A Scientist’s Primer on Mental Health

So okay it’s four after, I think maybe we’ll just go ahead and get started and we’ll see if other folks join us that’s great. So what the-
Thank you so much for coming, we’re really excited to share with you some mental health awareness during mental health awareness week.
And so I’ll just jump in and give my- and deliver the talk. I’ll introduce myself and Dragonfly Mental Health through the slides themselves.
If there are any issues throughout the talk or if you for some reason like suddenly can’t hear me or something and I’m not seeming to pay attention, maybe message Roo and she can get my attention and we’ll sort it out so um thanks for everyone’s participation. Let’s get the slides up.
And launch slideshow. Okay, can everybody see that okay? Getting some nods, thumbs up, excellent okay!
So today’s talk is “A Scientist’s Primer on Mental Health.
My name is Wendy Marie Ingram, I’m the co-founder and CEO of Dragonfly Mental Health, which is the organization that’s putting on this mental health literacy talk today!
Just as a disclaimer right at the beginning Dragonfly Mental Health is not a healthcare provider organization.
The information provided today does not qualify as medical advice and certainly does not substitute for speaking to medical professionals about your own or your loved one’s care.
If you are having a crisis right now and need emergency help, we recommend that you reach out to your local emergency services so that they can get you connected.
If you want to find a list from all over the world of local 24/7 hotlines, you can go to this website listed here, for to find crisis centres that are locally appropriate for you.
So the outline of today’s little chat and talk is: I’ll start with a little bit of a personal and Dragonfly Mental Health introduction.
I’ll delineate as clearly as I can what this talk is and what it is not meant to be.
We’re going to touch on a spectrum of mental health and then we are going to, the bulk of the talk is going to be a brief overview of mental health mental illnesses.
So we’re gonna spend a fair amount of time on mood disorders and anxiety and then touch a little bit more briefly on burnout, psychosis, substance abuse, autism spectrum disorder, and obsessive-compulsive disorder.
The um- Throughout these talks as well as re-emphasizing at the end, I will emphasize treatment and prevention and the importance of that and then at the end, hopefully, we’ll really be able to um discuss, uh have an open lively discussion, amongst all of us either through the chat or um we can have you un-mike, uh unmute yourselves at the end.
So as I mentioned, I have a PhD, I received my PhD from UC Berkeley in 2015, I studied Molecular and Cell Biology and prior to that I was in a BioChemistry research lab for four years and following my PhD, I went to Johns Hopkins at the School of Public Health to study Psychiatric Epidemiology, so my research interests, really have been quite long-lived, interested in brain and behavior research, and all the way from molecules to populations.
I’m really quite fascinated by and, now well-trained and knowledgeable, about psychiatric illness and so, in addition, to my research work over the years, over the last seven years, I’ve been really actively engaged in academic mental health advocacy.
So working first, at UC Berkeley, in a volunteer group, to create a peer-led organization there and then at Johns Hopkins, I helped start and found a mental health graduate network at the School of Public Health and now H’m the founder and CEO of Dragonfly Mental Health.
So Dragonfly for those of you who aren’t familiar is an organization that’s non-profit.
We’re just barely a year old and we really are founded on three major domains of activity.
The first is we’ve, we’ve created a global consortium focused on academic mental health, and so this is a group a large group of volunteers now that are all academics or academic adjacent individuals, that are working together to conduct research and address systemic issues, among, you know, within academia.
The second major domain of activity is that we really want to build a worldwide community of academics that care about mental health, both their own and their communities, and so one of the ways in which we do this is three days a week we have, we host something called Dragonfly Cafe. We also have an online slack space to bring people together who are passionate about these issues but maybe don’t have enough time to volunteer interest in joining the global consortium.
Dragonfly Cafe is open to all. It’s peer-to-peer support and it’s a really wonderful lovely place so I recommend checking that out and joining us some time. That’s where the gerbil thing was discovered (inside joke).
So the third and most, you know, immediately impactful set domain of activity we have really is focused on creating developing and deploying and delivering on-campus programs.
So these are our workshops, our literacy talks, such as this, our skills workshops, our anti-stigma campaigns, things like that, that are geared towards and we build evidence around you know and improve them so that they create cultural and climate changes directly in academic communities themselves.
