In Limbo

Note: A companion piece to this one was posted on DoubleXScience on 26 July, 2013.

I’ve been on medical leave for almost a year now, which is an odd sort of limbo that’s hard to explain unless you’ve experienced it.

At first I didn’t want to talk about it at all. The decision to take a leave was an excruciating one – no matter how logical it was. I was ashamed, feeling I’d failed at my job. I told only my closest friends and swore them to secrecy. After a while I realized that secrecy was only making me feel worse.

I’m an environmental scientist who loves writing and editing, I have tenure, two retrievers (one a very mischievous 12 weeks old), an h-index of 11 (whatever that means), a husband – oh and by the way I also have severe depression and anxiety. I’ve been emboldened to address this more personal issue by reading what other scientists have blogged about lately. If Olympian Clara Hughes and CBC host Shelagh Rogers could ‘come out’ about their depression, so can I. To understand a bit about depression from the inside, check out this spot-on post from Hyperbole and a Half.

My (limited) knowledge of leaves

As an undergrad, one of my professors was on leave and there were whispers in the hallways that she had chronic fatigue syndrome (CFS), a polite way of saying she was faking it. Department faculty muttered under their breath that she wasn’t that great of an academic anyway, so it was no loss to the discipline that she was on leave.

Another of my professors had a nervous breakdown. We heard (not officially, of course) that another faculty member had found her in her office, lying on the floor and crying. While she only took a short leave and then managed to get through the next term, the hallway whispers then were about how she’d overextended herself and been too ambitious.

A few years ago one of my colleagues at another university had heart surgery, and his doctor recommended a lifestyle change. Everyone talked about how good it was that he’d taken a medical leave, how great he looked, and what a smart choice he’d made to scale back his professional obligations and focus on the important things in life.

My entire experience is encompassed by these episodes – admittedly a very small sample that begs for more info and stories from other academics (please add your comments!). But the messages I got from these anecdotes were:

  1. Women taking medical leave are either too weak for the job or are over-reaching, while men are doing the right thing and encouraged in this by the community.
  2. Physical illnesses are easier for colleagues to deal with than mental ailments. Though I should note that although CFS was once considered to be all in a patient’s head, it has since been acknowledged to be a physical ailment.

What happened?

Returning home from a brief sabbatical at Oregon State University last February, I realized something wasn’t right. I was no longer interested in things that used to fire up my internal passions. I had a hard time talking to people – losing the thread of the conversation and forgetting basic words. I hated to be out in public, and found speaking in front of a group even worse. I’d get sweats and chills followed by extreme exhaustion, my voice sounding like it was being squeezed out of the stretched neck of a helium balloon.

From there I progressed to not sleeping – when I did fall asleep, I was startled awake by terrible nightmares. I had bouts of extreme anxiety and difficulty breathing followed by periods when I stopped talking, having nothing to say because there was absolutely nothing going on in my head. I couldn’t concentrate enough to read novels or research papers; following the thread of a logical argument or tracing character development was completely beyond my cognitive abilities. Noise of any kind put me on edge: traffic, people talking, the garbage truck, a lawnmower. Even the stimuli of driving became far too much for my mind to handle, making me angry and close to causing an accident. I couldn’t make a decision to save my life, whether it was what I’d wear that day or what time I should schedule a doctor’s appointment. For months I wished I could disappear, just quietly fade away into nothingness.

When I first went on leave I was sure that by now I’d be back to ‘normal’, but it turns out I’m just at the beginning of a long road that may not lead back to the old me. Although I described the symptoms above in past tense, they remain ever-present, though somewhat diminished. I see a doctor of some kind every couple of weeks, and have taken a broad cross section of antidepressants, mood stabilizers and anti-anxiety medications. The side effects have ranged from excruciating migraines and nausea, to a tremor that makes it look like I’m going cold turkey on a meth addiction.

After all that, the psychiatrist tells me I’m not one of the 40% of the population who is hugely helped by medication, and that – although I should continue with the latest drug cocktail – I’ll have to work harder in therapy to make up the shortfall.

I’m continually frustrated that I can’t reason my way through this. I can explain it rationally, see clearly how it happened and identify its root causes. But all the logic, graphs, or smarts in the world won’t fix it.  For things to improve I have to delve into the murky world of feeling and emotion. Thing is, that world is super uncomfortable to me, and certainly didn’t get me where I am. Being smart and rational, tenacious and tough, did. But that won’t help me much now.

I’m not writing this so you’ll feel sorry for me. I’m writing this so people know that it can – and does – happen to anyone. It’s not just a case of ‘weak’ or ‘over-reaching’ women: mental health can require just as much effort as physical health from both sexes. The prevalence of mental health issues in academia – even if only publicized for grad school – are staggering. Several of my friends have been crippled by mental health issues both in grad school and as profs. We can’t make it go away by ignoring it – instead we need to make mental health a normal part of everyday conversation, just like physical health, thereby reducing the stigma around it.

