Mental health and treatment in graduate school

Talking about mental health is hard. Let’s start there.

I think I have always been relatively transparent (some might disagree, which is fair) about my mental health experiences in graduate school. Now that I have the privilege of watching other new scholars grow and have been somewhat removed from my own graduate school experience in terms of time, I get to reflect on my entire journey.

I am not the first, and I will certainly not be the last, to talk about problems with mental health in graduate school education. (See here, here, and here for examples.)  However, for me, my own mental health journey during graduate school was greatly influenced by my sense of what was going on in my community, and as such, I think that simply having academics constantly engaged in this conversation may be an important step forward.

What does the problem look like, though? I cannot speak for anyone’s experience but my own, but in sharing my own experience, I hope that those who are struggling might find some comfort, if not insight. My goals in writing this are two-fold: (a) to help people reflect on their own experiences, and (b) to simply share what helped me through my own issues. In particular, I focus on why treatment was important for me.

Before I say anything else, I would like to emphasize that I am not a mental health professional. I do not claim to know why some of the things that I experienced happened, nor do I assume that other academics, much less a majority, have experienced the same things.

As a brief bit of background, I was not particularly attuned to issues of mental health before starting graduate school. I grew up in an environment that largely diminished mental health issues. However, throughout my time in graduate school, I slowly came to realize that my patterns of thought and behavior, whether chemically-induced or simply habitual, were causing major problems in my academic and personal development.

Some of the signs:

  1. Days to weeks-long periods where I would obsess over previous social interactions.
  2. Not being confident in anything I ever said in class, and taking any contradiction of anything I said in class as a sign that I didn’t belong there and that people didn’t like me.
  3. Complete withdrawal from my peers and colleagues for long periods of time.
  4. Complete dismissal of the idea that they were really peers and colleagues in the first place.
  5. Being unable to attend class because I couldn’t bring myself to be around other people.
  6. A paralysis where whenever I got any indication that I had made a mistake (real or not), I would find myself on my couch, in silence, unable to do anything or speak to anyone for hours on end.
  7. I was never much into crying, but oh goodness, the crying.
  8. Bouts of internal panic where certain stressors would send my brain into a kind of overdrive where my thoughts would become incoherent and I could not process events. This was often accompanied by actual physical reactions as well.
  9. A general lack of motivation or interest in anything I was doing, which I confounded with disinterest in my research or any research at all.
  10. Eventually, realizing that getting up every day was something I dreaded and that if I had my way, I would simply cease to exist.

Again, I do not claim that these issues emerged because of graduate school, but I do think that some aspects of the graduate school experience certainly did not help. Continuing with my disclaimers, I do not know if this experience is the norm, nor do I think it should be normed. I think that as a society, there is some serious work to be done to think about how the structure of graduate student life is or isn’t particularly healthy. We also, I think, need to have a conversation about certain tacit expectations we have that graduate school will be tough and stressful and life-swallowing. Until that happens, though, we as individuals also need to talk about ways that people can cope. Much of this evolution is just learning how to be an adult and deal with stress, but there are many other ways in which it is more specifically about real, psychological problems that cannot be attributed, I think, to simple immaturity.

First and foremost, I got help. I had always been fairly anti-therapy and very anti-medication when it came to psychological issues, but upon educating myself about the risks, I decided that the risks associated with trying treatment were much lower than the risks of leaving my issues alone. After a fair amount of evaluation, I was diagnosed with major depression as well as social anxiety. As such, it was recommended that I work simultaneously on two treatment paths – regular counseling with a psychologist and medication through a psychiatrist. For most of this time, every week (and later, every two weeks), I would have a session with a psychologist. Every two weeks (and later, every month), I would meet with a psychiatrist.

I think there’s an important point I should note here: I did not get better right away.