So at Dragonfly, we’ve developed a model for these on-campus programs where there’s essentially five domains of excellence.
One involves departmental, department-wide committee and commitment.
So and then another piece critical piece is peer-to-peer networks, so maybe having a graduate student-focused group, a postdoc focused group, a by faculty for faculty focused group, that that primarily or at least in part focuses on mental health.
And then the three things that Dragonfly can really help, other with, other than the setup and recommendations and coaching, about how to set up these committees departmentally or amongst peers, is to deliver or recommend skills.
Fighting stigma and improving mental health literacy.
And so everything that we do is, we customize it for each community because each community is unique and we know that their needs are too.
So, this is just a quick picture, of a snapshot of a sliver of folks, who are the amazing dragonfly volunteers, the lifeblood of this organization. And we now have over 120 volunteers, faring from over 15 countries, and it’s just a phenomenally diverse group of people who are really passionate about this and a joy to work with.

So now the talk, what this talk is meant to be, is a brief mental health introduction. It’s meant to emphasize depression and anxiety, we will because those are the most common mental health illnesses but we have expanded it to include a series of other relevant mental illness topics.
And it’s meant to be the beginning of an ongoing conversation about mental health literacy, culture change, and response preparedness.
It definitely is not going to be comprehensive knowledge and response training. It isn’t everything you need to know in a nutshell and it’s not going to be a research talk so I won’t mention anything that I work on
So we like to start this talk by setting up the concept that mental health is on a wide spectrum, and so if you’re mentally healthy, that really is on one end of the spectrum. You’re doing well, you’re resilient to changes and surprises in your environment, and you’re generally okay.
The thing everyone experiences, unless I guess, you’re locked in a bubble and now that covid has happened, I think even if you’re locked in a bubble, stress can still happen. Everyone experiences stress and stress on this mental health spectrum is characterized by you know expected and/or unexpected events or trials.
Things that can disrupt your mental health, your mentally healthy state but is pretty easy to get back to a mentally healthy state from. So states of stress, and there’s good stress, there’s bad stress, and so that that’s something that is characterized by being able to vary relatively easily through simple coping mechanisms get back to a healthy state.
Distress is when stress is impacting the person and their life and you know maybe has lasted a lot longer than normal typical stresses. Or is affecting more of their life or you know it’s something where it’s a state in the spectrum where someone can be, you know they may need more than typical simple coping mechanisms in order to get back to a mentally healthy state. Distress, however, is discrete from disease, in that while certain interventions like psychotherapy, can help certainly help people in a distressed state, disease is when the mental health of the individual has reached a point where there’s a diagnosable condition or disease that typically does require some kind of psychological, psychiatric or medical intervention in order to get that person back to a mentally healthy state.
I’ll add a caveat here that people who have mental health diseases or mental illnesses, they can operate even if they have a chronic disease, such as depression. They can operate on with good care and with an excellent treatment plan that works for them, in a mentally healthy state the vast majority of the time.
And then the final edge of this mental health spectrum is crisis, and so these are folks that may be experiencing acute psychosis or feelings of wanting to hurt harm themselves or others um it’s something that needs to be addressed immediately, it’s an emergent condition um and something that the person really cannot handle on their own and needs to be dealt with with with external support.
So today we’re really just going to focus on mental disease or mental illness.

So there’s a lot of different diseases that affect the brain and the mental illnesses generally fit these three pieces in order to be diagnosable.
So symptoms have to be consistent for more than a reasonable time. So this seems a little vague but- and it is but because the requirements are different depending on whether you’re talking about, depression or bipolar disorder or anxiety or post-traumatic stress disorder. These all maybe have different time periods that in order to be diagnosable and meet criteria but in general the symptoms have to be consistent but not necessarily constant that would be more days than not and people can still have good days, but if it’s happening more often than not then we’re talking about consistent symptoms and usually it’s longer than two weeks. However, if anyone is familiar you know with this or someone who’s struggled things like depression or chronic illnesses, like bipolar disorder can episodes and symptoms can last months especially without intervention. Sometimes even years honestly. So the second piece of what makes it a disease, is that the symptoms have to represent a significant change in the person’s normal experience upon the onset.
