How to use a month's absence from a PhD to recover from depression
February 23, 2017 5:28 PM   Subscribe

I'm working towards a PhD in a foreign country and recently returned to the U.S. as part of my recovery from depression (which was/is largely work related). What are things that I can add to my routine during this downtime to help me on the road to recovery, and how can I best prepare for returning to academia? Special snowflake details inside.

I've been suffering from major depression since approximately October. I'm 1.5 years into my PhD in Switzerland, and while I tried to find help when I knew things were on a downtrend, I was bounced from therapist to therapist (and through a useless university one) until December. This was partly because of problems with finding an English speaking therapist (even though I was in Zurich). I finally found an expat psychiatrist, who I was able to see once before going home to the U.S. for the holidays.

I went home for Christmas, which was exceedingly stressful since I had not told most of my immediate family about my depression. The reaction I usually get when I say I'm doing a PhD in Switzerland is "WOW. That's so cool! You must be having so much fun!", which makes me feel guilty about the situation I'm in, so my stress levels remained pretty high for the entire holidays.

I came back to the office in January to have my biannual meeting with my advisors, and it was a complete disaster. I had told them I was seeking treatment in the fall for depression, and they *seemed* to understand, but all that went out the window in the meeting. Among other things, I was accused of creating a hostile work environment because I wasn't saying "hi" to people in the morning or going to lunch with the entire research team (things that were only the norm since the fall because of the depression). It was a 90 minute shock meeting that attacked my character rather than my research progress, mainly because for my boss, team unity comes before anything else (in my progress report, I had indicated I was having communication problems with my technician, who doesn't seem interested in working on my project and has thus far avoided doing any of the tasks I have outlined in emails).

After this meeting, I was put through the wringer of the Swiss healthcare system. I had a major depressive episode, couldn't get in contact with my doctor, tried to go to a crisis center and was turned away to go to the ER. I ended up spending a week in a locked ward for psychotic/permanently suicidal people because there was no room in a depression clinic. There was a serious language problem as well (none of the doctors spoke good English, the nurses even less). I finally managed to get in touch with my doctor who helped me get out of the situation, and I saw him for a few weeks to adjust to antidepressant medication before getting the all clear to go back to the U.S. for a month and a half.

So far, my plans for this time have included exploring other options to find a path to complete my PhD (different advisor, potential mediation with my current advisor). Luckily, I have passed my general exams, so I'm a phd candidate, which apparently gives me more rights than I would have otherwise. I've set up an exercise schedule; I'm picking up some old hobbies to try and feel sane again (knitting, playing piano). I'm looking for ideas to ease back into my academic work, which is highly computational (engineering and architecture PhD). I'm also looking for things (recommended reading, meditation practices, etc.) to help me not continue to bottle up stress, and I'm still experiencing a fair amount of guilt for taking what looks like (altogether) a 3 month vacation to everyone else. What small (and large) things have helped you recover from academic depression?
posted by pianohands to Human Relations (10 answers total) 4 users marked this as a favorite
While you are still on leave: do 15-30 minutes of actual, no distractions work, every weekday, in the morning. Stop when that time is up. Reading is generally a great thing for PhD students, but it doesn't provide an output or a feeling of accomplishment (there's always more to read, so it can be great procrastination fuel), so for your purposes, this needs to be work that be creates some kind of record/end product. Write outlines. Analyze data. Create a detailed plan for the first month when you return to work, and then revise it, and then scale that plan back at least 50%. And yeah, you're going to need to figure out the advisor thing, but your best way out of this (at least if you're planning to stay on for your PhD) will be to have a clear plan for what you're going to do next instead of just running out your leave and then going back and floundering. Dipping back into it without any pressure or outside expectations for 20 minutes every morning can help you figure that out.
posted by deludingmyself at 6:54 PM on February 23, 2017 [6 favorites]

Hi, okay, i went through some serious shit... almost but not quite to the level you had to go through (didnt have a language barrier, but was totally isolated in academia, physically and mentally, with extremely unsuportive/adversarial advisors and deans), but still totally debilitating (and had some serious long term consequences). I am just letting you know that because i think the way i talk about stuff will make it sound like it wasnt that serious or that i am an outsider looking in or something.

This is not advice for the academic aspect, just for the recovery aspect.

It was hard for me to do at the time, but really try to spend time with people who make you feel okay. Like, really force yourself to do it, and try to do it as much as you can. For me, i just needed to be out with people i cared a bout... go to a movie, play a video game w my brother, hang out with someone when they are running errands, etc. I didnt need people to be providing exciting things; just their presence was helpful. This probably sounds stupid, but it helped a lot. It didnt actually feel like it was doing much at the time, but it really was. I have gone through a few major depressive episodes and every time this has been something i undervalued at the time but that was really helpful/important.

