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.