I’m on the train to France, where I’m working as a postdoc in mathematics. We are in the second year of the COVID-19 pandemic, and masks are mandatory, as well as filling out forms in French for every journey. My thoughts are racing. I have the feeling that I cannot finish my thoughts, similar to when one is trying to tell a story, but loses oneself in subordinate clauses and never finishes the original sentence or plot line.

As my thoughts speed up, I feel like I’m suffocating in my mask. 

Wait – people with severe COVID have that feeling too – maybe it’s that? Then I have to find a hospital here in France, and I only speak very little French – when I’m home I will immediately do a COVID test – but it’s also very likely that this is because of the upcoming psychosis – I haven’t been able to sleep normally for a week now.

Now I see there are police on the train. I panic. 

They are certainly here for me. I’ve probably made a mistake in the forms I filled out with help of Google Translate. They are going to arrest me and put me in jail – only to transfer me to a psychiatric hospital where they will force me to take Haldol (or just give me a jab with it), which will make my head hazy – doing math will be impossible for many months, my career will be over, my life will be over – and make me move like in an advanced stage of Parkinson’s. 

At this point I can only cry. They are walking by once again. I message a friend back home that I’m going to be arrested and my worst nightmare will come true.

When I arrive at my apartment in France, I immediately take a rapid test. Negative. That means the tightness in my chest is panic, not Covid. I take a Lorazepam tablet and slowly the tightness dissolves. I lie on my bed for 20 minutes, and I stop crying. Then I have to go to the meeting with my postdoc supervisor. I do my best to survive the meeting… my head is still racing yet numbed by the Lorazepam at the same time… I didn’t make any progress on my project (already for weeks now)… 

Now

It’s over three years later now, and in hindsight, that was indeed the beginning of a psychotic episode, followed by a depressive one that lasted for months. My postdoc project led to a paper, but to be fair, I didn’t contribute much, and I still feel embarrassed towards my co-authors and postdoc supervisor about my time in France and my little contribution to the project. Life is very different now. I’m a tenured assistant professor in mathematics in a place I really want to stay. My research is going well. I won a big early career award, and several other prizes. I obtained big personal grants. I am building my own research group. I married, bought a house, got a dog, and gave birth to an adorable kid. 

I want to tell my story to raise awareness about mental illness in academia, and hopefully to help someone else going through a similar experience. I didn’t have role models when I started my academic career. For a long time I thought that an academic (or other) career with such a severe condition was not possible, and there were also many times that I thought I couldn’t handle life at all. I suffer from psychotic and depressive episodes. Some psychiatrists say I have “schizoaffective disorder”; but at the moment I’m in treatment with the bipolar team. It doesn’t matter to me what the exact diagnosis is – the important point, for me, is how to manage it.

Completing my Bachelor’s and Master’s in Math

I did my bachelor’s degree at a university closest to the town I grew up. It was still too far to commute, so I moved out. It didn’t go very well. My mental health problems started at that point. In the end it took me 6 (instead of 3) years to complete with merely passing grades. My thesis project was dreadful; one the one hand I didn’t know what was expected from me (I had no idea how to conduct research), and on the other hand my brain wasn’t functioning, I was only trying to survive the bi-weekly meetings with my supervisor, after which I would disappear in my delusions for two weeks. In hindsight I had depression too, but I only found out years later.

After my bachelor’s I worked for a year at a software testing company and it was very boring. After this I decided to give studying one more go: I moved to the other side of the country and started a master’s in mathematics at a different university in a different field. I wanted a fresh start. My mental health problems were still very prominent, but as opposed to my bachelor’s, I obtained high grades and even finished early. My thesis project was the complete opposite experience from the one in my bachelor’s: I figured out how to do research, and I really liked it. My supervisor gave me a lot of freedom, but also the right guidance when I needed it, and it was a great experience.

In retrospect, my masters experience was hectic, with a concatenation of psychotic and depressive symptoms, but it never got so bad that anyone noticed. I was living in quite a solitary way. I kept my thoughts and problems to myself, and although I was not able to take good care of myself (I didn’t eat very well, was not asleep/awake at normal times, etc.), I did turn up for exams and did well (even with only studying the night before).

My PhD Journey

With the good experience of my master’s thesis and no idea what to do next, it was a logical step to start a PhD with the same supervisor as during my master’s project. During this time, my mental health problems started to disappear. My office was very peaceful, I loved the interaction with all these super smart people around me (up until then, I’d always had the experience of being the smartest one – which may seem nice, but it really isn’t!), and the research went great. The second year was hard though – I was stuck with the research, my supervisor did not have much time for me, and in hindsight I had a depressive episode again. I didn’t do anything useful for about 9 months. Then I had one very good meeting with my supervisor which put me back on track, and I finished a paper in a very short amount of time. Later I would learn that I also have hypomanic episodes, and that I can do extraordinary work in those. 

