Features Physics World  March 2018
(iStock / agsandrew)

My invisible battle

The stigma around mental illness is slowly crumbling, with society becoming increasingly aware of the problem that affects an estimated one in four adults, from any walk of life. But what about attitudes within the academic community? A theoretical physicist tells their story of battling mental illness while pursuing a research career, raising the question of whether the community does enough to help

The history of physics is littered with people affected by mental-health conditions, and too often their stories have sad endings. Isaac Newton, Wolfgang Pauli and David Bohm, to name a few, are all thought to have suffered to some degree, and Ludwig Boltzmann took his own life after struggling with bipolar disorder for years. But mental illness does not just strike the elite. It is something that can affect anyone and you will undoubtedly have friends, family or colleagues facing such problems. Unfortunately, there is very little awareness of mental health in academia and few practical resources or material to draw on.

I suffer from bipolar disorder, which has affected me throughout the various stages of my academic career. Nowadays, I am working within my university to try and establish an effective support network and to create awareness around mental health. As part of this effort I have decided to share the story of how my own mental health has affected me as an academic in physics.

I hope that by sharing my experiences it might help start a dialogue in our community. People should not feel embarrassed to talk about these issues, and those suffering from mental illness need to know they are not alone and there is always help available – although more options on that front would be beneficial. We also need to improve the stigma around mental health. In the past, people have said some awful things in front of me, directly to me and behind my back, whether intentional or not. Others, meanwhile, tend to laugh things off, especially when they’re uncomfortable. But mental illness isn’t funny or a joke. By generating awareness of the issues, I hope people will think twice before making light of matters.

Before I start my story, one of the first things you will have noticed is that I have chosen to remain anonymous. While this decision runs counter to the ideal culture of openness, it is a necessity for me. Many of my friends, family and colleagues are incredibly supportive of me, but unfortunately, some people still have a bizarre and outdated view of mental illness. It’s sad that I must think this way – and it makes me angry sometimes too – but it’s hard to express the discomfort it could cause me if my mental-health problems were publicly known.

The beginning

Bipolar disorder, formerly known as manic depression, is mainly characterized by experiencing periods of depression, where you feel low and lethargic, and periods of mania – feeling very high and overactive, sometimes in an unpleasant and disorientating way (such as having thoughts that don’t stop racing). Bipolar disorder is a wide-ranging term, covering varying degrees of severity and symptoms, and I fall on the “schizoaffective” side. This means that on top of the typical bipolar symptoms, I have also suffered from those associated with schizophrenia, including audible and visual hallucinations and delusions.

I was not diagnosed with bipolar disorder until my early 20s, but my therapists and psychiatric team have looked back at my past, and we think the symptoms started when I was around 15 or 16. During sixth form (age 16–18), I began to experience severe mood swings that could last weeks or months, disrupting my attendance, focus and levels of motivation.

These symptoms worsened during my undergraduate degree in theoretical physics. Depression made it hard for me to do basic things – even getting out of the house was a challenge, let alone attending lectures. Yet, if I was heading towards a manic episode, I felt like the most confident person in the world. The mania meant I needed little sleep. I could plough easily through the learning material, and would do well in exams and assessments. Although experiencing such mania seemed “useful” at times as an undergraduate, it ultimately caused chaos – the feeling never lasted and was often followed by a crash into depression.

As well as impacting my studies, such extreme highs and lows tested and strained my personal relationships, as friends and family would become concerned with my eccentric and erratic behaviour. Depending on how intense the mania was, I could lose touch with reality, suffer from delusions and become uncharacteristically arrogant. Sometimes I even experienced psychotic episodes, which were upsetting for all involved.

Depending on how intense the mania was, I could lose touch with reality, suffer from delusions and become uncharacteristically arrogant

The mania could sometimes wreak havoc on my finances. I planned many unrealistic scientific projects, often involving expensive equipment and exotic locations, all of which never got done due to a crash in mood, because I was off to plan “more important” things, or because they were just plain nonsense. There were some seriously chaotic times.

This was all about 15–20 years ago, at a time when people were even less aware of mental-health issues than now. As far as I knew, there were very few support services available at my university – although, given they were so hard to discover, there may have been more. Meanwhile, my undergraduate peers and many of the academic staff appeared to be uncomfortable around me. I often felt ignored and saw a lack of empathy in the community towards people who were clearly suffering. I can understand this a bit though, as my behaviour, depending on the mood swings, could be difficult to deal with.

