Friday, December 04, 2009

Teaching while Mentally Ill

(Cross-posted at BlogHer)

Imagine trying to teach while voices in your head are telling you your students are trying to kill you. That has been a reality for Elyn Saks, a professor of law, psychology, and psychiatry and the behavioral sciences at the University of Southern California's law school. This week Saks published an article in The Chronicle of Higher Education documenting her personal experiences with mental illness in academia.

Over the past few days, links to the article have been moving through academics' e-mail inboxes like wildfire. There's good reason why. Not only does Saks share some pretty startling experiences and talk about how she has overcome these challenges, but she also opens an interesting discussion on whether, when, and to whom an academic with mental illness might disclose her illness. Here's an excerpt:

The first question you must ask yourself is whether to tell your chair and dean. I can think of arguments both in favor of that, and against.

One of the pluses would be the psychological benefits of not having a secret and being able to be open. More practically you might be able to get extra support, or formal accommodations under the Americans With Disabilities Act (ADA). You would serve as a model for other academics in your department and your students.

There are, of course, real pitfalls to telling, too. There is a tremendous stigma, still, around mental illness. People may believe, consciously or not, that you are unreliable or even dangerous, and they may fear you. They may think you can't do the work or your scholarship isn't good, even if it is very good. That may not be intentional on their part but can nonetheless have a big impact on your work life and your prospects for tenure.

Saks is the author of a memoir, The Center Cannot Hold: My Journey Through Madness. (You can read a review of the book by a writer who has schizoaffective disorder herself at Femi-Nation.)

Mental health has become a big issue on college campuses. Campuses with unusually high rates of suicide have worried about distressed and distressing students for several years, and the shootings at Virginia Tech in the spring of 2007 raised awareness nationally of student mental health.

That said, aside from mental health centers for faculty and staff on some campuses, there has not been significant attention paid to the mental health of those who teach students. Anecdotally, there is evidence that mental illness in academia, particularly depression and anxiety disorders, are not uncommon. Years ago, I attended an academic talk on mental health, and the presenter mentioned he was studying four disorders in a particular (nonacademic) population: major depression, bipolar illness, schizophrenia, and dysthymia. Someone asked what dysthymia is—it's mild-to-moderate, long-term depression—and those in the room exchanged knowing glances. Finally, someone said, "Ohhhh. . . It's what we all have."

Many commenters on Saks's Chronicle article shared their own experiences. Wrote one,

Thank you for this brave and thoughtful piece. I struggle with chronic depression and find that academe is probably one of the best places for me, because of its relative flexibility (compared to many other workplace environments). However, I'm still not quite ready to be "out." I agree that coming forward would probably be a good thing, but it also presents more risk than I'm ready for. I really admire you!

Another has faced greater challenges:

I very much appreciate your article and walking the reader through an actual experience you probably have had many times. I suffer from chronic mental health issues, although not to the severity that you do. But nonetheless, they do have an affect on my ability to work at times. I do not feel safe in disclosing any of it to my academic employer. I often hear comments in the work place about people who "are depressed or whatever" are just weak and need to toughen up. I have attempted to get consideration for my "general health issues" in scheduling of courses and my duties as a program chair without much success. In fact, I have found the responses to be hostile. We need more people like you to come out into the open and speak up so that more of us in the shadows can also come out, without resorting to ADA or legal action, which I know in the end will be used against me one way or the other, because I don't work in an institution with tenure (proprietary college). Thank you.

A commenter on a post at Historiann shared her own experience of not getting support when she needed it:

Fried from post-partum depression but afraid that taking a semester’s unpaid leave would jeopardize my future tenure bid, I jumped back into my job 8 weeks after giving birth–with disastrous results. (My female chair’s attitude: “I made tenure as a single mom. You have to give up your life and do what it takes. DO IT.”)

It's tough for graduate students, too, whether they teach or are students. Wrote one woman with a disability that may be a mental illness on the blog Rate Your Students,

Ever since my diagnosis, I have prayed to every god imaginable that I could be "normal" again. And most of the time, I am. I'm properly medicated and as healthy as I can be. But, you have *no* idea how humiliating it is to approach a professor (especially a mentor or a "shining star" in your field of study) and say, "Hi. I'm abnormal. This here sheet of paper gives me accomodations for which most students would maim a nun. Please, oh pretty please, don't put as asterisk next to my grade when I earn yet another A." Because that's how I feel - I work my ass to the bone taking an overload of course hours, studying endlessly, researching for seminars, while working to pay bills and to gain experience - but every time I EARN an A, part of me feels like I don't deserve it...because there's still a socially accepted stigma about mental disorders (as is evidenced often on this blog.)

The grad student blogging at PhD Depression also connects the ways an academic life, and particularly the pursuit of a PhD, can contribute to a major depressive episode.

Dr. Isis also has a must-read post in which she responds to a scientist suffering from depression. In it, she not only offers sympathy, but also some concrete suggestions for accommodations, including some that may be made under the Americans with Disabilities Act. She also links to a post by computer scientist Mark Chu-Carroll, who also has depression. His post is also worth a read, as in it he considers why people have no problem watching him take pills for one illness but not for another:

Somewhat over 1/2 of the people who hear that I take an antidepressant express disapproval in some way. Around 1/3 make snide comments about "happy pills" and lecture me about how only weak-willed nebbishes who can't deal with reality need psychiatric medication.

I confess to being thoroughly mystified by this. Why is it OK for my stomach, or my heart, or my pancreas to be ill in a way that needs to be treated with medication, but it's not OK for my brain? Why are illnesses that originate in this one organ so different from all others, so that so many people believe that nothing can possibly go wrong with it? That there are absolutely no problems with the brain that can possibly be treated by medication?

