About two years ago I was suffering from a debilitating and possibly deadly illness. Sadly, I was suffering because I was refusing to get treatment. I had seen others get this illness treated with medication and some of them had suffered from bad side effects, which scared me. I convinced myself that I could beat my illness without medical attention. But my condition worsened and it was affecting everyone around me.
If I told you that condition were cancer or Parkinson's or some other obviously physical ailment, I'm sure you would be scratching your head as to why I refused treatment for so long. However, my ailment wasn't obviously physical. Instead, it was mental. When I finally sought a diagnosis, I learned that I was suffering from an extreme anxiety disorder and moderate depression.
When I tell this to people who know me well, they're almost always surprised. This is because I was generally pretty good at hiding my symptoms. It was only when I was alone that I would obsess for hours about some interpersonal interaction from earlier in my day. It was at night when I couldn't sleep. It was in the mornings, in the shower when I battled the voices that told me I wasn't good enough, and I shouted back in irrational but real anger. It was in my office that I continually looked over my shoulder for my colleagues to find out that I didn't belong at Caltech (impostor syndrom is a real thing!).
Near the end of my refusal to seek treatment, I wrote a blog post for Astrobites entitled Zen and the Art of Astronomy Research, which pretty much went viral within the astro community. In it, I said:
Most people find the topic of mental health a bit unsettling, so I made sure to qualify what I meant by the term. I wasn’t insinuating that anyone in the room was crazy or mentally unstable. And I wasn’t trying to get all squishy with my audience by talking about warm fuzzies, or fuzzies of any [temperature] for that matter. But in the same way that it’s important for you to take care of your lower back by lifting with your legs, it’s important to take care of your mental state while you tackle the rigors of science. After all, you can in principle reduce your data with a bad back. However, if you’re not thinking clearly, or if you are perpetually unhappy with your lot in life, your astronomy research will certainly suffer.
I think it took writing this down on the page in order for me to recognize and come to terms with my own problem. Soon after writing this article, and obsessing endlessly about others' perception of it, that I decided to seek help.
My first stop was to Caltech's excellent Staff and Faculty Consultation Center. After a few sessions there focusing on my fear of being discovered as a fraud by my colleagues, I came to realize that what I was going through wasn't as rational and as firmly rooted in empiricism as I had convinced myself it was. I also realized that my tendency to endlessly replay interpersonal interactions wasn't just a part of my personality, but related to a chemical imbalance. I had the equivalent of a herniated disk, but in my brain. And just as if I had injured my back, there exists a variety of treatments for my ailment. Further, I didn't have to be "crazy" to need treatment for my mental state. There's no shame in seeing a physical therapist. There's no shame in seeing a mental therapist.
The first couple counselors I met with didn't really work out. One even tried to engage me in an academic pissing match, touting his credentials and bragging about the various institutions in which he held appointments. Next! I was tempted to give up and attribute the shortcomings of those first few therapists to a failure of counseling in general. But with the encouragement of my wife I pressed on and settled on Dr. Delker. She really understood me, was patient, yet knew when to be direct with me and call me on my B.S. On that latter point, she kept pushing me on my fear-based refusal to try medication.
Counseling was going well for a few months. But then one day I found myself at a stop light with someone tapping their horn behind me. I looked up and realized that not only had I been stopped at a green light, but it was now turning yellow. Further, the reason I was stopped there was because I was yelling at myself. Why? Because I had said something to a colleague that belied my ignorance about an aspect of a astronomy. Now, I can look back and see how ridiculous that was. I was just over three years out of grad school (at the time), of course I haven't mastered GR by now! But my sprained mental state was forcing me to beat myself up about it, much like an allergy suffer's immune system overreacts to pollen and attacks its own body. Just as I take a daily dose of Zyrtec, I needed to start thinking seriously about meds for the chemical imbalance my brain.
Hence the screen cap of my morning inbox, pictured above. Every day I take an allergy pill and a dose of Lexapro (similar to Prozac). Ever hear the tearm "miracle drug"? Man, Lexapro is the bomb! After a month of minor side effects, including a mild upset stomach (I now take the pill with food), I found myself in a whole new world. Suddenly I was able to make mistakes and...not think about it for days. I was able to hear criticism. But more importantly and amazingly, I was suddenly able to hear compliments and not assume I had fooled the person complementing me. I was finally able to hear praise. I could give a colloquium and not obsess about the slide transition I missed and I was actually able to hear it when people said, "That was a great talk!" I can't tell you how good it feels to hear someone say that and not have to brush it off. It wasn't humility that caused me to do that before. I was that I truly couldn't hear it.
Now, to be sure, the solution I found is not a magic bullet. I also put in a year of weekly therapy sessions that helped me uncover and deal with uncomfortable events in my past that trigger certain reactions in me. Also, I'm fortunate in the extreme that the first medication I tried worked so well. This is not the case for everyone. Finally, I'm currently working with my psychiatrist to ween myself off of the drug now that my brain has been retrained (I can feel habitual reflexes to react the way I used to, but I can coldly refuse to follow those reflexes). Drugs are not the ultimate and final solution (like Patton Oswalt, I can't help but worry about being dependent on medication after the pending apocalypse :)
Back when I was suffering from my ailments, one of the recurring ideas that I used to dwell on was what I would do if I had one wish. What I'd always come up with was not riches, nor super powers or anything like that. My single wish used to be that I could truly be as exceptional as people in my department and science field thought I was. My wish was that I could be like that guy in the movie Limitless, and I could take a pill that would make me as smart as my colleagues at Caltech.
In many ways I found that pill...and much, much more! (plus it didn't involve a fight to the death with the Russian mob at the end of the story :) But instead of adding something, all the pill did was remove the barriers that prevented me from seeing the truth that, you know, I'm actually pretty good at what I do.
It is now my goal to be an outspoken advocate of mental health in my community. Now that I'm "on the other side" I can clearly see how many other scientists suffer in varying degrees from what I suffered. This widespread problem is resulting in a large impact on scientific productivity and a lot of unhappiness in the halls of our highest places of learning. It needn't be that way. We need to start recognizing that mental health is not a matter of crazy vs. sane. It's a matter of happy vs. unhappy, productive vs. destructive, and no different than physical wellbeing. Just as I wrote in in that Astrobites post,
This might sound like strange advice coming from a professor. Shouldn’t I be telling you about publishing or perishing? Shouldn’t I tell you to suck it up and pull an all-nighter again? Well, science is fundamentally a human pursuit and we do ourselves and the field a disservice by forgetting this simple fact. Unhappy graduate students tend to be sloppy, less productive researchers. Happy students, on the other hand, vigorously pursue interesting science questions, give outstanding talks and churn out well-written papers. Thus, as a professor, it’s in my best interest to work in a science field full of mentally-healthy [individuals].