phd students depression

PhD students’ mental health is poor and the pandemic made it worse – but there are coping strategies that can help

Senior Lecturer in Technology Enhanced Learning, The Open University

Assistant Professor in Strategy and Entrepreneurship, UCL

Disclosure statement

The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

University College London and The Open University provide funding as founding partners of The Conversation UK.

View all partners

A pre-pandemic study on PhD students’ mental health showed that they often struggle with such issues. Financial insecurity and feelings of isolation can be among the factors affecting students’ wellbeing.

The pandemic made the situation worse. We carried out research that looked into the impact of the pandemic on PhD students, surveying 1,780 students in summer 2020. We asked them about their mental health, the methods they used to cope and their satisfaction with their progress in their doctoral study.

Unsurprisingly, the lockdown in summer 2020 affected the ability to study for many. We found that 86% of the UK PhD students we surveyed reported a negative impact on their research progress.

But, alarmingly, 75% reported experiencing moderate to severe depression. This is a rate significantly higher than that observed in the general population and pre-pandemic PhD student cohorts .

Risk of depression

Our findings suggested an increased risk of depression among those in the research-heavy stage of their PhD – for example during data collection or laboratory experiments. This was in contrast to those in the initial stages, or who were nearing the end of their PhD and writing up their research. The data collection stage was more likely to have been disrupted by the pandemic.

Our research also showed that PhD students with caring responsibilities faced a greatly increased risk of depression. In our our study , we found that PhD students with childcare responsibilities were 14 times more likely to develop depressive symptoms than PhD students without children.

This does align with findings on people in the general UK population with childcare responsibilities during the pandemic. Adults with childcare responsibilities were 1.4 times more likely to develop depression or anxiety compared to their counterparts without children or childcare duties.

It was also interesting to find that PhD students facing the disruption caused by the pandemic who did not receive an extension – extra financial support and time beyond the expected funding period – or were uncertain about whether they would receive an extension at the time of our study, were 5.4 times more likely to experience significant depression.

Our research also used a questionnaire designed to measure effective and ineffective ways to cope with stressful life events. We used this to look at which coping skills – strategies to deal with challenges and difficult situations — used by PhD students were associated with lower depression levels. These “good” strategies included “getting comfort and understanding from someone” and “taking action to try to make the situation better”.

Interestingly, female PhD students, who were slightly less likely than men to experience significant depression, showed a greater tendency to use good coping approaches compared to their counterparts. Specifically, they favoured the above two coping strategies that are associated with lower levels of depression.

On the other hand, certain coping strategies were associated with higher depression levels. Prominent among these were self-critical tendencies and the use of substances like alcohol or drugs to cope with challenging situations.

A supportive environment

Creating a supportive environment is not solely the responsibility of individual students or academic advisors. Universities and funding bodies must play a proactive role in mitigating the challenges faced by PhD students.

By taking proactive steps, universities could create a more supportive environment for their students and help to ensure their success.

Training in coping skills could be extremely beneficial for PhD students. For instance, the University of Cambridge includes this training as part of its building resilience course .

A focus on good strategies or positive reframing – focusing on positive aspects and potential opportunities – could be crucial. Additionally, encouraging PhD students to seek emotional support may also help reduce the risk of depression.

Another example is the establishment of PhD wellbeing support groups , an intervention funded by the Office for Students and Research England Catalyst Fund .

Groups like this serve as a platform for productive discussions and meaningful interactions among students, facilitated by the presence of a dedicated mental health advisor.

Our research showed how much financial insecurity and caring responsibilities had an effect on mental health. More practical examples of a supportive environment offered by universities could include funded extensions to PhD study and the availability of flexible childcare options.

By creating supportive environments, universities can invest in the success and wellbeing of the next generation of researchers.

• Higher education
• Mental health
• Coping strategies
• PhD students
• Give me perspective

Service Delivery Consultant

Newsletter and Deputy Social Media Producer

College Director and Principal | Curtin College

Head of School: Engineering, Computer and Mathematical Sciences

Educational Designer

Managing While and Post-PhD Depression And Anxiety: PhD Student Survival Guide

Embarking on a PhD journey can be as challenging mentally as it is academically. With rising concerns about depression among PhD students, it’s essential to proactively address this issue. How to you manage, and combat depression during and after your PhD journey?

In this post, we explore the practical strategies to combat depression while pursuing doctoral studies.

From engaging in enriching activities outside academia to finding supportive networks, we describe a variety of approaches to help maintain mental well-being, ensuring that the journey towards academic excellence doesn’t come at the cost of your mental health.

How To Manage While and Post-Phd Depression

Why PhD Students Are More Likely To Experience Depression Than Other Students

The journey of a PhD student is often romanticised as one of intellectual rigour and eventual triumph.

However, beneath this veneer lies a stark reality: PhD students are notably more susceptible to experiencing depression and anxiety.

This can be unfortunately, quite normal in many PhD students’ journey, for several reasons:

Grinding Away, Alone

Imagine being a graduate student, where your day-to-day life is deeply entrenched in research activities. The pressure to consistently produce results and maintain productivity can be overwhelming. 

For many, this translates into long hours of isolation, chipping away at one’s sense of wellbeing. The lack of social support, coupled with the solitary nature of research, often leads to feelings of isolation.

Mentors Not Helping Much

The relationship with a mentor can significantly affect depression levels among doctoral researchers. An overly critical mentor or one lacking in supportive guidance can exacerbate feelings of imposter syndrome.

Students often find themselves questioning their capabilities, feeling like they don’t belong in their research areas despite their achievements.

Nature Of Research Itself

Another critical factor is the nature of the research itself. Students in life sciences, for example, may deal with additional stressors unique to their field.

Specific aspects of research, such as the unpredictability of experiments or the ethical dilemmas inherent in some studies, can further contribute to anxiety and depression among PhD students.

Competition Within Grad School

Grad school’s competitive environment also plays a role. PhD students are constantly comparing their progress with peers, which can lead to a mental health crisis if they perceive themselves as falling behind.

This sense of constant competition, coupled with the fear of failure and the stigma around mental health, makes many hesitant to seek help for anxiety or depression.

How To Know If You Are Suffering From Depression While Studying PhD?

If there is one thing about depression, you often do not realise it creeping in. The unique pressures of grad school can subtly transform normal stress into something more insidious.

As a PhD student in academia, you’re often expected to maintain high productivity and engage deeply in your research activities. However, this intense focus can lead to isolation, a key factor contributing to depression and anxiety among doctoral students.

Changes in Emotional And Mental State

You might start noticing changes in your emotional and mental state. Feelings of imposter syndrome, where you constantly doubt your abilities despite evident successes, become frequent.

This is especially true in competitive environments like the Ivy League universities, where the bar is set high. These feelings are often exacerbated by the lack of positive reinforcement from mentors, making you feel like you don’t quite belong, no matter how hard you work.

Lack Of Pleasure From Previously Enjoyable Activities

In doctoral programs, the stressor of overwork is common, but when it leads to a consistent lack of interest or pleasure in activities you once enjoyed, it’s a red flag. This decline in enjoyment extends beyond one’s research and can pervade all aspects of life.

The high rates of depression among PhD students are alarming, yet many continue to suffer in silence, afraid to ask for help or reveal their depression due to the stigma associated with mental health issues in academia.

Losing Social Connections

Another sign is the deterioration of social connections. Graduate student mental health is significantly affected by social support and isolation.

You may find yourself withdrawing from friends and activities, preferring the solitude that ironically feeds into your sense of isolation.

Changes In Appetite And Weight

Changes in appetite and weight can be a significant indicator of depression. As they navigate the demanding PhD study, students might experience fluctuations in their eating habits.

Some may find themselves overeating as a coping mechanism, leading to weight gain. Others might lose their appetite altogether, resulting in noticeable weight loss.

These changes are not just about food; they reflect deeper emotional and mental states.

Such shifts in appetite and weight, especially if sudden or severe, warrant attention as they may signal underlying depression, a common issue in the high-stress environment of PhD studies.

Unhealthy Coping Mechanisms

PhD students grappling with depression often feel immense pressure to excel academically while battling isolation and imposter syndrome. Lacking adequate mental health support, some turn to unhealthy coping mechanisms like substance abuse. These may include:

• Overeating, 
• And many more.

These provide temporary relief from overwhelming stress and emotional turmoil. However, such methods can exacerbate their mental health issues, creating a vicious cycle of dependency and further detachment from healthier coping strategies and support systems.

It’s essential for PhD students experiencing depression to recognise these signs and seek professional help. Resources like the National Suicide Prevention Lifeline are very helpful in this regard.

Suicidal Thoughts Or Attempts

Suicidal thoughts or attempts may sound extreme, but they can happen in PhD studies. This is because of the high-pressure environment of PhD studies.

Doctoral students, often grappling with intense academic demands, social isolation, and imposter syndrome, can be susceptible to severe mental health crises.

When the burden becomes unbearable, some may experience thoughts of self-harm or suicide as a way to escape their distress. These thoughts are a stark indicator of deep psychological distress and should never be ignored.

It’s crucial for academic institutions and support networks to provide robust mental health resources and create an environment where students feel safe to seek help and discuss their struggles openly.

How To Prevent From Depression During And After Ph.D?