My undergraduate tutor did take notice, however, and was particularly concerned about me. He tried to get me to go to some of the limited available services but I did not listen. The problem with being manic is that you feel great at first and why would you want to stop that? However, when I felt depressed I couldn’t even think of talking to someone new, and unfortunately, I didn’t have much down time in-between. In hindsight, I wish I had listened to my tutor more.

A downward spiral

Although I faced problems during my undergraduate degree, my ambition to study physics remained strong, and I got a PhD studentship in theoretical physics at a different university. Unfortunately, despite all my enthusiasm for physics, my illness continued to worsen.

It’s hard to understand why. I’ve wondered if getting older meant my symptoms got worse, or if the open nature of research work lends itself to mood swings. There are big pressures during a PhD, such as managing your time, meeting deadlines and planning your future career, and I also had the legacies of my illness to carry, including friendship issues and financial debts. It did not help either that I had less direct supervision, leaving less chance for someone to intervene.

My illness continued to get worse and I had some severe bouts of mania during these times (I felt I was really going mad) and some serious depressive crashes. Being manic felt like it helped me do amazing research, but once things calmed down, I would re-read my notebook from the previous few days or weeks and often find utter nonsense in there despite me feeling I had done something amazing at the time.

In stark contrast, the depressive episodes were harder and darker than ever, and led to time off, disruption and, most distressingly, my first suicide attempt. Thankfully, the city I had travelled to to do this had some wonderful members of the public who prevented me from going through with it. Meanwhile, back at home the police had been called and had I think (I still don’t know fully what happened) been to my place of work. It felt humiliating at the time, but this forced me into my first proper treatment and I was put on some serious medication to try and lift my mood.

I hated taking medication – it made it hard to concentrate and I had difficulty performing the problem solving and logical thinking I needed to carry out research. I felt it was impacting my ability to work and ruining any chance I had of a career in research and academia. So, I would come off the medication – a disastrous decision. I usually ended up in a period of mania or hypomania – a milder version of the condition – that then resulted in a bigger crash, and ultimately, I would be forced to go back on the medication by friends and my medical team.

I felt at this point that the people around me, at work and at home, did not understand the illness or the effects of managing it. I was feeling very low and had a year remaining of my PhD. I needed to finish my doctorate and look for a job, but I also needed some time off to get my health under control. When I informed my department, I was told, however, that I would have to have my stipend suspended if I wanted to take time away from my PhD – essentially, I would be forced to take unpaid leave.

The university offered no sympathy and no empathy towards my case. I was shocked and hurt

I still cannot believe this was how they handled someone who was suffering from severe depression. I was a good student – I had been awarded prizes in my first and second year and was otherwise on track to successfully get a PhD. Yet the university did not try and find a solution that would help get me through this horrific time. They had no protocols or systems in place to help students in bad situations, and they did not look for alternative funding. There was a total lack of effort from my department and supervisor, and I wasn’t even given details of support programmes that could help while I continued to work – I had to find them myself. It was worse than during my undergraduate degree – there was no sympathy and no empathy towards my case. I was shocked and hurt, but had no other choice than to plough on with the work.

New place, old problems

Fortunately, the National Health Service (NHS) was fantastic, and with its support I got through the final year of my PhD. I even managed to submit my thesis on time, which was pretty good considering everything that was going on. In spite of my troubles, my mental-health problems had once again not dampened my love of studying physics and doing research. Not wanting to leave academia, I amazingly found my dream job – a two-year postdoc in the US. Working abroad felt like it would be a fresh start and the institute I was going to be at was one of the best in the world for my chosen field.

I needed to have a good crack at this new job but, once again, I felt my medication was limiting my ability to work properly. So, I decided to stop taking it, which led me to some very scary and dark times in my life.

It’s often hard for people to understand why I would go on and off my tablets like this: surely controlling the bipolar disorder was the priority? Had I not learnt from past experiences? But all I wanted was a fair chance to do something I love, and I’ve always felt the medication was stopping my academic brain functioning to its full capacity, holding me back from succeeding and developing in the field.