The silver lining

Even though the days can be a struggle, I’ve found that some good things have actually come out of the whole mess.

1. I get a sense of accomplishment from much smaller tasks.

A day at work used to include reviewing a paper and a thesis chapter, doing some data analysis, preparing lectures and teaching, meeting with students and planning fieldwork – while also making notes on ideas for a new grant. I wasn’t happy unless I’d done a half million things (okay, maybe I’m exaggerating) by the end of the day. I can’t do that anymore. These days it’s an accomplishment to spend an hour weeding the garden, or to get through a training class with the dogs. A blog post like this one can take me almost a full day.

2. I think more carefully about how I spend my time.

With limited energy, I usually have to factor some serious rest and recoup time into my day. So I think hard about what I want to do most – blog, garden, walk the dogs, read? I plan for far fewer things, and try to enjoy them more.

3. I’ve connected with a broad community of interesting people.

Twitter and the blog are great since I don’t get out much. 🙂 I’ve met colleagues I wouldn’t have otherwise, and connected with new groups and initiatives. It’s given me a more balanced perspective on what we do as both scientists and academics.

4. I spend more time with my dog (now two dogs).

This one’s important, because without my dog I wouldn’t have made it through the lowest times. Having to get up every morning to feed and walk her kept me from sinking as deeply as I could have.

5. I’m writing more.

As part of my therapy and also on this blog – to keep somewhat current and to let off some of the steam that’s generated by our current government (!!).

6. I’ve started doing nature photography.

It makes me really focus on the here and now, and helps me see things I might have missed before.

7. I know who my friends are.

People who know what’s going on check in every now and then, keeping the conversation causal and light, while also letting me know they’re there. Colleagues who haven’t heard from me in a while get in touch and ask how things are. Others whom I thought were friends? Maybe they think I have cooties that they’ll catch just by talking to me. 🙂

8. I’ve learned (a bit better) how to say no.

Many of us have trouble saying no – to being a guest editor, speaking at a conference, co-authoring a paper…the list goes on. Pre-tenure, it often feels like you can’t say no. Other times you’re trying to cover all your bases, applying for three grants in case one doesn’t work out. Murphy’s Law says they’ll all be funded, and you’ll have triple the work.

To preserve my health I’ve had to say no. Not as often as would be good for me! But definitely more than I used to.

9. My family has been fantastic.

My husband has been amazingly patient and supportive, taking on all sorts of tasks that I can’t handle (like going to the grocery store) and encouraging me to talk. I’m in touch with my sister more, and it’s nice to hear how my nephews are doing. My parents have been understanding in a difficult situation – I hope they’re still understanding once I’m further out of the woods. 🙂

If you only read one part of this post:

Do you (knowingly or not) stigmatize mental health issues? If you think less of me after reading this post, that might say more about you than me. Perhaps you have personal experience with these issues – either directly or through someone else. And if you recognize yourself when you read this – talk to somebody. You aren’t alone. Try to find that silver lining. Most importantly, remember that depression doesn’t define you. You’re still yourself – with just a little extra thrown in.

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46 thoughts on “In Limbo”

  1. Thanks for writing this out for others to read and see.
    1) In my first week @ UC Berkeley, a (male) professor committed suicide right AFTER he got tenure. There’s a lot of pressure and expectations on young career people.
    2) An asst prof at my old school had a breakdown (similar story to the one you describe) based on something similar — expectations of over-achievement, etc.
    3) I personally have struggled for years to dump the idea that I need to publish to be successful (e.g., http://www.aguanomics.com/2008/12/public-or-academic-intellectual.html). I now think the opposite, since there are far more useful and interesting things to do besides publish.
    4) Nothing is more important than your mental and physical health, followed by your relationships. Career is a distant third (even if it’s rewarding), as very few people can do career without health and friendships.
    5) There are MANY ways to be productive and useful to society. Motherhood is a classic example of an underrated, yet massively important “job”. I tend to rate “satisfied customers” over any other metric.

    Reply
    • Thanks for sharing more stories of mental health in academia, Dave. I agree with your comments about importance of publishing vs. all other potential things a scientist can do – this is why people are pushing for inclusion of blogging/scicomm etc in tenure packages. There’s more than one way to get the science out. And finally – very true that nothing is more important than your mental/physical health. Hard to remember that sometimes… 🙂

      Reply
  2. This is a very important post. Thanks for writing it, thanks for sharing it. The issues you discuss are a ‘sleeping giant’ in Academia – we must awake and recognize its importance – part of this process means that people with courage (like you) write and speak about your own experiences. This will help with a broader collective standing up, discussing, getting rid of the stigma associated with mental health issues. There must be support — but for there to be support there must be broad recognition that mental health is AS IMPORTANT as physical health issues.