A PhD student’s experience is often marked by high rates of depression, a concern echoed in studies from universities like the University of California and Arizona State University. If you are embarking on a PhD journey, make sure you are aware of the issue, and develop strategies to cope with the stress, so you do not end up with depression. 

Engage With Activities Outside Academia

One effective strategy is engaging in activities outside academia. Diverse interests serve as a lifeline, breaking the monotony and stress of grad school. Some activities you can consider include:

• Social gatherings.

These activities provide a crucial balance. For instance, some students highlighted the positive impact of adopting a pet, which not only offered companionship but also a reason to step outside and engage with the world.

Seek A Supportive Mentor

The role of a supportive mentor cannot be overstated. A mentor who adopts a ‘yes and’ approach rather than being overly critical can significantly boost a doctoral researcher’s morale.

This positive reinforcement fosters a healthier research environment, essential for good mental health.

Stay Active Physically

Physical exercise is another key element. Regular exercise has been shown to help cope with symptoms of moderate to severe depression. It’s a natural stress reliever, improving mood and enhancing overall wellbeing. Any physical workout can work here, including:

• Brisk walking
• Swimming, or
• Gym sessions.

Seek Positive Environment

Importantly, the graduate program environment plays a critical role. Creating a community where students feel comfortable to reveal their depression or seek help is vital.

Whether it’s through formal support groups or informal peer networks, building a sense of belonging and understanding can mitigate feelings of isolation and imposter syndrome.

This may be important, especially in the earlier stage when you look and apply to universities study PhD . When possible, talk to past students and see how are the environment, and how supportive the university is.

Choose the right university with the right support ensures you keep depression at bay, and graduate on time too.

Remember You Have The Power

Lastly, acknowledging the power of choice is empowering. Understanding that continuing with a PhD is a choice, not an obligation. If things become too bad, there is always an option to seek a deferment, pause. You can also quit your studies too.

Work on fixing your mental state, and recover from depression first, before deciding again if you want to take on Ph.D studies again. There is no point continuing to push yourself, only to expose yourself to self-harm, and even suicide.

Wrapping Up: PhD Does Not Need To Ruin You

Combating depression during PhD studies requires a holistic approach. Engaging in diverse activities, seeking supportive mentors, staying physically active, choosing positive environments, and recognising one’s power to make choices are all crucial.

These strategies collectively contribute to a healthier mental state, reducing the risk of depression. Remember, prioritising your mental well-being is just as important as academic success. This helps to ensure you having a more fulfilling and sustainable journey through your PhD studies.

Dr Andrew Stapleton has a Masters and PhD in Chemistry from the UK and Australia. He has many years of research experience and has worked as a Postdoctoral Fellow and Associate at a number of Universities. Although having secured funding for his own research, he left academia to help others with his YouTube channel all about the inner workings of academia and how to make it work for you.

Thank you for visiting Academia Insider.

We are here to help you navigate Academia as painlessly as possible. We are supported by our readers and by visiting you are helping us earn a small amount through ads and affiliate revenue - Thank you!

2024 © Academia Insider

Setting the Scene: Understanding the PhD Mental Health Crisis

• First Online: 15 September 2022

Cite this chapter

• Zoë J. Ayres 2  

9172 Accesses

This chapter deep-dives into research that has explored the so-called “PhD mental health crisis” looking at both statistics and common stressors that PhD students may face during their studies, as well as the possible causes for increased incidences of mood disorders in the PhD population.

(Trigger Warnings: suicidal ideation, suicide, self-harm, anxiety, depression, discrimination)

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save.

• Get 10 units per month
• Download Article/Chapter or eBook
• 1 Unit = 1 Article or 1 Chapter
• Cancel anytime
• Available as EPUB and PDF
• Read on any device
• Instant download
• Own it forever
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Highly educated was deemed to be having successfully completed an educational program of 3–5 years outside of the university setting or having a bachelors or master’s degree.

Note that the 2019 survey was the first time that the survey was offered in four additional languages including Chinese, Spanish, French and Portuguese which may have impact on the results.

If you are experiencing suicidal ideation and/or self-harming, there is a range of support available to you, detailed in the online resources accompanying this book.

You will note I have placed “failed” in quotations. This is because I do not believe that choosing to leave a PhD is failure, it is just a different decision. We will discuss this in detail later on in the book.

Many of these studies use IQ as a measure of intelligence, though there is evidence to suggest that IQ tests have biases, and a person can improve their IQ results over time with practice, suggesting it is not a true measure of intelligence.

For me, it was really feeling like a fraud (struggling from the impostor phenomenon that really fuelled my struggles during my PhD. I used errors made in the lab as “proof” in my own head that I did not deserve to be doing a PhD.

Satinsky EN, Kimura T, Kiang MV, Abebe R, Cunningham S, Lee H, Lin X, Liu CH, Rudan I, Sen S, Tomlinson M, Yaver M, Tsai AC (2021) Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students. Sci Rep 11(1):14370

Article   Google Scholar  

Evans TM, Bira L, Gastelum JB, Weiss LT, Vanderford NL (2018) Evidence for a mental health crisis in graduate education. Nat Biotechnol 36(3):282–284

Bertolote J (2008) The roots of the concept of mental health. World Psychiatry 7(2):113–116

Google Scholar  

Crook S (2020) Historicising the “crisis” in undergraduate mental health: British universities and student mental illness, 1944–1968. J Hist Med Allied Sci 75(2):193–220

Andersen J, Altwies E, Bossewitch J, Brown C, Cole K, Davidow S, DuBrul SA, Friedland-Kays E, Fontaine G, Hall W, Hansen C, Lewis B, Mitchell-Brody M, McNamara J, Nikkel G, Sadler P, Stark D, Utah A, Vidal A, Weber CL (2017) Mad resistance/mad alternatives: democratizing mental health care. In: Community mental health. Routledge, Abingdon

The Graduate Assembly (2014) Graduate student happiness & well-being report. University of California, Berkeley, CA

Levecque K, Anseel F, De Beuckelaer A, Van der Heyden J, Gisle L (2017) Work organization and mental health problems in PhD students. Res Policy 46(4):868–879

Guthrie S, Lichten C, Belle J, Ball S, Knack A, Hofman J (2017) Understanding mental health in the research environment. RAND Europe, Cambridge, UK

Smith E, Brooks Z (2015) Graduate student mental health. University of Arizona Tucson, AZ

Williams S (2019) Postgraduate research experience survey 2019. Advance HE, York

Woolston C (2019) PhDs: the tortuous truth. Nature 575(7782):403–407

Byrom N (2020) The challenges of lockdown for early-career researchers. eLife:9e59634

Garcia-Williams AG, Moffitt L, Kaslow NJ (2014) Mental health and suicidal behavior among graduate students. Acad Psychiatry 38:554–560

ten Have M, De Graaf R, Van Dorsselaer S, Verdurmen J, Van’t Land H, Vollebergh W, Beekman A (2009) Incidence and course of suicidal ideation and suicide attempts in the general population. Can J Psychiatry 54(12):824–833

DiscoverPhDs (2017) PhD failure rate – a study of 26,076 PhD candidates. https://www.discoverphds.com/advice/doing/phd-failure-rate . Accessed 3 Mar 2022

Young SN, Vanwye WR, Schafer MA, Robertson TA, Poore AV (2019) Factors affecting PhD student success. Int J Exerc Sci 12(1):34–45

PubMed   PubMed Central   Google Scholar  

Karpinski RI, Kolb AMK, Tetreault NA, Borowski TB (2018) High intelligence: a risk factor for psychological and physiological overexcitabilities. Intelligence: 668–623

Givens JL, Tjia J (2002) Depressed medical students’ use of mental health services and barriers to use. Acad Med 77(9):918–921

Moran H, Karlin L, Lauchlan E, Rappaport SJ, Bleasdale B, Wild L, Dorr J (2020) Understanding research culture: what researchers think about the culture they work in. Wellcome Trust, London, UK

Moss SE, Mahmoudi M (2021) STEM the bullying: an empirical investigation of abusive supervision in academic science. EClinicalMedicine 40:101121

Devos C, Boudrenghien G, Van der Linden N, Azzi A, Frenay M, Galand B, Klein O (2017) Doctoral students’ experiences leading to completion or attrition: a matter of sense, progress and distress. Eur J Psychol Educ 32(1):61–77

Limas JC, Corcoran LC, Baker AN, Cartaya AE, Ayres ZJ (2022) The impact of research culture on mental health & diversity in STEM. Chemistry s(9):e202102957

Cerejo C, Awati M, Hayward A (2020) Joy and stress triggers: a global survey on mental health among researchers. CACTUS Foundation, Solapur

Berhe AA, Barnes RT, Hastings MG, Mattheis A, Schneider B, Williams BM, Marín-Spiotta E (2022) Scientists from historically excluded groups face a hostile obstacle course. Nat Geosci 15(1):2–4

Bhopal K (2015) The experiences of black and minority ethnic academics: a comparative study of the unequal academy. Routledge, Abingdon

Book   Google Scholar  

Woolston C (2018) Feeling overwhelmed by academia? You are not alone. Nature 557(7706):129–131

Moore S, Neylon C, Eve MP, Paul O’Donnell D, Pattinson D (2017) “Excellence R Us”: university research and the fetishisation of excellence. Palgrave Commun 3:16105

