Mental Health in Academic Research - Who takes care of the immunologist´s soul?

Summary

This episode of the Young Immunologist podcast discusses mental health during a PhD journey. The guest, Julian, shares his personal experience with mental health issues during his PhD and the challenges he faced. He emphasizes the importance of having empathetic people around and finding support from others who have similar experiences. The episode also highlights the impact of academic pressure on mental health and the need for institutional support. The conversation concludes with three tips for dealing with stress and maintaining mental wellbeing. The conversation explores the topics of negative thinking, anxiety, overcoming mental health challenges, personal growth, self-acceptance, and seeking help and support.

Takeaways

• Having empathetic people around and finding support from others who have similar experiences is crucial for mental wellbeing during a PhD journey.
• Academic pressure and the fear of failure can contribute to mental health issues such as anxiety and depression.
• Seeking professional help and support from psychologists or therapists is important for managing mental health during a PhD.
• Being kind to oneself and acknowledging small successes is essential for maintaining mental wellbeing.
• The mindset and thinking process play a significant role in managing stress and maintaining mental health. Negative thinking can lead to anxiety and panic disorders.
• Challenging mental health issues is a process that takes time and effort.
• Facing and overcoming mental health challenges can lead to personal growth and self-acceptance.
• Seeking help and support from trusted individuals or professional resources is crucial in managing mental health.

Chapters

00:00
Introduction

02:18
Julian's PhD Project

03:55
Mental Wellbeing during PhD

07:14
Imposter Syndrome and Mental Struggles in Academia

10:15
First Signs of Mental Health Issues

17:14
Academic Pressure and Mental Health

19:00
Seeking Help and Support

23:19
Substance Abuse and Mental Health

29:00
Impact of Environment and Supportive Network

36:15
PI's Support and Empathy

39:04
Three Tips for Dealing with Stress

44:27
Negative Thinking and Anxiety

48:47
Overcoming Mental Health Challenges

50:59
Personal Growth and Self-Acceptance

51:26
Seeking Help and Support

Transcript

Nóra (00:02.042)
Mental health during your PhD. When so many things must work in the lab, you feel like your future depends on your work, then some important aspects such as health or wellbeing lose their priority. Welcome to the next episode of the Young Immunologist podcast, supported by the German Association of Immunology. Your host is today, Dr. Nora Balzer, for you, just Nora, immunologist, bioinformatician, and science communicator.

I'm thrilled to welcome our guest today. Julian has been struggling with mental health issues during his PhD journey. He is brave enough to share his story with the community and raise awareness for wellbeing in academic science. And he brought his psychologist today, Alex, who will share his experience and expert knowledge on mental wellbeing during PhD. Thank you very much for both of you joining us today.

Julian, give us some information about you.

Julian (01:00.469)
Hey, I'm Julian and I was a former PG student for many years actually in Austria at an institute and I luckily finished now at the end of last year and currently I'm a postdoc and I will switch to an industry position soonishly. Yes, and I'm here today because obviously during my PG I was unlucky enough to get mental health issues which I had to struggle a lot with and I'm still struggling.

but I'm on the way to get better again. So that's a positive part of it.

Nóra (01:32.53)
Thank you. Alex, what can we know about you?

Alex (01:37.118)
Hi, I'm Alex. I'm a psychotherapist, psychologist and psychoanalyst. And yeah, I'm Julian's psychotherapist. And he invited, he asked me if I want to join and maybe help and get some, some insights because I'm working at an employer assistance program, which, which helps people in worst work-based problems, but also personal.

work-based problems and a psychotherapist in a private practice. So maybe I have some insights which I can help with in this podcast.

Nóra (02:18.702)
Yeah, definitely. Thank you very much. Let's start at the beginning. Julian, what was your PhD project about?

Julian (02:26.997)
So actually I'm also an immunologist. That's why I knew about this podcast. The project was somewhere in, let's say, it was crossing the field of cell biology, immunology, and let's call it data science. So in general, I was studying how immune cells were migrating. And the question for us was if actually immune cells use some kind of what they saw before, like the gradient they were seeing, the concentration. And so if that helps the cell in the future to make specific decisions, for example, to turn left or turn right and these kinds of things.

So because we did a lot of single cell tracking of cells in different kinds of systems, microfluidic devices, oncology, and it's similar to our tissue, we had a lot of data. And obviously, if you have a lot of data, you need a lot of good analysis way. And I had no idea before about any of these, let's say, data science programs. I teach this all by myself during my PhD and switched field system extend into more data science. For example, this would also be my position in the future in the company, which actually I think also was

not, it was great for me, but it also potentially was also part why I got this kind of mental issues because he's suddenly also switching to something which you have absolutely no idea about. And especially my PI also didn't know so much about this. It would technically be somewhere, let's say in the void with not so many people who can actually help you in this. Yeah, but it was a very interesting thing and we're soon also going to publish this. So it actually was also successful at the end. So it was the great part of it.

Nóra (03:55.79)
Yeah, congratulations for the soon to be published work. And how was your time as a PhD from the mental wellbeing perspective?

Julian (03:59.277)
I'm gonna go to bed.

Julian (04:06.509)
I think that's interesting. I think at the first year when we started our PhD, you get these introductions in our institute and they even also showed these kind of mental welfare and at some extent, because you see this kind of, the first year, it's super exciting, you're super happy because everything is new, you have so much freedom. And then, so the first year is good and then suddenly it slowly declines and I think then you have the third, fourth year crisis to some extent, because you have no idea where it's going and you feel like nothing is working or something. Just...