And so um you know I usually make a joke here about in my academic community there are some people who are just irritable and that’s their personality. It’s not that they’re necessarily suffering from depression so just because you meet some of these symptoms uh if it doesn’t meet all this criteria. If it doesn’t indicate a significant change in the person’s normal experience then they uh then it’s not necessarily meeting this particular criteria.
And then the third and really most important piece here is that social occupational educational or some other important functioning must be negatively impacted by these changes.
So I want to make a few points about mental diseases, because it applies to all of them every single thing I’m going to be talking about today, is a real biologically and environmentally driven illness, that can be episodic, it can be chronic or they can be singular events that happen.
Basically, all of them are preventable and or highly treatable.
And what we know from epidemiological studies is that it is critical to a mentally healthy climate and culture to have access to care and community support in getting that care.
So the first topic we’re going to talk about is mood disorders and anxiety. This is what I study so um I’ll be a little long-winded on this.
So mood disorders include depression and bipolar disorder and a few other things, but these are the two most common. Depression is something, major depression is a disease that affects up to 16% of an entire population in their lifetime. So it’s really quite prevalent. It’s a lot more prevalent than you might imagine. Bipolar disorder is about 2.5% lifetime prevalence.
We also know that anxiety is something that can either be a disease on its own or it can, it is often what’s called highly comorbid or coexisting, so you’ll have anxiety symptoms and depression symptoms or bipolar disorder symptoms at the same time or in the same person. So they tend to run together basically.
So one of the things that we’re talking about mental health literacy and improving that and especially focusing on mood disorders is um you know, so a lot of us here in Dragonfly are motivated by our own lived experience or losses. I, for example, have lost two classmates to suicide from my graduate program and they, losing them is a devastating event, but rather than talk about suicide itself directly, we focus on talking about improving mental health literacy and improving detection and awareness around mood disorders.
Because mood disorders underlie 80 to 90 percent of suicides and so the best way to treat or prevent suicides is actually to treat the underlying mood disorder and get people who are suffering from them to the care that they need so in the general population.
If you did a screen of everyone today, you’d probably expect about 6.7 of people to be diagnosable with a current episode of depression or bipolar disorder, and maybe about six percent of people would uh meet criteria for anxiety, an anxiety disorder of some sort.
However, the reason why we’re really emphasizing this amongst academics is that were, you know, we knew this kind of colloquially but now there’s more and more evidence being accumulated that graduate students in particular and probably throughout academia rates of depression and anxiety are much much higher than they are in the general population. So you get six to eight times higher rates of depression and anxiety amongst graduate students based on this paper that came out in 2018.
And so like I mentioned treating the underlying mood disorder is the most effective way to prevent suicide, and you know if you do know someone or you yourself are experiencing any suicidal thoughts or ideation, the two most important critical things in the moment is to restrict means to carry out an act and to avoid substance use these two things greatly increase the risk to the individual.

So the symptoms of mood disorders and anxiety, really are kind of fascinating and I have a whole other talk that is on youtube going into the nitty-gritty details about this, I don’t have time since we’re talking about all these other illnesses too but depression and bipolar disorder affect your mood, they affect your body and your behavior, and they affect your sleep, your metabolism and can affect your thoughts.
And one of the most disturbing aspects of uh mood disorder is that um your you can develop thought disorders, where you really believe that- become to believe that you don’t deserve to get better, that you don’t belong maybe in academia or that you- you’re not as bad as other people and you should be able to do this on your own, and get through it on your own, which is extremely problematic in seeking care once you’ve gotten to the point where, where your thoughts are now being changed by the illness itself.
The causes of depression and bipolar disorder and anxiety are myriad also so we do know that there’s a number of pathways that can all kind of lead to the same manifestation or sets of symptoms.
You can have immune or endocrine dysfunction. You can just be suffering from nutritional sleep or exercise deficiencies, and develop depression and then we also know that there are biological neurological pathways most predominantly well known and studied are the serotonergic pathways but we do have a lot of studies that indicate genetics play a pretty big role. And trauma especially childhood, early adverse events, as well as ongoing trauma can induce or increase the chances of someone developing depression.
