Working towards your PhD while grappling with chronic mental and physical health conditions… well, sucks. Graduate school is often depicted as a training ground for intellectual growth, a hallmark of academic rigor providing access to a playground of ivory towers. For many, it’s a demanding but ultimately rewarding journey. However, for those of us navigating graduate school while grappling with chronic health conditions, the experience can be a labyrinth of unexpectedly demanding challenges. 

My own journey as a PhD student in Philosophy has been profoundly shaped by my experiences with Bipolar Type II Disorder and chronic pain. While graduate school has tested my resilience, it has also given me a new perspective on community, self-worth and the journey of coping in the face of adversity. This post explores how these experiences have influenced my academic development, pushing me to redefine success in my own terms. Ultimately, I hope to share a lesson that has been critical to my journey: authentic participation in community can create profound feelings of wholeness and belonging, providing an anchor for stability amidst the demands of academic life.

From the Beginning

I had already spent over five years managing Bipolar Type II Disorder by the time I entered graduate school, but it remained no easy task. The stress of my first year provoked several hypomanic episodes, each resulting in a handful of overly excited and awkward social interactions, but nothing I couldn’t make up for. Over time, I settled into a precarious but functional dance, compensating for my inevitable dips in productivity during depressive episodes by leveraging my hypomanic phases as opportunities to excel academically. With heightened energy and a grandiose sense of purpose and ambition, I worked intensely to produce quality work in advance, hoping to build a buffer for the weeks of executive disfunction and mental fog that were sure to follow.

It was during these low periods that I grappled with resolving the tension between my intense desire to isolate and the desperate need for comfort from loved ones. While imperfect, this system provided me a baseline level of functionality with which to navigate academia, though non-optimally. I permitted myself a few moments of necessary retreat, such as a day spent in bed rot, while also pushing to care for myself and take walks outside, until I could return to my studies and friends. It was a decent system that came to me one afternoon when I went out with my friends despite feeling too weak of will to hide my melancholy. To my surprise, they weren’t bothered by my sullen attitude; they were genuinely happy that I was simply there, even if I was sad. That authenticity, as uncomfortable as it was, was a breath of fresh air, cutting through the self-imposed pressure to appear “fine.” It didn’t “make everything better,” but knowing my friends loved and supported me, even in my lowest moments, made it substantially easier to “go back to normal” when the depressive episode eventually subsided. 

My experience with chronic pain, however, was different. The pain crept in slowly. So slowly, in fact, that six months passed before I finally recognized the aching and shooting pains wracking my body were more than the lingering effects of a bad mattress or a stressful week. To pose a philosophical question: how many days of pain must a person endure before their condition is truly “chronic”? “People without chronic pain surely don’t ask that kind of question,” I told myself, as the chilling realization of my new reality settled in.

The effects of the pain on my academic progress were intense. I began missing classes. The brain fog and constant headaches made reading and researching akin to mountain climbing without proper boots. I made progress, but painstakingly slowly, and the quality of my work was rapidly declining. Unlike my depressive episodes, my pain yielded no period of peace for recovery, instead making me want to isolate even more. I became obsessed with discovering the source of my pain. My usual week of isolation turned to months as a wave of doctor’s appointments crashed over me, leaving no answer in sight.

Echoes of Denial and the Search for Understanding

Adjusting to any major change in your well-being, mental or physical, can plunge you into a confusing and frustrating period of denial. When I was first diagnosed with bipolar disorder, I experienced a whirlwind of new medications, unusual and sometimes debilitating side effects, along with fleeting moments of stability. The concept of a “working” medication became elusive. It was during this time that I decided to transfer to a university closer to home, hoping my family would provide some comfort as I adjusted to my new life. I effectively became my own test subject, navigating a medical landscape that, while deeply personal, also felt sterile and highly procedural.

I was slow to learn how to accurately identify my own symptoms, particularly hypomania, which I commonly mistook for periods of genuine growth, sustained happiness, increased productivity and surging opportunity. I would eagerly pursue these opportunities, often realizing in hindsight that I had overburdened myself, and would eventually be forced to relinquish them. Oddly, acquiring accommodations with disabilities services was one such opportunity. Despite advocating for students with disabilities, the process was a nonsensical nightmare of bureaucracy and paperwork that I failed to complete despite paying for my psychiatrist to write the required letter documenting my diagnoses. 