And at the end, it gets, again, better because it's suddenly finished and everything seems to come back together again. And this was the thing similar for me. The first year start, you finally get a salary because as far as it was a master's, you don't get anything. And it's like, oh, I have money, I can do stuff. And then with my PI, it was very great because we could choose our project. So it was not a project which he had in mind. So technically everyone who came to the group could choose, either he gave you one or you can made up one yourself. And I decided to make a one myself.

So it also became like your baby to some extent. So it's like your project, you're responsible for it, and it's your idea. And this actually feels great at the start because it's like, oh, that's mine, I can do whatever I want. And you play around a lot in the first year. Actually, it's also was heavily encouraged by our institute and also by MIPI that you play around a lot, that you find your way, find what is interesting. So the first year was really great. I'd also think the second to some extent, and then things don't work out as typical, I think, with most PhDs.

if you're not very lucky where everything works out. And then you suddenly start thinking, okay, what is it my problem? Is it me? What is happening here? Will I ever get my data? And then you also have these contexts, for example, with people outside of academia, it was like, you know, let's say the smart people who went into economics or other things. And it's like, oh, how much money they earn. And it's kind of like, oh my God, what am I doing here? So you also have like these kind of, let's say, peer pressure to some extent from the outside.

Um, so I actually, that also is like punching onto your, let's say mental health to some extent. Um, yeah. And then at the end now, as I switched fields, that was also, I think it was great to one extent because, you know, it's like, you learn something new and, uh, if you learn something new, everything is like interesting to some extent because like whatever you write one line of code, let's say two plus two is something, oh, I put coding or something. I guess you get this initial very quick feeling of success.

Julian (06:29.333)
But then the more deep you go into it, and suddenly it also becomes more and more complicated. And it's like, I have no idea what I'm doing. And then you need people who help you. And then, you know, your eye has no idea about programming or anything else. It's like, so whom do I ask? And then you search the internet for hours, or you try to talk with someone who can help you. You don't find anything. And it's like, oh my God, where is this going? I cannot do anything about this. So this wasn't again like, ah, bad. But then at the end, when you put it to get into CISES or into the paper, then again, it becomes.

this great feeling and it's like, why the end it's not that bad actually looks quite good. And then you get these compliments from your PI or from collaborators, actually, this data really great. It looks good. I was like, oh, yeah, nice. Oh, suddenly my someone is like stroking my soul in a niceness. So it's an up and down in academia, I would say.

Nóra (07:14.126)
Yeah, so for you it was like a shape like that. Yeah, interesting, because for me it was something different. I think in the first year of my PhD I learned the term imposter syndrome, that am I good enough? May someone else could do it better. So Alex, how is it you may have some experience with academic students and mentors struggling?

Julian (07:15.774)
Yes, yes, exactly.

Alex (07:36.882)
Especially with the imposter syndrome, when it comes to that, a lot of people working in academics experience some kind of imposter syndrome feeling because there's so many struggles that come up. Maybe sometimes there's a reason why they go into academia, because they want to achieve something.

But then they struggle with the real world, with the real academics. And I mean, there's so many possibilities why it can occur, but it is something that is quite usual with people in academia. And that often leads to depression or the other way around, or then, and or panic attacks as well. So that are really common things.

especially in higher education, academia. You could say, and I think I could back that up with numbers as well, as higher you educated or working in education, as high as the chance that you have some kind of mental problems. So that's my experience.

Nóra (08:54.074)
Which is somehow so weird, yeah, that it doesn't make sense in my mind, but I experienced the same. So do you have some kind of experience that these mental questions or problems are coming at the beginning of an academic journey or more at the end of the PhD? So do you have any experience with that?

Alex (09:16.934)
Um, but my experience with people I was working with usually more at the end, um, because it takes so much time and then they realize, I think, like I mentioned a bit before, um, it's not like I've expected it to be, I cannot change the world or maybe not be a total genius in my fields. Um, maybe they are. Um,

But it does not feel like it. That's often what the people experience and tell. Um, so in my experience from listening to them and working with them more to the end, but it can, it can be, it's yeah.

Nóra (10:03.964)
Okay. Yeah. I see. Uh, Julian, when was the first moment or what was the first moment when you felt that something is off and not really normal?

Julian (10:15.065)
I think actually, I think for many mental diseases, it's, I would actually say it's not a one thing moment. Normally like with depression or like as in imposter syndrome, it's nothing which you realize suddenly, you know, it's a slow thing and at some point you might realize it. I was, let's say, luckily, unlucky that it was having panic attacks and this thing, you know, that is a sudden thing.

nothing which is slowly developing is thinking, bam, it's there. And then you're in the fear of death for some reason. It is, but I think you never explained it actually before how it was for me. So in this case, so actually I started to having migraines during work and actually it was not normal like, so I developed like hemophlegic migraines, which is stroke like symptoms. So I was at work and suddenly I was blind on one of my eyes, some extent. And, uh, then you obviously were like, Oh, well what's happening here? And.