And depression is not something that, mood disorders are not something that, anyone’s immune to, especially depression and so it’s something that affects all of us.
I do want to emphasize and I’ll kind of make some points on most of these illnesses of, that just struggling with or having developed a mental health condition, does not mean that you are not cut out for academia, that you’re not going to be successful.
And so an example that if-
A wonderful example is Professor Kay Redfield Jamison, who is a professor at Johns Hopkins and she is one of the world’s experts on bipolar disorder and struggles with the disease herself. She wrote this incredible book called an unquiet mind which was a memoir about her own lived experience.

So next we’ll talk about something that’s a little related to depression and people are always you know tend to be a little confused about well what’s depression and what’s burnout.
The thing – the critical piece about burnout is that it’s work-related. is-
So it tends to be very very work-related, whereas depression and other mood disorders and anxiety, can kind of affect all aspects of your life.
So the symptoms of burnout are emotional or physical exhaustion, reduced resilience and adaptability, you may develop a cynicism about work or your colleagues that you work with, and it’s usually accompanied by reduced performance or ability to concentrate especially at work.
The causes – you know burnout has really grown in in the literature as being pretty well studied and the causes really seem to be um pretty uniformly extreme chronic stress relating to work or sometimes other ongoing activities, feeling a lack of control especially at work or maybe experiencing bullying or toxic work environments or relationships and especially a big cause is having very poor work-life balance.
The great thing about burnout is that if any of this is resonating with you, we have very clear evidence that some, some nice- sometimes more complicated to achieve things than others but these things work, they definitely improve the situation, and improve people’s mental health.
So taking breaks or vacation is critical, and very, very helpful when someone is suffering from burnout. Sometimes people need to negotiate better hours or certain accommodations that really work for them to allow them to do their job at the capacity they’re expected, while not taxing their system.
And improving communication with your boss or your colleagues can really help as well.
So seeking support and building better relationships at work very intentionally can be very good. So creating like a peer network or scheduling time to just spend together and get to know each other as people, not just colleagues.
And then mindfulness, sleep and exercise all seem to be very effective strategies for burnout.
So if none of those things really are working for you and you’re experiencing something that you’re you know thinking might be burnout and these aren’t working, it might be something more severe might be depression, so that’s when you would definitely want to go talk to a psychologist or your primary care physician and see if maybe you need more advanced care.
So psychosis is something that’s relatively rare but it is something that when it occurs both for the individual and the people in their community it can be very distressing.
So symptoms involve being disconnected from reality, bizarre behavior experiencing, what are called delusions, so these are strongly held fixed beliefs that are not supported by other people’s experience or evidence, hallucinations these can be auditory or visual or even tactile, and uh psychosis is often accompanied by chaotic or incoherent speech and or writing so especially in these days where we’re more emailing to one another and not seeing each other in person as much, it might come across in their writing or emails.
And so psychosis or psychotic disorders really affect only about one percent of the population worldwide and the causes are really, there’s a huge genetic component here.
It’s about 50% estimated to be driven by genetics and about 50% environmental triggers and so you can also induce psychosis through extreme sleep disturbance.
Some folks have experienced psychosis after being sleep deprived for five to seven days. You can also induce psychosis with substance use, certain hallucinogens or withdrawal from substances. So you can have alcohol withdrawal psychosis for example, and it can also accompany other disorders, most predominantly bipolar mania or borderline personality disorder, and these are usually determined by a psychiatrist and end up being called psychotic features of one of these other underlying disorders.
What’s great is that you know despite how you know worrying it can be for someone to experience psychotic symptoms and in fact, a lot of folks who especially are higher educated or have higher coping skills, may really try to hide it and not tell people about it because they’re embarrassed or they’re worried about it that their, you know, their brain has broken forever. I’m- It’s not true, so the- there are excellent treatments for this and people can lead very productive, enjoyable lives even if they’ve experienced these signs and symptoms.
So antipsychotics, psychodynamic therapy, dialectical behavioral therapy are all excellent treatments and the key really is to get into treatment as soon as you start experiencing these, these symptoms.
