mentalhealth

A new way forward: healing from depression (25 Nov. 2015)

I used to love goal-oriented words like “achievement” and “success”, but after my experience with depression, they’re more likely to make me uneasy than swoon. An inordinate focus on what I achieved, rather than an appreciation for my nuanced person, is part of what led to my struggle with mental health. Having refocused the way I interact with myself and the world makes me never want to go back to my old model of measuring self-worth.

six sigma

I want my life to be filled with a lot less of things like Jack Donaghy’s (30 Rock) Six Sigma seminars.                   

Earlier in my Ph.D., I lived for the feeling that came from a grant being recommended for funding or receiving positive feedback on a talk. There was a certain high that came along with external validation – particularly because I didn’t do enough to internally validate myself. In a sense, I was my accomplishments and my goal of becoming a tenured professor. I used my academic performance and future to justify my worth.

Without a strong sense of intrinsic value, I was easily punctured. If a funded proposal justifies your existence, a rejected one can be devastating. The worst harm, though, came from my own words, goading me to excel at any cost. Self care? Not for me. It was something I neither needed, nor indulged in. I got all the reassurance necessary from elusive academic successes.

It was untenable.

mountain vista

I’d rather my life be filled with moments like this.

A major component of my healing from back-to-back episodes of major depression, complete with visits to two hospitals, was a greater focus on myself. I learned to listen to what I really needed and, spoiler alert, it wasn’t another first-author paper. I started treating myself gently and cultivating positive self-talk. I took time to notice.

All of this self-assessment and noticing led me to a surprising conclusion: I no longer wanted to go into academia. I continue to think that science is fascinating and wonderfully weird, but I no longer have the drive to be the one doing the discovering. I also don’t envy the long hours of and high demands on pre-tenure faculty members. I’ve come to the comforting conclusion that I can continue loving and advocating for science without being an academic scientist.

Biodiversity

Isn’t Biology grand?

These days I spend most of my time wrapping up my dissertation on the sex lives of incredibly promiscuous beetles, but I carve out chunks of time for my future career path of science communication. I write for SU’s College of Arts & Sciences communication department and I love it. I get to talk to scientists across the college studying topics ranging from climate change, to genetic disorders, to micro-scale physics. I get to indulge my curiosity and focus on improving my writing, a practice I adore.

I don’t like to ascribe utility to depression, but in my healing I’ve found a more sustainable way to live. I am not the number of papers I’ve co-authored, nor am I the latest feedback on a grant proposal. I am an artist. I write for fun and hopefully will write for a career, too. I love science and movies and cooking. I look for joy and intellectual stimulation in life. I am not my C.V.

As I close out my month of writing for metathesis I want to thank everyone who has taken the time to read my posts (if you missed any of them, check out my experiences with depression, thoughts on mental health and academia, and insight into what psychiatric hospitalization is really like). Depression dismantled my life, but with an incredible support network I was able to put together a new, more compassionate one. Open, honest discourse is needed to tear down the stigma associated with mental illness and hospitalization. As such, I encourage you to share anything that spoke to you as widely as you’d like.


As a Biology Ph.D. candidate, Liz Droge-Young studies the incredibly promiscuous red flour beetle. When not watching beetles mate, she covers the latest science news on campus for Syracuse University’s College of Arts & Sciences communication department. She is also a mental health advocate, a voracious consumer of movies, and a lover of cheese.

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Behind the doors of psychiatric treatment centers (20 Nov. 2015)

McLean hospital

 Exterior of McLean Hospital, the institution referenced in Girl, Interrupted (photo by John Phelan)

 “Is it going to be like ‘Girl, Interrupted’?” I cautiously asked my husband before being taken to the psychiatric wing of our local hospital. He assured me it wouldn’t and, in unfortunate ways, he was right.

I spent less than four hours under the hospital’s care, but what I saw I did not like. I was wheeled on to the locked floor by two security guards, past patients that didn’t look like me; they seemed overwhelmingly middle aged and male. I passed people in hospital gowns and people who were not high functioning. I was terrified.

I was condescended to as I tried to explain why I thought this was a higher level of care than I needed. I had signed away my autonomy at check in and was now in the unenviable position of trying to convince the psychiatric nursing staff that I was sane. Though I knew how it would look, I couldn’t help myself from sobbing out the words, “I’m not crazy.” In the end, they let me go that night. As scared as I felt in the hospital, the truth was I did need that level of care and had for months.

I should note that this, the first and briefest, hospitalization was to be followed by two additional trips, each substantially better than the last. The subsequent hospitalizations were both critical for my safety. Moreover, I count my stay at the last hospital among the most important experiences of my life.