Then I also developed speech problems during this onset. So I suddenly couldn't talk with the people anymore. And it got even worse at some point. I couldn't even think anymore. So I was thinking like a baby to some extent who could not really communicate anymore because I couldn't understand what people were telling me. I couldn't communicate what I was feeling. I couldn't even think what I was doing or feeling. So they brought me into an emergency unit where they actually also thought I potentially might have a stroke. So I got the diagnosis.

and they put me in MRI and they said, oh, that's actually nothing. So most likely what's happening is you have a very severe migraine. Um, but it was very, very terrifying because if you're there, you cannot speak. It cannot communicate. Technically I have no control of anything anymore. So technically as a baby, you're technically dependent on everyone around yourself, especially when you're not at home where you technically can lie down. Uh, and from this, I developed this kind of panic disorder because when I went out of the house, I was feeling very, very vulnerable because

What happens if I get this panic, like the migraine, if I'm outside, for example, if I'm in the city, if I had work, how do I get home? Who brings me home and this kind of stuff. So, and then suddenly sometimes I got these panic attacks, once in a while, and you know, they're very severe and there's like, it's hard to explain to people who don't have them, but in short, you can imagine that it's like a fear of death in a very short amount of time, it's like this, there's a tiger appearing in front of you and you now need to run for your life, something like this, or you just stand your ground like this typical fight or flight syndrome. But this...

Julian (12:31.105)
can be absolutely nuts. It can be in a restaurant where you're with friends, you have a lot of fun and suddenly you get this panic attack and then you technically just want to run away because you have this feeling of utter fear and of death to some extent. So it's very, very hard on yourself psychologically as well as on the body because technically your body is preparing for running away as fast as possible. And because of that, I had these panic attacks at some point I was just afraid of getting panic attacks. So if

because I was outside and I got panic attacks. And then I sometimes lost control of myself. So I was becoming hysterical, running away. People had to run behind me. They had no idea what's happening here. And also I didn't know myself what's happening. And because of this, obviously I developed this called generalized anxiety disorder, like GAD. So I think you just have anxiety, so of leaving the flat. So one thing which I have very severely is called agoraphobia. So I'm afraid of open places or...

where there are a lot of people. So the more people there are, the more afraid I get because if it's kind of saying.

Nóra (13:31.798)
like giving a scientific talk would be a no.

Julian (13:35.089)
Especially as this kind of was writing me inside I was always very introverted. So I normally didn't like to give public talks But with this kind of stuff, it became very bad So I had talks where I was standing in front actually sort of will faint now in the next couple of seconds So it was very bad, but you know, it is still you force yourself to go through this But it feels very terrible and after you start to take it I could immediately go home go to bed because I used to take all the energy I had for this whole day There's an anathesis anxiety disorder

And actually I became, you know, a retreat more and more because you don't want to go outside anymore. You don't meet with friends anymore because they're always afraid of whatever you're afraid of getting afraid at the end. And the problem is with these. Yeah, sure.

Alex (14:13.742)
Can I add something in here, Julian? Because the panic that Julian described is often the symptom of something that is behind that. Which does not mean that it's not real, it's very real. And it feels like, like Julian just told it, it kills you at some point. And then the fear becomes that thing that is frightened and so on and so on. But...

And that's the tricky thing because, and maybe that's the point I tried to make before when I tried to mention that, especially in academia or very intelligent people have that way more often because they have the ability to think and to kind of, the problem occurs to them and they notice the symptoms, which other people...

often discard. And then it's really hard to look back why it could have happened. And that's something people are struggling for years or even more. So that's the tricky thing. And that's why it's often not that easy to work with it or find the root cause of that.

Nóra (15:36.986)
Yes, that was also my first question when Julian was describing his symptoms and did you try to hide it? Or I would have been afraid that someone thinks that I'm kind of crazy. So it's...

Julian (15:44.35)
Yeah.

Julian (15:49.537)
Yeah. That's why you have this panic disorder or like you get this kind of anxiety. You don't want to lose control, especially not in front of other people. So you want to always look like perfect in a specific way. And a lot of other people I know who have mental issues, a lot of people don't know it because they don't discuss it with other people because they don't want to share it. And, you know, especially with, let's say, these chronicle mental problems, you try to be as normal as possible in front of public.

Nóra (16:03.343)
Right.

Julian (16:18.429)
and these kind of things. You don't want anyone to know about it. So actually you force yourself through a lot of things which potentially you even shouldn't force yourself through in some instances or the other. Yeah, but what I want to say, you know, you have this anxiety disorder and the panic attacks and then you retreat and it's a process even of feeling you know, you try to battle it, you force yourself to go out, to meet with friends, to go to restaurants, to go into the city and this kind of stuff. So because that is how actually fight this kind of anxiety and then panic attacks, you cannot give in to them.

but still it's like, it's an ongoing battle at the end. So you always will have them to come back and then it's somehow like, so you get this kind of relapses to some extent. And this is also wearing you down to some extent. So it's like you have these kinds of walls, you push yourself and then, you know, it tears down these walls. And at some point I got a depression because of this, because I always had this feeling, you know, no matter what I'm doing, it's not getting better. And this I think was in the worst time of my life at some point. Then I had a severe depression, I had anxiety, just all the migraine and the panic attacks.

And it was very, very hard to get out of this and doing a PhD at the same time. That was very, very terrible. The combination of

Nóra (17:17.338)
and a PhD journey. Yes.

Yes, I can imagine that, especially during the academic setting where you, of course, you want to show that you are great and you belong to this one percent who are just really good in that what they do. And then having such panic attacks when you cannot really show that what you have done going to a conference, giving a poster presentation. So can you describe how the academic setting may impact it on your mental health? What is the connection?

Julian (17:27.286)
Mm-hmm.

Julian (17:36.405)
Mm-hmm.

Julian (17:45.195)
Yes.

