As a PhD student with mental health challenges, I sometimes question whether my experience is the same as my peers. Did they look for a supervisor who understands mental health?  Do they see themselves reflected in resources about 鈥榗aring for your mental health鈥� and 鈥榮elf-care for students鈥�?

Don鈥檛 get me wrong, entering a PhD and being me has been remarkably rewarding. I have a supportive environment to explore my ideas, where my strange questions can lead to insightful conversations. I鈥檝e met peers who not only accept and encourage me but challenge my conceptualization of the world and my approach to research. I have a supervisor who sees value in my perspectives and believes in me. When applying to 杏吧原创, I was even exposed to . In essence, it feels like my potential in defining myself as an academic is limitless. While I鈥檓 still waiting for this to come crashing down (I鈥檝e heard this happens in second year), I can鈥檛 help but think it鈥檚 the contrast between the supportive spaces I鈥檝e found and the concessions I鈥檝e had to make that makes my disappointment sting all the more.

At times, it can feel like the very institution of academia doesn鈥檛 accept me, and that even with acceptance, inclusion isn鈥檛 guaranteed and support is strictly rationed. For example, despite publishing an article on , 杏吧原创鈥檚 counselling services aren鈥檛 set up to provide long-term support 鈥� which automatically necessitates that I seek support off campus. In order to pay for therapy, I鈥檝e had to label myself on provincial and school documentation as having a disability (regardless of whether I identify as that). While I鈥檓 grateful for the support that鈥檚 offered, the process of being forced into a label has sucked.

While writing this, the qualitative researcher in me couldn鈥檛 help but see the underlying theme in my experiences 鈥� the disconnect between the people and the system. My social and academic environments are ones of support and collaboration, where being me is a strength. How, then, have our institutional processes and policies not caught up?

These systemic barriers probably won鈥檛 change anytime soon (or maybe they will, and I鈥檇 be thrilled to be wrong here) but here are steps that prospective and current PhD students can take to protect or maintain their mental health based on my own experience:

Prospective students:

1. Include what you need (for your mental health) as a criterion in your search for the perfect supervisor or school.
2. Have open conversations with your potential supervisor about mental health. See if they are open to using different approaches to support you.
3. See if you can speak to a current graduate student about their experience. This can help you get a feel for the lab culture, and if it would be a supportive and inclusive environment.

New students:

1. Get registered with your university accessibility services as quickly as you can. Your disability coordinator can help you navigate OSAP and the NSLSC.
2. Think about moving your health information to Health Services on campus. This can be helpful for coordinating your services and setting up a comprehensive circle of care.
3. Pay attention to when bursaries open and close at your university. There are usually programs or bursaries that are specifically for helping people with disabilities.
4. See if you qualify for any of the awards .
5. Be open with your supervisor. It鈥檚 not all sunshine and daisies and sometimes they can suggest strategies to help you cope.
6. Establish your support network prior to entering the program. Your supervisor isn鈥檛 your therapist, and it can be easy to cross boundaries and over-share if you don鈥檛 have solid supports in place prior to starting the program. Further, I鈥檝e found it hard to connect with peers if they don鈥檛 share similar life experiences and have relied on my friends more than ever.

The items in this list came from hours wading through blogs and Reddit treads (which, frankly, are often gloomy) and conversations with other folks who have been there, done that. As such, this isn鈥檛 a prescriptive list outlining the steps to success for PhD students with mental health concerns, but rather steps that have been helpful for me so far. I hope these lists might even slightly reduce the amount of labour necessary for our participation in academia. At the heart of it, I write this because, at the end of the day, we belong here.

Mel Edwards is a first year PhD Student in the Spatial Determinants of Health Lab. Her research interests include the use of e-mental health to support underserved populations in rural communities

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It has been an absolute pleasure to work as a part of the Spatial Determinants of Health lab over the past summer. Through the I-CUREUS award, I was able to work with Dr. Paul Peters and an MSc student, Maria Tovar Hidalgo, on a scoping review that examined oral health inequities within rural regions of Canada. The goal of this research was to assess how rurality can affect oral health experiences and outcomes in comparison to urban areas. The research also aims to contribute interventions which have improved poorer oral health outcomes within similar rural communities in countries like Australia, Sweden, and Norway. My work on this project primarily focused on conducting a literature search and extracting subsequent data which would be included in the scoping review.

Before this experience, I had only performed literature reviews for my health science courses and over the summer I was able to familiarize myself with research tools, such as , and gain a practical understanding of how policy research is composed. I quickly learned that every step within the process of synthesizing data is thorough, and that collaboration is key when it comes to being successful within health research.

I was fortunate to have joined a lab in which I was able to not only collaborate with Maria as often as I had but one in which we could discuss our research within lab meetings and troubleshoot any issues or challenges that might have come up within all of our various research projects. Dr. Paul Peters also maintained a lab environment that prioritized the success and wellbeing of all researchers. I was overwhelmed with the number of resources available at the beginning of the summer that would help me navigate health research and the tools he supplied to encourage better mental health management. I am grateful to have had such a supportive lab and mentor as part of my first research experience.