Russo G (2013) Education: financial burden. Nature 501(7468):579–581

Khoo S (2021) How Canada short-changes its graduate students and postdocs. https://www.universityaffairs.ca/opinion/in-my-opinion/how-canada-short-changes-its-graduate-students-and-postdocs/ . Accessed 4 Mar 2022

UK Council for International Student Affairs (2022) Student work. https://www.ukcisa.org.uk/Information%2D%2DAdvice/Working/Student-work . Accessed 2 Jun 2022

Kearns H, Gardiner M, Marchall K, Banytis F (2006) The PhD experience: what they didn’t tell you at induction. ThinkWell, Glenelg North

Jackman PC, Jacobs L, Hawkins RM, Sisson K (2021) Mental health and psychological wellbeing in the early stages of doctoral study: a systematic review. Eur J High Educ. 12(3):293–313

Clance PR, Imes SA (1978) The imposter phenomenon in high achieving women: dynamics and therapeutic intervention. Psychother Theory Res Pract 15(3):241–247

De Rond M, Miller AN (2005) Publish or perish: bane or boon of academic life? J Manage Inq 14(4):321–329

Miller AN, Taylor SG, Bedeian AG (2011) Publish or perish: academic life as management faculty live it. Career Development International. Emerald, Bingley, UK

Hazell CM, Chapman L, Valeix SF, Roberts P, Niven JE, Berry C (2020) Understanding the mental health of doctoral researchers: a mixed methods systematic review with meta-analysis and meta-synthesis. Syst Rev 9(1):197

Lim MH, Rodebaugh TL, Zyphur MJ, Gleeson JFM (2016) Loneliness over time: the crucial role of social anxiety. J Abnorm Psychol 125(5):620–630

Yu B, Steptoe A, Niu K, Ku P, Chen L (2018) Prospective associations of social isolation and loneliness with poor sleep quality in older adults. Qual Life Res 27(3):683–691

Casey C, Harvey O, Taylor J, Knight F, Trenoweth S (2022) Exploring the wellbeing and resilience of postgraduate researchers. J Further High Educ 46(6):850–867

Zapf MK (1991) Cross-cultural transitions and wellness: dealing with culture shock. Int J Adv Couns 14(2):105–119

Sokratous S, Merkouris A, Middleton N, Karanikola M (2013) The association between stressful life events and depressive symptoms among Cypriot university students: a cross-sectional descriptive correlational study. BMC Public Health 13(1):1121

Dickson-Swift V, James EL, Kippen S, Liamputtong P (2007) Doing sensitive research: what challenges do qualitative researchers face? Qual Res 7(3):327–353

Boynton P (2020) Being Well in Academia: Ways to Feel Stronger, Safer and More Connected. Routledge, Abingdon

Download references

Author information

Authors and affiliations.

Zoë J. Ayres

You can also search for this author in PubMed   Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Ayres, Z.J. (2022). Setting the Scene: Understanding the PhD Mental Health Crisis. In: Managing your Mental Health during your PhD. Springer, Cham. https://doi.org/10.1007/978-3-031-14194-2_3

Download citation

DOI : https://doi.org/10.1007/978-3-031-14194-2_3

Published : 15 September 2022

Publisher Name : Springer, Cham

Print ISBN : 978-3-031-14193-5

Online ISBN : 978-3-031-14194-2

eBook Packages : Biomedical and Life Sciences Biomedical and Life Sciences (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

The Savvy Scientist

Experiences of a London PhD student and beyond

PhD Burnout: Managing Energy, Stress, Anxiety & Your Mental Health

PhDs are renowned for being stressful and when you add a global pandemic into the mix it’s no surprise that many students are struggling with their mental health. Unfortunately this can often lead to PhD fatigue which may eventually lead to burnout.

In this post we’ll explore what academic burnout is and how it comes about, then discuss some tips I picked up for managing mental health during my own PhD.

Please note that I am by no means an expert in this area. I’ve worked in seven different labs before, during and after my PhD so I have a fair idea of research stress but even so, I don’t have all the answers.

If you’re feeling burnt out or depressed and finding the pressure too much, please reach out to friends and family or give the Samaritans a call to talk things through.

Note – This post, and its follow on about maintaining PhD motivation were inspired by a reader who asked for recommendations on dealing with PhD fatigue. I love hearing from all of you, so if you have any ideas for topics which you, or others, could find useful please do let me know either in the comments section below or by getting in contact . Or just pop me a message to say hi. 🙂

This post is part of my PhD mindset series, you can check out the full series below:

• PhD Burnout: Managing Energy, Stress, Anxiety & Your Mental Health (this part!)
• PhD Motivation: How to Stay Driven From Cover Letter to Completion
• How to Stop Procrastinating and Start Studying

What is PhD Burnout?

Whenever I’ve gone anywhere near social media relating to PhDs I see overwhelmed PhD students who are some combination of overwhelmed, de-energised or depressed.

Specifically I often see Americans talking about the importance of talking through their PhD difficulties with a therapist, which I find a little alarming. It’s great to seek help but even better to avoid the need in the first place.

Sadly, none of this is unusual. As this survey shows, depression is common for PhD students and of note: at higher levels than for working professionals.

All of these feelings can be connected to academic burnout.

The World Health Organisation classifies burnout as a syndrome with symptoms of:

– Feelings of energy depletion or exhaustion; – Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; – Reduced professional efficacy. Symptoms of burnout as classified by the WHO. Source .

This often leads to students falling completely out of love with the topic they decided to spend years of their life researching!

The pandemic has added extra pressures and constraints which can make it even more difficult to have a well balanced and positive PhD experience. Therefore it is more important than ever to take care of yourself, so that not only can you continue to make progress in your project but also ensure you stay healthy.

What are the Stages of Burnout?

Psychologists Herbert Freudenberger and Gail North developed a 12 stage model of burnout. The following graphic by The Present Psychologist does a great job at conveying each of these.

I don’t know about you, but I can personally identify with several of the stages and it’s scary to see how they can potentially lead down a path to complete mental and physical burnout. I also think it’s interesting that neglecting needs (stage 3) happens so early on. If you check in with yourself regularly you can hopefully halt your burnout journey at that point.

PhDs can be tough but burnout isn’t an inevitability. Here are a few suggestions for how you can look after your mental health and avoid academic burnout.

Overcoming PhD Burnout

Manage your energy levels, maintaining energy levels day to day.

• Eat well and eat regularly. Try to avoid nutritionless high sugar foods which can play havoc with your energy levels. Instead aim for low GI food . Maybe I’m just getting old but I really do recommend eating some fruit and veg. My favourite book of 2021, How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reduce Disease , is well worth a read. Not a fan of veggies? Either disguise them or at least eat some fruit such as apples and bananas. Sliced apple with some peanut butter is a delicious and nutritious low GI snack. Check out my series of posts on cooking nutritious meals on a budget.
• Get enough sleep. It doesn’t take PhD-level research to realise that you need to rest properly if you want to avoid becoming exhausted! How much sleep someone needs to feel well-rested varies person to person, so I won’t prescribe that you get a specific amount, but 6-9 hours is the range typically recommended. Personally, I take getting enough sleep very seriously and try to get a minimum of 8 hours.

A side note on caffeine consumption: Do PhD students need caffeine to survive?

In a word, no!

Although a culture of caffeine consumption goes hand in hand with intense work, PhD students certainly don’t need caffeine to survive. How do I know? I didn’t have any at all during my own PhD. In fact, I wrote a whole post about it .

By all means consume as much caffeine as you want, just know that it doesn’t have to be a prerequisite for successfully completing a PhD.

Maintaining energy throughout your whole PhD

• Pace yourself. As I mention later in the post I strongly recommend treating your PhD like a normal full-time job. This means only working 40 hours per week, Monday to Friday. Doing so could help realign your stress, anxiety and depression levels with comparatively less-depressed professional workers . There will of course be times when this isn’t possible and you’ll need to work longer hours to make a certain deadline. But working long hours should not be the norm. It’s good to try and balance the workload as best you can across the whole of your PhD. For instance, I often encourage people to start writing papers earlier than they think as these can later become chapters in your thesis. It’s things like this that can help you avoid excess stress in your final year.
• Take time off to recharge. All work and no play makes for an exhausted PhD student! Make the most of opportunities to get involved with extracurricular activities (often at a discount!). I wrote a whole post about making the most of opportunities during your PhD . PhD students should have time for a social life, again I’ve written about that . Also give yourself permission to take time-off day to day for self care, whether that’s to go for a walk in nature, meet friends or binge-watch a show on Netflix. Even within a single working day I often find I’m far more efficient when I break up my work into chunks and allow myself to take time off in-between. This is also a good way to avoid procrastination!

Reduce Stress and Anxiety

During your PhD there will inevitably be times of stress. Your experiments may not be going as planned, deadlines may be coming up fast or you may find yourself pushed too far outside of your comfort zone. But if you manage your response well you’ll hopefully be able to avoid PhD burnout. I’ll say it again: stress does not need to lead to burnout!

Everyone is unique in terms of what works for them so I’d recommend writing down a list of what you find helpful when you feel stressed, anxious or sad and then you can refer to it when you next experience that feeling.

I’ve created a mental health reminders print-out to refer to when times get tough. It’s available now in the resources library (subscribe for free to get the password!).

Below are a few general suggestions to avoid PhD burnout which work for me and you may find helpful.

