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Author Topic: clinical major depression and academic life  (Read 5938 times)
deadchildstar
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« on: November 29, 2011, 11:42:00 am »

I'm wondering if the Chronicle has ever done a column, series or feature on major depression. I've tried searching the site, but didn't find much dedicated to this topic. I can't imagine that's because it's not relevant.

Speaking strictly personally for a moment, I am a new PhD student presently suffering from clinical major depression - that is, not your average "grad school fosters depression" bouts of self-doubt, blues or burn-out. I finished my Masters several years ago, then worked before applying to a PhD - including doing University lecturing/teaching as well as administrative non-academic work.

In between, however, a number of very difficult life-events intervened, leaving me with a serious, clinical case of major depression involving crippling self-doubt, bad habits, crying jags, suicidal thoughts, irrational negative thinking patterns, you name it. While I have been in therapy, and am on medication, those things only help control depression. And while I am hopeful, in my better moments, that I am "getting better" as far as a bigger picture goes, it doesn't make any of this go away, and certainly not fast.

Up until finishing my Masters, I was a very good student - not perfect in terms of procrastination and with your average self-doubt, but confident and effective enough to get my work done, receive scholarships, get some small things published, and have a relatively normal academic existence alongside your average ups and downs. In my professional academic life teaching courses part-time, I did reasonably well, I was getting more and more confident as a lecturer before life went downhill.

At some point in the past year, amidst my depression, I was driven and confident enough to complete a proposal, get accepted and receive a fellowship. But now that I've begun the program, I'm filled with self-doubt/loathing and am having serious depressive episodes. Now, I find myself completely panicked and barely able to complete a grad seminar presentation, late with everything, timid to participate in class, convinced I'm not capable of writing papers. I'm aware enough to get myself to the school counselling department, but in terms of finding any other support, I find myself adrift.

In my professional experiences before returning to school, I found that people - friends, employers - don't understand  depression and sometimes don't care to. At my last job, I had a major episode that could have got me fired, so I had to disclose something of my condition to my employers in order to hang onto my job at that moment. The way I was treated after that was unbelievable, bordering on offensive. Before any of this happened to me, I'm not sure I would have even quite understood depression as an illness.

Needless to say, I'm hesitant to reveal any of my problems, even in confidence, to my anyone in my program - and I suspect that it could be detrimental to my career. However, I have no way to explain missed deadlines, days at a time spent in bed and "off the radar" and other depressive behaviour that seems strange or unacceptable to an outsider. On better days, I'm hopeful that with continued therapy and progression in the program I'll find some better ways of coping. In the meantime, though, it's a huge struggle, and one that I don't always overcome.

As anyone who is depressed will tell you, these things can spiral out of control in your head - so an email I've neglected to respond to, or a single missed deadline becomes, in my mind, reason to fail me in the course, withdraw my funding and kick me out of the program. Which only makes responding to that email or finishing that paper even more of a roadblock.

I guess I'd like to know if anyone out there has ever had experience dealing with the practical and professional side of academia while suffering depression. Do you tell your advisor(s)? Department head? Just seek therapy?

At the moment, I'm struggling with how to handle my current situation, but I also wonder how it will affect me down the road, and what the implications are in a broader career sense. I don't want to receive a reputation or be labelled for something that may not affect me in the same way in a few years time. While depression is an illness, like many illnesses, you can be treated, find better ways of coping, etc.

To date, I have not found any helpful resources online - everything is of the more general "depression is common among graduate students" type of advice.

Yes, it is common, and many people struggle with different types of depression, and it's difficult for everyone - but I suspect there are very few resources or articles dedicated to major depression and its implications for an academic career.

Any thoughts on the topic, or links to possible relevant articles, are appreciated.
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greyscale
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« Reply #1 on: November 29, 2011, 12:25:41 pm »

I suffered from depression off and on throughout college, grad school, and postdoc. It never quite became a major problem (but your description sounds so similar to mine!), but a surprising number of people I knew did need serious intervention like hospitalization. Some of them went on to finish their degrees, and some chose other directions. So, you're right that you'll find a lot of generic stuff about "depression is common in grad school" but some of those cases are also pretty serious.

My grad school had group counseling sessions (cognitive behavior therapy) for grad students. That might be a good addition to your individual therapy - I found it extremely reassuring to know that other grad students had the same problems as I did. But, that was more helpful for my ongoing sense of being an imposter than for treating real depression. Is your therapist familiar with academic life? My therapist spent her early career working at campus mental health services; now she has her own practice near campus and I think many of her clients are faculty.