In fact, I had several fairly major setbacks in the road, including a period where I stopped therapy because I wasn’t seeing progress, at least two changes in my psychologist and one change in my psychiatrist, maybe five or six changes in medication as we tried to figure out what would work, consequential swings in mood and other physical reactions as my body reacted to the chemical changes, a fairly embarrassing moment where I got in an argument with the leader of a group therapy session and never went back, at least one fairly frightening withdrawal period that involved extreme paranoia and insomnia when I stopped taking a medication, and lots and lots of me going into an appointment with nothing to say but, “I feel exactly the same as I felt last week, if not worse.”

In my case, I didn’t see a lot of immediate change, but upon reflecting on my entire treatment period over the course of three to four years, I can see now that I changed tremendously. I went from dangerously low moods to fairly middling moods by the end of graduate school. While I cannot say that I was completely “fixed” by the end, I know that without having addressed it head-on, my outcomes might have been very different.

Not everyone is going to need the same things, but for me, what was probably the most important part of my growth was recognizing I had a problem and sticking with working towards a solution. Farther down the road, I think it paid off. Was the process of writing and completing my dissertation still difficult and stressful? Of course. Did I still have my low moments? Yes. But I was better able to cope with those moments because I had finally gotten to the place where I knew for a fact that those moments would be temporary. I may not have the kind of zest for life that a completely healthy person would have, but there is something comforting about knowing I am nowhere near where I used to be.

In reference to my own experience, were I to go and give my early-scholar self some advice, this is what I would say.

  1. Not all professors are particularly adept at addressing these issues, nor do I think, being a faculty member now, that we can be expected to do so. If you feel that you are in danger, seek professional help, as the conversations you have with unqualified (though well-meaning) individuals may in fact make things worse.
  2. If you feel comfortable enough, do try to be honest with at least one person about what you are going through. No, do not use them as your therapist, but it was critically important to me that at least one person knew what was going on so that when I did have depressive episodes that got in the way of my academic work, at least someone knew why it was happening and didn’t think it was just because I was a bad student.
  3. Patterns are patterns, no matter how bad. Psychological treatment is about more than just suicide prevention (which is what I used to think). You don’t need to be immediately in danger of dying to see a primary care physician. The same applies here.
  4. Putting a priority on your treatment is important. This does not mean ignoring academic responsibilities, but it does mean arranging your life such that you still have time for therapy. The times when I skipped therapy because “I just have too much to do this week” never turned out particularly great.
  5. Advocate for yourself. Communicate with your mental health providers about your goals, fears, and concerns. If you feel that you are not getting what you need, just let them know.
  6. Sometimes, you will withdraw from people who care about you. Sometimes, this will be for quite some time. That is okay. Of course, you should still be respectful of the people around you, but make sure to consider your own needs as well. People who care about you will understand.
  7. Be patient with yourself. Change will not happen tomorrow. It may not happen next week. But over the long-run, change, indeed, will come.

In defense of STEM re: critical pedagogy and content

At this point, I’ve participated in a lot of discussions about how to incorporate more critical discussions about race, gender, and power in the classroom, and thus far, they’ve been dominated by people from the humanities and social sciences. I think these are really important discussions, and I’m glad to be a part of them.

For me, these discussions often become a bit uncomfortable when we start talking about STEM. Usually, these discussions start with some comment about the difficulties of incorporating these discussions into the STEM classroom, and responses tend to vary anywhere from an insistence that these topics permeate any discussion to mild (or not so mild) indignation that STEM people don’t seem to care about these issues.

As someone with an undergraduate degree in STEM, and as someone who has spent some time teaching STEM topics, I can’t help but feel a bit defensive in these discussions. I think there are parts of this discussion that are indeed true: I do think that STEM people, on average, do not think about these issues in their daily lives and work quite as much as their non-STEM peers.

That said, I think that non-STEM people tend to forget that there may be significant periods in STEM classrooms where we are literally not talking about people. When I taught about deriving the formula for a correlation, I wasn’t talking about people. When I sat in a classroom and learned SQL, we weren’t talking about people. We were talking about databases and pivot tables. What were the tables in the data about? Many times, not people. (Throughout the duration of my education, I’ve worked with a surprising number of datasets about different kinds of boats.)