Julian (17:53.333)
I think in academics, you have these, like, especially in my case, you know, you have your own project, but who is going to do it? You know, in an company, potentially, if you get sick, you call yourself sick and someone else will take over what you're supposed to do. But in a PhD project, mostly, or even a postdoc, there's no one who will do it. So if you don't go on with it, the project will technically just stand still. So there's no progress and therefore there's no progress to finishing your PhD. So technically,

It's like a bit of a single it's like being self employed to some extent. So you know, if you're self employed, and you're getting sick, there's no one who is doing your job at the end, you are the only one who can push it and do it. And I think this is also often not helping. And then also you have a lot of these pressure, you know, publish or perish. If you want to stay in academia, what are you going to do? It's like if you don't finish your project, there's no way you can stay in academia, because then people say, Oh, you need a good paper. Otherwise, without a paper for us all the paper in these kind of that journals, you will not go anywhere afterwards. So

I think that the pressure you have in academic systems is massive in this kind of things.

Nóra (18:50.667)
Right.

Nóra (18:55.126)
It is. So you have recognized it, okay, something is really not working well, and it may, it possibly has some mental background. So how did you look for help? Was there any sort of institutional support or how was it for you?

Julian (19:00.438)
Mm-hmm.

Julian (19:04.31)
Mm-hmm.

Julian (19:10.525)
Yes, I think initially as most people who develop mental issues, you try to ignore them. Like, you know, you assume it's like a normal wound when you injure yourself, I will heal by itself. There's no problem with that. Which with mental health problems doesn't work like that. So, you know, they just stay there. They grow potentially and they move into the subconscious to some extent. So it doesn't get better. For me, it actually got worse over time. You know, I just pushed it away. And then because I think it's like how you grow up, how your environment is and these kind of things. And it's going to be

I grew up with my family, I think, you know, these old baby boomer families, you know, there are no mental issues. That is not existing. It's just weakness. So yes, yes. And then you don't want to give into it because, you know, you grew up with this, you are not weak, you have to push yourself through this and this kind of stuff. But if it doesn't get better.

Nóra (19:48.78)
A shot is a solution for everything.

Julian (20:03.657)
What are you going to do? It got worse significantly for me. It developed over time, panicked and anxiety, depression and so on. And then you fell into a hole and you cannot get out of it. So I started then to look to psychologists first. So Alex actually was my second psychologist. There's also one thing I want to mention first of all. If you search for help, don't treat, how you say, there would be the German saying sometimes you need to kiss a lot of rocks to find the prince.

Nóra (20:17.379)
And how did you find Alex?

Julian (20:32.077)
And I think not every psychologist is resonating with you. My first psychologist was, for example, psychodrama, and that was absolutely not resonating at all with me. So it didn't work with me. Might work a lot for other people, but there are different kinds of psychologists with different kinds of ideas how they treat a specific problem. And Alex was helping me very much. And how I met him actually was via a good system by our institute to have a so-called employee assistance program.

And there's no question asked. So if you have any kind of problem, you just write them. And the Institute is paying, I think, for the first couple of sessions. So you don't need to pay anything. And you get an immediate response. So I was writing them one day. And I think even the evening on the same day, I had the response. And I think I was meeting Alex already the next day. So it was extremely quick. And even on a private thing, if you call up psychologists, they would tell, oh, maybe next week, two weeks, or month, you will get an appointment. So it was very quick and very fast.

And it was very good as obviously even after years, I'm still this Alex. So, so maybe Alex want to explain a bit more about the employee assistance program.

Alex (21:38.43)
Yeah. Um, so I'm working desert. That's why I should know it. Um, it's, it's basically many of the, of the things you already mentioned. It's a workplace benefit. And sometimes it's an academia, like it was in your case, but usually it's a work workplace benefit. And they offer employees, um, some kind of, uh, confidential access to professional counseling in many.

areas. Most of the time it's psychological in some way, but it's services, psychological, financial, law and so on for personal or work related issues. And it's usually quite quick. So the response

Alex (22:38.782)
my ERP Institute. And then it's easy going. You can either meet up in person or do it via online video calling, telephone, and so on. The important thing is to help someone. And in the ERP Institute I'm working for, we had six hours of counseling sessions.

If there is another topic occurs, maybe there's another six hours of counselling. And that's covered by the Institute in Julian's case. And quite simple.

Nóra (23:19.726)
Yeah, that's great.

Julian (23:19.729)
I think actually also what I was doing at the start before I met Alex, I also went to, I think potentially it's even law in Austria that you have to have an occupational psychologist. The problem was for me, it didn't help very much because the person we had was only focused on stress-related things, which was not in my case, it was something completely different. But at least she also handled me further. You can go out and contact the ERP or the

Julian (23:49.737)
I would even argue that maybe in Germany you should also have these kind of, because you also have an occupational physician. So I would assume there should always be an occupational psychologist in most institutes.

Alex (23:58.402)
Yeah.

Nóra (24:00.142)
Yes, and but maybe before seeking for help, some, so we are PhD students, we sometimes think, okay, we are too deep into our project, we are too stressed, and somehow we need to just shut down. And then sometimes we also may come to the idea to touch some kind of substances. It can be alcohol, drugs, or maybe the best case is probably medication from a psych and psychotherapy.

Julian (24:27.19)
Mm-hmm.

Nóra (24:30.216)
it for you? Did you get any help at this direction?

Julian (24:35.665)
Yes, actually, I also went to a neurologist slash, what is it? Psychiatrist and psychiatrist. And it was very interesting. And I will never forget this kind of mini because it was during my height. Because again, I was trying to avoid going there because, you know, it's this kind of, you know, I'm weak potentially now, but I'm not, I'm strong. I will manage this by myself. You know, um, then I was going to her and I was discussing all these kinds of problems.