I'm sorry that I don't have more useful answers to your actual questions - I have not done a good job of telling my advisors about my depression. My grad advisor was the type who'd think of depression as an actual medical condition (like it is) so I don't think he'd have held it against me if I had said something, but he was also fine with my bursty productivity.
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deadchildstar
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« Reply #2 on: November 29, 2011, 12:51:13 pm »

Thanks for your response, greyscale - while writing my post, I was conscious of not wanting to suggest that anyone's depression isn't significant. I think it's probably a matter of amplitude and potentially causality. I think they both manifest themselves in very similar ways, and certainly the feelings are powerful in any case.

But I guess I'm frustrated with the general advice because much of it, like often with procrastination advice, just seems pat or like, well duh - if I could actually get out of bed and go exercise, yes it might make me feel better, but that's presuming that I don't have crippling self-defeat/fear/agoraphobia and paranoia that makes even getting out of my apartment a huge accomplishment.

As well, no one seems to talk about whether or not you should talk about it, or if that winds up biting you in the butt later on.

Because of my own negative experience, coupled with being paranoid, my inclination is to not tell anyone other than a medical professional. But I find myself lost when asked why, for instance, I didn't respond to an email, and you run out of excuses like "it fell into my spam folder" or "my internet was out" pretty darn quickly - and I feel like a fool saying, oh sorry I couldn't face the universe this week. That simply doesn't cut it professionally. (My main way that I combat this particular problem is by responding immediately so I don't have time to think about putting it off, even if I say, I'm busy but I'll answer you later... this doesn't always happen though).



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msparticularity
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« Reply #3 on: November 29, 2011, 1:22:34 pm »

There are at least a couple of threads on depression over in the "Health Issues on the Job" child-board in "Balancing Work and Life." While it hasn't been a terribly active issue recently, there are a number of us who can very definitely identify with what you are going through, and if you revive one of those threads--or begin a new one--I suspect you will find several people who can share their own experiences and coping strategies.

The most important suggestion I can offer for now is that you go immediately to your campus disabilities office and get a file set up. Do not even attempt to negotiate for needed accommodations with your own department/program; as you've discovered previously, they may or may not have any idea of the legal protections offered for a disability like depression, and, as you've also pointed out, they may have no clue that this is a medical disability. The Disabilities Office will handle the negotiations for you, too, without revealing your exact condition: they will just say that you have a qualifying disability.
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"Once admit that the sole verifiable or fruitful object of knowledge is the particular set of changes that generate the object of study...and no intelligible question can be asked about what, by assumption, lies outside." John Dewey

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lasquires
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« Reply #4 on: November 29, 2011, 1:45:01 pm »

I've never dealt with depression quite this severe, and I'm a high functioning depressive, but much of what you're talking about resonates with me.

I cannot emphasize enough how much it helps to find a therapist who has some familiarity with academia, particularly if you are dealing with cognitive distortions relative to your work and professional relationships. Getting a handle on those distortions and developing strategies to counter them is key to moving forward.

At this point, I think you're right not to discuss your depression with your advisor or department head. However, if your depression is adversely effecting your work, could you look at taking medical leave for a semester while you get healthy?
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hegemony
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« Reply #5 on: November 29, 2011, 2:11:21 pm »

I think a blanket "Sorry, I've been feeling overwhelmed" covers a lot of the territory -- everyone can identify with feeling overwhelmed.  I suspect major depression is not uncommon in academia, but people cover it up as best they can.  One problem (from the observer's point of view) is that the prognosis is unknowable -- how soon will the person be back to regular functioning, etc.?  It's unpredictable, so people feel at a loss.

One thing I do know is that problems require support, and major problems require major support.  You need to throw everything you have at this problem, including slowing down your program if that's feasible.  (And helpful.  Some people do worse without external pressures and structure.)  Therapy, group therapy, anti-depressants, massages, piles of trashy novels or a premium Netflix subscription -- whatever improves life even a little bit.  No trying to tough it out.  And keep up your levels of social interaction, even though you won't feel like it -- they help "reset" emotions.  Isolation is lethal.  Hang in there!
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drscot
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« Reply #6 on: November 29, 2011, 7:02:06 pm »

I think a blanket "Sorry, I've been feeling overwhelmed" covers a lot of the territory -- everyone can identify with feeling overwhelmed.  I suspect major depression is not uncommon in academia, but people cover it up as best they can.  One problem (from the observer's point of view) is that the prognosis is unknowable -- how soon will the person be back to regular functioning, etc.?  It's unpredictable, so people feel at a loss.

One thing I do know is that problems require support, and major problems require major support.  You need to throw everything you have at this problem, including slowing down your program if that's feasible.  (And helpful.  Some people do worse without external pressures and structure.)  Therapy, group therapy, anti-depressants, massages, piles of trashy novels or a premium Netflix subscription -- whatever improves life even a little bit.  No trying to tough it out.  And keep up your levels of social interaction, even though you won't feel like it -- they help "reset" emotions.  Isolation is lethal.  Hang in there!