Even when we are talking about people, there are often ways in which issues of race or gender or class are not immediately applicable. I’ve had by DNA put through gel electrophoresis on multiple occasions to assess characteristics of my human DNA, but no, I don’t think there was any reason to discuss those types of issues in that moment. At some point in my education? Sure. In that moment or even in that particular class space? Debatable.

There are subtle ways to incorporate critical reflection into the classroom, yes. I myself have made mention of the limitations of using dichotomous indicators for measuring gender identity. However, I feel that as a function of the subject matter, responsibility for STEM educators to use critical teaching is different. Not lessened. Just different.

Where this kind of thinking does fit more universally is in considering the classroom environment. Many STEM fields have traditionally been dominated by white, class-advantaged, heterosexual men. So there are many ways in which the system, as it stands, still systematically excludes marginalized populations from STEM and, as one mechanism, creates uncomfortable and sometimes harmful classroom environments. It’s at this juncture that I think STEM educators need to be most in touch with critical pedagogies. STEM educators have a responsibility to understand how the dynamics they develop in their classrooms and the systems in which they participate contribute, often, to the disparities we see in terms of the participation of othered people in the field. With this, STEM educators have a responsibility to be open to and learn alternative ways of creating learning and living environments that are cognizant of the power in the room.

That all said, I do wish that discussions of critical pedagogy and content  would be more open to the idea that no, all of our respective academic spaces are not the same. No, the concepts we are talking about do not apply in the same ways across disciplines. If we are going to develop ways to create an educational world that is, across the board, reflective of the justice we seek, being sensitive to the variety of ways knowledge is legitimately created is just a practical reality.

Diversity for the sake of diverse learning spaces

In 2003 (Grutter v. Bollinger), the United States Supreme Court ruled that the affirmative action policies of the University of Michigan Law School were not unconstitutional. In the dissent, Justice Rehnquist noted that school administrators cited the need for a diverse student body to “ensure that these minority students do not feel isolated or like spokespersons for their race; to provide adequate opportunities for the type of interaction upon which the educational benefits of diversity depend; and to challenge all students to think critically and reexamine stereotypes.” Similarly, the ruling (authored by Justice O’Connor) stated that the Constitution “does not prohibit the law school’s narrowly tailored use of race in admissions decisions to further a compelling interest in obtaining the educational benefits that flow from a diverse student body.”

This justification is also used here at my own institution, as per the academic strategic plan: “Diversity, in the broadest sense of the term, is absolutely critical to ensuring excellence in our core missions of discovery and learning. The human condition is fundamentally shaped by the context in which we have lived, learned, and now reside. A university offers an exceptional opportunity to bring together people from different personal and scholastic backgrounds in the name of higher learning. The experience of being an African-American is different from that of being a Hispanic. The same is true for gender, ethnic groups, social class, place of origin, sexual orientation, and countless other genetic, cultural and environmental parameters. It is also true that engineers have different perspectives than lawyers, as well as classicists compared to chemists. At one level, all such claims are obvious. The human condition, and human lives, is shaped by these different experiences, and they give rise to very different prisms by which each individual thinks about problems and opportunities and then approaches solutions.”

There are parts of these notes with which I sympathize, and parts that make me deeply uncomfortable. This discomfort isn’t because I think the statements are incorrect; there are various pieces of evidence circulating (especially recently) that cite the benefits that diverse student bodies bring to academic spaces. Nor do I think that there’s any particular problem with stating these benefits, since I do think it highlights the value of perspectives from historically excluded and marginalized populations.

My problem is when this is the only justification provided. In short, it’s not my job as a person of color or as a gay man to enhance your academic experience.

This isn’t to say that I don’t also benefit from a diverse learning space. My undergraduate institution was very diverse in many ways, and I think it really contributed to a healthier environment to the extent that I did not particularly feel isolated, and I did learn a great deal from those with backgrounds different from mine.

For me, though, the most important reason to include more “diverse” populations (in quotes to acknowledge the possible oddity of calling any particular population diverse) is not because of what it brings to others, nor is it particularly because those people will benefit from having more “diverse” colleagues. The most important reason is related to the fact that persons of color (speaking from my own identifications) have historically been excluded from quality institutions of higher learning, which is something (I assume) we agree is morally wrong.