I started to find out that I work in a weird way: for months I fail to do any “real” work. I just sit at my desk, handling e-mails, teaching goes OK, and my brain just feels like understanding mathematics is too difficult for me. It is like reading 19th century Russian literature versus an easy detective novel: sometimes my brain is too tired for the former, but is able to handle the latter. In those long periods I can’t think deeply enough to understand math, but I can handle the easy math I teach, and easy tasks such as organising events/seminars etc. And then I have a short amount of time, less than a couple of weeks, in which I suddenly can think – I can read (and understand!) papers, I can see connections between different areas of math in my head (I literally see concepts, like sigma-algebras and such, as shapes), which allows me to pose conjectures and prove theorems. It started small, but after some successful conjectures and proofs, I started to feel (a little bit) more confident. I always used to think that I was lazy and incapable of “real work” (also because in school I got straight A’s without having to make any effort), but now I thought: maybe I can do something useful with my life.

Orientation: What to do after my PhD?

I decided to find out whether an academic career would be something for me. By the last year of my PhD, I had several preprints out, and people in my field started noticing me. I decided to go abroad for a couple of months, to another much bigger lab in a country where I didn’t speak the language: France. If I would survive, I would start looking for a postdoc. In my country and field, it’s mandatory to do the postdoc abroad, preferably several and preferably in the US, to have any chance of a tenure track position. Anyway, I went to France for 3 months, and it went great. The people in the lab were great, my work went very well, and we wrote a very nice paper together. I felt like I could really leave the past, with all the mental health problems, behind me, and start a new life as an academic. 

I received several postdoc offers around the world. I decided that I would make a list of possible places, and I would visit the top 3 or 4, and then decide. So I planned those visits in the next half year. It gave me quite some stress: having to choose between far away from friends and family (US or Canada), but great for my career; or stay in Europe and have a smaller probability of landing a tenure-track position afterwards. And the prospect of relocating and leaving everything behind gave me quite some stress too.

Around the same time there was a deadline for which I wanted to submit two papers: the one with the people in France, and one with my PhD supervisor. I simply loved the collaboration in the last two weeks: it was intense, we all worked very hard, and there was constant deliberation with both teams about every detail of the papers. I started to sleep less and less and work more and more. When the deadline was over, I stopped sleeping at all. My thoughts were racing faster and faster. The great (manic) feeling turned grim. I started seeing weird colours and shapes in my surroundings. I saw a crane topple on my flat, a train on the road, and I started hearing voices. In a lucid moment, I thought (for the first time in my life realising it at the moment it happened): this is psychotic: I need medication for it to go away.

Together with two friends, we tried to find help for me. I found a nice, good (also first time in my life) psychiatrist, got prescribed antipsychotics and week by week it got better, but I also got into a deep depression. And this new psychiatrist noticed. For the first time in my life, someone told me: The way you feel now is a clinical depression, it is not your normal self. In hindsight I had been depressed so many times during the 10 years prior to that, but no one noticed, and I never realised it myself. I even attempted suicide a couple of times, but I always thought of it as a logical response to my troubled life. And no one knew, and also the psychiatrists I saw earlier in my life never noticed. It was a real eye-opener. Another major difference with the 10 years before was that I confided in two friends. Slowly it got better and better. But then…

The Covid-19 Pandemic

I was slowly recovering, but then the pandemic happened. All things that kept me going—having lunch with my colleagues at work, and exercising my hobby with friends every week—came to a halt. I became very isolated, and it felt like the world abandoned me. I had felt abandoned many times in my life, which made this an all-too-familiar-feeling, and fed my delusions. I thought that the pandemic was a conspiracy to thwart my recovery from psychosis: everything that helped me, by having contact with the “real world” through work and a hobby (and also meeting my psychiatrist in real life) was taken away from me. The universe was trying to drive me crazy. And it partly succeeded: I didn’t manage to do any deep work during the whole pandemic. I had already finished my PhD thesis; however, I defended in the middle of the pandemic, alone with all opponents on Zoom, and without sleep the nights before and after, completely stuck in delusions and voices. The defence was so-so, but good enough for the committee to grant me the PhD. I still feel ashamed of my mediocre performance in front of those important people in my field.

Postdocs

I did two postdocs in two different countries in Europe, for most part during the pandemic. In all this time, I was in good mental health for one month only. I had long periods of deep depression: sometimes I could only lie on my bed the whole day, only getting out to pee, not even to eat or drink. This alternated with short periods of psychosis, though some delusions (like “the pandemic is a conspiracy to thwart my mental health”) and the hearing voices remained during the depressive phases. I tried many different antipsychotics, and my psychiatrist was a great support, but it was hell: the side-effects, the withdrawal during switching, and the ineffectiveness on the voices in my head. 