This is when the schizoaffective element to my illness started to become very apparent. I was becoming delusional and having psychotic episodes. I thought I was being followed or attacked by creatures. I became scared to go out of my apartment, too frightened to even leave the bedroom. My colleagues started to worry as I became erratic around them.

The medications I was then prescribed in the US were much stronger than my previous tablets and the impact was horrendous. I was sleepy all the time and it became impossible to function normally, but they kept me out of hospital. A real battle began and this period of work was a disaster for me as I couldn’t find a balance – I seemed to be either manic or too depressed to get to work or knocked out by medication.

Difficult decisions

At the end of the placement I returned to the UK and took up a two-year postdoc with my previous university. It was a very generous offer and this was due to my record of good performance – at times – as a PhD student. At this point my UK medical team changed my prescription again, as they were shocked by how many tablets the US doctors had put me on. Unfortunately, going off one type of medication and onto another was as bad as when I had stopped taking them completely. I started to become manic but was keen to hide it from people as it felt good – I felt like my old self again. But I began to hear voices, my behaviour became erratic, and it ended how it usually ends – in stronger medication and a lot of time off work.

I felt like I was failing. I really wanted to work in physics research but it was looking increasingly impossible

I felt like I was failing. I really wanted to work in physics research but it was looking increasingly impossible – the bipolar disorder was ruining my career in academia. At this point, I started to become suicidal again. Thankfully, though, things calmed down, and towards the end of the postdoc I made the difficult decision to find a different career.

I chose teaching – something I had always been interested in – but my heart was still in academia. I became very depressed again and found managing my illness through the teacher training and first year to be very tough. Thankfully, I had outstanding support from my mentors and lecturers. It was very different from my experience in academia – the education staff showed empathy and it was an unusual experience to feel supported. During this time, I was also incredibly lucky to meet the amazing person I would later marry. I suddenly had the support I never really had before, and I learnt to understand and manage the disorder much better.

I worked as a teacher for three years until a perfect opportunity came up to re-join my old university physics department on a permanent basis in a position involving both research and teaching. And this is where I am still – doing the research I love and enjoying teaching at a university level.

I am in a much better position with my mental health than I ever was, but the bipolar disorder will never truly go away. I have been on medication for about 13 years and still occasionally suffer from mania and depression, and the desire to reduce my medication. Fortunately, I have the support and love of my partner to keep me on the right track and, with the help of friends and learning from my experiences, I have managed to get through relapses without too much disruption.

Combating the stigma

My story highlights the struggles of dealing with mental illness while pursuing a career in academia – but whether this is a problem specifically within physics, or whether it is a wide-spread problem across the academic community, I cannot say. Without seeing reliable statistics, all I can offer is my own personal evidence, and what concerns me from that is the lack of awareness and understanding of such issues within the academic workplace.

I hasten to say that I don’t think this is a problem solely limited to academia – the stigma that surrounds mental health is rooted in our society’s attitude and culture. But this has been improving a lot in recent years, and there are many initiatives striving to improve awareness and provide support (see box opposite). Indeed, I have friends working for companies that have a supportive and open culture when it comes to mental health. I wish this was the case everywhere. Even my own time as a teacher highlighted the comparative lack of support in academia.

Again, I can only give my own anecdotal evidence, but there seems to be more stigma towards mental health in academia and improvements don’t seem to be keeping pace with the wider world. I know colleagues who have mental-health issues but refuse to come forward about them because they are worried about the stigma. Throughout my own career I have experienced some terrible attitudes from people, which I have found hurtful and sometimes cruel. It worries me greatly that our community lacks empathy towards individuals who are unwell.

So why is academia worse? In my opinion, it partly comes down to the nature of academic work. The career paths are target-based, stressful and very competitive. There are limited pots of money and contracts are often short. It’s not surprising that working in such an environment can trigger mental illness. This backdrop means people who are unwell for a long period of time can be viewed as a liability, and working with them could be seen as detrimental to a project’s progress. I worried about this constantly when I was unwell – I felt I was wasting money and stopping a project from moving forward. I often sensed that people thought less of me and would not take a chance on me – at stages I even got the impression that my colleagues did not trust my work. I have seen this in how others suffering from mental illness have been treated too, and these attitudes mean you also begin to doubt your work and capability.

