STEMming the tide of mental health crises
Posted On: 10-02-2019
Two neuroscientists and a sociologist reflect on mental health experiences of people in science. What is it about the environment in STEM labs that might increase the risk for anxiety and depression?
By Praachi Tiwari and Vidita Vaidya with inputs from Gita Chadha
When TheLifeOfScience.com approached us about an article for a series on mental health, I realised that we were in a unique position. Perhaps because of our lab’s scientific interest in psychiatric disorders such as anxiety and depression, discussions about the prevalent cultures in academia are frequent among us. These are usually informal conversations in the lab, over tea, or on a walk around our lovely campus – personally, I cherish these experiences. My advisor at TIFR Mumbai, Vidita Vaidya and I decided that it might be worthwhile to share a glimpse of these conversations. We envision that this could inspire more such conversations between the graduate student community, advisors and institutional leadership. This involves opening ourselves to the uncomfortable debate of whether a PhD in STEM (Science, Technology, Engineering and Math) fosters working environments for graduate students that per se enhance risk for, or unmask, underlying mental health conditions.
My PhD work seeks to understand the neurocircuitry underlying anxiety and depression, something that my lab has been exploring from multiple angles for almost two decades. Since I started four years ago, I find that my perception and understanding of mental health challenges has changed substantially. My experiments have given me a sense that we have to expand our understanding of mental health disorders to incorporate a much bigger role for the environment in both shaping and unmasking underlying psychopathology. Environmental conditions play a critical role in both studies with animal models, and from clinical observations of patients.
The rest of this article documents a recent exchange between Vidita and I, where we spoke about the enhanced risk for mental health disorders amongst the graduate student community in STEM disciplines, and if things have changed over the years. Along the way, we also invited our sociologist friend Gita Chadha, to give us some key perspectives based on her engagement with studying scientific institutions and cultures.
Praachi: Everyone I know in graduate school – in India or abroad – knows at least one person directly impacted by mental health issues. I wonder if my perception of the scale of the crisis is coloured by these conversations, or is it really as bad as it seems?
Vidita: I have asked myself the same thing too, Praachi. We know that the World Health Organization estimates the risk for psychiatric conditions at about 13% for the general population. And I remember being rather taken aback at a relatively recent study carried out for STEM departments across several institutions that suggested as high a possibility as 40% of graduate students dealing with some form of mental health issues. From my personal experiences as a Principal Investigator, and from conversations with students, I was well aware that there is indeed a problem, but seeing a number of that magnitude in a published survey really drove home further the fact that this is not a perceived crisis – this is a serious issue that does need attention.
Praachi: Then why is there a starkly enhanced risk for STEM graduate students? As a graduate student studying factors that affect vulnerability for psychiatric disorders, I am particularly curious about this.
Vidita: We need to directly address the possibility that stress associated with graduate school in the STEM disciplines may increase vulnerability for psychiatric disorders. Let me ask you this, Praachi, from all the conversations you have been privy to, can you think of particular milestones for a graduate student… time-points when stress is so amplified that they could be precipitating or exacerbating factors?
Praachi: Hmm… I’m not sure if this can be called a milestone, but the first few weeks of grad school can be pretty intimidating. Most of us make it here after having triumphed through substantial academic pressure and highly competitive exams. We may have been the local “stars” at our schools and colleges. But the steep transition from a college environment to that of a graduate programme can sometimes be overwhelming.
Vidita: Can you elaborate, Praachi?
Praachi: For me, it was the constant feeling of not knowing enough. Right from school, we were consistently rewarded for knowing information. By the time we make it into graduate school, this pattern is so ingrained that we are strongly conditioned to have an inherent discomfort with not knowing something. When I first came to TIFR, I must say, I felt out of place. Nobody had taught me to say “I don’t know”. It was never an acceptable statement. This can instil an ‘imposter syndrome’ which becomes hard to shed. It would really help if people further ahead in their scientific journey acknowledged openly how they felt during their initial years in graduate school. As someone who left an Indian education system for higher studies abroad, did you ever feel this way too, Vidita?
Vidita: You bet! In my first semester in grad school in the US, I was convinced I knew pretty much nothing about neuroscience, and you’re right – that feeling of ignorance can be rather overwhelming. All of us go through this to different degrees. Unfortunately, not knowing somehow gets equated with failure. Failure, especially for experimentalists, is an essential building block to scientific discovery. We expect graduate students to quickly accept failure as a part of their journey, without ever actively discussing our own engagement with failures. The impact this can have on self-esteem is underestimated. Advisors would do well to drop this perceived ‘requirement’ of appearing invulnerable. In my personal experience, a willingness to admit to one’s own insecurities serves to open the door for stronger mentor-mentee relationships with grad students.