Alex (24:42.135)
interesting.

Julian (25:03.765)
some point she realized that I was obviously in a very severe depression. And then she told me, so that's technically her words, because I denied she wanted to give me psychopharmac. And I said, No, I don't want them. I don't need that. I will get out of this myself. And then she told me, it's actually only the same three ways. So I get it out of this either you become addicted to alcohol or drugs, or you do suicide, or you take the psychopharmac. Because getting out of this loop of panic attacks, anxiety disorder and depression is

alone near impossible because the depression takes away all the positive feeling you needed to fight your anxiety and so I think you will be in a loop which goes spirals downwards. That was very on point what she was saying so and yes then I agreed okay I will take the psychopharmac and then I started taking them but even then it took me a single month or so until I finally was ready to open the package she gave me.

And she'd prescribed me a couple of them and I only still only took one. So, you know, it was still a battle inside of me. It's like, oh no, I don't want to take them. You know, it's some kind of, you have this feeling to some extent that you would lose to something like, you know, the mind would win or something like this. So you still always have this kind of struggle with yourself to some extent. So it's very weird to explain to people.

Nóra (26:22.05)
Yes, and Alex, what is your experience from the praxis with substance abuse and substance usage as a therapy in higher academics?

Alex (26:38.015)
Yeah. To be honest, I don't like to work with substance abuse a lot. So I don't do that much because I'm not that experienced with it. But to answer the question in academia, it happens a lot. I mean, I was in a university as well. So I saw that myself. And then

If people ask for therapy or help who have a problem with substance abuse in some way, they're often quite young and they're often quite educated in my experience. But you also need to think that good educated, young and willing to go to therapy with that. So maybe that's also.

thing that you have to keep in mind. So yeah, but I think the root cause is often, as I mentioned before, somewhere else. And the substance abuse is kind of the way they are dealing with it in some way. Also good substance abuse. I mean, in case of, I mean, good substance abuse, I think it's never good, but not thought as something.

Nóra (27:36.289)
Right.

Alex (28:05.11)
bad, like eating too much and not getting fed off it, playing too much on your computer, doing too much sports, learning too much, studying too much, thinking you could be the best if you just write one paper after another. It can also be some kind of substance quote and abuse.

Because it's something extreme and people tend to flee in the extremes where they don't see anything else when they want to hide a problem or something. So that's my experience with that. I think.

Nóra (28:50.378)
Right, yes of course we all start this academic PhD journey because we want to become an outstanding scientist and this outstanding is to belong, yeah, belong to the top. It's always comes that we need to do something abnormal to be above the normal. Very interesting.

Alex (29:00.231)
often here.

Alex (29:11.274)
And maybe that's the reason why in academia, so many people tend to that substance abuse them. Because if they can't be that good, like they imagined maybe, there's an easier way to get high by something, what intended.

Julian (29:11.286)
Hmm.

Nóra (29:32.575)
And as an immunologist, we are in the lab, so we have just a direct way to find those substances in the lab that needs to be tracked. And I made the experience that it got ignored usually if too much ketamine was used and so on and so forth. And I think it's a big problem. Okay, but now we are going back to mental health.

Julian (29:57.002)
Hehehe

Nóra (30:00.326)
I also know from my personal experience that different countries have different approaches to handle mental challenges. So how did your environment react when they got to know that you are taking pills to fight for your mental health?

Julian (30:20.185)
I think that was very interesting also with my family. I said, you know, there were these, uh, there's no mental issues to some extent. So, but actually in this case, my parents were actually very supportive because I think in this case they were saying, you know, as long as it's happy, it's fine. Um, coming being in Vienna is also very interesting. This concept because you know, technically in the like central Europe and you're connecting the West and the East. And I think a lot of, in the orange city, a lot of Eastern Europeans are. And for them, I think mental health issues is also something which is like, it's non-existing. No.

So it's a lot of weakness for them if you would have something like this. So, and as I have a lot of these people as well, I met them, it's also a bit hard to discuss these kinds of things with them. But I think that the heaviest counter arguments I got from friends at home in Germany, which, but they also were on this, let's say, alternative cloud, let's call it this way. So I go, did you try yoga? Did you try Ayurveda and this kind of stuff? You know, don't take any kind of psychopharmac. But also I have to say, it also resonates partially with me

With psychopharmacart there's always this kind of, I'd say, stigmata that it changes you. You know, you take a psychopharmacart and then not you're you again, or anymore. So you're someone else because it changes your mind and then suddenly you're someone completely different, which actually is absolutely not true. I was talking to a friend who also took psychopharmacart and then she said, she actually can be herself because of the psychopharmacart, because she's an extroverted person.

and she also had anxiety problems and panic disorders. And then you know, you treat yourself, you don't go to parties anymore, you don't go to festivals or this kind of stuff. But as an extrovert, you know, you want to do that because you wanna interact with people. So actually taking a psychopharmac actually helped her to be herself again, to some extent. And also for me, that was the biggest thing. I was afraid that I'm not myself anymore. So that something changes inside of me and I'm not like the Julian anymore, which I knew to and I become someone completely different.

But in the end it was absolutely not true. It's like it also just helps you to be yourself again. So, but it's still a big stigma, which I hear is still from a lot of people. But yeah, I think at the end you get these three groups, like neutral people who are like, okay, don't care. Then you have supportive ones. Oh yeah, do it. It's as long as it helps you. It's great. And then you have the other group of people. No, never do that. Why would you take that? Don't do that because it will change you and not do yourself anymore.