Hegemony is so right about not going it alone.

But you will not be in a position to deal with a complex menu of options. So, wherever you can quickly get professional support (on campus, if it's available, as suggested upthread), go there. Find the direct route to help. But you, as all of us do sometimes, still need the best help you can get. If you have choices, look for the ideal trinity: trusted (reputation), professional, close. If necessary, in that order.

BUT as with all answers here, as soon as you find a helpful live connection, go with that. No one in an anonymous forum is the best source of reliable advice, but sometimes they may point you to it. See how it goes, and God be with you, if that sits well with you. If not, I will pray into the silence anyway, and think of you; whether the words are heard or not, someone far away is doing his best to help, in the only way he knows how.

DrS
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prytania3
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« Reply #7 on: November 30, 2011, 10:09:47 am »

Vyvanse and Abilify.

Vyvanse will cure whatever ails you--depression, procrastination, weight gain, it even curbs the desire to smoke. Abilify levels you out.

If you are on SSRIs--no wonder you are depressed. They don't work worth a damn. YMMV.

But then, I'm bipolar.
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mfaeer
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« Reply #8 on: December 04, 2011, 1:52:40 am »

I'm wondering if the Chronicle has ever done a column, series or feature on major depression. I've tried searching the site, but didn't find much dedicated to this topic. I can't imagine that's because it's not relevant.

Speaking strictly personally for a moment, I am a new PhD student presently suffering from clinical major depression - that is, not your average "grad school fosters depression" bouts of self-doubt, blues or burn-out. I finished my Masters several years ago, then worked before applying to a PhD - including doing University lecturing/teaching as well as administrative non-academic work.

In between, however, a number of very difficult life-events intervened, leaving me with a serious, clinical case of major depression involving crippling self-doubt, bad habits, crying jags, suicidal thoughts, irrational negative thinking patterns, you name it. While I have been in therapy, and am on medication, those things only help control depression. And while I am hopeful, in my better moments, that I am "getting better" as far as a bigger picture goes, it doesn't make any of this go away, and certainly not fast.

Up until finishing my Masters, I was a very good student - not perfect in terms of procrastination and with your average self-doubt, but confident and effective enough to get my work done, receive scholarships, get some small things published, and have a relatively normal academic existence alongside your average ups and downs. In my professional academic life teaching courses part-time, I did reasonably well, I was getting more and more confident as a lecturer before life went downhill.

At some point in the past year, amidst my depression, I was driven and confident enough to complete a proposal, get accepted and receive a fellowship. But now that I've begun the program, I'm filled with self-doubt/loathing and am having serious depressive episodes. Now, I find myself completely panicked and barely able to complete a grad seminar presentation, late with everything, timid to participate in class, convinced I'm not capable of writing papers. I'm aware enough to get myself to the school counselling department, but in terms of finding any other support, I find myself adrift.

In my professional experiences before returning to school, I found that people - friends, employers - don't understand  depression and sometimes don't care to. At my last job, I had a major episode that could have got me fired, so I had to disclose something of my condition to my employers in order to hang onto my job at that moment. The way I was treated after that was unbelievable, bordering on offensive. Before any of this happened to me, I'm not sure I would have even quite understood depression as an illness.

Needless to say, I'm hesitant to reveal any of my problems, even in confidence, to my anyone in my program - and I suspect that it could be detrimental to my career. However, I have no way to explain missed deadlines, days at a time spent in bed and "off the radar" and other depressive behaviour that seems strange or unacceptable to an outsider. On better days, I'm hopeful that with continued therapy and progression in the program I'll find some better ways of coping. In the meantime, though, it's a huge struggle, and one that I don't always overcome.

As anyone who is depressed will tell you, these things can spiral out of control in your head - so an email I've neglected to respond to, or a single missed deadline becomes, in my mind, reason to fail me in the course, withdraw my funding and kick me out of the program. Which only makes responding to that email or finishing that paper even more of a roadblock.

I guess I'd like to know if anyone out there has ever had experience dealing with the practical and professional side of academia while suffering depression. Do you tell your advisor(s)? Department head? Just seek therapy?

At the moment, I'm struggling with how to handle my current situation, but I also wonder how it will affect me down the road, and what the implications are in a broader career sense. I don't want to receive a reputation or be labelled for something that may not affect me in the same way in a few years time. While depression is an illness, like many illnesses, you can be treated, find better ways of coping, etc.

To date, I have not found any helpful resources online - everything is of the more general "depression is common among graduate students" type of advice.