Briefly, I’d add that my feelings here extend beyond academia. The same justification is often used elsewhere, especially in community development. Throughout my life, I’ve seen various news reports about the extent to which, for example, having gay men move into a neighborhood benefits the entire community. While I appreciate the magical powers that these reports have assigned to me in terms of my queer ability to raise the property values of my neighbors’ homes, it still feels tokenizing, as if they need me as a gentrifier (which has its own problems) more than I deserve the right to live in a safe community.

My overall point is that the compelling reasons for diversity should not primarily be because of its ability to increase the excellence of an institution. It should be because that institution has a commitment to upholding justice.

Affirmative Action may be uncomfortable, and that’s okay (for some people)

Last year, Vanderbilt University brought Sheryll Cashin to discuss her book Place, Not Race: A New Vision of Opportunity in America. I attended, as did several of my colleagues and friends. And for those of us that were trying to work towards a more equitable and justice-oriented campus, it was…interesting, to say the least. Overall, I found it somewhat narrow and felt that it missed the point. I was deeply troubled for a while, especially as the audience consisted mostly of white members of the community who, more often than not, were in a place of power. What were they taking away from this talk, and how much harder was it going to make my job?

In discussing her opposition to affirmative action, she said one simple, powerful phrase that brought the crowd to its feet, notably without myself and my colleagues: “I was raised to care about other people’s children.”

In a lot of ways, I think this sentiment in opposition to affirmative action, that those in the dominant majority are being slighted in a zero-sum game of college admission, is very unhelpful. It was deeply troubling to me for a while, and only made me even more cynical about our ability as a community to enact real justice for those who are underserved in higher education or, more broadly, the world.

That said, I’ve thought about it a lot. And while I still think that it’s a huge problem that this was announced to a crowd of white people who overwhelmingly endorsed this point of view, I sympathize with where Dr. Cashin in coming from, in certain ways. Before anyone either (a) decides to dismiss everything I’m about to say as anti-justice or (b) use what I’m saying as a part of their anti-affirmative action platform, let me say up front: I support affirmative action, and I generally disagree with most opposition that those in the dominant majority have against affirmative action. What has changed in my thinking is that overall, I think it’s okay for black people to be uncomfortable when thinking about it.

Obviously (or maybe not, for some people), it’s not okay when someone assumes that a black person got into college because of affirmative action. I’ve gotten these comments before, anywhere from “It would be great to be black so I could get into college more easily” to “Well it’s good for you that you got affirmative action to be here.” I’m not going to spend time explaining why these statements are deeply offensive and hurtful, because it should be clear, but there’s a second reaction that I think we don’t think about a lot.

At least for me, when I was in college, I didn’t really understand how college admissions worked. Frankly, I’m still only fuzzy on the details. The secondary, but longer-lasting issue for me when it came to those offensive comments was that they’d dig their way into my subconscious and gradually start to feel true. Did I only get in because of my race? Do I not measure up to other people here because I didn’t get here on my own merit? I’m not saying that they’re healthy thoughts, but I think that if other black students were also feeling this way, I’m okay with that acknowledgement.

I think it’s okay for black people to feel uncomfortable about affirmative action as it relates to our own personal lives. I think that overall, that’s where Dr. Cashin was coming from (though it’s still thoughtless to not consider your audience). It’s for the same reason that, for a good portion of my young adult life, I was also against affirmative action. In a lot of ways, it’s not great to feel like you might be getting special treatment in spite of your merit.

All that said, I don’t think it’s valid for this to be a talking point for white people on this topic. It’s not up to white people to decide, in my opinion, whether or not my discomfort works for or against their own policy opinions. I’m not sure, now being pro-affirmative action, what exactly you do about the discomfort. It’s definitely hard to reconcile with broader senses of policy justice. These feelings, I think, are exacerbated by a life of feeling like my stereotype was lesser (in academic words, stereotype threat) and living in constant doubt because of it. Even with my updated understanding of the policy, knowing that I’m not actually taking the place of someone more “qualified,” it’s still a slight nag I have in the back of my mind.