Alex (32:36.559)
Maybe that comes, Julian, maybe that comes because there's some, some

Alex (32:45.614)
which really change you. Often mood stabilizers like lithium or things that are prescripted when it comes to schizophrenia, hard word to pronounce and so on. But usually something that does not occur very often.

Julian (32:54.473)
Mm.

Julian (33:06.438)
Mm.

Julian (33:11.089)
Yes.

Alex (33:12.482)
there are some ways where it can influence your mood in a negative or in a character changing way.

Julian (33:16.836)
Mm.

Julian (33:21.301)
Hmm. And actually, I think I also got this kind of point, you know, psychopharmacists are something which you have to take long term. So I think I took my psychopharmacist for more than a year at the end. And the majority of these kind of drugs you need to take for quite some long times at the end. And then obviously, you have this, let's say, more conspiracy theory people, you know, it's just the farmer, they want to do it because, you know, they can earn a lot of money with you. That's why it's also bad. So that also hurts to some extent. That's why you should avoid it. It's just what farmer wants you to do.

Nóra (33:49.606)
It's so interesting what you both have just mentioned, because so far I always thought that mental disorders have a genetic background and no real reason. And now I'm just wondering, is it possible that a PhD journey or an academic stress can just trigger this kind of disorders to come up, to show up?

Alex (34:12.51)
Yeah, yeah. Usually you make it a third genetic, a third, or even more than a third youth, and then a third social influences in the present or like the years before. So that's the that's the mixture. And in some diseases or mental disorders, the genetic part is a big

a bit more than I just mentioned, like in schizophrenia, for example, as far as we know. But depression is usually at least a third in the childhood than how you grew up and then how it's triggered. And childhood and how you grew up afterwards is also the influence why you may be in academia. So it's a double trigger if you want. Because...

there's a reason, there's something that happens where it kinda, the foundation. And if the foundation is clear, it still can occur. And if the foundation is broken, the house can still stand, so to say, but it's way harder. And then there are reasons that put you in academia. Maybe you, like we talked before, like you wanna achieve something and...

if you fail or are really good at that but something is not working the way you thought or imagined it to be, then the trigger for a depression for example is way higher.

Nóra (35:55.518)
Oh wow, that's really a new lesson I learned at the moment. And Julian, now we are also coming to a great network that can support you or not support you. And of course as a PhD student, PhD is not a nine-to-five job, you just spend your whole week, days and nights there. So people who are around you are very important.

Julian (36:15.048)
Mm.

Julian (36:21.463)
Mm-hmm.

Nóra (36:22.97)
Here I would like to ask you about your doctor father, your principal investigator, your academic leader. Because in the academics usually you get a leader position if you are an outstanding scientist. But it usually doesn't mean that you are a great manager, an empathic leader. So how was it for you? How did your PI react or how did he support you?

Julian (36:41.782)
Yes.

Julian (36:47.229)
I can tell you two stories in this case. So I was lucky, because my PI was very empathetic person. So when I told him that I have these kind of issues, he was immediately saying, okay, you know, Julian, if you feel bad, you know, just stay home, don't you don't need to come, you don't need to put into the system that you're sick or something like this, you know, just come and go as you feel like when you're at work, you get a panic attack or anxiety, just leave, you know, just drop everything, just go home, you know, you're more important than the signs, you're more important than the experiment at the end. So

first focus that you get healthy, and then you can continue this kind of things. And he was very supportive in this kind of things and talking, but also know from other people in the different institutes and also in our institute that they had similar issues or the same issues with anxiety, depression, worse things, and their BI was a complete difference. So they were great scientists, but they were absolutely horrible human beings in this case. So technically forcing them to come to work while they had...

severe issues, very severe depression, and it's kind of been forcing them to work 10, 12 hours a day, also on weekends and also on public holidays. So you can get these both and I think for me it helped because you know, I could focus on myself to heal. But for these people, I think they actually went, let's say mentally more down the drain at the end, because you know, they technically are forced to do stuff, which actually should rather focus on healing. And you know, I think it's counterproductive, because you know, for my boss at the end, it was much more valuable because I could heal and I could work again.

more normally. So I got more data at the end and better than that. Actually for me, you know, you go to work happily, they say it this way, you know, you have a nice boss, you want to go there, you like the boss, you like the group, everything is fine, the people understand you, you know, you get an understanding and that this empathy you get from other people makes you also to like to work and do what you're doing. If this is not the case, and you hate what technically going to work, even if you like your project, but if you hate everything around it, then the thing goes, your work will become worse at the end.

Nóra (38:36.99)
Right, so for me it was similar and for me gaining distance from my project, telling to myself that my academic success is not making me to a better person or if my project doesn't work out, I'm still just good enough and so I always told myself if my project doesn't work out then I just go home and make three kids and be a stay-at-home mother.

Julian (38:48.719)
Mm-hmm.

Julian (39:00.155)
Hmm? Heh.

Nóra (39:00.342)
But then the project worked out, but it was always just a good thing to tell myself, okay, there are so many things in life out of my PhD thesis. So what are the three things that you could just put together that could help to someone who feels too stressed?

Julian (39:04.749)
Mm.

Julian (39:09.013)
Yeah.

Julian (39:21.914)
Ooh, three things. Well, I think first is having empathic people around yourself. Be your group leader, the group itself, or a partner, or friends, you know, people you can talk to. And the second thing would help me a lot because in my group of MIPI, they didn't understand what I had for issues. You know, it was like, they are empathic enough to understand I'm feeling bad. But they, you know, if I tell them I have a panic attack, it's like, well, yeah, what is that?