• Exercise. When you’re feeling down it can be tough to motivate yourself to go and exercise but I always feel much better for it afterwards. When we exercise it helps our body to adapt at dealing with stress, so getting into a good habit can work wonders for both your mental and physical health. Why not see if your uni has any unusual sports or activities you could try? I tried scuba diving and surfing while at Imperial! But remember, exercise doesn’t need to be difficult. It could just involve going for a walk around the block at lunch or taking the stairs rather than the lift.
• Cook / Bake. I appreciate that for many people cooking can be anything but relaxing, so if you don’t enjoy the pressure of cooking an actual meal perhaps give baking a go. Personally I really enjoy putting a podcast on and making food. Pinterest and Youtube can be great visual places to find new recipes.
• Let your mind relax. Switching off is a skill and I’ve found meditation a great way to help clear my mind. It’s amazing how noticeably different I can feel afterwards, having not previously been aware of how many thoughts were buzzing around! Yoga can also be another good way to relax and be present in the moment. My partner and I have been working our way through 30 Days of Yoga with Adriene on Youtube and I’d recommend it as a good way to ease yourself in. As well as being great for your mind, yoga also ticks the box for exercise!
• Read a book. I’ve previously written about the benefits of reading fiction * and I still believe it’s one of the best ways to relax. Reading allows you to immerse yourself in a different world and it’s a great way to entertain yourself during a commute.

* Wondering how I got something published in Science ? Read my guide here .

Talk It Through

• Meet with your supervisor. Don’t suffer in silence, if you’re finding yourself struggling or burned out raise this with your supervisor and they should be able to work with you to find ways to reduce the pressure. This may involve you taking some time off, delegating some of your workload, suggesting an alternative course of action or signposting you to services your university offers.

Also remember that facing PhD-related challenges can be common. I wrote a whole post about mine in case you want to cheer yourself up! We can’t control everything we encounter, but we can control our response.

A free self-care checklist is also now available in the resources library , providing ideas to stay healthy and avoid PhD burnout.

Top Tips for Avoiding PhD Burnout

On top of everything we’ve covered in the sections above, here are a few overarching tips which I think could help you to avoid PhD burnout:

• Work sensible hours . You shouldn’t feel under pressure from your supervisor or anyone else to be pulling crazy hours on a regular basis. Even if you adore your project it isn’t healthy to be forfeiting other aspects of your life such as food, sleep and friends. As a starting point I suggest treating your PhD as a 9-5 job. About a year into my PhD I shared how many hours I was working .
• Reduce your use of social media. If you feel like social media could be having a negative impact on your mental health, why not try having a break from it?
• Do things outside of your PhD . Bonus points if this includes spending time outdoors, getting exercise or spending time with friends. Basically, make sure the PhD isn’t the only thing occupying both your mental and physical ife.
• Regularly check in on how you’re feeling. If you wait until you’re truly burnt out before seeking help, it is likely to take you a long time to recover and you may even feel that dropping out is your only option. While that can be a completely valid choice I would strongly suggest to check in with yourself on a regular basis and speak to someone early on (be that your supervisor, or a friend or family member) if you find yourself struggling.

I really hope that this post has been useful for you. Nothing is more important than your mental health and PhD burnout can really disrupt that. If you’ve got any comments or suggestions which you think other PhD scholars could find useful please feel free to share them in the comments section below.

You can subscribe for more content here:

Share this:

• Click to share on Facebook (Opens in new window)
• Click to share on LinkedIn (Opens in new window)
• Click to share on Twitter (Opens in new window)
• Click to share on Reddit (Opens in new window)

Related Posts

The Five Most Powerful Lessons I Learned During My PhD

8th August 2024 8th August 2024

Minor Corrections: How To Make Them and Succeed With Your PhD Thesis

2nd June 2024 2nd June 2024

How to Master Data Management in Research

25th April 2024 4th August 2024

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Notify me of follow-up comments by email.

This site uses Akismet to reduce spam. Learn how your comment data is processed .

Privacy Overview

• About the LSE Impact Blog
• Comments Policy
• Popular Posts
• Recent Posts
• Subscribe to the Impact Blog
• Write for us
• LSE comment

Cassie M Hazell

January 12th, 2022, is doing a phd bad for your mental health.

9 comments | 77 shares

Estimated reading time: 6 minutes

Poor mental health amongst PhD researchers is increasingly being recognised as an issue within higher education institutions. However, there continues to be unanswered questions relating to the propensity and causality of poor mental health amongst PhD researchers. Reporting on a new comparative survey of PhD researchers and their peers from different professions, Dr Cassie M Hazell and Dr Clio Berry find that PhD researchers are particularly vulnerable to poor mental health compared to their peers. Arguing against an inherent and individualised link between PhD research and mental health, they suggest institutions have a significant role to play in reviewing cultures and working environments that contribute to the risk of poor mental health.

Evidence has been growing in recent years that mental health difficulties are common amongst PhD students . These studies understandably have caused concern in academic circles about the welfare of our future researchers and the potential toxicity of academia as a whole. Each of these studies has made an important contribution to the field, but there are some key questions that have thus far been left unanswered:

• Is this an issue limited to certain academic communities or countries?
• Do these findings reflect a PhD-specific issue or reflect the mental health consequences of being in a graduate-level occupation?
• Are the mental health difficulties reported amongst PhD students clinically meaningful?

We attempted to answer these questions as part of our Understanding the mental health of DOCtoral researchers (U-DOC) survey. To do this we surveyed more than 3,300 PhD students studying in the UK and a control group of more than 1,200 matched working professionals about their mental health. In our most recent paper , we compared the presence and severity of mental health symptoms between these two groups. Using the same measures as are used in the NHS to assess symptoms of depression and anxiety, we found that PhD students were more likely to meet criteria for a depression and/or anxiety diagnosis and have more severe symptoms overall. We found no difference between these groups in terms of their overall suicidality. However, survey responses corresponding to past suicidal thinking and behaviour, and future suicide intent were generally highly rated in both groups.

42% of PhD students reported that they believed having a mental health problem during your PhD is the norm

We also asked PhD students about their perceptions and lived experience of mental health. Sadly, 42% of PhD students reported that they believed having a mental health problem during your PhD is the norm. We also found similar numbers saying they have considered taking a break from their studies for mental health reasons, with 14% actually taking a mental health-related break. Finally, 35% of PhD students have considered ending their studies altogether because of their mental health.

We were able to challenge the working theory that the reason for our findings is that those with mental health difficulties are more likely to continue their studies at university to the doctoral level. In other words, the idea that doing a PhD doesn’t in any way cause mental health problems and these results are instead the product of pre-existing conditions. Contrary to this notion, we found that PhD students were not more likely than working professionals to report previously diagnosed mental health problems, and if anything, when they had mental health problems, these started later in life than for the working professionals. Additionally, we found that our results regarding current depression and anxiety symptoms remained even after controlling for a history of mental health difficulties.

The findings from this paper and our other work on the U-DOC project  has highlighted that PhD students seem to be particularly vulnerable to experiencing mental health problems. We found several factors to be key predictors of this poor mental health ; specifically not having interests and relationships outside of PhD studies, students’ perfectionism, impostor thoughts, their supervisory relationship, isolation, financial insecurity and the impact of stressors outside of the PhD .

the current infrastructure, systems and practices in most academic institutions, and in the wider sector, are increasing PhD students’ risk of mental health problems and undermining the potential joy of pursuing meaningful and exciting research

So, does this mean that doing a PhD is bad for your mental health? Not necessarily. There are several aspects of the PhD process that are conducive to mental health difficulties, but it is absolutely not inevitable. Our research (and our own experiences!) suggests that doing a PhD can be an incredibly positive experience that is intellectually stimulating, personally satisfying, and gives a sense of meaning and purpose. We instead believe a more appropriate conclusion to draw from our work is that the current infrastructure, systems and practices in most academic institutions, and in the wider sector, are increasing PhD students’ risk of mental health problems and undermining the potential joy of pursuing meaningful and exciting research.

Reducing this issue to the common rhetoric that “PhD studies cause mental health problems” is problematic for several reasons: Firstly, it ignores the many interacting moving parts at work here that variably increase and reduce risk of poor mental health across people, time, and place. Secondly, it does not acknowledge the pockets of incredibly good practice in the sector we can learn from and implement more widely. Finally, it reinforces the notion that poor mental health is the norm for PhD students which then becomes a self-fulfilling prophecy- and itself ignores the joy of pursuing a thesis in something potentially so personally meaningful. Nonetheless, a significant paradigm shift is needed in academia to reduce the current environmental toxins so that studying for a PhD can be a truly enjoyable and fulfilling process for all.

Note: This article gives the views of the author, and not the position of the Impact of Social Science blog, nor of the London School of Economics. Please review our  Comments Policy  if you have any concerns on posting a comment below.

Image Credit: Geralt via Pixabay. 

About the author

Dr Cassie M Hazell (she/her) is a lecturer in Social Sciences at the University of Westminster. Her research is on around mental health, with a special interest in implementation science. She is the co-founder of the international Early Career Hallucinations Research (ECHR) group and Early-Mid Career representative on the Research Council at her institution.

Dr Clio Berry is a Senior Lecturer in Healthcare Evaluation and Improvement in the Brighton and Sussex Medical School. She is interested in the application of positive and social psychology approaches to mental health problems and social outcomes for young people and students. Her work spans identification of risk and resilience factors in predicting mental health and social problems and their outcomes, and in the development and evaluation of clinical and non-clinical interventions.