So as I said psychosis, just like bipolar disorder or depression, is not the end of your career, there’s an amazing book called the center cannot hold written by Professor Ellen Sax, who is a law professor in California, so I would recommend checking that out.
Substance Use Disorder, this is something that is really an unfortunately highly stigmatized mental illness and it is a mental illness. So the symptoms that you know, elevate something from substance use to a substance use disorder is usually laid out as daily use or binge behavior.
If someone’s experiencing frequent blackouts from using these substances or they find that they’re lying about their use to their colleagues, to their loved ones, to their family. If they’re experiencing cravings or the cravings themselves, or their use are impacting their work or ability to do their job or hold their job, this is when it is now problematic.
And if it affects their friendships and their relationships and it can also all of these things can affect. many substances can affect both your mental and physical health, so for example, alcohol abuse or alcohol use disorder can lead to the development of depression conversely. We know that if someone is experiencing depressive symptoms, they’ll often try to self-medicate so to speak and numb the pain that they’re feeling psychically with substances. So it’s a two-way street and they can be difficult to disentangle, but they do they’re both treatable and they both can be um treated together as well.
So the causes are also really predominantly genetic, so our our estimates are that about 40 to 60 percent of substance use disorder really can be attributed to genetic predisposition, you know as I kind of mentioned if someone’s having other issues or stresses in life that they’re trying to cover up, they can use substances as coping behavior or self-medication and then also just the easy access to so much of this and the social pressure to engage in moderate you know drinking or maybe cannabis use where it’s legal can lead these individuals to develop independence, which is really unfortunate.
And as i mentioned it is linked to other mental diseases, so it’s it’s often very complicated for folks to, who develop this disorder, to, to get and seek treatment especially because of the stigma, which is just such, such a tragedy.
So what helps and what’s great about this like any other mental illness is that it’s treatable and so detoxification programs support groups to maintain sobriety individual or group counseling and peer support are incredibly effective.
Unfortunately in the US, only about 10 percent of people meeting criteria for substance use disorder seek treatment in a given year, so we really need to make some societal changes there to encourage people to get the care that will help them.
And in addition, if anyone’s having experiences of other diagnosable mental illnesses like anxiety or depression or bipolar disorder those need to be treated as well
So autism spectrum disorder is actually probably the most complicated thing that I’m reducing to one page, which is unfortunate but it bears looking at because of the prevalence in academia.
So the symptoms with autism spectrum disorder are complex, developmental, it’s a complex developmental condition that involves persistent challenges in social interaction, often affects speech and can create nonverbal communication skill issues, and can often also result in restricted or repetitive behaviors.
And so there, there are a lot of still unknowns about the, the causes of autism spectrum disorder, but we know full well that vaccines have nothing to do with it, but we do know that maybe about a quarter of cases seem to be linked to novel genetic mutations that people may experience.
Usually, these are the, the ones that are um, in individuals who have lower IQ, lower capacity whereas some folks with autism spectrum disorder have extremely high IQ and, and capacity and ability to work and live and have relationships.
And so that leaves us with about three quarters of multigenic risk or it’s just not known basically, but what’s great is that there’s a lot of research in this area and there’s a lot of support available, and so there’s a lot of comorbid like I said coexisting mental illnesses in autism spectrum disorder as well.
So if people have developed depression or ADHD or OCD medication for those are really, really helpful to help the individual and psychotherapy, occupational or educational therapy, sensory integration are all excellent treatments for folks with autism spectrum disorder.
A lot of people probably already know about a famous autistic individual and professor, professor temple grandin and if folks want to learn a little bit more about her, oliver sacks an amazing writer and neurologist wrote a book called an anthropologist on mars about her and her experiences.
There’s also a twitter handle autistics in academia.
So the final piece that we’ll talk about is obsessive-compulsive disorder.
So the- Oh and I guess in the last one I didn’t emphasize this, but autism spectrum disorder is slightly higher rates among academics than the general population.
So obsessive compulsive disorder involves includes the symptoms of a really strong urge to perform certain routines or rituals, this is the compulsion, and or unwanted repetitive thoughts or intrusive fears, this is the obsession.