I’d rather acknowledge it than pretend it’s not there. It’s the main reason why I don’t think affirmative action is necessarily a perfect situation, but it’s easier when I recognize that I feel this way, and then can work that into my more complete perspective on the policy. It’s not all about me, but in some respects, my thoughts about me are a part of it. Frankly, I’m okay with that.

Methodological elitism and quantitative ego

I was having a talk with the sagacious Ben Skinner the other day about our methodological training, and as I am prone to doing, I have found myself reflecting on that conversation probably more than is healthy. I am not, in my estimation, a master of research method, but I think Ben and I both have had unique experiences in this regard. Both of us have been exposed to the very applied side of methods training within the econometric tradition in education policy, while also having had experience in the world of more statistician-dominated methods training.

The foundation for the discussion we were having was that from both of our perspectives, many of the people in education policy (and at least in my opinion, in social science in general) have placed a certain premium on being able to do rigorous quantitative research. Whether or not that is positive for our field, what it also produces, in many ways, is a certain type of egoism that leaves and perpetuates a gap between how good people think they are at quantitative and computational methods and how good they actually are. This in turn produces three negative outcomes (among others) that I think are particularly problematic:

  1. People can often uncritical of their own methods when faced by those who they feel are not as well trained,
  2. A certain sense of already having accomplished mastery leads people to feel that what they have is “good enough” for being thorough, and
  3. A social hierarchy is produced where those with this mathematical ego see themselves as better than others.

(I should note that the community to which I am referring includes myself. I will also note that Ben, from my conversation, also is reflective on this – I am just avoiding speaking for him.)

On the ego side, I think it’s simpler to see how this is, if not unjust, at least very annoying for the rest of the field. I think it doesn’t require much discussion to justify why this is a bad thing. But I think the methodological deficiency might take a bit of explaining, which I might outline more over time, but here are the cliffnotes…

On the math side, I think that many social scientists learn the basic mechanics and assumptions of regression analysis and, in some places, econometric methods of causal inference. For most of what we do and the work we produce, I think this passes the sniff test: it really is good enough. But often, it’s not. In particular, I’ve found that many of my colleagues (and I say this with the understanding that I am also mathematically deficient in many ways) lack a certain sense of nuance in terms of how data exists (or doesn’t) in time and space. This has implications for many modeling shortcuts I’ve seen, where “good enough for discussion” is prioritized over using distributions and statistics and mathematical perspectives that are outside of our basic econometric paradigm, even if those other perspectives may be more technically correct and may more faithfully describe the world we are trying to explain.

On the computational side, while I think we acknowledge that the flows of research through (especially recent) history have often been determined by our computational capacity as a field, I do think, as was Ben’s point to me (as I understood it), that we forget that we play an active role in creating that capacity. Not everyone needs to be out there creating new computational methods, sure, but I do think that it’s better for research if people are willing to look outside of their comfort zones to find better pathways for answering their questions. Moreover, the questions we ask are constricted by the methods we know, and so even if we aren’t able to commit the time to fully and deeply understanding other computational options, refusing to engage with them functionally limits the creativity and scope of the work we can do. Quantitative research will always be limited simply by the availability of data, but we’re only exacerbating this problem when we limit ourselves to only answering the questions whose required methods are within our current, at-the-moment skill sets.

I don’t think a lot of this is particularly a social science research problem, exclusively. I think math and computational methods hold a privileged position in our society that at least for my part, I don’t think they deserve. But I also don’t think it’s wrong to say that a general lack of faithful rigor in methodological training beyond “good enough” is real and has important implications for the construction of that same society. (And in defense of quantitative methods, I think rejections of quantitative paradigms from those in other communities often suffer from similar types of egoism.)

In the end, I think both the elitism and the deficiencies are essentially tied to one another, and they can’t be addressed separately from one another. I think quantitative researchers, as a field, could benefit for getting off their methodological high horse every now and again to not only reflect on what we don’t know, but also on the need for us to fix it.