Yes, it is common, and many people struggle with different types of depression, and it's difficult for everyone - but I suspect there are very few resources or articles dedicated to major depression and its implications for an academic career.

Any thoughts on the topic, or links to possible relevant articles, are appreciated.

I hate to play armchair psychiatrist, but are you sure you're not bipolar? Your description of your illness raises a lot of bipolar flags for me (I'm bipolar, so I have a good sense of the disease). You write:

"While I have been in therapy, and am on medication, those things only help control depression"

You might want to seek a second diagnosis. Sorry if this is presumptuous, but if you're only taking anti-depressants and not a mood stabilizer, this could be a problem.

« Last Edit: December 04, 2011, 1:55:11 am by mfaer » Logged
psyche74
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« Reply #9 on: December 04, 2011, 2:38:15 pm »

My perspective is a bit unconventional, so please ignore it completely if it doesn't seem useful, but just in case it might be helpful...

My father suffered from clinical depression (and was also diagnosed OCD). I have found throughout my life that I share many of his natural tendencies (counting steps, needing light switches to click on after an even number, etc.), or at least shared them at one point. With the OCD tendencies, I eventually recognized I had a problem--the compulsions were controlling me and I didn't like that. So I started deliberately choosing to do the thing that felt 'off.' That was a form of self torture :) It was like listening to nails on a chalkboard for the most trivial of tasks. But I continued to operate that way, and eventually that 'grating' lessened. One day, I finally stopped thinking about the stupid light switches, and now I flip them once like anyone else.

Okay, so that's an OCD story, but it highlights my perspective. One of your comments particularly resonated with me: "these things can spiral out of control in your head." That I understand quite well. Over a year after my father died, I was exhibiting clear signs of severe depression: staying in bed literally 19 hours per day, not leaving the house, doing nothing during the 5 hours I managed to make it out of bed, etc. During one of my brief moments not in bed, I remember standing near the kitchen and thinking (without much concern about it), "this is a problem." I didn't really care. But I was aware. So like my response to the OCD traits, I decided to just start doing the opposite of what I felt. The mantra of 'just do it' is what I kept in my head, and eventually I became a functioning member of society again (not that you or anyone else with depression isn't a functioning member--it's just that *I* wasn't). I remember John Nash's line from A Beautiful Mind where he talks about having certain appetites that he doesn't indulge--in his case, seeing people who weren't there. I appreciate that perspective. If you can identify a general pattern of behavior that you can and want to employ, you can just choose to do that, whether you feel like doing it or not.

So for some things, like finishing papers or responding to emails, I would want to have a standby behavior to employ when things started getting away from me. With delayed emails, I would have a 'form letter intro' that I would use every time that said something along the lines of "I'm sorry this is so late" and then not belabor the point further but move right into the actual email. Yes, some people may be annoyed. Yes, by delaying you may have burned/damaged some bridges. I would just acknowledge that and move forward as those things are not within your control anymore. Just do what you can control.

This is the sort of advice I give to myself constantly, as in my head things have a tendency to go round and round and fill me with anxiety if they get the upper hand. So I just mentally 'check' them off: yep, that could happen; yep, that could happen, too; nope, I have no idea how to prevent it--maybe this, maybe that, etc. Okay, so what do I know for sure that I can do? I can go work on my paper (or write that email, or study for a test, and so on). These are the things I can control for sure. These are the things I will choose to do. And then I go listen to Frank Sinatra's 'Luck Be a Lady.' :)

So for me, controllability is key (not surprising given my OCD tendencies). And it helps a lot to identify many of my feelings as leading me in the wrong direction. When my feelings are running counter to what is helpful for my life, I choose to act counter to them. I still haven't mastered being able to not *have* the anxiety, but at least I can "pretend," and in pretending, my life proceeds as if I weren't having the anxiety...albeit with a good deal more insomnia than I would like.

I have no idea if my methods would work for others or if they should be used at all, but it seems to have worked pretty well for me. So if you find something in it that you can use, that's great. If not, at least writing it gave me a break from putting together a presentation I've been working on all weekend!
« Last Edit: December 04, 2011, 2:41:46 pm by psyche74 » Logged
artandscience
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« Reply #10 on: December 14, 2011, 9:21:50 pm »

deathchildstar:
You've described much of what I am going through at the moment. Others on this forum have provided excellent advice. I will echo msparticularity's recommendation to register with your university's disability office. They will be your advocates. On disclosing your condition to your advisor--I recommend against it. There is so much stigma surrounding depression. Your advisor may be fine with this; or perhaps s/he will not.
Good luck with this. Stay in contact with real, live people even if that is uncomfortable. You will get better.
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