• Pingback: Is doing a PhD bad for your mental health? | Thinking about Digital Publishing

My own experience of doing a PhD (loneliness, the lack of routine, imposter syndrome) has led to my discouraging my daughter, who has a history of mental health issues, from considering it at the moment, despite her having the academic aptitude and even a topic. I would hazard a guess that the problems are worse in the humanities than in the applied sciences, where most PhD students tend to work as part of research teams and be well supported in more structured environments.

• Pingback: What can universities do to support the well-being and mental health of postgraduate researchers? | Impact of Social Sciences

Fascinating research… I had a terrible PhD, but most of the mental health issues arose after the fact. If you ever conducted another survey it would be interesting to include those who had recently finished a PhD.

Looking at your follow up BJPsyche paper, I noticed you haven’t gone into the correlation between subject and mental health. I’d be interested to know how sciences vs humanities compared.

I see that your work is very restrained in discussing the causes of mental health issues, and I’m sure you have plenty of hypothesis. In my experience, a key factor is that there is no mechanism to hold supervisors to account for the quality of their supervision. (Linking to the point above, I believe in the sciences supervisors with poor outcomes do suffer repetitional damage – not so in the humanities.)

I’d also add that the UK’s Viva system, which I believe is unique globally, is a recipe for disaster – years of work evaluated over the course of just a couple of hours by examiners who, again, are not held accountable in any way.

I wrote my experience up here: https://medium.com/the-faculty/i-had-a-brutal-phd-viva-followed-by-two-years-of-corrections-here-is-what-i-learned-about-vivas-5e81175aa5d

• Pingback: The benefits of getting involved with the LSESU as a PhD student | Students@LSE
• Pingback: “Am I ready for a PhD?” - The Undercover Academic
• Pingback: #AcWriMo & online writing communities for off-campus PGRs – UoB PGR Development
• Pingback: Psychische Herausforderungen während der juristischen Promotion › JuWissBlog
• Pingback: What To Expect When You’re PhDing - Völkerrechtsblog

Leave a Comment Cancel reply

Your email address will not be published. Required fields are marked *

Notify me of follow-up comments by email.

What can universities do to support the well-being and mental health of postgraduate researchers? February 1st, 2022

Related posts.

Is peer review bad for your mental health?

April 19th, 2018.

Book Review: Being Well in Academia: Ways to Feel Stronger, Safer and More Connected by Petra Boynton

February 27th, 2021.

Mental health risks in research training can no longer be ignored

June 25th, 2018.

The neurotic academic: how anxiety fuels casualised academic work

April 17th, 2018.

Visit our sister blog LSE Review of Books

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Psychol Res Behav Manag

Prevalence and associated factors of depression and anxiety among doctoral students: the mediating effect of mentoring relationships on the association between research self-efficacy and depression/anxiety

1 Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China, gro.latipsoh-js@hyoahz

2 Department of Library and Medical Information, China Medical University, Shenyang, China

3 Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China

4 Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, China Medical University, Shenyang, China

5 Department of Dermatology, First Hospital of China Medical University, Shenyang, China

Weiqiu Wang

Shanshan jia.

6 Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital of China Medical University, Shenyang, China

Deshu Shang

7 Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China

8 Department of Developmental Cell Biology, Cell Biology Division, Key Laboratory of Cell Biology, Ministry of Health, China Medical University, Shenyang, China

Yangguang Shao

9 Department of Cell Biology, Key Laboratory of Cell Biology, National Health Commission of the PRC, China Medical University, Shenyang, China

10 Department of Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China

Xinwang Zhu

11 Department of Nephrology, First Affiliated Hospital of China Medical University, Shenyang, China

Shengnan Yan

12 Graduate Division, School of Public Health, China Medical University, Shenyang, China

Yuhong Zhao

Although the mental health status of doctoral students deserves attention, few scholars have paid attention to factors related to their mental health problems. We aimed to investigate the prevalence of depression and anxiety in doctoral students and examine possible associated factors. We further aimed to assess whether mentoring relationships mediate the association between research self-efficacy and depression/anxiety.

A cross-sectional study was conducted among 325 doctoral students in a medical university. The Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 scale were used to assess depression and anxiety. The Research Self-Efficacy Scale was used to measure perceived ability to fulfill various research-related activities. The Advisory Working Alliance Inventory-student version was used to assess mentoring relationships. Linear hierarchical regression analyses were performed to determine if any factors were significantly associated with depression and anxiety. Asymptotic and resampling methods were used to examine whether mentoring played a mediating role.

Approximately 23.7% of participants showed signs of depression, and 20.0% showed signs of anxiety. Grade in school was associated with the degree of depression. The frequency of meeting with a mentor, difficulty in doctoral article publication, and difficulty in balancing work–family–doctoral program was associated with both the level of depression and anxiety. Moreover, research self-efficacy and mentoring relationships had negative relationships with levels of depression and anxiety. We also found that mentoring relationships mediated the correlation between research self-efficacy and depression/anxiety.

The findings suggest that educational experts should pay close attention to the mental health of doctoral students. Active strategies and interventions that promote research self-efficacy and mentoring relationships might be beneficial in preventing or reducing depression and anxiety.

Introduction

Recently, the mental health status of students has become a hot topic in public health, higher education, and research policy. 1 – 3 Depression and anxiety are two of the most common psychological disorders. Researchers have reported depression and anxiety among students in several countries and in numerous disciplines, such as counseling, medicine, law, and psychology. 4 – 14 Depression is defined as a mood that includes a feeling of hopelessness, helplessness, or worthlessness. 2 Anxiety is an emotion characterized by unpleasant inner feelings, which is accompanied by caution, complaints, meditation, nervousness, and worry. 5 Depression and anxiety can affect a person’s behavior, academic performance, and general health, as well as quality of sleep, eating habits, and well-being. 8 In addition, it has been confirmed that depression and psychological distress influence suicidal ideation in undergraduate and graduate students. 15 – 18 However, mental health among doctoral students has been relatively ignored by researchers and educational experts. It has only been in the last 2 years that this topic has begun to attract more and more attention.

A doctoral student’s school career is full of hardships and happiness. Doctoral students frequently feel a sense of urgency, worry, and stress as they work toward their doctoral degrees. In addition to financial support and future employment, doctoral students worry about writing a thesis, publishing papers, and handling relationships with advisors. In recent years, a few scholars have explored the prevalence of mental health problems among PhD students. 3 , 12 , 19 – 21 In 2013, Levecquea et al investigated PhD students in Belgium. They concluded that approximately half the PhD students in Flanders had at least two symptoms, and 32% reported at least four symptoms on the 12-item General Health Questionnaire (GHQ12). 3 According to a 2015 survey at the University of California, approximately half the PhD students in science and engineering were depressed. 12 Springer Nature did a survey of PhD students in 2017, and confirmed that 12% reported seeking help for anxiety or depression caused by PhD studies. 20 A 2018 survey of graduate students via social media revealed that 41% of graduate students scored in the moderate–severe range for anxiety and 39% scored in the moderate–severe range for depression. 21 Doctoral students with mental health issues are more likely to drop out of PhD programs. 22 The high attrition rate in PhD programs caused by the dropout of PhD students with psychological illness is damaging to research institutions and the whole research industry. 23 However, there have been few reports on the mental health of doctoral students in medical universities.

Students in medical schools engage in rigorous medical training. 24 , 25 Previous studies have demonstrated that medical students have more pressure, more burnout, and a greater prevalence of mental health disorders than the general population or students in other disciplines. 26 – 31 Medical training varies considerably by discipline, institution, and country. US and Canadian medical students enter medical education systems after they receive a bachelor’s degree. 32 , 33 In China, students can enter medical schools after graduating from high school (similarly to the UK and France). In general, there is an entrance examination required for students with a master’s degree who would like to study for doctoral degrees. Doctoral students need another 3 years to earn a doctoral degree, allowing for an extension of 3 years. Master’s degree candidates in grade two have the choice to apply for a master–doctor combined-training program (a total of 5 years for a doctoral degree, allowing an extension of 3 years). Doctoral students can be either full-time or part-time students. Part-time doctoral students are those who are studying doctoral courses while working in clinical settings or having another job. As such, for clinical doctoral students, some are still fully engaged in clinical work while earning their doctoral degree, whereas others are temporarily away from clinical work to concentrate on the doctoral program research. It is a bit too much to expect clinical doctoral students to do clinical work and research at the same time throughout their doctoral training.

Sociodemographic variables, such as age, sex, and marital status, have been reported to be associated with the mental health of postgraduate students. 8 , 10 However, sex differences in depression among medical students have also yielded mixed results, showing either no difference or high prevalence among female or male medical students. 27 , 29 , 33 Further exploration among doctoral students is still needed. The execution phase during doctoral study has been shown to be prone to mental health problems among doctoral students. 3 Additionally, researchers have suggested that work–life balance is the key factor related to the mental health problems of postgraduate students. 3 , 21 Employed doctoral students work full time or part time while they are studying for their doctoral degree. In this case, conflict concerns not only balancing family and work but also completing the doctoral program itself. Few scholars have focused on the conflicts among family, work, and a doctoral program. Getting married and raising children also puts a strain on doctoral students. Doing experiments, writing a doctoral thesis, and publishing doctoral qualification papers requires considerable time, energy, and financial resources.