Praachi: I want to come back to this fish-out-of-water feeling; this gets really highlighted in an environment where you feel there is absolutely no one whom you can relate to. Things like gender, class, caste, sexuality, disability and language barriers can make the impostor syndrome much worse. In fact, before I came to TIFR, I spent a semester in another graduate programme where I experienced an unhealthy working environment. It took courage to extricate myself from that situation. It was because of other support structures – family and friends – that I could take the bold decision to quit. At that time, there were murmurs of disapproval that as a girl I hadn’t been able to handle a tough situation; but in reality, I know it took much more courage to take the decision to leave. I look around and see so many examples of friends who carry the burden of unfairly high expectations; they may even be poster children for their communities. In these situations, worsened by a lack of institutional support, it is no wonder that the stress gets overwhelming.
“When I decided to quit, there were murmurs of disapproval that as a girl I hadn’t been able to handle a tough situation; but in reality, I know it took much more courage to take the decision to leave.”Praachi Tiwari
Vidita: Do you think having counsellors available on campus, as part of student bodies, on thesis committees that one can share one’s concerns with, helps in such situations?
Praachi: What can help is seeking mentorship from multiple quarters. These can be faculty members other than your advisor, colleagues from your lab or graduate students who are further along in their academic journey. However, few institutions nurture strong graduate community-based programmes or talk openly about student mental health. Institutes can correct this by incorporating students into decision-making bodies dealing with students’ issues. Done well, I have no doubt counsellors will be effective, but I have seen that academic counsellors don’t always respect confidentiality and this vitiates trust. We need counselling offices whose primary focus is on graduate students’ well-being.
But I think that few things can compare to being in an environment where we can have open discussions with other grad students or PIs. Unfortunately, seeking support from the advisor is often extremely difficult because there is a major power imbalance between graduate students and faculty. Do you have any thoughts about this as an advisor yourself?
Vidita: Absolutely. I think acknowledging the role of strained student-advisor relationships is critical in the grad school scenario. Students perceive that their scientific career trajectory is in the hands of the advisor, and this results in a feeling of powerlessness when the student-advisor relationship goes awry. The power equation is very steep in the direction of the advisor, and the onus should be on faculty to work to neutralise this as best as they can.
Yet, simply expecting universal good behaviour from faculty isn’t enough. Institutions have to put in effective checks and balances to run successful graduate programmes, with mentorship being a key valued trait for academic excellence. One way to check for this steep power-imbalance is to ensure that evaluations of faculty factor in 360-degree feedback, with former and current mentees having a chance to opine on the quality of training and mentorship received as a component of the faculty evaluation process. However, this works only if there is actually a consequence, one that the institution can stand by to ensure that the future generation of scientists have a voice that is actually heard.
Praachi: One of the things that benefited me at TIFR was the fact that there were lab rotations in the first year. Thanks to the rotations, I got to experience labs and working styles of PIs before I made my choice. I didn’t have access to this in my previous grad school experience, so there I was focused solely on the project, funding, how long it will take to finish, and so on. I learned the importance of my working environment, the hard way. Choosing a mentor was a key factor in helping me enjoy my experience of grad school. There is almost a feeling of having lucked out if you end up with a positive mentee-mentor equation! This is viewed as the exception and not the norm.
Vidita: I relate very well to this. I often say that I am lucky… that by some stroke of fate, I had amazing mentors in grad school who continue to have my back years later. It matters immeasurably to have this support, and yet we all keep referring to this as ‘good luck’. However, if we look world over there are some institutions, labs, individuals that seem to do this more effectively than others, and have nurtured entire generations of scientists, who then pay it forward. And this brings us to a question that I often find myself struggling with: Is the culture prevalent in STEM today weeding out the very sort of people we should be doing our best to retain? In the headlong rush for rewarding productivity, are we losing individuals who focus on mentorship and nurture of scientific creativity? It helps if advisors and mentors demonstrate healthy work-life balance themselves, and guard against valorising untenably long hours. We rarely open ourselves up to the possibility that the practice and culture of STEM itself could be studied, and to ask if there are corrective measures to better our own academic working environments. We tend to isolate ourselves from the humanities like sociology of science, and unfortunately, this isolation has come at a cost.
Praachi: This seems like a good time to pull in Gita Chadha, who is a feminist sociologist who has worked in the area of critical science studies. Gita, would you say there is something about the culture of STEM academic disciplines that increases the risk for mental health disorders?
Gita: The statistics you have cited for STEM indicate that there must be something specific to the cultures of STEM that can be correlated to a compromised sense of well-being in the community. The fact that you are asking this question, Praachi, is a significant shift in the way we look at mental health, and I thank you for making this shift. Conventionally, we tend to think of mental health as predominantly determined by psychological and biological processes. It’s important to also see mental health as a function of social structures and cultures. We require a paradigm shift on how we perceive mental health in our worlds. Counselling and medical services, which need to be instituted, must come with a social understanding of mental health rather than put the entire onus of personal well-being on the individual. We can relate this to the larger cultures of modernity in our worlds where we place an unnatural emphasis on individual achievement and success.
