Mental health has received more and more attention in the last few years. The topic is also getting an increasingly large platform in social media or in podcasts. Mental problems correlate with the increase in pressure and stress that people are exposed to e.g., in their jobs. In our times, you often need to find the perfect work-life balance to avoid a burnout. I once read: work-life balance sounds like there was once too much life. Of course, that is not the case, but I personally think that in earlier times, work might have been less stressful and people might have been under less pressure. Nowadays, the separation of work and life is sometimes not possible anymore.
Defining mental problems
27.8% of adults suffer from mental health problems in Germany – that corresponds to the population from North Rhine Westphalia1. Women are more often diagnosed than men and the numbers are increasing! From 2011 to 2021, the reported sick days of German employees grew by 40%2. Not just the job, but also other circumstances can contribute to the development of mental illness. Predispositions for mental problems can be biological factors (e.g. genetics), psychosocial factors (e.g. difficult childhood, toxic environment), or social factors (e.g. low education level, low income).
The term depression is nowadays used very generalized, that’s why I want to explain it in more detail. The two most common mental diseases are anxiety disorders and depression. Anxiety disorders are the most common ones (worldwide in 2019: 3.8%), followed by depression (worldwide in 2019: 3.4%)3. Both disorders often go along together.
We all had or have fears of different things throughout our lives: Spiders, flying, height, exams, and so on. Those fears are normal and useful to some extent. However, an anxiety disorder is when fear reactions occur in situations that are actually harmless. The fear is disproportional to the actual threat. Those affected experience the fear very intensely, both mentally and physically, when they have panic attacks, for example. When the anxiety is generalized, people are worrying continuously about many/all things in life, which in return makes them feel restless and sleepless4.
Because the term depression is often misused, I would like to inform you about the criteria required for the diagnosis of depression: When at least five symptoms, including one main symptom, are present for two weeks or more, the diagnosis of depression is made. Main symptoms can be loss of pleasure and interest and/or having a depressed mood and “emptiness”, while there may be other symptoms like lack of drive or increased fatigue; difficulty concentrating, remembering and making decisions; feelings of guilt, worthlessness, and helplessness; change of appetite; persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and pain for which no other cause can be diagnosed; thoughts of death or suicide, suicide attempts4,5.
Burnout is in its own category, but the symptoms can be the same as those of depression, so it is difficult to make a clear distinction. The symptoms of burnout tend to focus on work rather than life as a whole.
Mental problems in PhD life
Being a PhD student often means, that you have a lot of work and little life. It can be dominated by a lot of responsibility, stress, many working hours even on the weekend, difficulties with your boss, frustration, competition, limited contracts, low income while you have high costs, and a never-ending to-do-list.
A study conducted in 2022 asked for the satisfaction of PhD and master students in their current program6. Only 62% were satisfied with their graduate degree experience. They also rated their worries since starting their studies: The biggest concern was difficulty in maintaining work-life balance followed by financial worries after the graduate degree and uncertainty about the future career. So, all together, many students are concerned about their current and also their future life. Of course, also the COVID-19 pandemic contributed to that, since there was lack of social support and networking opportunities e.g., in-person events. 70% of the students said that they spend more than 40 hours per week on their program, because there is a “long-hours culture” at the university. Even working through the night is normal.
Here I mentioned just some of the everyday problems which one can face during a graduate school. However, it becomes apparent that the combination of these problems can lead to mental problems during the doctorate program.
In a study from 2018, Evans and others demonstrated that graduate students are six times more likely to suffer from depression or anxiety than the average population7. 41% of master and PhD students that were interviewed suffered from anxiety, 39% from depression. They also asked them about their work-life balance, showing that a good work-life balance correlated with better mental health. Additionally, they found out that many students with mental illness are missing a proper mentorship or don’t feel valued by their mentor. So, there is a correlation between less anxiety/depression and supporting, positive mentorship.
I believe the academic system needs to become more aware of mental health. For this, there needs to be a cultural change. Faculty and administration could be trained to support graduate students to provide guidance in their mental health needs. Additionally, there should be more awareness of mental illness in science and especially during the PhD program without stigmatizing people for sharing their mental health problems. It should become normal to ask for help if needed, and there need to be subliminal offers for graduate students. In my eyes, it should be in everyone’s interest, especially of supervisors, that students feel appreciated, guided, and not continuously stressed and pressured to avoid burnout. Otherwise, as I wrote above, students may lose motivation, have difficulty concentrating, and their performance will suffer.
Find help – offers from University of Bonn and general offers
The University of Bonn offers psychological counseling, where you can get an appointment if you have any problems8. In an emergency, you can go to the university psychotherapy outpatient clinic at any time. The BIGS Immunosciences and Infection has also a mentoring program, which offers to talk confidentially to someone in case you have problems during your PhD, for example with your supervisor9. You can find the links in the reference list. If you want to find help outside of university, you can go to your general doctor or call 116 117, they will help you coordinate finding a therapy spot.
If you feel that you need help, you don’t have to wonder if you really need it, and there is no reason to be ashamed of it. The sooner you get help, the sooner you will feel better and the less severe your problems will eventually be. Remember that more than one-third of doctoral students suffer from mental health problems. You are not alone!
Author: Michaela Limmer
1. DGPPN. Zahlen und Fakten der Psychiatrie und Psychotherapie. https://www.dgppn.de/_Resources/Persistent/154e18a8cebe41667ae22665162be21ad726e8b8/Factsheet_Psychiatrie.pdf (2019).
2. DAK. Neuer Höchststand bei Fehltagen durch psychische Erkrankungen in 2021. https://www.dak.de/dak/bundesthemen/psychreport-2022-2533048.html#/ (2022).
3. statista. Anteil der Betroffenen ausgewählter psychischer Erkrankungen und von Substanzmissbrauch weltweit im Jahr 2019. (2019).
4. ADAA. Depression and Anxiety. https://adaa.org/understanding-anxiety/depression.
5. Deutsche Depressionshilfe. Deutsche Depressionshilfe. https://www.deutsche-depressionshilfe.de/start.
6. Woolston, C. Stress and uncertainty drag down graduate students’ satisfaction. Nature 610, 805–808 (2022).
7. Evans, T. M., Bira, L., Gastelum, J. B., Weiss, L. T. & Vanderford, N. L. Evidence for a mental health crisis in graduate education. Nat Biotechnol 36, 282–284 (2018).
8. University of Bonn. Psychological Counseling. https://www.uni-bonn.de/en/studying/consultation-and-service/psychological-and-social-counseling/psychological-counseling?set_language=en.
9. BIGS. BIGS Mentoring. https://www.bigs-immuno.uni-bonn.de/bonn-international-graduate-school-of-immunosciences-and-infection/organization.