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Facing Stigmas in Academia on World Mental Health Day

Do our brains truly recover after depression?

October 10th was World Mental Health Day—a day created by the World Federation for Mental Health (WFMH) almost three decades ago. This year’s theme was mental health promotion and suicide prevention—more than well-warranted based on the high suicide rate in most countries. In 2016, the World Health Organization reported an estimated 793,000 suicides globally, with men nearly twice as likely to take their own lives compared to women.

By focusing on suicide prevention, WFMH’s goal was partly to attract the attention of governments around the world so that public health officials would take the issue more seriously. President Dr. Alberto Trimboli stressed that goal in a statement on WFMH’s website: “Suicide is preventable and can therefore be avoided, which is why all of our efforts and public policies should focus on prevention. However, oftentimes, people who suffer from mental illness lack access to mental health services, sometimes because there are no services in their community and sometimes because they must wait months to be seen.”

Foundry Co/Pixabay
Source: Foundry Co/Pixabay

As I read his words, I found it impossible not to think back on the time I spent in my PhD, where services were undeniably limited for the students who were making little money and didn’t have the luxury of leaning on others—like family members—to help them out financially. I was surrounded by colleagues who, like me, were weighed down by the unforgiving academic atmosphere. Most of us were highly-driven perfectionists—for me, admitting that something was wrong with my mental state felt like giving into a weakness I may be able to “push through.” A few years into graduate school I knew I couldn’t keep operating under such stress and that things were only getting worse, so I sought out counseling, but I felt alone in that endeavor until a few of my peers confided in me that they did the same. Even so, seeing a psychiatrist or therapist wasn’t something I heard anyone openly share until the end of my PhD, at the beginning of 2018.

Around that time, I could feel a positive shift in academics’ willingness to speak about the importance of mental health. For instance, a study published in Nature in 2018 revealed that PhD and master’s students worldwide reported rates of depression and anxiety six times higher than that of the general public. Studies like this, along with heart wrenching Op-Eds and a growing community of scientists in social media platforms like Twitter, are helping us move away from the stigmas attached to mental health and treatment for depression, but we have a long way to go. It has only been in the year or so since finishing up my PhD that I’ve returned to a less anxious version of myself—a person more familiar to me than the person I became throughout my graduate experience. And that made me wonder… what do we really know about depression and our ability to bounce back from it?

Depression is a mood disorder characterized by feelings of sadness and apathy, but it’s far more complex than that. According to the American Psychological Association, there are five categories of depression, but major depressive disorder is the one you may hear about most often. Depression is not only a chemical change in your brain in response to what your environment throws at you—your genetic makeup is a key contributor, one that scientists still don’t fully understand. There is no singular “depression gene”—research indicates that there are many different genes that play a role in making you more or less likely to suffer from a depressive disorder.

Ulrike Mai/Pixabay
Source: Ulrike Mai/Pixabay

The dangers of not treating depression also vary depending on a person's age. Depression can make it hard for you to focus and learn, and as a child or adolescent that can mean falling behind in school or stopping attending altogether. Research has also shown that chemical changes during depressive episodes, with the hormone cortisol for example, can increase your risk for illness years later, even if at that point you’re no longer clinically depressed.

And just like depression isn’t the result of one gene or environmental factor, it doesn’t seem to affect just one region of your brain. Researchers have used a combination of techniques, including positron emission tomography (PET), single-photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI) to gain some insight. An fMRI can track which regions of your brain are engaged during different tasks based on blood flow to those regions, whereas PET and SPECT can help researchers estimate the sizes different brain regions and how densely packed those regions are with neurons. Some studies using these techniques have shown that depression can cause our hippocampus—a region essential for critical thinking, learning and memory—to shrink. One of the hypotheses behind that phenomena is that stress—which often fuels depression—underlies the loss of volume, because it has already been implicated in blocking production of new neurons in the hippocampus.

So, can your brain recover from depression? Some studies—including ones looking at hippocampal atrophy—would say no, but depression is so poorly defined at multiple levels (e.g., yes we know neurotransmitters like serotonin and dopamine are important, but what are they actually doing to our brains?) that it’s unclear how many factors actually come into play when your brain is regaining balance.

So, at this point, preventative treatment is key. And, back to my own experience, for those who accept or subscribe to the idea that stress, overwhelming pressure, and feelings of inadequacy are just the way things are I would ask: why? Why do unnecessary all-nighters and hazing by superiors have to be a part of anyone's academic experience?

Here's the good news: People seem to be talking about their experiences more openly. Social media, for all of its faults, is creating a space to be heard, and to share information with others. The more people out there tearing down the mental health stigma, the better off we all are.