“We require a paradigm shift on how we perceive mental health in our worlds.“Gita Chadha
Prachi: You’re right, but how do we think this through in the context of STEM cultures, where success is often measured by productivity, through impact factors of journals published in, citation indices and such? Is there a way out of this?
Gita: In academic domains, particularly in the sciences, our cultures reward individual ’genius’ and promote a culture of competition. We assume that ‘healthy’ competition is the only way to promote scientific productivity. So, individuals are rewarded for excellence. This must change, particularly in fields where it is possible to reward groups, laboratories and collaborations. We need to promote a social imagination of science and see it as a human activity that is done in and by groups of people rather than by isolated individuals.
But Praachi, let me push the argument even further, into the domain of the ‘how’ and ‘what’ of the production of scientific knowledge itself. I’d like to suggest, however idealistic it might sound, that a holistic relationship between human beings and nature is crucial to our sense of ease and well being. When this relationship is constructed in anthropocentric terms, we dis-ease ourselves, and nature too. STEM fields often do so. We need to understand that science must become a deeply ethical enterprise that sees human beings as part of nature. A stronger connection between human beings and nature is central to our personal sense of well-being. Scientific institutions and cultures, unfortunately, often imagine science and the scientist, in opposition to nature.
A holistic relationship between human beings and nature is crucial to our sense of ease and well being. When this relationship is constructed in anthropocentric terms, we dis-ease ourselves, and nature too. STEM fields often do so.Gita Chadha
Praachi: How do you think this can be changed or dealt with, while including students in the process of dealing with such issues?
Gita: It is important to first, integrate social science and humanities within the curriculum of graduate studies in the fields of STEM. An awareness of the historical, philosophical, social and political context of science and scientific theories would go a long way in putting measure on the absolute value of science in the minds of young people. But more importantly, this will help in creating an enabling environment for students who come from marginal social locations of gender, caste, class, disability and sexuality. If we sincerely want to make a more inclusive culture of science, it is important to promote ideas of social justice in scientific communities. While we have created a discourse of science as being above all social bias against people, we find that scientific cultures reproduce social bias at every level of their practice.
Vidita: This makes a lot of sense, Gita. The point you made about social bias is highly relevant because, more often than not, science – and by extension scientists – are viewed as highly rational and hence incapable of reproducing the biases that run rampant in society in general. This is patently untrue, but is a commonly held perception which can then prevent the calling out of deep-seated issues and biases in the scientific community that require remedial action.
Praachi: Thanks for this chat, Vidita and Gita. I hope sharing this with the wider audience will serve to seed further conversations amongst all stake-holders concerned about mental health for STEM graduate students. I just want to add that I am struck by the fact that some of the issues we highlighted today also resonate with insights gained from studies in animal models of psychiatric disorders, some of which Vidita and I work on in our lab. Work from many groups has highlighted the high cost of social isolation in setting up dysfunctional responses in neurocircuits that regulate mood behaviour. Stress alone may not result in a mental health challenge, but when it is overlaid with the continuous feeling of having no control over changing the stressful situation, it can serve as a major risk factor in setting up a state referred to as learned helplessness. Remarkably, work in the field also indicates that simply having the percept of control over terminating the stress, and hence making it relatively predictable, can be a powerful factor to promote resilience. While one has to be cautious in simply extending the observations in animal models directly to humans, this body of literature does inform us of the importance of feeling like one has some control over stressful environments and experiences. This chance to write up our chat and discussion has left me wanting more of such dialogues at all levels.
Praachi Tiwari is a fourth-year PhD student at Tata Institute of Fundamental Research, Mumbai. Her research interests encompass understanding the mechanisms that regulate susceptibility to anxiety and depression. She also studies the regulation of hallucinations by serotonin receptors. When not in the lab, Praachi loves travelling, dancing and is a food aficionado.
Vidita Vaidya is a faculty member in the Department of Biological Sciences at TIFR and works on the neurocircuitry of emotion. She is committed to diversity and inclusion in academia. When not in the lab, Vidita is happiest curled up with a book and a good pot of masala chai.
Gita Chadha is a faculty member at the Department of Sociology at the University of Mumbai. Her research interests include sociological theory, cultural studies and feminist science studies. She has published extensively and co-edited two book volumes, Feminists and Science: Critiques and Changing Perspectives in India. Gita is also a closet poet, and knows the nooks and crannies of Bombay better than many.
Illustration by Ipsa Jain Title: The mute self Note: Conversations with "the impostor" crowd headspace needed to think and speak.