Why is it OK for me to take expensive, addictive drugs for a painful but non-life-threatening problem with my stomach; but totally unacceptable for me to take cheap harmless drugs for a painful but non-threatening problem with my brain?

What about you? How have you seen mental illness addressed on your campus, in your or your child's classroom, or in your workplace? Is it stigmatized? And what are you doing to cope or to help?


Anonymous said...

Feeling really tired on a Friday after meeting with my boss and a colleague, both male academic psychiatrists, as I defended my decision to allow one of my clinical staff persons to work from home one day a week to help balance work/life after having a baby. We work in a specialty clinical program for persons with schizophrenia. For our patients, managing stress is essential. But not for our staff!

fatedplace said...

Thank you for such a good survey of the responses in the blogosphere to Saks Chronicle article. I, too, read the article and found it an amazingly helpful resource.

In the past year I've struggled with depression that has seriously affected my progress toward my PhD. At my lowest my inability to stay on track working with an adviser collided with my need to explain why I had come up short. I had to explain why I was failing. This was a difficult discussion. I had to explain my personal struggles, and in particular I had to explain how the medicines I was taking for these struggles had not made things better. In fact the medicines had made everything worse.

I was not myself and I was not doing the work that reflected my abilities as a student and scholar. Having a frank discussion about this with my adviser was one of the hardest thing I've ever done, but it didn't make anything better. Ze was understanding, but there was nothing for ze to DO to help me. Understanding, at least in this instance, was not enough--not from my perspective.

Yet I continue to press on toward completion of my degree and I work to overcome the mental hurdles. I have had the need to explain my situation to one of my advisers, but not to all of them. This inequality, I think, presses upon me the truth of Saks' claim that telling your colleagues or bosses is situational and personal. When and if the need arises again, I will consider telling my other advisers, future colleagues, or employers.

Anonymous said...

This article is great! I can't wait to read the literature it references. I can really relate to a lot of this. I'm actually going to resume college this spring for a degree in education. I want to work with kids who have mental illness. But I'm concerned about how my own mental illness might affect my career. Could I ever be lucky enough to find an employer in such a specific field who is progressive enough to be understanding and supportive?

I worked through a temp agency one time at an office where I had a huge amount of responsibilities. I got overwhemed. One morning I was having a particularly hard time with my mental illness so I called to tell them I'd be about 15 minutes late. It was the first time this had ever happened and I'd been told I was doing a good job. But when the woman asked why I was going to be late and I told her it was a health issue, she demanded to know details. I said it was personal so she fired me. Pretty sure that's illegal but what could I do? I ended up in a hospital later that day.

I went two years without working recently, and returning to the workplace was a very hard adjustment. I decided this time to disclose the fact that I have a disorder at the interview. The manager actually gave me a chance but was pretty hostile the few times I needed anything. It's hard to know whether you should disclose a disability sometimes. If you do, they might not hire you and there's nothing you can do to prove it, but if you don't, they can claim to be exempt from responsibility because they never knew, and you don't want to wait until something bad happens before it comes out. I guess it's just a personal decision we all have to make, at least until stigma is reduced enough.

I completely agree that employers tend to think you're incompetent if you're mentally I'll. They seem to think it's the same thing as being mentally retarded.

I also can relate to feeling guilty asking for things I need. For example I know from past experience that I really benefit from having a pet, and legally if I give a note from my doctor to my landlord, I can have one even if it's normally against the rules. I'm going through some particularly difficult times right now but I don't want my landlords to think I'm a 'difficult tenant' or anything, or that I'm abusing my rights, so I'm afraid to ask. But it frustrates me that there is such stigma and that we are often treated with disdain for exercising our rights for things we need.

Anonymous said...

I don't work in acadaemia - I'm a public historian working with museums. Mental health advocacy is still an issue. My current diagnosis is generalized anxiety disorder with mild clinical depression. Every two weeks I go to see my psychologist, and it means I come in two hours late. I'm very, very lucky that my boss is so understanding.

Every year when we get new benfits information I have to check and make sure mental health is still covered. It is very frustrating that if I were diabetic everyone would be understanding but because it's mental I have to be careful who I tell.

Anonymous said...

There is still a stigma to mental illness. The first word that comes to mind is Nuts. My son has schziophrenia, and until he became ill, I had no idea about this illness. I am told it can be heritary, his grandfather talked to himself all the time. Most the time I had no idea what he was talking about. I thought grandpa had too many beers. Thirty years later.......I understand. He's is gone now, my husband just said, that's just "Pop", he called him.
My son had an incident at his apartment, he didn't like the lady down stairs from his apartment, because she would sit on the stairs and smoke cigarette. My son doesn't like any kind of smoke. He let her know his feeling, and said she was smelling up his doorway. Later, that day the manager told me that his medication must be off. He was just fine, and so was his medication. People with mental disablities at this present time in life, will still have be stero-typed as "Nuts". I have a million and one stories. I love my son, and I pray that when I died, someone will still look after him. He knows he is ill, but still won't take his medication. I told him that I will make sure he doesn't go to the hospital, and I will make sure he gets the medication so he doesn't go. Read between the lines. Am I wrong? To see him in the mental hospital over medicated because of his size, was the most terrible thing I ever experienced. I take each day as it comes now, and do the best I can to get him to his doctor, and get the medication he so desperately needs. I wish I could change the way people think, but I can't. Education is the only way. If my son didn't get sick, I would still be in the dark about alot of mental illness's.