Mentorship effectiveness and mentoring functions are thought to be vital to graduate-student programs. 34 , 35 Mentors have a great responsibility to guide their doctoral students through the doctoral program. Advisor mentoring affects student-research self-efficacy, productivity, and development as a scientist. 36 – 38 Recently, a study explored the effect of a supervisor’s leadership style on the mental health of graduate students. 3 Nearly half the doctoral students who withdrew from the doctoral program reported experiencing insufficient supervision, highlighting the fact that good supervision was important for completing the doctoral program. 39 , 40 A survey in 2018 indicated that a weak relationship with a mentor is a common characteristic of most graduate students who experience anxiety and/or depression. 21

Research self-efficacy refers to the individual’s confidence in the successful completion of various aspects of the scientific research process, 41 such as data collection, performing experimental procedures, and writing papers. 42 Studies have evaluated the important role of research self-efficacy in research training. Self-efficacy is a factor that affects how much effort students spend on research tasks and how long they persist when they experience difficulties. 43 Some universities in the US have used research self-efficacy to evaluate the effects of degree programs on graduate research ability. 44 A study has shown that research self-efficacy can predict the research interest and knowledge of doctoral students. 45 Some researchers have reported that high research self-efficacy is correlated with future research involvement and research productivity. 46 , 47 It was suggested that research self-efficacy could play a mediating role between the research-training environment and scientific research output. Furthermore, the relationship between stress and depression has been shown to be mediated by stress management self-efficacy. 48 Interestingly, the length of student–advisor relationships has been reported to be significantly correlated with student research self-efficacy. 36 Moreover, among agricultural students, research self-efficacy has been found to be negatively associated with research anxiety. 49 Therefore, the higher the students’ research self-efficacy, the lower their research anxiety. However, it is not clear whether scientific research self-efficacy is correlated with levels of generalized anxiety.

In this study, we aimed to investigate the prevalence of depression and anxiety among doctoral students in a medical university in China, determine factors that are associated with depression and anxiety, determine whether mentoring relationships and research self-efficacy are associated with depression and anxiety, and test whether mentoring relationships mediate the association between research self-efficacy and depression/anxiety.

Participants

We recruited doctoral students from October to November 2017 using a combination of snowball sampling and stratified sampling from five medical schools and four affiliated clinical hospitals at a medical university in northeast China. This university has the authority to grant doctoral degrees in six major disciplines (basic medicine, clinical medicine, biology, stomatology, public health and preventive medicine, and nursing), including 49 different majors. Our inclusion criteria were still studying at the medical university, had not yet earned a PhD degree, enrollment in a successive postgraduate and doctoral program, and no history of depression or anxiety before entering medical school. A total of 437 doctoral students (218 male, 219 female) were enrolled. This study received approval from the Committee for Human Trials of China Medical University (CMU17/375/R). Written informed consent was obtained from all participants before they entered the experiment. All questionnaires were filled out anonymously and confidentially.

Sociodemographic and doctoral factors

Doctoral students’ sociodemographic status included age, sex, marital status, children, and income. In addition, we selected some doctoral characteristics that might affect the mental health of doctoral students. We asked participants whether they had been employed before doctoral enrollment. Clinical doctoral students refers to students who were doing clinical work while earning their doctoral degree. Grade was measured assigned to one of four categories (1, first year; 2, second year; 3, third year; 4, fourth year or above). Mentors meet with their doctoral students regularly or irregularly. They come together and analyze the latest literature, discuss the research direction or experimental methods, and revise the thesis. Therefore, the frequency of these meetings can reflect the strength of the relationship from a certain quantitative angle. The frequency with which doctoral students met with mentors was measured with one item: “On average, how often do you meet with your advisor? (1, at least once a week; 2, at least once a month; 3, seldom)”. In most medical universities, doctoral students are required to publish at least one academic paper indexed by the Science Citation Index or Social Science Citation Index. Only when this qualification has been reached are doctoral students able to apply for a doctoral degree. The perceived difficulty in publishing a doctoral qualification paper was assessed by one item: “How much effort do you think it takes to publish doctoral qualification papers? (1, a little bit of effort; 2, some effort; 3, a lot of effort). Considering that the total time and energy of doctoral students is limited, we asked the doctoral students, “Do you have difficulty in balancing work, family, and the PhD program? (1, almost no difficulty; 2, some difficulty; 3, great difficulty)”.

Depression questionnaire

We chose the nine-item Patient Health Questionnaire (PHQ-9) 50 to evaluate depression among doctoral students. Each item is measured on a 4-point Likert-like scale (0, not at all; 3, almost every day) based on the frequency of depression symptoms over the last 2 weeks. Total scores range from 0 to 27. A higher PHQ-9 score represents more serious depression (0–4, none–minimal; 5–9, mild; 10–14, moderate; 15–19, moderately severe; 20–27, severe). In general, a diagnosis of depression can only be arrived at after clinical assessment by a mental health professional. With such questionnaires as the PHQ-9, it has been shown that at certain cutoffs there is good correlation with diagnostic interviews. PHQ-9 scores of 10 or above had a sensitivity of 88% and a specificity of 88% for major depressive disorder. 50 The Chinese version of the PHQ-9 has been used in older people and hospital inpatients, with sound reliability. In the current study, Cronbach’s alpha for the PHQ-9 scale was 0.918.

Anxiety questionnaire

We used the seven item Generalized Anxiety Disorder (GAD-7) to indicate the degree of anxiety among doctoral students. 51 The GAD-7 contains seven items that are rated on a 4-point Likert-like scale (0, not at all; 3, almost every day). The total score ranges from 0 to 21. A higher GAD-7 score indicates more serious anxiety (0–4, none–minimal; 5–9, mild; 10–14, moderate; 15–21, severe). Using a threshold score of 10, the GAD-7 has a sensitivity of 89% and a specificity of 82% for major generalized anxiety disorder. 51 The Chinese version of the GAD-7 has been used in outpatients with satisfactory reliability. In the present study, Cronbach’s alpha for the GAD-7 scale was 0.946.

Mentoring-relationship questionnaire

The 30-item Advisory Working Alliance Inventory-student version (AWAI-S) was used to assess the mentoring relationship from the student’s perspective. 36 This scale is a brief, self-reported measure designed on the basis of the Working Alliance model. Its developer, Schlosser, believed that a favorable supervisory alliance was vital to outcomes. 52 The scale has had good reliability in previous studies. 53 The AWAI-S consists of three domains: rapport (11 items), apprenticeship (14 items), and identification-individuation (5 items). Each item is rated on a 5-point Likert scale (1, strongly disagree; 5, strongly agree). The AWAI-S scale contains 16 reverse-scoring questions. High scores (after reverse scoring) suggest that the advisee has a strong mentoring relationship with the advisor. The internal consistency of AWAI-S scores from previous studies ranged from 0.84 to 0.95 36 , 54 and was 0.95 in this study.

Research Self-Efficacy Scale

The Research Self-Efficacy Scale (RSES) was used to measure the doctoral students’ perceived ability to fulfill various research-related tasks. 55 The RSES comprises 50 items with four subscales: conceptualization (18 items), implementation (19 items), early tasks (5 items), and presenting the results (8 items). Individuals were asked to mark the tasks they perceived they could perform. The strength of each item was rated on a 10-point scale ranging from 0 (no confidence) to 10 (complete confidence). A total RSES score was calculated, ranging from 75 to 500. A higher score indicates higher self-efficacy. The internal consistency of RSES scores was 0.98 in the present study.

Data analysis

We used SPSS 17.0 for all statistical analyses. We investigated demographic and doctoral characteristics using ANOVA for continuous variables and chi-squared for categorical data. Correlations among depression, anxiety, mentoring relationships, and research self-efficacy were examined by Pearson correlation. We performed hierarchical linear regression analysis to explore the association of mentoring relationship and research self-efficacy with depression/anxiety. In this study, depression and anxiety were modeled as dependent variables, RSES as an independent variable, AWAI-S as a mediator, and sociodemographic and doctoral variables as controlled variables. In step 1 of the regression, sociodemographic and doctoral variables were entered as controlled variables. Because linear hierarchical regression analysis requires continuous variables, the grade, frequency of meeting with a mentor, difficulty in publishing a doctoral qualification paper, and difficulty in balancing work–family–doctoral program was dummy coded. In step 2 of the regression, research self-efficacy was added. In step 3, the mentoring relationship was added. The asymptotic and resampling method was used to examine mentoring relationship as potential mediator in the association between research self-efficacy and depression/anxiety, based on 5,000 bootstrap samples. 56 A bias-corrected and accelerated (BC a ) 95% CI was used to estimate mediation. If the BC a 95% CI excludes 0, this indicates that the mediation is significant. All statistical tests were two-sided (α=0.05). P <0.05 was considered statistically significant.

Sociodemographic and doctoral characteristics of respondents

After exclusion of 45 doctoral students who refused to fill out questionnaires, the 392 who completed the questionnaires were included. A total of 67 questionnaires with missing values >10% were deemed invalid. As such, we collected 325 valid responses. The effective response rate was 74.37%. The mean age of the participants was 31.1±5.3 (23–47) years. Of the 325 respondents, 60.3% were female, 50.8% married or lived with a partner, and 40% had one or more child. The monthly income for 56.6% of respondents was <CN¥3,000 per month (equivalent of local per capita income), 50.8% had been employed before doctoral enrollment, and 40.6% were clinical doctoral students. Furthermore, 13.8% seldom met with their mentors, 37.2% thought they should try their best to publish a PhD qualification paper, and 31.1% reported that they had difficulty in balancing work–family–PhD ( Table 1 ).