    Reply
    • Thanks Chris. I didn’t realize how much courage I’d require until I pressed ‘publish’. But I’m glad it’s generated some conversation around this ‘sleeping giant’ that we all tiptoe around in academia. Health in general (physical & mental) is very important – academia (and some corporate cultures as well) seems more than happy to overlook health for the sake of products/papers/outcomes/etc.

      Reply
  3. Thank you so much for sharing your experiences – I sincerely hope that this and others like it will help change parts of the academic ‘culture’. I have battled for years to curb parts of my passionate nature as scientists, especially female, are often scoffed at if they appear to be ’emotional’ (or at least women are emotional and men are driven, but thats another monster all together). Though still in my grad studies I have felt the crippling effects of stress, fear, and feelings of inadequacy. I would argue that mental health and happiness is even more important in many instances than physical, as feelings of depression & anxiety can be so completely debilitating. I have recently decided that I will value my happiness & that of my partner above all other professional ambitions & successes – despite the ‘costs’. What is the worth of a successful career if one cannot be healthy enough to live & enjoy it? And I too will spend many hours in my garden or on my bike this summer – living! Kudos to you.

    Reply
    • Thanks Barb! I think it’s important to address the gendered aspect to health issues in academia. It’s also good to discuss these things in grad school so that people are prepared and informed, rather than suddenly confronting unexpected mental health issues once they get a tenure track position (or while they’re trying desperately to get one of the few TT positions available!).

      Reply
  4. A wonderful and brave post Sarah… the more we talk about mental health the less stigmatized it will become – it’s something nearly everyone is affected by either directly or indirectly. ~Erinn

    Reply
    • Thanks Erinn – based on the responses I’ve had to this post, far more people than I thought are affected by mental health issues. I hope we can talk about them more openly not just in academia, but in society as a whole.

      Reply
  5. Thank you for this post. It’s very timely for me, and hits very close to home. I might have written a lot of it myself, actually. I appreciate your honesty and candour.

    Reply
  6. I was brought to your blog entry by a tweet from Quirks & Quarks. I almost didn’t leave a comment, but I wanted you to know that many people will be reading this post. Many will also feel a strong connection to it, even if they do not leave their own comment. Thanks for sharing your stories.

    Reply
    • Thanks for leaving a comment Steph. Based on the number of hits this post got, there are many people not commenting. But hopefully readers get something useful from it.

      Reply
  7. Hi Sarah-thanks for your bravery and openness. I have been coping with this since childhood and it ain’t for sissies!
    I’ve been on most of the different meds at one time or another and at the ripe age of 60 can say fairly confidently that I’ve tried just about everything.
    I just felt moved to share with you that the one thing that has really helped me move from coping to actual healing is medidtation.
    All the best to you sister,
    Kim

    Reply
    • Thanks for the meditation suggestion Kim. I’ve tried it on & off but, like anything, have to specifically make time for it so I can do it consistently. Totally agree that depression’s not for sissies – lots of us out there who are tougher than we think!

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  8. An incredibly moving and insightful post. Academia has too long ignored mental health. Thank you for sharing this intensely personal part of you. In your bravery and in speaking from the heart, the ripple effect reaches so much further than you’ll ever realize. I will be chewing on your list of things learned for some time. Thank you.

    Reply
  9. So – a successful career, a supportive husband, and dogs? DOGS? As terrible as your experience has been, do you have any idea how much this sounds like a great big load of self-indulgent piffle for many of us with depression?
    Try this on for size: No career worth speaking of, killed before it started (along with too many other dreams) and now too late to ever recover … An unreliable spouse prone to playing blame games … And children, not dogs, whose never-ending needs and demands are vampire-like in their draining of time and energy and motivation (or so it feels, despite them objectively being good kids) …
    Now let’s talk about the difference between at least having the hope and the possibility of someday returning more or less to one’s previous, successful life … And having nothing to look toward to at all, with or without depression, except endlessly the same old, same old …
    Best wishes dealing with your depression (sincerely) but do understand why I – and I dare say many, many others with depression – would trade lives with you in a flash … Because even with depression, some are a whole lot better off than others.

    Reply
    • Yes I have a career to go back to – which I went to school for 10 years & worked 80h weeks to get. I have dogs – making a conscious choice NOT to have kids for the very reasons you mention in your comment. And I have a supportive husband – lucky for me that I married a really good guy.
      These things don’t make my depression any different or easier than yours. I may have a better support system, but the depression itself is just as debilitating. That’s also why the post includes good as well as bad things – because when things are really bad, acknowledging even the smallest of things that are good can help push some of the darkness aside.
      Good luck with your depression, but don’t imagine for a second that mine is any ‘better’ than yours.