During this time I managed to interview for a tenure-track position in another country via Zoom. I got the job, but I weaselled out and told them I had a better offer elsewhere. I landed another tenure track position in my home country, and although I had just obtained a big grant to conduct my own research in France, I refunded the grant and went “home”. 

Tenure (track)

I started my tenure-track position thinking the following: “Everyone thinks I’m great, I got prizes for my PhD thesis, I wrote some nice papers, I’m good at teaching, but in reality, I’m a train wreck: they don’t know what I’m hiding, namely that 90% of the year I’m incapable of doing any “real” work, hearing voices all the time that prevent me from deep thinking.”

But at the same time, I was starting weekly therapy. I learned that I was allowed to be proud of what I had achieved, not only ashamed of what I had not. I learned to be at ease with my way of working: not being able to do deep work most of the time, because of the voices, but trust that the short, intense periods when the voices subside would always come, and that I can do amazing work in those short periods of time. I learned how to deal with the voices and being OK with myself (and not hard on myself) during the rest of the time. I learned to trust my friends and share more with them, to do reality checks.

My new job and the prospect of tenure brought a lot of stability to my life. I moved in with my partner, bought a house, and got a dog. My research went well again, as did my teaching and management tasks. I was still hiding everything from everyone though, afraid they wouldn’t give me tenure if they knew. I got tenure after a year. I really felt like telling my line manager (who is very kind and supportive) parts of my story, and I took her for dinner that same evening and I told her the most important parts. It was such a relief not having to hide anymore! 

Learning to Live with Mental Illness

The stability of tenure brought even more peace in my life. My work continued to be fine, I enjoy teaching and management tasks, and I patiently wait for the times when the voices in my head subside and I can write papers I’m proud of. I obtained a big personal grant, started working with my first PhD student, won a international early career award, and most importantly: I’m fine with who I am. I am confident that I’m able to handle this job despite my episodes of psychosis and depression. They still happen, but I have so much experience that I’m able to handle it. I don’t experience psychosis before beyond the point of realising what’s happening to me. It starts with not being able to sleep, panic attacks (from which I don’t panic anymore, it’s just a highly uncomfortable physical sensation), and then I quickly contact my healthcare professionals, and we make a quick and effective medication plan to stop the episode. When I’m depressed I know I have to wait it out, but in the meantime I try to stay as active as possible, taking walks every day, eating well, and being nice to myself. I talk about it with friends. I know it will go away at some point – it always does. 

The stability of tenure also gave me the confidence to fulfil a big dream: to start a family. A couple of months ago our kid was born, and I’m enjoying it very much. I love the combination of working and coming home to my family. After all these tough years, I’m very grateful for my life now, and I couldn’t be happier with my job and my family.

Tips from my Experience

Psychosis and depression are a severe conditions, so good professional help is crucial. The path towards recovery and learning to deal with your mental challenges, is a highly individual journey, so it is important to find health care professionals who match with your attitude towards life. It was only after 10 years that I found a psychiatrist who I could trust and this made a huge difference. Finding good therapist was also a break through in my life, where I learned to deal with hearing voices all the time, but also to open up to friends – seeing that they supported me through difficult times was a real turn in my life. 

At work I believe it’s safe not to disclose much. There is still a lot of stigma and prejudice, which is also the reason I write this blog post anonymously, despite having tenure; I still want to become a full professor at some point, and unfortunately I have enough bad experiences of myself and seeing others not be taken seriously after people found out about my/their psychotic episodes. I did tell my line manager (and before my PhD advisor) parts of my story, and they are very supportive. It is a difficult and delicate balance between telling some people at work as to not have to hide, but not too much to get to be seen as crazy and incapable of certain things. Because I want to break the stigma (but without jeopardising my career), I chose to let it be known to the outside world that I sometimes struggle with “mental difficulties”, but only a few people at work know the details. I do think that academia is a perfect place for people with a mental challenge. There is a lot of freedom to plan my productive working time around my episodes. And a healthy work-life balance is key.

One more thing I want to say is that I live in a very structured way: I have a very healthy lifestyle, I do a lot of sports, I always go to bed early, I eat very little and strictly healthy foods (vegetables, fruits; no alcohol, cookies, etc.) – anti-psychotic medication messes with your appetite; most people taking it long-term get very obese and their life expectancy declines with as much as 20 years compared to the general population. My lifestyle can’t prevent me from ever having episodes again, but I’m convinced it prevents many, and it helps me to grow old in a healthy way despite taking antipsychotic medication.

The anonymous author is a tenured assistant professor in mathematics at a university in Europe. The author has obtained several big personal grants, won a range of prizes an awards, and enjoys every aspect of their job very much, as well as spending time with their family, doing sports, and exercising hobbies with friends.