfed by it. 

The best gigs I have ever had the pleasure to go to all had The Prodigy headlining the bill. Milton Keynes Bowl 2010, Brixton Academy 2012 and Creamfields 2013. All events that I will never forget. They have become pieces of my history which will inevitably shape my own future. The ‘we don’t give a shit’ attitude they repeatedly evoked towards negativity has been a driving force in my own life. The message helped stimulate movements to surround myself with people that actually matter, alongside changing and removing toxic parts of my life. Both of these actions helped to trigger movement onto the correct path for increasing my own self-worth and general happiness. You must think that I’m overexaggerating when I say that a band can have this ability, but they did. Re-listening to songs that I grew up with immediately induces memories. Happiness in some circumstances, and the feeling of growth in others. The latter particularly applies to the turbulent periods of my adolescence, wherein I would usually rinse either ‘Fat Of The Land’ or ‘Invaders Must Die’ on repeat if I had a shitty week. But that’s why it still invokes incredible emotions. It allows me to understand and accept just how far I have come, all the way back from starting out as an initially bullied, weird little kid, to now; wherein I am a successful young adult… and PROUDLY still a pretty fucking weird person.

Keith, you helped me pave my own way. I know the worth of being unique. I have embraced that, so thank you for being a core component to helping me identify and realise that fact. Rest in peace, you twisted instigator. 

If you haven’t really listened to The Prodigy before, please give some of their records a listen. If you wanted a top 10 list in terms of which songs impacted my life the most, I have left that below. I am sure that I’ll be listening to them over and over for another 20 years to come.

  1. Poison
  2. Voodoo People
  3. Breathe
  4. Firestarter
  5. Charly
  6. Their Law
  7. Serial Thrilla
  8. Diesel Power
  9. Smack My Bitch Up
  10. Out Of Space
  11. Bonus: Run With The Wolves