I often sensed that people thought less of me and would not take a chance on me, or even did not trust my work

The reasoning behind these attitudes could be numerous – perhaps some people think that having a mental illness means you are not as intelligent, or maybe they think avoiding people with mental illness is simply logical and practical for the benefit of their project. Whatever the reason, I believe it comes down to ignorance and a lack of awareness, and this is something I would like to address. I think it is vital that we generate awareness of mental-health conditions and highlight the problems that some of us have to go through, ultimately improving the support offered in the academic workplace.

By making sure the community is informed and aware, you can also reach and educate those suffering from mental-health problems, ensuring they know they are not alone and that there are different support systems and actions available to them.

I’ve had people approach me with concerns about their own mental health and one of the first things they ask about is the side effects of medication. It’s not good that people are having to think about this before seeking medical help, but it is a genuine concern for my colleagues and friends in academia. As I’ve said, some of my biggest battles have concerned medications – I often felt the tablets were holding me back, suppressing my concentration and ability to do research. When your brain power, logic and problem solving are the most important tools of your job, it’s difficult to face tablets that might suppress that.

While I may not enjoy taking it, medication is the best way for me to stay well. That, however, doesn’t mean it’s the case for everyone – for others, cognitive behavioural therapy or counselling, for example, might be a better fit. It is therefore important to make sure people are aware that seeking help doesn’t necessarily mean tablets and, if it does, then there is nothing wrong with that. The most important thing is to get help and get well.

Unfortunately, mental-health conditions don’t simply go away, and often people don’t understand this. Like a physical injury or illness, they believe it will just pass or that medication will miraculously cure it forever. Personally, if I appear to be “normal” that does not mean there are no underlying issues. I manage this illness with medication and seeing professionals, and I will likely have to continue doing so for the rest of my life. It is important that employers and colleagues understand this is a long-term battle. They need to be able to make adjustments for the bad days or the side effects of medication, while also not penalizing those who are suffering.

A helping hand

Despite the steps that must still be taken, I must give credit where it’s due and point out that things have improved considerably in recent years. In general, mental-health awareness has increased ten-fold and there is more information readily available. Universities often have more visible counselling services that offer students a range of resources such as self-help guidance, drop-in sessions, workshops and one-to-one support. At the department level, I think undergraduate tutors and postgraduate supervisors are often more understanding nowadays and have greater empathy towards these issues because of society’s changing attitudes. Whether there are official systems in place to, for example, refer students to counselling or to help financially support them if they need a break from their studies, I cannot tell you – such information does not seem to be readily available.

At the staff level, a lot still needs to be done. For example, I recently approached occupational health at my current university. It initially looked promising, as they came up with a very good support mechanism for me. Knowing I had this, and therefore a better chance of success to pursue research, made me feel much more confident at work. Unfortunately, this did not last. When I had problems, the support network failed, and I felt alone and worried once more. We’re getting things sorted, and our new head of department has been very supportive and keen to do something, but the incident has highlighted for me that the mental health of staff and students is not a priority for the department.

I decided to see what I could do to stop this happening again, to me or other people at the university. Working with the human resources and occupational health teams, we discussed ways of improving the current support network with the heads of the university’s departments. We planned to introduce a mental-health first-aid initiative and a new departmental “listener” scheme, so there are known members of staff people can talk to about their problems. Unfortunately, things appear to have ground to a halt. It seems fashionable for employers to talk about mental-health support but they don’t necessarily follow-up on the discussion. This is incredibly frustrating as it could provide vital help for people.

It seems fashionable for employers to talk about mental-health support but they don’t necessarily follow-up on the discussion

The best support mechanisms I’ve found are with the NHS and its specialists. They have been amazing over the years and I am still lucky to meet them regularly – whether it be a nurse, a psychiatrist or a psychologist, they have always found time. I am very fortunate considering the stories we hear about long waiting times and delayed treatment. It would be great if universities also provided support systems for students and staff that could potentially take some of the pressures off the NHS.

I hope that my story helps raise the awareness of mental-health conditions in academia and the problems those suffering from them face every day. It is our job to make sure the bright minds around us now and in the future have the support they need to progress in academia. After all, their work could lead to the next big scientific breakthrough, but how could they achieve those feats if we let them slip through the cracks because we are ignorant of their battles?