There is so much misunderstanding and stigmatization surrounding mental health, and this is pushed to the extreme with hospitalization. Because people feel ashamed to share their experiences, and understandably so, the only picture the general public often has of a psychiatric hospital is from popular culture. Psychiatric hospitals are the light-on-patient’s-rights, long-term care units of Girl, Interrupted. They are places where unruly men are lobotomized in One Flew Over the Cuckoo’s Nest. They are insane asylums filled with deranged patients of American Horror Story’s or Modern Family’s gross misrepresentation of modern inpatient care. As a gleaming exception to the rule, It’s Kind of a Funny Story provides a modern account of psychiatric hospitalization that felt close to my experiences. It’s because of the paucity of the later example, and a profusion of the former, that I choose to share my experiences.

“Whenever you’re planning suicide,” my fellow patient answered. I had asked her when she knew it was time to seek hospitalization. During the year surrounding my hospitalizations, I frequently wondered when it was time to go in. Her answer draws a bright (and appropriate) line separating inpatient from outpatient services. In practice, I can tell you it’s much muddier. If every day is progressively a little worse than the last, it’s hard to identify the tipping point. In my second two hospitalizations someone else had to make me see that we had already moved well beyond the line that indicated it was time to turn to enhanced care.

hospital hallwayModern psychiatric wings may look like a standard hospital hallway

When I was hospitalized the second time at the local hospital it was Valentine’s Day and I wasn’t supposed to be there. Let me clarify, I very much wanted to be at a hospital, but because of my lingering fear of the local options, I had been scheduled to be admitted to a private institution in Connecticut. That morning we heard that I would need to wait through another weekend until a bed would be free for me. I couldn’t handle the small extension and it was back to the local, public hospital we went. I had strongly diametric feelings about going to a private versus a public hospital. I didn’t want steak and risotto for dinner, I just wanted to feel safe with other patients that wanted to heal. New York’s public hospitals include people who are there voluntarily and involuntarily and they take all patients. They both need to and should accept all patients because every person deserves care, irrespective of level of function or financial status. It does, however, mean that the care they provide needs to meet a wide level of needs. Necessarily, safety is prioritized above deep healing.

In some ways the local hospital was like you might imagine. Yes, the doors are locked, they take away your belts and shoelaces, and depending on the nurse, the staff might make you open your mouth after taking a pill to confirm that you actually swallowed your medications. We had the option of meeting daily for group psychotherapy and occupational therapy, which could be helpful or just a way to pass the weighty hours between other activities depending on the day.

On the whole, by keeping me safe from myself, I was able to stabilize at the hospital, but not for lack of a few major missteps. I focused on processing feelings on my own and in frequent meetings with an intern psychologist. I learned new coping skills from the occupational therapist. My meds were rapidly changed as we settled on a new cocktail to which I better responded. I was often treated with respect by the nursing staff, though that was not absolute. Interactions with rotating students and some of the other patients were less helpful. After hearing about my good marriage and successful research pursuits a med student told me he didn’t understand why I was depressed, and went on to ask me what I thought I would get out of suicide. I experienced friction from a few religious patients who strongly suggested that I talk to a priest, or vocally expressed their displeasure at my atheism. A psychotic male patient, and I mean that in the clinical sense of the word, physically threatened some female patients with sexual assault and made me fear for my safety until he was transferred to a different unit. Despite these complications, my first true hospitalization was both needed and successful in my stabilization.

Four Winds

The grounds of Four Winds Hospital, the site of my last hospitalization

My experience at Four Winds Hospital eight months later was so very different. From the intake procedures, which included a visual inspection of your body for any signs of physical harm, it was clear the doctors and staff were there to care for your whole being. Unlike my first experience, Four Winds provided programming throughout the entire day to build coping skills. This programming was offered in addition to regular meetings with a therapist and psychiatrist. Breaks to let the mind rest from the emotionally intense work of healing included walks around the autumnal, tree-lined campus, or art therapy with more media than I could get into in my 10-day stay.

At Four Winds I worked on deep emotional issues with a fabulous therapist, a bulldog of a psychiatrist, a convention-busting art therapist, and a whole host of supportive and encouraging nurses. I was introduced to the powerful system of Dialectical Behavioral Therapy. I wrote prose and poetry. I poured out the pain of my core into paintings and sculptures. I laughed with fellow patients at the absurdity of what mental illness had put us through. I worked hard. And I healed.

The two hospitals could not have been more different in many ways, but at their hearts, they were both needed to keep me safe and alive. Despite a multifarious system of caregivers we assembled who ensured I was never alone “on the outside,” both times I was admitted I needed more care than my unofficial team could provide. Both hospitals were instrumental in my ultimate healing. Unfortunately, the more depressive episodes someone has, the more likely they are to have another major episode. Because of this I can’t say that I am “cured” and will never need to be hospitalized again, but knowing that facilities like Four Winds exist heartens me that, should I again need inpatient care, there are good facilities that provide true healing.

My greatest hope for this brief post is that it grants insight to the locked facilities that are psychiatric hospitals. They are not the places portrayed in mainstream media. They vary in quality and clientele. They are chronically underfunded and overstretched. And they are crucial to the healing and survival of so many.