      Reply
  10. People with depression know that it isn’t a relative condition and It doesn’t exist in context (e.g., I have this or don’t have that). It just is. As a result it is harder for people without depression to understand when someone who appears to have it all, becomes or is depressed. This is one of the lessons we need to learn about depression and telling stories about experiences will eventually lead to greater understanding. Thanks for sharing and stay focused on the support, while striving to realize those who criticize just don’t get it.

    Reply
    • Yes, depression can happen to anyone regardless of socioeconomic status, ethnicity, age, etc. Everyone has different triggers and, as I mentioned in my reply to HJ above, some people may have better support systems than others. But depression itself doesn’t discriminate.

      Reply
  11. It would be very unfortunate if commentators on this blog who also have depression – as I do – were to have our views devalued and dismissed by being told we “just don’t get it”, because we don’t present in the accepted way …
    Depression most certainly does exist in context – for example around the world both its rate of incidence and the manner in which it is expressed are culturally variable. For individuals, what may be irrelevant to the onset of depression for some may be highly relevant for others. And acknowledging that is also part of a greater understanding.

    Reply
    • What is shocking is that as someone with depression you would devalue and dismiss someone else with depression.
      Depression can exist in context such as situational depression (caused by an outside stress) or can even be environmental (Seasonal Affective Disorder.) It can, and does, exist as in cases of major depression where there is a chemical imbalance caused that occurs with no major life changes. Depression is not a black and white mental health issue.
      Saying my depression is worse than your depression is counterproductive to increasing the understanding and acceptance of mental illness in society.
      D

      Reply
      • Thanks for your comment – I particularly agree with the last sentence. Instead of ranking mental illnesses as bad, better, best, we need to acknowledge that they’re all difficult for the person experiencing them. The important thing is to accept these illnesses as easily as we accept a broken leg or heart attack, and work towards healing them.

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  12. Thank you for your bravery in writing about this. I shared my own personal struggle with depression (http://www.insidehighered.com/blogs/university-venus/becoming-clich%C3%A9 and http://www.insidehighered.com/blogs/university-venus/turning-corner). You should also check out this series of posts, as many of them deal with mental health issues and the treatment of women of color in academia (http://thefeministwire.com/2012/10/black-academic-womens-health-to-be-in-context/). Finally, I’m currently reading (and by currently reading, I mean it’s sitting on my coffee table, taunting me) the book Depression: A Public Feeling where the author (a professor) talks quite candidly about her own struggles with depression.
    Please keep writing.

    Reply
    • Thanks Lee – I especially liked the part in your first post where you talked about living a ‘performative’ life. It feels like that a lot – you get through your to-do list, go through the motions of playing whatever role is required (wife, mother, professor, etc.), but you’re not really there. Your soul is MIA. Thanks also for the book recommendation – will check it out.

      Reply
  13. @snowhydro Thanks for sharing!
    You are the only one who can decide what makes your life successful. Another journal article or grant really doesn’t add up to much in the scheme of things. I’ve recently had physical issues arise that required medication (according to my doctor) that make me more spaced-out than normal and forgetful. Recognizing these limitations, I decided to delegate more of the everyday portions of projects to other staff allowing me to focus on fewer projects.
    Think about how we approach a watershed, we know that all parts of the watershed are interconnected—water, land, plants and critters. Your self, life and body are all connected. Your physcial state will impact your mental well being and vice-versa. Please seek healing for the body and spirit in addition to your mind. Find an accupuncurist (brilliant for my issues). Kim said meditation help her. Mix your nature photography with your love of water. Love your dogs they are full of unconditional love for you!
    Just some thoughts for you…

    Reply
    • Yes, thinking like a watershed – great metaphor! Funny you should mention acupuncture – we were just talking about that as a possible aid in recovery. Though when your health plan doesn’t cover either that or therapy…
      We (or maybe I should just speak for myself and say ‘I’) often have to remind ourselves that more grants/papers/etc don’t necessarily make us successful. It’s more about how well you live your life and how good you feel about it.

      Reply
  14. Thanks for your post, Sarah. Seems that we all struggle to figure out how to work through the hard parts of life that don’t fit well together. The typical way that people talk about this is how to balance all the things we find important in life (family, work, accomplishments, etc.). I’ve found that my expectation of “balance” probably leads to some of my difficulties in the first place. Still working through it, of course.

    Reply
  15. I experienced severe depression and anxiety during grad school. It took me over 2 years to ‘come out’ and tell my advisors about it. They told me that “all grad students have mental health issues” and that I should start taking walks to relieve stress (but shouldn’t do other exercise because it would take too much time away from my research). Not helpful. I should have taken leave but instead kept pushing myself and destroying my health.

    Reply
  16. Hello, Sarah 🙂 I really enjoy reading your blog, and thank you for sharing — mental health is so important and I’m glad you have the support of friends and family, and your dogs (I don’t know what any of us would do without them). All the best, Sam

    Reply

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