My body knew there was a problem before my brain. During my doctoral program, I began to suffer full-fledged panic attacks several times a day accompanied by sensory issues. Loud noises were piercing triggers, and a passing siren would leave me in a fetal position. I had never experienced anything like it, and I felt like I was spiraling out of control. There were other problems too. Opening a Word document to write or cracking the spine of a book sent waves of anxiety and panic through my body that came to rest in the back of my throat. I constantly replayed conversations with colleagues and faculty in my mind, highlighting my every fault. I needed hours before and after classes to work myself up and calm myself back down from these interactions. But the panic attacks were my primary concern: I couldn’t control them the way I could adjust my schedule to satisfy these mental rituals by which I got through the day.
Seeking treatment was difficult. I may have been a little afraid that I was going crazy, but I was truly terrified that I was “making it up.” I had to plan months ahead: seeking appointments with university mental health in September meant I had to start the process in April. This strategy, luckily, was one with which I was already intimately familiar. With enough planning and adjustment, I could keep my crises at bay and still function.
After several false starts in therapy, I was a mess. Although I depended on these meetings to make it through the week, mental health care exacerbated my problems rather than calming them. I would leave sessions barely composed but sobbing, frequently in more distress than before I came. Everyone has to deal with anxiety and stress amid the pressures of graduate school. I was just regular sad, like every other person—only I had the audacity to go and be extra about it. I worried that that I was a burden, that I was stealing valuable resources and time from those who were actually struggling with “real” mental health problems. (This last fear relies on the grim realities of university mental health clinics being understaffed and under-resourced to accommodate the needs of the student body.)
In short, beginning treatment undid so much of the careful work by which I taped everything together. Focusing attention on my mental wellbeing also meant I had less time to complete the rituals by which I survived the daily pressures of academia. My work was suffering as I struggled to maintain research, and I worried about telling my committee members. Who would understand? What could they do? This whole affair was in my head, after all.
I was diagnosed finally with obsessive-compulsive disorder (OCD), a reality that brought clarity if not comfort. OCD manifests differently for different individuals, and I recognize much of myself in Simon Fox’s incisive descriptions on this same platform. My own compulsions were largely mental rituals, making them initially hard to distinguish from obsessions. I have been performing these elaborate mental compulsions my whole life, and I would get trapped in mental loops for hours every day. I had also learned how to live with these rituals, to engage in them as a running commentary in the back of my mind while doing other activities. It would be impossible to depict my OCD except as near-constant mental torture. I felt trapped in my body. I had frequent breakdowns where I would lose all emotional control, sobbing for hours at a time. I couldn’t move. I was in constant mental anguish.
I wish I could tell you there was a diagnosis that helped or a particular flash of insight and healing that I rode to my graduation. I stuck it out in large part because taking a personal break would have meant losing my healthcare. But if I could do it all over again, I’m not sure that I would. I am certain that the support of understanding friends, colleagues, and faculty carried me across the finish line.
Living with OCD Post-Graduation
The “health” of mental health is rarely, if ever, epiphanous. After graduation, I sought out a therapist and psychiatrist who both specialized in OCD, and the combination of cognitive behavioral therapy, exposure and response prevention, and pharmaceutical assistance began to gradually take the edge off the mental gymnastics by which I survived. I have been lucky to see success in addressing my compulsions even amid a pandemic that has presented waves of new triggers for anyone suffering from mental health conditions.
Although treatment changed my life, the success of my treatment is not a cure. My OCD is simply a part of how my brain works. As an anxiety disorder, OCD is assessed not by its novelty but by its persistence: time spent, interference caused, distress felt, etc. Accordingly, the mental ruts, the compulsory pathways carved into my thinking are still there, and I meander down the familiar path repeatedly throughout the day. My therapist says that’s a good thing since it provides me with daily practice in response prevention, in indulging myself in compulsions to calm the mental storm.
According to one 2015 study, the average sufferer of OCD takes more than ten years since the onset of symptoms to receive a diagnosis of OCD. I had been alone with my compulsions for so long that I was terrified and ashamed to let others see them. I was terrified that I would become someone different, that I would be unable to recognize myself. When self-hatred is all you know, when your mental critic becomes inextricable from compulsions as part of a broader mental disease that forces you to go through actions, emotions, feelings, and cycles of rumination that are meant to keep you from a perceived greater danger, then self-hatred and mental anguish become a part of yourself, familiar old friends without whom you can’t see yourself living.
If my inner critic is, as one doctor put it, “pathologically harsh, sadistic, and maniacal,” research and writing are an anxiety minefield testing the durability of my ego, my conception of myself. In many ways, I am relearning how to think and how to relate to myself as a person again, rather than judging myself based on academic performance. How do I engage with myself in sincere, reflexive ways without retreating to the habitual warmth of my compulsions? How do I engage with the thoughts and ideas of others when it’s not a coping mechanism to distract my own cyclic mental rituals? I don’t know the answers to these questions, but I’ve chosen to live with the uncertainty they raise by finding myself in contexts that don’t fan the flames of my mental obsessions.
Life Outside of Academia
Discovering myself apart from the academy has brought some of its own clarity. Some days I am convinced that the academy runs on mental health disorders. The competitive pressures of research, of the job market, of the reality that the field in which you have spent your whole life training hasn’t bothered to make room for you—these pressures work to crush the psyches of graduate students and contingent faculty alike into a paste that can hide cracks in an ivory tower built for (and maintained largely by) ennobled white men of leisure, those for whom the stakes of academia are a game rather than a constantly perilous threat to one’s self-worth.
As I write this a couple of years out of my program, my worst fear has come true. I am absolutely a different person now that I don’t spend several hours of my day locked in a cycle of ruminating between obsessions and compulsions. I’m only cautiously beginning to think again, to read again. And it’s such a wholly different experience for me than it used to be that it is hard even for me to imagine just how much censure and torment I was experiencing. I’ve been more interested in my happiness of late. I have taken up video games, and I am discovering hobbies that have nothing to do with my research. I even intentionally gave myself some time away from academic work in order to discover who I am apart from my job.
Some days, I am convinced that the mental breakdowns fostered by graduate study are a feature, not a bug, of the academic system. Students who fail to secure jobs or funding are converted to data that proves the fortitude and prestige of graduate programs. Mental breakdowns vouchsafe a school’s intellectual rigor so that the collective gaze remains transfixed on the towering edifice rather than the base, where mental health is far from the only sacrifice demanded by the ivory gods. Surely the brightest minds of our generation can re-imagine teaching and learning alongside collaborative, encouraging models of knowledge production that don’t attack the mental wellbeing of students? If the academy’s collective responses and proposed solutions to pandemic learning challenges are any indication, many scholars can and are participating in this important work re-envisioning higher education in truly inclusive ways. But universities? Universities have an awfully long way to go.
2 See, for example, another account of OCD at Yale http://technology.yaledailynews.com/features/opinion/ocd-and-yales-silence/
3 These are the qualitative categories of the Y-BOCS assessment for OCD. See https://iocdf.org/wp-content/uploads/2014/08/Assessment-Tools.pdf
Zachary G. Smith is a Kansas City sports fan from the dark days, a Patrick Rothfuss fan who still believes there will be a book three, and an avid doer of NYTimes crosswords + Spelling Bee. He enjoys reading science-fiction and fantasy, playing Rocket League to disassociate, doting on his two cats–Devi and Jax (see “Rothfuss fan” above)–and listening to the music of Taylor Swift. You can find him on Twitter @ZGSmith.