I have no idea how it feels, but having people who have the same, and this actually was very surprising for me when I went around quite openly to talk with people about this. Also other people opened up to me, they said, I have the same, I have a panic attack, and I said, oh, you also have anxiety disorder. And then you make friends with other people and you can understand each other. It's similar like a hobby to something, you can assume. If you like cars and you talk to someone who doesn't like cars, it's like, well, it's a car for me.

don't understand what you're saying. But if you've met someone else also lost cards and you can talk for hours about it and understand everything you're saying. The same with mental issues. You know, it's like, if I talk to someone who has panic disorder, they perfectly understand. I say, I have this kind of feeling, you know, I know that one. Yeah, exactly. You know, you get this feeling you're not alone. You also have other people that go exactly the same thing. And that actually makes you makes it less heavy on yourself. So having people who suffer from the same is also was really great for me.

It's not great for them that they have to think, but you know, in a general for us together, it is great that you have someone to talk to and who understands you. The third thing, maybe Alex wants to throw in something.

Nóra (40:55.226)
Alex if you want, yeah you can just really help.

Alex (41:00.674)
I'm not sure if I can really help because there is no guideline to generally avoid stress. When you raised the question just two minutes before, I took my pencil and asked myself what could I generally advise people, but I think the advice would be a mistake because it's so individual.

Um, what everyone can do to cope with that. And I think even cope is the wrong, wrong word because coping, um, it's, it's not dealing with it, you know, it's, it's giving, putting a layer over it. But I think you don't want to do that. Um, so I think I can't really answer the question.

And I think that's the best answer I have because maybe it sounds weird, but everyone needs to come up with the solution how to deal with the stress themselves. Because that's essentially the only important thing. How you do it, not how Julian or you, Nora, cope with that.

hope again. Deal with it or accept it.

Julian (42:33.581)
actually, I also have, it reminds me, or like it came, two things came to my mind again. One thing, which is very important, be nice to yourself. So that is also something which I had to learn. And that was very brutal because I had the anxiety disorder with the panic attacks and during the height, I couldn't leave my flat. So even going out for five minutes to go to a shop in front of our flat was terrifying for me. And I still went and then I went through it. I had panic attacks and I went through this panic attacks, you know, and then

I had this short feeling of success, you know, although all of these counterpressure I had, I still did it. But then the next thought in your mind was already, yes, but it's normal. So why are you happy about something which technically you should be completely normal. So technically downgrade yourself, your success and technically success in this case should be relative. So what is easy for someone else might not be easy for you. So you shouldn't put it like this and you should be proud of yourself that you actually push yourself through even the small things, you know, it's like.

Even if I go out for a walk, you know, I'm terrified to death and I go out for two minutes walk. It's already success. The next day, five minutes, 10 minutes, you know, you push it. It might be not big for someone else who doesn't suffer from anything, but for you, it is a success. And you need to acknowledge this was also very big for me to think. And this is the second part I want to say. And I think you even said it before, you know, the thinking is very important. You get like a lot of people, you know, you see this coaches mindset, but actually I also realized myself is really a thing. It's like.

how you're thinking of specific things. You might define your life about your project, but at the end, it doesn't mean anything. It could be a very bad project by itself. It doesn't mean that you're a bad person. It could be a very hard project. It doesn't mean that you're a bad scientist. It is completely relative, all of these things. So I can also tell you this is what I realized with my thinking process, because I'm a very negative person. I was an utter pessimist in the past. So I had this kind of thinking, if you think about the worst and you prepare for the worst, nothing...

can throw you out of line. But actually, I think there's also a very good recipe for depression at the end, because you always think about the most negative thing which can happen to you. I think it also was one of the reasons why I actually went down this whole rabbit hole. And one example which I like to give to people how bad it was in my head, especially during the onset of the anxiety and panic disorder. I was going mushroom picking with my family. We were in a forest which actually was very good because no people, it's nature. So actually I was feeling semi-fine. Then I was going to forest, there was this tree stump.

Julian (44:56.225)
but it was like broken off. So it was a bit pointy at the top. And my mind immediately said, hmm, if you fall unconscious right now, you fall on this tree stump and you pierce yourself to death. And then I was afraid, you know, it's like immediately I got panic because like, you know, oh yeah, if I fall unconscious right now, I will die. And this is this kind of super negative thinking. And then there's technically two ways down this road you can go. It's like one, you completely go with it, which in this moment I did back then, you know, it's like, oh yeah, if I fall unconscious and then I die, and then you go into panic. But the other point is like, you can...

think about it in a way it's like, oh, let's think about this thing, you know, it's like, what is the chance that I actually fall unconscious? I think you never did since I was a child or something. This is why I remember. So it's very unlogical that this happens. So you actually think about your own thought process, you know, as it was a distance, as if I think this is a negative thought. This is also something I learned when I was starting with mindful meditations, that you think about your own thoughts, you know, what is this for kind of sources? And I saw it's a bad

giving some kind of label to a solid or a distancing to some extent to yourself. And starting doing this, I realized that let's say 80% of my thoughts were negative. And then you start going along this kind of thought thing and you rework them to some extent and then it also helped a lot for me, you know, that you change your way of thinking about problems or issues.

Nóra (46:14.97)
Yeah, however, I really liked what Alex also said that we are all unique and individual the way we are. And putting labels on the totes that they are bad totes, they should go away, they are good totes. So just really just like letting totes in and out is just really a great idea. Um, yes.