I guess this is predicated on you having some genuinely caring people in your life available to you. When i was super depressed, i definitely didnt want to be around my friends because i felt ashamed and didnt want them to see me like i was, didnt want to be a bummer, whatever. A lot of it was pride; i didnt want to seem weak and i didnt want to ask for help. I really stopped talking to friends and family. At some point i had to force myself to interact with them, not really because i wanted to, but because i knew it was good for me. It helps remind you that people care. People who care about will be there for you and want you to reach out to them. It might not seem like it but it is true. If you think of the people you really care about, and think of them being in pain, you would be happy to help them relieve that pain and would want to be able to do whatever you can to help them out. Those people feel the same about you. If you think of events in your past or what you read or hear, whenever someone has a friend who was going through a really hard time, for whatever reason, people never say "thank god they didnt try to get my support," they say "i wish i had known, i wish i could have done something." And i know that for me, some of the people who had been a bit judgey became totally supportive and giving when they realized things were serious.

Also, if at all possible, spend time outside in the sun for a bit every day. Let that sun hit your face.

ps. about the guilt... something that has helped me is remembering, "it doesnt fucking matter". if people look at you askance then fuck them. This may also sound stupid but it has been really really useful to me. I may expand on that more later, and hopefully it is helpful

pps. sorry this is so long. Brevity is not my strong suit
posted by miss so and so at 7:25 PM on February 23, 2017 [5 favorites]

Sorry you're going through this. GABA really helps a friend with his anxiety/depression issues. You're doing (or starting) the other things I was going to recommend that also help him - exercise (running), and meditation. He's doing Headspace, but I hear good things about Calm as well. I think you need a smartphone for those, but I could be wrong - check out the sites if need be.

In looking up stuff to help him out, I came across some recommendations for Feeling Good. He's not much of a reader, so he hasn't read it - but it might be worth investigating.

Enjoy and heal during your 3 months off. Think of taking this time off now as an investment in your future self.
posted by backwards guitar at 8:01 PM on February 23, 2017

The best thing I did for my academia-related malaise was quit the PhD program. Academia sucks. It's isolating. It lacks all the support and community you get in almost any workplace. And it's really overrated. If your career doesn't absolutely need it, spend the month figuring out the fastest path to paid employment in your field.
posted by salvia at 8:09 PM on February 23, 2017 [7 favorites]

I don't want to be a downer but I agree with salvia. It only gets more intense.
posted by k8t at 9:02 PM on February 23, 2017

1) Get sunshine every day. 20 minutes if you can.
2) Exercise every day. Get your heart rate up. If you can't run ( I can't, bad knee) walk briskly enough so that conversation would be difficult.
3) Guided meditation if that suits you. Plenty of affirming apps out there.
4) Volunteer. The number one thing that makes me feel better is helping someone else. Going out into the community to do so is best, because an actual human connection is a++ 10/10. But if not possible, try something like - You can do things like transcribe prisoner letters or tag pictures of Mars. Whatever you're interested in, there's something at least tangentially related where you can help someone. I really think so many people with mild-moderate depression could improve by helping others. I now knit for charity during my daily commute. It has helped me a lot.

I hope things get better for you. Time heals most wounds.
posted by greermahoney at 11:09 PM on February 23, 2017 [4 favorites]

Hi, I've also been depressed since October! It's a great club apart from the clubhouse being all shitty and on fire and stuff.

I can't speak to the PhD angle (or solving the big problem), but something very small and manageable which I'm finding really helpful is to spend five minutes 2-3 times each day lifting weights.

Nothing huge - I'm using a 2.5kg dumbbell because I'm also weak and noodly for other-chronic-illness reasons - but I lift it with both arms until I can really feel the strain and I try only to focus on the sensation of the lifting and the feeling in my muscles while I'm doing it. I suck at 100%-clear-your-mind type meditation, but focusing on this feeling and this feeling only is helpful, plus every day it's a small boost of "this is getting easier/I can lift a bit more/I'm gaining some strength even though I feel terrible".

Personally I hate the global advice to do cardio-type exercise when you're depressed (though I do try to walk as much as I can too), because I have a bunch of breathing/breath-holding related anxiety and cardio is a huge trigger for that, so it usually makes me feel worse and more of a panicky mess rather than better. Strength-related exercise works a lot better for me.

I also want to say that your experience with your university and the mental health services in Switzerland sounds really difficult and traumatic, and that you shouldn't feel bad if that is contributing to making you feel bad (if you know what I mean). I think a lot of advice about depression skims over the fact that a) it can be an inherently traumatic experience and b) a lot of the things involved in living with it, dealing with it and treating it can also be really traumatic. I've never had to seek care outside of my own country/cultural context, but even within that context I've had some massively traumatic experiences.