 

As a Biology Ph.D. candidate, Liz Droge-Young studies the incredibly promiscuous red flour beetle. When not watching beetles mate, she covers the latest science news on campus for Syracuse University’s College of Arts & Sciences communication department. She is also a mental health advocate, a voracious consumer of movies, and a lover of cheese.

 

Hidden mental health troubles in the ivory tower (13 Nov. 2015)

An initial reason for not sharing my experiences with depression was a persistent fear that people would think I was not strong enough for academia. My identity was so tightly wrapped up in my productivity, my latest department seminar, and my C.V. that the very thought of someone questioning my academic grit was enough to keep me from seeking treatment or even admitting to myself that something was wrong.

Fig 1

Fig 1: photo credit: D.A. Sonnenfeld

But I did have enough grit to excel in academia; I was tough as nails, strong as diamond, but that had very little bearing on my being strong enough to care for myself. Fortunately, around this time, I ran across a post by a favorite scientist blogger. He queried how many of his readers took a prescription drug, any drug, to enable successful academic performance. One in three of the over 150 reader responses in his unscientific, yet illuminating, poll confirmed the professional need for prescription drugs. One in three. These results were posted when I still shied away from talk therapy, let alone medication. It dawned on me that muscling through mental illness wasn’t the only option. Moreover, pushing through might not be a very good option.

A trip through academicsblogs suggests that not only is mental illness is pervasive in academia, but there is a paucity of research on mental health in the ivory tower. Being a scientist myself, I tried to find some nice, tidy statistics about the prevalence of mental illness in academia versus the general public, but repeatedly came up empty handed. The best evidence comes from two studies from the U.K. and Australia. A survey from the UK indicates nearly half of all academics report high or very high stress levels, though specific connections to anxiety, depression, or other disorders were not explored. Additionally, the magazine New Scientist reports that an Australian study found three to four times the incidence of mental health among academics compared to a general population. Unfortunately, the Australian study is behind a pay wall that, even with my University credentials, I can’t access to explore further.

There are a few factors that I propose contribute to the frequency of mental illness in academia, particularly among graduate students. Anyone who’s spent time in a graduate program or has loved someone working on their graduate degree knows the pressure to achieve can be intense. Graduate research can be an isolating experience as you zoom in on an ever-narrowing topic of study. Academia is also filled with rejection. Rejection of manuscripts, unfunded grant proposals, failed experiments, tenuous committee meetings, poorly received presentations, and the list continues. Unless you have a supervisor dedicated to championing academia’s infrequent successes, which I fortunately did, all the perceived failures can lead to a demoralizing collection of years.

Fig 2

Fig 2: photo credit: Greg Dunham

Another factor that’s less discussed, but I think is important to consider, is the predisposition of academics. I can only speak specifically to my observations in my little corner of Biology, but I suspect there is great overlap with other disciplines. We’re a detail and data-oriented bunch, trained to engage in the rational rather than the emotional side of our brains. We tend to be over-achievers, the highest achieving of which can still feel their contributions to science are not enough. Partitioning off important emotions, or even ignoring them in favor of the path to achievement, certainly did not help me with self-awareness.

In my experience, I used the academic pursuit to deny myself care. I tried to logic my way out of depression – I had a great partner and friends, I was successful in my work, it was simply illogical that I felt the way I did. In my last grasps to ignore that something was very wrong I turned harder into my research, attempting to fill my emptiness with data collection. It didn’t work.

One of the initially perplexing aspects of my depression was the timing. Depression didn’t follow a series of rejections, arise at a period of particularly high stress, or spring from a volatile relationship with my advisor and colleagues; depression hit when things were going well. After much discussion with my therapist, we decided that it was precisely the lack of academic or professional pressures to fixate on that unveiled the trouble underneath. My depression was not situational in the sense of a stressful external event causing my symptoms. It was clinical. It was major depressive disorder.

Fig 3

Fig 3: photo credit: Fresaj

In my case, genetic and early family environment most influenced my depression. Depression shows up on both sides of my family tree, for certain in at least the most recent generations when it’s become more societally acceptable to discuss mental health. I’d prefer not to delve into the early family environment portion, but I will say that overt abuse isn’t the only thing that can compromise a secure childhood. In short, many factors insidiously aligned to lead to my depression.

I continue to be frustrated at the lack of discussion of mental health in academia, despite its pervasiveness. At no point during any of the orientations I attended as graduate students was there mention of coping with mental illness while in grad school. If the existence of mental health facilities on campus were discussed, it was brief enough to be promptly forgotten. Discussions with fellow graduate students revealed that I am certainly not the only one to deal with depression. I’m also not the only one who has been hospitalized while in grad school. I can’t help but think that if I was aware of how common mental illness is in academia and if I knew that there is no shame in obtaining treatment, then I may have sought help much sooner.


As a Biology Ph.D. candidate, Liz Droge-Young studies the incredibly promiscuous red flour beetle. When not watching beetles mate, she covers the latest science news on campus for Syracuse University’s College of Arts & Sciences communication department. She is also a mental health advocate, a voracious consumer of movies, and a lover of cheese.