Julian (46:20.214)
Mm.

Alex (46:33.87)
I have one more thought to that stress we just talked about. I mean, stress, that's quite a modern capitalist word. I mean, of course we can measure stress, but we can't measure the stress. We can measure that what we think the stress is. Often I like to ask the question, just imagine the word stress of what you're describing.

does not exist because then people need to come up with what triggers that stress. And often that's the problem because somebody told me he or she is stressed and so on and so on and so on but can't tell me the reason why the person is stressed. But if I asked, what's behind that?

Alex (47:32.542)
seeable root cause. And that's the important thing. Just cancel that stress and then you're really close to the root cause because then you can at least say, yeah, I'm really afraid of that to be in that podcast or whatever. And then we can talk about being afraid of being in that podcast, for example.

made up story by the way. But yeah. So I think that's important as well because stress, why is everything stress nowadays?

Nóra (48:04.773)
I hope so.

Nóra (48:17.142)
Right and find a cause and the root of that. Why do you feel the way you feel is a really important advice. And Julian, I mean now you are also you finished up your PhD, you are starting with your new job, so you had like a challenging phase in your life and but you have been working on that hard and now it's you are here and talk about that. So what doesn't kill you makes you stronger.

Julian (48:37.612)
Mm-hmm.

Julian (48:44.842)
Mm-hmm.

Nóra (48:47.056)
I think it's really a good sentence for you. How did your mental journey during your PhD made you stronger and made you the person who you are now?

Julian (48:58.281)
Well, I think it's a hard question because I would argue it's a double-edged sword to some extent. So on one hand, fighting mental health issues is not like a wound, you know, it's a one-time thing. We don't care. And it's a process, a process which takes years at the end normally to take care of it. So I have up and down. Even today, I still struggle with them. It gets better and better. So actually you just comb it and you get more and more out of it. But to say, you know, on one hand, you I would still argue I lost.

some parts of quality of life because you know, I still have this agoraphobia. So for me, it's hard to go into big cities when there are a lot of people. So it's still a lot of stress for me. So this sums up I lose. So and I still struggle with it I can and then still battling it that I can get it bad. But on a general term, I actually think I feel much stronger and I think allies can support it because he wins through multiple years was this with me. Because you learn far more, you know, you learn more about your thoughts. I said before, you know, I was an utter pessimist in the past, you know, this I'm actually not anymore. So

I don't have these negative thinking anymore that much. Maybe I get one or two a day maximum if I would go through this process. So it actually helps the quality of life to other extent are much better nowadays because you learn much more about yourself. You learn who you are, what you are, what your thoughts are. And potentially also, you might also do, maybe I always was an introvert. Maybe I always don't like big groups of people. It might not even be that it's just anxiety. Maybe it's just something else you need to accept because sometimes you...

want to push yourself to things which you don't want or don't like. You know, it's like it's kind of typical saying no, but you're a pleaser. So you want to please people so you don't want to say no to specific things. So also learn more about these kinds of things that actually know your own boundaries, that you accept your own boundaries to some extent as well. So I think this is very great that in total, I would consider myself actually in after you're all much stronger. And if I actually manage also to overcome all this anxiety, I think, and then I really became much stronger. And.

I would say for myself, a better person.

Nóra (50:59.958)
Right, and I think it was such a brave decision to share your personal journey to help other PhD students or young immunologists or anyone who are listening us and maybe they are struggling with similar issues like you. So Alex, if any of our listeners feel the similar like Julian, what would be the first step, what would be your advice?

Alex (51:26.522)
The very most important thing is to talk to someone where you feel safe. So the safe space and talking to someone is maybe the most important thing. Because there are always people who listen or want to listen to you. If you don't have friends and family next to you or you think they're not fit for that what you want to tell them, there are some numbers you could call.

I think we could link them. There's for example in Germany the Telefonzellsäger where there's someone you could call, they are qualified and can listen to you and help you at some point in Germany. If you have a German insurance then psychotherapy is covered by the Krankenkasse.

you need to wait some time. And if it's really, if it's really urgent, and you have suicidal thoughts or thoughts, thoughts that come close to that, then call the ambulance 112. Yes, essentially, there's a chance that they get you to the hospital and maybe to psychiatry. But having worked in some of them.

That's not a big deal. They're here to help you. It's not like a madhouse, like in some movies. Um, that's just the hospital for people with mental problems, um, who are close to harm themselves or somebody else. And that's a quite good way in the end. I think there are many ways before that often, and there are many numbers and institutions. Um,

which we will link and you can find them, but you can also Google them. I mean, you Google all the time, so you can do that. But in the end, call the ambulance or ask somebody to call the ambulance for you.

Nóra (53:40.546)
Right, I think it's a very important advice that if you feel that you need help at the moment, we will just put everything into the show notes, all the important contacts, or if you need a supportive network, you can also contact us to exchange. But calling the ambulance is really an important first step if you feel that now you cannot control your feelings and your thoughts anymore.

Thank you very much for sharing this very interesting and feeling full journey. Julian, I wish you all the best for your future career. Alex, thank you very much to share your thoughts from the professional perspective. Thank you very much and I wish you all the best.

Julian (54:21.005)
Thanks a lot.

Alex (54:32.334)
Thank you for having us. Bye bye.

Julian (54:34.081)
Thank you as well.

Nóra (54:34.886)
Thank you! So I just stopped sharing. I stopped recording, yes. I'm...