And so what this disorder can do is end up causing someone to spend up to hours a day performing physical or mental rituals that really can be disruptive to their life and relationships and can lead to even avoidance of triggers or people because they’re embarrassed about their, their obsessions or their compulsions.
So the causes are again myriad, their genetics, trauma, as well as brain structural differences, have all been implicated in the causation of a compost- obsessive compulsive disorder and while one percent of the population worldwide would be diagnosable with ocd, what we find is that in academia in some studies that we’re looking at engineers and some other, more stem folks, the, the rates can be as high as 3.5%.
So that’s three, three and a half times higher likelihood of folks having ocd in our communities, the academics.
What helps again treatable, cognitive behavioral therapy, exposure and response prevention and then certain medications for example, some SSRIs but not others, really do help with ocd and if you’re interested in finding someone else who’s very successful and open about their condition, Dr Nadine Nuller on her website, is able, uh is writes blogs and, and seems to be a nice advocate for better understanding and appreciation of ocd folks.

So I’ll just re-emphasize here that mental disease is highly treatable. So for major depression, the most common um mental illness, that people will experience, especially in academia 80% will respond to standard treatment. So you know there’s a lot of hesitation to seek care, unfortunately, in fact, the average person waits six to eight years to seek treatment from their first onset of depressive symptoms and this is just tragic because the, the longer a mental illness goes untreated, other comorbid disorders can complicate that recovery and delay the treatment response.
So you know it’s really like cancer 50 years ago where we didn’t have early detection and a lot of people you know suffered needlessly and, and we’re dying from cancer because we weren’t catching it early. So mental illness is the same, the sooner you notice symptoms and signs and seek treatment and seek support and start creating a treatment plan and solutions for yourself the- you know the better off you’re going to be.
And the, the studies that have been done also really really clearly indicate that community support and encouragement is hugely impactful for people seeking care and sustaining their treatment. And so that’s why we really talk to everyone in academia, not just folks who are interested in this or might be struggling we want to improve mental health literacy among everyone because community support is so critical.

So I’ll skip this and just go to the point that you know you probably are all familiar with, postgraduate education really is unique, the faculty positions and education come with unique pressures and culture.
And it turns out that the cultural and systemic barriers are really quite extensive that make graduate students and faculty less likely to seek support.
And we do have a lot of wellness programs things like yoga and meditation are more available these days but programming for undergraduates, really we’re finding are not as effective for graduate students, post-docs, faculty and staff.
And so I also always like to include in these talks a little moment to talk about diversity of experience. So there are some folks who, while no one’s immune to depression or mental illnesses, there are some folks who are going to be experiencing additional traumas and stresses um that others who don’t belong to those groups won’t experience and maybe aren’t aware of.
And so um these are all in the boxes that i’m gonna bring up, these are all things that people have said to me or I’ve heard from from folks or experienced myself.
And so women are more likely to experience sexual harassment and violence. First-generation students are more likely to have economic challenges. People of Color experience racism and discrimination at alarming and systemic rates and methods. International students are more likely to experience cultural and language barriers. And folks belonging to the LGBTQ+ community are much more likely to experience marginalization and homophobia.
And from what we know about intersectionality when someone belongs to more than one of these groups it’s often more than additive the impact on their lives and um also their mental health.
So I would like to. I enjoy bringing up this comparison, and the irony of it. In that you know, we have elite athletes in our world who function physically at the highest levels and continue to break barriers and and all kinds of amazing records year after year after year, and yet when they’re injured when their uh their instrument their body experiences an acute pain or you know seems to be having something chronic, they respond to it right away even courtside, in front of the whole world to see.
And yet in academia where our minds are our instrument, when we experience trauma, or um you know you know are starting to have some problems with our instrument that’s most critical for us, we tend to just keep doing the same thing and that’s really problematic.
And I hope we can work together to change that in academia.
So with that, that’s the end of the talk and I will, it seems like a few more people joined us which is great and so for anyone who’s here now. I’d like to pose to you some of these questions to maybe get the ball rolling start the discussion but we really are open to talking about just about anything at this stage in the game. So are there any thoughts or questions or things people wanted to bring up or chat about.