Some interesting things that I learned within my lab were how to adjust and calibrate a search string so that the resulting literature would become increasingly relevant to what I was searching for. As well, I learned about a multitude of comorbidities within oral health, a field that I was not very familiar with before this project, and about the innovative ways in which oral health could be improved, down to the fluoridation of drinking water. I went into this lab with some understanding about how rurality and access to care can affect health outcomes, however, I was challenged to learn about an entirely different field of public health than what I was exposed to within my classes. Through my participation in this research, I familiarized myself with the scope of oral health within the context of effective health policy development.

This experience allowed me to develop my critical thinking, organization, and time management skills. I was also exposed to a variety of research questions when going through published articles which I am inspired to pursue within my later career. I hope to apply these skills within my future in healthcare and to find many more opportunities as enriching as my time within this research lab.

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Story of being diagnosed

As my middle son entered grade 3, we began to see he was struggling in the classroom and at home. He had recently switched from the English-stream in school to a French-immersion stream. While this was difficult, he was having trouble adjusting that we couldn鈥檛 just attribute to the change in the classroom setting. These signs included not completing classroom tasks, having difficulty in writing, increasingly disorganized, and frequently being distracted in class. At home, he was more tired at the end of the day, more prone to outbursts, and was getting more frequent migraines. It took us some time to see ADHD as a possible diagnosis as he wasn鈥檛 hyperactive (on the outside) or disruptive in class. We now know that our conception of ADHD was lacking and based on information that was incomplete and/or wrong.

Our first step in seeking a diagnosis was to complete an online questionnaire for ADHD based on what we see in him, with the intention of sharing this with his pediatrician and getting a referral for a psychological assessment. However, when my partner and I filled in the form it was like a lightbulb turned on 鈥� I immediately saw these same symptoms in myself. After speaking with my doctor, I made appointments for psychological assessments for myself and for my son.

Symptoms of ADHD

ADHD is a genetic, neurological disorder that is indicated by problems with attention, impulsivity, and/or hyperactivity. Many adults with ADHD have difficulties with inattention but exhibit few or no symptoms of hyperactivity (source). Adults with this set of symptoms related to inattention but not hyperactivity have the 鈥減redominantly-inattentive鈥� ADHD subtype (source). This form of ADHD primarily affects executive functions of the brain, such as verbal and nonverbal working memory, self-regulation, motivation, and planning. These differences can present as difficulty in maintaining attention or focus, use of working memory and recall, regulating emotions, organizing, or prioritising tasks.

The  associated with inattention:

• Often has difficulty sustaining attention at work or play;
• Frequently does not pay close attention to details or makes careless mistakes at work, school or other tasks;
• Often has problems organizing chores or activities;
• Is easily distracted by outside stimuli;
• Frequently does not follow through when given instructions or fails to complete work or school assignments, chores or other activities, even though the person understands what is expected;
• Often becomes forgetful when performing routine chores;
• Frequently puts off or avoids tasks that require sustained attention;
• Often loses materials needed to complete tasks or activities; and,
• Appears not to be listening even when spoken to directly.

An ADHD Professor

As a professor, these symptoms can be both a blessing and a challenge. While I鈥檓 easily distracted by shiny new projects, I can also be creative and like to join new teams. I can be forgetful of specifics (names especially), I focus on ideas and connect what we鈥檝e said before to new things I鈥檝e learned. Sometimes I can work on one idea to the expense of many other small tasks, but my hyper-focus can be a real benefit to getting last-minute grants submitted.

What I鈥檝e learned in the past months is that I have developed a series of tricks to compensate that have brought me to where I am. On the positive side, I have allowed for flexibility in my home and work life, where I can alternately be distracted or hyper-focused, sometimes going to coffee shops to write at 5 am for days in a row. On the negative side, the differences I have with executive functioning can result in difficulties with administrative tasks, both getting them done and having the details completed correctly. At home, this is compensated by an incredibly organized partner with a tremendously detailed memory. At work, this is compensated by having administration send multiple email reminders.

Where my story is going

The act of knowing that I have ADHD has helped immensely. While it has allowed me to develop new strategies for helping through some of the difficulties, more importantly, it has given me some leeway to be kind on myself. When I鈥檓 having trouble getting things completed, when I miss deadlines, when I forget things I was supposed to complete, I can have a bit of forgiveness and look at ways to help myself for next time.

Since my diagnosis, I have also begun to trial medication to treat ADHD symptoms. Thus far it has been incredibly successful. Combined with anxiety medication, I have been able to improve on my systems for focus and planning. At home, this has resulted in less daily stress and being generally more cheerful.

I plan on posting more about this in the future and have some strategies for how I use tools for ADHD as an academic. You can also follow me on Twitter where I post about ADHD, academics, research, and other things.

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This blog is about the spatial and social determinants of health. As a recently minted at the , I found that I have needed a way to get my ideas outside of the academic arena. This blog may help me do that.

Not everything I write about is related to health research, and not all health research is what it seems. I take a very broad view on health and include the broad range of social, environmental, and spatial determinants in my perspective. I view my research from a positive health perspective, where I try not to focus only on disease and illness, but also on the positive factors that promote health living and a healthy being.

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