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.

Untreated depression: It will damage your brain.

Image: Kat Jayne

It is a scary prospect, but it is something that has accumulated serious momentum. From a scientific point of view, I have to admit I do find it fascinating. However, from a health perspective, this is rather worrying. The conclusions being drawn? Untreated depression may be causing brain degeneration.

Considering one in four people in the UK will experience a mental health problem each year, this might raise concern. It becomes even more alarming with the publication of a recent study highlighting that approximately 35% of people newly diagnosed with depression refused to seek treatment. Without professional help, how long can depression toxify and contaminate an individual’s identity? Easily an entire lifetime. Not seeking help for prolonged periods of sadness or emotional absence may not be just affecting your character, as was often thought for decades. 

The ‘all in the mind’ mentality is dead. The divide between physiology and psychology was clearly defined for many years. When patients were physically unwell – because of say, a broken bone or arthritis – any accompanying mental health instabilities were waived off. Depression often accompanied these ailments (and still does, of course), but the diagnostic significance of such was irrelevant. If a patient suffering from a chronic disorder like arthritis said they were depressed, the general consensus amongst medical practitioners was: ‘well you would be, wouldn’t you?’. The same conclusion was always drawn. The patient was simply depressed as a consequence of the pain associated with their arthritis, or their broken leg, and so forth. No real attention looked into the other potentiality; what if the depression causes physiological ailments? What if a psychological disturbance could be having serious negative effects on the body?

In the 21stcentury, the argument for this is strong. Chronic, untreated depression appears to have a degenerative effect on the brain, damaging it from the inside. Here I want to highlight some key pieces of research which link depression to neurodegeneration. The idea here is to help us all understand just how important seeking assistance might be if you think yourself or a loved one might be suffering from a chronic depressive episode. Trying out different methods to combat depression will be beneficial both for emotional stability and life fulfillment, but also for the health of our brains, too.

A major finding was published when discovering differences in the brain scans of depressed and non-depressed patients. Looking at cases of major (clinical diagnosis of chronic) depression which had lasted for more than a decade, the Centre for Addiction and Mental Health in Ontario, Canada identified that during episodes of major depression, the patients’ brains would show signs of inflammation. The study group identified that a key protein associated with the central nervous system (brain and spinal cord) inflammatory response was approximately 30% higher in the brains of people who lived with depression for more than a decade. However, this isn’t the only study to report such a finding. Another study published in 2016 looked at the whole-body levels of CRP (another biological marker of inflammation) in patients with depression and those without. The observational studyidentified that depressed individuals exhibited CRP levels more than 30% higher than those without depression.

The results presented here are startling, collectively indicating that we may need to change our thinking about depression and its effects. The evidence strongly affirms that depression truly is a biologically based disorder, rather than something that only exists in the field of psychology. But how does this link to degeneration of the brain?

Whilst inflammation is used to protect the body from infection amongst other functions, excessive inflammation can cause extensive cellular damage. Chronic inflammation within the brain has been linked to several destructive neurodegenerative diseases. One of which is Parkinson’s disease, which primarily manifests itself as a movement disorder, wherein patients begin to show signs of slowed movement (bradykinesia), until movement becomes practically impossible without medication. This primary symptom is caused by the destruction of neurons in the portion of the brain which is essential for movement. Unfortunately, there is currently no cure.

Whilst the contribution of inflammation to Parkinson’s disease does not appear to be the primary causation, in Alzheimer’s disease it may be a different story entirely. Alzheimer’s disease is the most common neurodegenerative disease in the world. In the United States alone, approximately 5.7 million peopleare currently suffering with the disease, which is primarily associated with progressive and severe memory loss. Again, there is currently no cure. Recent researchpublished in the Lancetnow appears to highlight neuroinflammation as a central cause of Alzheimer’s disease, with many otherstudies further supporting this idea.

Multiple lines of research therefore support the idea that ignoring a potential major depressive episode could have considerably devastating consequences for the long-term health of the brain. What can we do to fight back? Alongside seeking professional support, as little as 20 minutes of exercisecan reduce your bodily levels of inflammation. This is alongside the general health benefits of exercise, including reducing the risk of type 2 diabetes and cancer. Diet is the next big consideration. There are several foods which should be avoided due to their contribution towards inflammation, including red meat and refined carbohydrates. On the other hand, there are many foods which are considered to be anti-inflammatory, including green leafy vegetables such as spinach and kale, fatty fish like salmon, and a range of berries. A more exhaustive list of pro- and anti-inflammatory foods can be found here. Supporting this switch in diet, women whose diets include more foods which trigger inflammation and fewer foods which restrain inflammation have up to a 41% increased risk of being diagnosed with depressionthan those who mostly eat a less inflammatory diet.

Depression is a biological disorder and we all need to take this into consideration. Its link to inflammation and bodily damage cannot be underestimated, and it is something we must consider when either ourselves or a loved one is currently suffering a major depressive episode. If you are adamant about not seeing a professional (I highly advise you do, however), exercising more and switching up our diets may provide an answer that we desperately need.

A new year should never mean a new beginning.

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The new calendar year… a time associated with celebration yet often tainted with the thought of beginning anew. As January rolls in, many of us are overcome by feelings of starting over, in correlation with forgetting of the past. Whilst new year’s resolutions should often to be employed if you believe you have the ability to become a better person, trying to forget or ignore previous life experiences would be cheating yourself. Continue reading “A new year should never mean a new beginning.”

Anxiety: How it links to our future.

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“After all, what is happiness? Love, they tell me. But love doesn’t bring and never has brought happiness. On the contrary, it’s a constant state of anxiety, a battlefield; it’s sleepless nights, asking ourselves all the time if we’re doing the right thing. Real love is composed of ecstasy and agony.

― Paulo Coelho, The Witch of Portobello

This quote really stuck with me. Love is an incredible thing. Whether that feeling is for a significant other, or perhaps for work or even an environment, it is an emotional rollercoaster. You appreciate how fantastic that person/thing is. However, at the same time, it can cause a sense of worry and sadness. What happens if things change? How certain is the path that I currently walk on? What if change detrimentally alters my current position or relationships? Continue reading “Anxiety: How it links to our future.”

It is time to crucify the self critic.

Self-criticism. It can be one of the most disabling components of our psychological wellbeing. Unfortunately for most of us, we will always be our own worst-critic. Relationships, friendships, work progression; self-critical thoughts can make us second guess our ability and worth in all of these areas. Continue reading “It is time to crucify the self critic.”

The disaster of getting inside your own head.

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I am sure we can all relate to this. Whether it’s insecurities which have built up as a direct consequence of our scrambled society, or perhaps due to previous exposer to a singular toxic perpetrator; self-criticism can cause undeniable havoc and internal conflict. The constant flux within our culture, alongside a concurrent addiction to unrealistic expectations has led to the manifestation of many young individuals feeling like they will never be good enough. Continue reading “The disaster of getting inside your own head.”

Don’t let the past dictate your future.

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Most of us understand that an upsetting childhood can affect our adult lives. Depending on the nature of the trauma and the resilience of the individual, resulting consequences can sometimes lead to misery, which often manifests itself through extended depression and anxiety. This is especially the case if no professional help is sought. Continue reading “Don’t let the past dictate your future.”