Sociodemographic and doctoral characteristics of respondents (n=325)

Sociodemographic and doctoral characteristics by depression and anxiety

The prevalence of clinical depression was 23.7% (moderate, moderately severe, and severe) and the prevalence of clinical anxiety was 20.0% (moderate and severe; Tables 2 and ​ and3). 3 ). Factors that were significantly different among respondents at varying levels of depression included age, marital status, having children, employment, grade, frequency of meeting with mentors, difficulty in publishing, and difficulty in balancing work–family–doctoral program. Factors that were significantly different among respondents at varying levels of anxiety included being a clinical doctoral student, frequency of meeting with mentors, difficulty in publishing, and difficulty in balancing work–family–doctoral program.

Sociodemographic and doctoral characteristics by depression (n=325)

Sociodemographic and doctoral characteristics by anxiety (n=325)

Means and correlations among age and PHQ-9, GAD-7, AWAI-S, and RSES scores

Mean scores for the PHQ-9, GAD-7, and AWAI-S and their correlations with each other and age are presented in Table 4 . Age was positively associated with the PHQ-9. However, there was no significant effect of age on the GAD-7. Both PHQ-9 and GAD-7 scores were negatively associated with AWAI-S and RSES scores.

Correlations among age, AWAI-S, RSES, PHQ-9, and GAD-7 scores

Abbreviations: AWAI-S, Advisory Working Alliance Inventory-student version; GAD, Generalized Anxiety Disorder; PHQ, Patient Health Questionnaire; RSES, Research Self-Efficacy Scale.

Associations of mentoring relationship and research self-efficacy with depression/anxiety

As shown in Tables 5 and ​ and6, 6 , sociodemographic and doctoral variables contributed to 17.7% of the variance in PHQ-9 scores and to 18.3% of the variance in GAD-7 scores. Doctoral students in their fourth year had greater PHQ-9 and GAD-7 scores than first-year doctoral students. Compared with those who met with their mentors at least once a week, doctoral students who met with their mentors only once a month had higher PHQ-9 and GAD-7 scores. Moreover, respondents who reported that they had to try their best to publish doctoral qualification papers had higher PHQ-9 and GAD-7 scores than those who felt they only had to put forth a little effort. Finally, doctoral students who had great difficulty in balancing work–family–doctoral program exhibited a higher level of depression and anxiety than those who had almost no difficulty.

Factors related to depression using hierarchical regression analysis

Abbreviation: PHQ, Patient Health Questionnaire.

Factors related to anxiety using hierarchical regression analysis

Abbreviation: GAD, Generalized Anxiety Disorder.

After adjustment for controlled variables, the RSES was negatively associated with depression ( b =−0.211, P <0.001) and anxiety ( b =−0.242, P <0.001), and accounted for 3.8% of the variance for depression and 5.0% of the variance for anxiety. In step 3, the AWAI-S was negatively associated with depression ( b =−0.257, P <0.001) and anxiety ( b =−0.246, P <0.001), and accounted for 5.3% of the variance for depression and 4.9% of the variance for anxiety. In step 3, when the AWAI-S was added, the absolute value of RSES b was diminished. Therefore, the AWAI-S might be a mediator in the association between research self-efficacy and depression/anxiety.

Mediating role of mentoring relationship

As shown in Table 7 and Figure 1 , research self-efficacy had a significantly negative correlation with depression/anxiety (c). Research self-efficacy correlated with the mentoring relationship (a). Mentoring relationship correlated with depression/anxiety negatively (b). BC a 95% CI for a×b of the mentoring relationship did not include 0, indicating that mentoring relationship partially mediated the relationship between research self-efficacy and depression/anxiety (c’). Mentoring relationship explained 37.68% of the variance for depression and 29.73% of the variance for anxiety.

Theoretical model through which mentoring relationship mediates association between research self-efficacy and depression/anxiety.

Notes: c, Association between research a elf-efficacy and depression/anxiety; a, association between research self-efficacy and mentoring relationship; b, association between mentoring relationship and depression/anxiety; c’, association between research self-efficacy and depression/anxiety after adding mentoring relationship as a mediator. * P <0.05; ** P <0.01; *** P <0.001.

Bootstrapping test of indirect effect of mentoring relationship acting as mediator on association between research self-efficacy and depression/anxiety

Notes: a×b, indirect effect of research self-efficacy on depression/anxiety via mediator mentoring relationship; c, association between research self-efficacy and depression/anxiety; a, association between research self-efficacy and mentoring relationship; b, association between mentoring relationship and depression/anxiety; c’, association between research self-efficacy and depression/anxiety after adding mentoring relationship as mediator.

Abbreviations: BC a , bias-corrected and accelerated; GAD, Generalized Anxiety Disorder; PHQ, Patient Health Questionnaire.

We found that depression and anxiety symptoms are common among doctoral students in medical universities. Approximately 41.2% of doctoral students showed symptoms of mild depression and 23.7% showed signs of moderate–severe depression. Moreover, 33.5% of the students had mild anxiety symptoms and 20.0% had moderate–severe anxiety symptoms. Researchers worldwide have used the same scales to carry out epidemiological surveys on depression and/or anxiety. An investigation indicated that 53.8% of undergraduate college students at Emory University had moderate–severe depression. 57 In 2017, it was reported that 29.2% of medical students in Nepal had moderate–severe depression. 58 Evans et al conducted a survey that included 90% PhD students and 10% master’s students. Results suggested that 39% of postgraduates had moderate–severe depression and 41% moderate–severe anxiety. 21 Differences in terms of score and positive rate might be related to differing methodologies. Levesque et al found that 33.33% of doctoral students experienced a common psychiatric disorder (GHQ12), such as depression. A PhD candidate was 2.4 times more likely to develop psychiatric health problems than someone in the general population with a bachelor’s degree. 3 Bernstein reported that 42% of PhD students in science and 48% of PhD students in engineering at the University of California were depressed on the Center for Epidemiologic Studies Depression Scale. 12 The psychological stress of medical doctoral students is much higher than that of students with other majors, and students in medical schools have more symptoms of depression than the general population. 26 , 29 However, few reports have focused on the mental health of doctoral students in Chinese medical universities.

Research self-efficacy negatively correlated with depression and anxiety. However, few researchers have reported such an association. Mee found that self-efficacy mediated the relationship between smoking behavior and depression. 59 Pu et al verified that dispositional optimism partially mediated the relationship between self-efficacy and depression. 60 Razavi et al reported a negative relationship between self-efficacy (General Self-Efficacy Questionnaire) and research anxiety among master’s and PhD students at Islamic Azad University. 61 In addition, we found that research self-efficacy (RSES) and mentoring relationship (AWAI-S) correlated significantly. This result was consistent with a previous study. 64 Research self-efficacy has often been studied in relation to research-training environments and research productivity. 47 , 62 Lambie et al found that among PhD students, research self-efficacy was associated with research interest and knowledge. 45

Our study indicated that the association between research self-efficacy and depression/anxiety was partly mediated by the mentoring relationship. As for strategies for promoting research self-efficacy of doctoral students, Overall et al found that high levels of autonomy and strong levels of academic support were associated with higher levels of research self-efficacy. Likewise, students with lower research self-efficacy experienced lower levels of autonomy and lower levels of personal support. 44 Love et al reported that supportive peers or supervisors contributed to positive research experience. Positive team-research experiences were able to predict research self-efficacy. 63 As such, the correlation between mentoring relationship and research self-efficacy might be bidirectional.

Our results also indicated that mentoring relationship correlated with depression and anxiety. Studies suggest that the mentoring relationship is positively correlated with research self-efficacy and negatively correlated with student stress. 53 , 54 , 64 , 65 Peluso et al found that the academic advisor relationship played a role in protecting the mental health of experimental psychology students in Canada. 10 Gottschall also showed a significant association between a harmonious mentoring relationship (RHI-M subscale) and decreased depressive symptoms among Canadian graduate students. 66 In addition, Lunsford suggested that mentoring by doctoral advisors correlated with student outcomes, including satisfaction and academic production. 37

Most importantly, we found that mentoring relationship mediated the correlation between research self-efficacy and depression/anxiety. As far as we know, this issue has not been studied before. The empirical findings in this study have very important applications for general doctoral training strategies and specific interventions for depression and anxiety. The mediating effect suggests that active strategies and interventions that promote research self-efficacy and mentoring relationships might benefit the mental health of doctoral students. Developing courses related to choosing research topics, performing experiments, analyzing data, and writing papers are good strategies for improving research self-efficacy. We should encourage doctoral students to participate in research practices and academic exchange. In addition, we should monitor mentoring relationships, depression, and anxiety by mixed methods at regular intervals, with students’ permission. If we find poor relationships between mentors and their mentees, we must recognize this issue’s importance and adopt flexible methods to deal with it. For example, we should allow the student to change mentors or give them more research support from another faculty.