Even without accommodations, I eventually settled on a medication regime that afforded greater functionality, but I retained my system of isolation and re-emergence. I had resisted the idea of permitting myself to “bed rot” when a depressive episode settled in, worrying about the stigma against isolating oneself during episodes of mental illness. Through trial and error, I learned forcing myself out of bed only prolonged my suffering, turning a four-day episode into a two-week slump. After taking a day or two to recover in private, I could usually feel a flicker of myself returning, enough to venture outside to birdwatch or spend time with my friends. 

I am profoundly blessed to have a best friend in academia who also grapples with chronic mental illness. Years of enduring finals week during depressive episodes and chaotic house parties on the weekends had brought both of us an understanding of the divide that occasionally arises between one’s personal and academic life. She understood what it was like to strive for excellence, attending office hours and writing for hours, only for a poorly timed episode to kick your legs out from under you. There’s something beautiful about forming connections with others vulnerable enough to express feelings usually hidden away. When depression struck either of us, we might recede, silent for a few weeks, but we always welcomed each other back with grace, no need for apologies or lengthy explanations. 

Coping with Bipolar II became a testament to the strength of my coping and support systems. Confused as I was in the beginning, I have learned that managing my bipolar disorder requires understanding my limits and acknowledging that I can’t do this alone – I need community support – and that’s okay. The coping mechanisms I have developed give me an opportunity to give myself grace and forgiveness, and to let myself rest when needed. When my experiences with chronic pain began, I fell back on many of these coping mechanisms. While many worked, chronic pain was a different beast, blurring the lines between mental and physical wellness. 

While it was easy for me to recognize I had some kind of mental illness, the onset of my chronic pain brought on an insidious sort of denial. For months, I was largely unaware how long I had been suffering, a fact that now, in retrospect, is shocking. It was my wife who finally connected the dots; I had been in unexplainable pain daily for four consecutive months. The realization was sobering: how could I have failed to notice? I finally made a doctor’s appointment, naively hoping for a quick fix, a simple adjustment or some perfect pill.

My hope didn’t last for long, crumbling under the weight of medical bureaucracy: “Insurance said no MRIs without at least six weeks of physical therapy and persisting symptoms,” my primary care physician told me. I had to pay for six weeks of alternative care just to access a service my insurance covered – the injustice of it took my strength of will – I felt powerless. By this point, the pain had become unbearable.  I was missing work and rarely saw my friends. I left the doctor’s office with a prescription for a muscle relaxant, a referral to a physical therapist, and a growing sense of despair as I wondered how much worse the pain would get before I made it to physical therapy. When I found out I had to wait 6 months for an appointment, I broke down. 

In the following months, my condition worsened at an alarming rate. I would wake up in agony, sobbing silently on the bathroom floor, hoping my wife wouldn’t wake up to my distress. I tried everything – Icy Hot patches, ibuprofen, joint supplements, a “neck hammock”, a neck brace, yoga, stretching, additional neck support during sleep – every remedy my family and I could think of. After accepting that nothing was helping, the thought of an emergency room visit began to loom, a desperate plea for an answer to the relentless question of, “What the heck is going on?”

Bargaining with the Body and Mind’s Fury

As the chronic pain escalated, my ability to function deteriorated, unravelling my academic and social life with it. I was bargaining with my mind and body, attempting to negotiate a return to my former self. I had long since stopped attending department events, and months had passed since I had spoken with my friends. My preliminary exams, crucial for my master’s certification, were falling further behind, and even responding to student emails became an insurmountable hurdle. I knew something had to change – I certainly was not in a “sustainable” state – but “what” needed to change remained agonizingly unclear.

Attempting to figure out what a “sustainable” state would be while I waited for physical therapy, I began reflecting on my journey with Bipolar II, noting an unsettling parallel: the powerful urge to isolate coupled with a yearning for comfort from others. During depressive episodes, I’d withdraw, believing I was shielding others from my internal chaos. Similarly, with chronic pain, the relentless ache consumed me. It was impossible to hide, with my posture, grimace, and inability to concentrate betraying me. Eventually, the solitude became stifling, and I knew I had to massively reorient my approach to coping with my new condition.

I was forced to break my isolation and to be vulnerable with others as I had always been with my best friend. I started reaching out to my friends, confessing that I had been struggling with a physical health condition. It was almost embarrassing at first. How are you supposed to respond when your friend tells you they have been in daily pain for months and have no idea why? But my friends were wonderful and welcoming. Being with them, even briefly, brought a sense of peace and aliveness. It made the pain momentarily more bearable, a powerful reminder of the life I was desperately trying to reclaim. However, unlike the shallower depths of my depression, where I could eventually stand up and return to the world, the pain offered no such safety.