When you are working through your feelings, I'd urge you not to downplay your own experience of this trauma, or feel like it was an inevitable cost of trying to do the business of getting well - it's worth addressing as part of your overall treatment.
posted by terretu at 1:32 AM on February 24, 2017 [2 favorites]

I'd consider leaving the PhD program if I were you. 1.5 years is still early days and it sounds like it's not a great fit for you. Can you really envision spending another 4 years or so there? Do what's best for you and your health. PhDs can be brutal on people who aren't suffering from depression. Perhaps you can transition to a masters to still get something out of it? You could always reapply to programs in your native country down the track.
posted by emd3737 at 1:45 AM on February 24, 2017 [1 favorite]

I'm so sorry this happened to you. I have spent two years in Switzerland and agree that getting help for mental issues was difficult. I ended up paying out of pocket for online therapy, but I understand not everyone can do that.

I am facing the decision of going back to grad school (only for my master's) and I wonder if things that are already difficult like academia aren't much more difficult when you do them away from home. Is there a possibility for you to transfer to a school closer to home? There's really no shame in needing as much support as you can get while doing something so intensely difficult and isolating and mind-screwing.
posted by LoonyLovegood at 2:59 AM on February 24, 2017 [1 favorite]

I wouldn't necessarily quit just because PhD programs get more intense. They do, but it may also be that you'll come out of the other side of this with a much larger mental toolkit and an increased ability to handle very difficult situations. (And you've already been through a lot! Give yourself credit for enduring that, for deciding to treat your mental health in the first place, and for persevering until you got reasonable treatment.)

As far as stress goes, I heard a really interesting talk from a psychologist who studies stress a year or so ago that resonated with me. Her basic premise was that an underrated way to react to stress is to try to find a way to embrace it, or at least allow it to be present, and that doing so can actually make you more capable. Another point she made was that generally, people don't stress out about things they don't care about. So being stressed out is kind of a signal that you care a lot about something. The trick is that it might not be finishing your PhD, it might also be feeling like a success or wanting to please people or providing for people or a complicated mixture of things.

So as a first thing I might just try and take some time to look at your stress from a sort of warm, nonjudgemental, detached perspective and try and figure out what it is at the root that is actually making you stressed out. What I remember as the next step is to try to reframe it as indicating something you want, and the step after is to figure out what (if anything) is in your control that you can do to move in that direction. So for example, if I'm stressed out and it turns out it is because I am scared of dying without accomplishing anything worthwhile, I might reframe that as wanting to make an impact through my work. I can't control how other people might evaluate my work, but making sure the research I'm doing actually feels important to me might be at least partially under control, since I have some say over the research direction. Just an example and yours are likely to be totally different. Anyway, the point is that stress isn't always negative in and of itself, and the fact that you're experiencing it, even at levels that may feel overwhelming, isn't necessarily a sign that anything is wrong. Stress can accompany really powerful changes and it can also help you make them.

This is totally not an endorsement of grad school workaholism btw - I think you can try to embrace stress when it comes up, and also choose to live a balanced life with lots of time for exercise and socializing and things they enjoy.

As far as time away goes, one thing that has helped me a lot when my mental health is poor is structure, which I'm kind of loath to admit because I always chafe at schedules. But both the happiest and the most productive I was in grad school was when I had a regular rotating dinner scheduled with around ten of my friends: I got to see people I loved and I only had to cook one night a week, but critically, I also had somewhere to be at 7:30 and so my days actually had a regular sort of rhythm to them. If you don't have specific reasons to get moving and see other people, it's easy to just waste lots of time depressively/anxiously ruminating. Being engaged in stuff helps a lot, and it's much easier for me to be engaged in things when I actually have to physically show up somewhere and can't leave myself the option of spending the afternoon staring at the wall/TV/internet. I like the suggestion to do 15-20 minutes of work a day, if you're not in the phase where it feels like your body is physically rejecting your PhD work (if that's where you are, giving yourself a week or two where you don't think about work at all might serve you better, as long as you actually come back to it). If you can do it at a library or coffee shop, I think that might be even better; better still might be to make a regular appointment with someone you like to go to the library/coffee shop and work next to one another. Or something like that.

Finally, another thing that I think helps is knowing you're not alone. And you're really not -- I'd say probably 25-50% of my academic friends are on antidepressants (including me, hi!), I know at least one person who was briefly voluntarily sectioned during grad school (and is doing way better now), I know a bunch of people who took significantly more than three months off, and I know a bunch of people who had bad experiences with the first lab they joined and ended up being much happier after finding a better fit. So that can be a good thing to keep in mind if you start to feel guilty about taking the time to treat your mental health.
posted by en forme de poire at 5:15 AM on February 24, 2017 [4 favorites]

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