I had poured everything into graduate school, enduring intentional overwork, criticism for poor quality work and misaligned priorities, and sacrificing countless nights hunched over my laptop, driven by an ambition that now felt cruel to my aching body. I was certain I couldn’t continue in my current state; something had to give. It wasn’t just the physical pain that hurt; it was the grief of deferred dreams, a life I had so meticulously planned seemingly crumbling around me. It was the raw, visceral pain of recognizing one’s limits, and realizing even the most dedicated students could not overcome the barriers of physical and mental illness without a fundamental shift in their approach to coping with the stresses of graduate school.

The Dawn of Acceptance and a Path to Wholeness

Finally recognizing my limitations—after all attempts at bargaining, pushing through and sacrifice had failed—was when I decided to do something I had never done while coping with mental illness during my undergraduate degree: I took a small break from my PhD program. This wasn’t a decision made lightly or without significant internal turmoil, steeped in guilt and fear of judgement. The academic world, riddled with unrealistic, and sometimes hidden, expectations makes it easy to interpret this break as a weakness or worse, “failure.” I had internalized these norms for years, striving to “grin and bear it” bipolar episode after episode.

But, for me, to interpret this as a failure would be to prioritize my identity as an academic over my identity as a person grappling with genuine and complex health changes. My decisions felt like a radical act of self-care, a conscious decision to finally create the space needed for me to heal and continue searching for proper treatment outside the high-stakes pressure-pot of academia. It was an acknowledgement that my strength can, and often does, come from the wisdom of knowing when to pause, heal, and redefine the requirements of success in my own terms. 

My academic development tells a story of intellectual and personal exploration, the success of which was dependent on maintaining my health and well-being. Experiences with chronic mental and physical illness while in graduate school can, at times, impose such an overwhelming pressure that it threatens to drain the very will from your bones. I understand that persistence and grit are virtues to survive in academia, but a significant, perhaps the most significant, part of my journey has been recognizing that I am not defined by my academic pursuits or ability to conform to common expectations about completing a doctoral program. I am, first and foremost, a person with a wealth of lived experiences, striving to contribute positively to a world posing seemingly insurmountable challenges, and this contribution requires me to care for myself.

Giving back to the world sometimes requires giving back to ourselves by allowing others to be there to support us. While isolation can offer a necessary period of healing and reflection, rebirth and sustained progress come when met with the unwavering support of a loving, understanding community. My journey has been filled with hardships, grief, and unexpected detours, but has ultimately led me to a deeper sense of wholeness and belonging. 

Conclusion

The path through graduate school is rarely linear, especially when complicated by chronic health conditions. It’s a journey punctuated by moments of sadness and recognition. In many ways, I grieve the version of myself that I was before experiencing chronic pain. From denying emerging symptoms to bargaining with my mind and body for a return to some semblance of normalcy, and, finally, to the acceptance of my new reality, each stage has taught me about myself and how to cope in times of stress. My experiences with Bipolar II disorder and chronic pain have both pushed me to adapt and practice self-compassion. The urge to isolate, a familiar shadow from my struggles with depression, returned with the onset of my chronic pain. As it persisted, the ties I held with my community began to weaken.

What I have learned, more than anything, is how vital it is to engage authentically with your community. While our loved ones can’t “heal” all wounds, their support brings with it a wonderful sense of wholeness and belonging. It’s in this space of shared vulnerability, the acceptance of our struggles, that we can find the strength to navigate one of the most challenging chapters of academic life. Taking a leave from my PhD program was not a failure, but a decision made with self-compassion to prioritize my well-being over conventional academic success. I can’t help but feel proud of myself when I think of how far I have come since I was first diagnosed with bipolar disorder during my second semester of undergraduate school. 

This ongoing journey continues to remind me that we are not defined by our illnesses or our setbacks, but by our capacity for resilience and willingness to be vulnerable and engage authentically with others. The ability to express pain and be met with understanding is a powerful force that brings me some sense of sustainability as I wait for my scheduled medical care. I’m comforted by the knowledge that when the world pushes me too hard, there is always a community waiting to pull me back.

Laura Dickey is a graduate student in the PhD in Philosophy program at the University of Wisconsin – Madison. She specializes in applied ethics, focusing on the use of predictive machine learning in criminal justice decision-making. Laura is dedicated to fostering kindness and intellectual curiosity in higher education settings and currently serves as a mentor for undergraduate students pursuing graduate school. Outside of her work, she enjoys bird watching, playing music, and writing poetry.

This blog is kindly sponsored by G-Research