The percentage of scores that could be categorized as depression and anxiety in the fourth year or above was higher than that in any other grade. Senior students might face more pressure from the institution, the need to graduate, financial burdens, and finding a job than is faced by more junior students. Our findings are in line with a survey in Vietnam, which indicated that major depression and general anxiety rates of medical students were higher in the fifth grade than in the first grade. 67 In contrast, a study of undergraduates in Brazil discovered that 30.8% of first-year students and 9.4% of sixth-year students presented anxiety. 68 Levecque et al observed that mental health problems were more prevalent at the beginning of the PhD program than in the execution phase. This difference with our results could be due to cross-cultural differences in training systems and graduation requirements.

The frequency with which mentees met with their mentors showed a significant relationship with depression and anxiety. This measure is a function of the mentors in terms of quantity. Under great academic pressure, doctoral students who often met with their mentors were less stressed than those who seldom met with their mentors. An ideal situation is that the advisor is accessible at almost all times. Besides weekly group meetings, students should schedule a weekly one-on-one session with an advisor. Students who meet less frequently with their mentor are more likely to be depressed when they encounter difficulties. Moreover, the duration of each meeting and the content of the meeting might also play a vital role in completion of the doctoral program.

Our results also suggest that difficulty in publishing a doctoral qualification paper has a significant effect on depression and anxiety. This has also become one of the main factors preventing students from completing the doctoral degree. Certainly, doctoral students who have greater academic self-efficacy might have less academic pressure and a low risk of mental health problems. In recent years, many policies have been implemented to increase the number of doctoral students enrolled, develop master–doctor combined programs, and expand the requirements for a doctoral degree. However, the cultivation of mentoring ability, availability of funding for doctor training, and assistance for doctoral students in mastering experiments and writing papers are still lacking. Such problems might not only be related to increasing the risk of mental health disorders but might also correlate with deferred graduation, increased dropout rates, and academic misconduct.

Finally, it has been shown that doctoral students who have difficulty in balancing work–family–doctoral program will have a greater risk of depression and anxiety than those who have almost no difficulty. An imbalance among family, work, and doctoral program places great pressure on doctoral students and seriously hampers their progress in doctoral programs, which leads to poorer mental health and even poorer physical health. Although the effect of work–life balance on mental health has been identified in the past, 69 , 70 only in recent years has work–life–doctoral program balance been taken seriously. Sapey, a scientist in the UK, has pointed out that work–life balance in academia is a challenge for her. 71 – 73 She said that she has balanced two vocations (clinical and academic work) and a family (mother of a child), sometimes very badly, sometimes reasonably, and only very, very occasionally has she handled it very well. Is there any successful family–work–doctoral program balance experience from which to learn? Bellucci and Nancy performed a qualitative investigation of PhD nursing students in the US, and suggested that multiple time management and stress management strategies would play a crucial role in balancing the responsibilities of work, family, and a PhD program. 74 Martinez et al interviewed full-time doctoral education students and categorized balancing school–work–life into four themes: purposeful management, well-being, support, and tradeoffs. 75

Limitations

Several limitations of this study should be mentioned. First, we performed only an exploratory survey of doctoral students in a medical university. We will perform a multicenter investigation in multiple cities in the future. Second, it was a cross-sectional study. The results of this study did not reveal causality. We expect to conduct a longitudinal study on associated themes. Further studies should include qualitative measures as well.

Our study has provided insight into the prevalence and factors associated with depression and anxiety among doctoral students in China. Our study revealed that 23.7% of doctoral students showed signs of depression and 20.0% signs of anxiety. Our findings indicated that research self-efficacy and mentoring relationships were protective factors for depression and anxiety. Mentoring relationship mediated the association between research self-efficacy and depression/anxiety. In addition, we revealed that the frequency of meeting with mentors, difficulty in publishing a doctoral qualification paper, and difficulty in balancing work–family–doctoral program were significantly associated with both depression and anxiety. Our findings also indicated that year in school was also associated with depression and anxiety. These findings suggest that policymakers and managers in medical universities should pay close attention to the mental health of doctoral students. Potential interventions might include (but are not limited to) promoting research self-efficacy of doctoral students, monitoring the mentoring relationship, and developing courses that teach how to perform various tasks necessary for obtaining a doctoral degree.

Acknowledgments

This study was funded by the Liaoning Province Education Science 13th Five-Year Plan 2017 of China (No. JG17DB564) and the National Natural Science Foundation of China (No. 71473268). We would like to thank the experts who have offered us constructive suggestions. We would like to acknowledge all the faculty and students for their great help in distributing questionnaires and collecting data.

The authors report no conflicts of interest in this work.

Clearing now open. Find out more Go to Clearing page .

Nearly half of PhD students consider developing a mental health problem ‘normal’

A new study led by the University of Westminster in collaboration with researchers from the University of Sussex and Brighton and Sussex Medical School shows that 42% of PhD students consider developing a mental health problem a ‘normal’ part of the PhD process.

The researchers also found that more than a third (35.8%) of doctoral researchers considered ending or taking a break from their studies due to poor mental health, while just over 14% of doctoral researchers had formally suspended their studies due to mental health problems. 

They discovered that compared to working professionals, PhD students are particularly vulnerable to mental health problems, and found initial evidence that PhD studies might be causative of this. 

The study, published in Humanities & Social Sciences Communications and funded by Office for Students and Research England, investigated depression and anxiety levels through a nationwide survey of PhD students in the UK to ask them questions about their mental health. Over 3,000 PhD students completed the survey, as well as a matched control group of 1,168 working professionals. 

PhD students reported significant anxiety and depression levels, a difference which was not explained by a higher rate of pre-existing mental health problems.  The new collaborative research, which is the biggest ever controlled study on PhD student mental health and the first of its kind based in the UK, examined the mental health of PhD students and some factors that might increase their risk or protect against poor mental health. It comes after a recent international survey conducted by Nature, which found that 36% of current doctoral researchers reported seeking help for anxiety and/or depression.

These new findings provide an evidence-based mandate for universities and funders to reflect upon practices related to doctoral researcher training and mental health. Attention should now be directed towards understanding what factors may explain heightened anxiety and depression among PhD students to inform preventative measures and interventions. To help achieve this, the researchers are currently analysing data looking at viable, specific risk factors associated with poor mental health amongst PhD students with the goal of developing policies, strategies and interventions to improve and protect PhD students’ mental health.

Talking about the research, lead author of the study Dr Cassie Hazell , Lecturer in Psychology at the University of Westminster, said: “PhD students are a key part of the university community and are the future of research. Our findings demonstrate that a worrying proportion of PhD students are experiencing clinically significant levels of poor mental health that exceed those seen in other working professionals. It seems clear to us that there is something about the PhD process that is triggering mental health problems, and that a paradigm shift is needed. Without this change, PhD students, academia, and society as a whole will suffer.”

Professor Jeremy E. Niven, Dean of the Doctoral School at the University of Sussex, added: “Doctoral researchers are a key part of universities, they're future thinkers, innovators and leaders that are vital in building and sustaining our economy. Our research shows that they are particularly susceptible to some mental health difficulties that may be linked to the PhD itself. Universities and funding agencies really need to reconsider what is expected of a PhD Thesis or changes in the acceptable length of time over which funding is provided.”

Read the full paper in the Humanities & Social Sciences Communications journal .

• Share on Facebook
• Share on Twitter
• Share on LinkedIn

Related articles

Westminster’s Black History Year Researchers Network holds first residential writing retreat

University of Westminster and HMP Pentonville celebrate success of collaboration at graduation event at Pentonville Prison

University of Westminster hosts roundtable to raise awareness of LGBT+ domestic abuse

Press and media enquiries.

Contact us on:

[email protected]

We use cookies to ensure the best experience on our website.

By accepting you agree to cookies being stored on your device.

Some of these cookies are essential to the running of the site, while others help us to improve your experience.

Functional cookies enable core functionality such as security, network management, and accessibility.

Analytics cookies help us improve our website based on user needs by collecting information, which does not directly identify anyone.

Marketing cookies send information on your visit to third parties so that they can make their advertising more relevant to you when you visit other websites.

Stack Exchange Network

Stack Exchange network consists of 183 Q&A communities including Stack Overflow , the largest, most trusted online community for developers to learn, share their knowledge, and build their careers.

Q&A for work

Connect and share knowledge within a single location that is structured and easy to search.

Is it a good idea to open up to your PhD advisor about depression?

Basically what the question says: is it a good idea to sit down and openly talk with their PhD advisor about struggling with depression?

Sending support to anyone out there struggling ♡

• May be of interest: PhD supervisor wants me to quit after break –  Snijderfrey Commented Aug 10, 2023 at 20:23
• About 15 years ago one of my PhD students talked to me about his depression. If you are interested I can write an answer. –  Moishe Kohan Commented Aug 10, 2023 at 21:00
• @MoisheKohan I would appreciate that very much! –  polyalex Commented Aug 14, 2023 at 8:31
• Welcome to Academia.SE. I rephrased your question somewhat -- we don't really take "poll" questions like "has anyone ever...", since you cannot draw meaningful conclusions from a few self-selected data points (other than the trivial: yes, in the history of academia, someone has tried this). But I suspect you're really looking for advice, which this formulation should still invite. –  cag51 ♦ Commented Aug 15, 2023 at 22:15
• Also, does this answer your question?: How do I talk to my professor about my anxiety/depression? –  cag51 ♦ Commented Aug 15, 2023 at 22:17

3 Answers 3

I can give you the perspective from the supervisor's side. It's a good thing to ask your fellow graduate students, but the drawback of that approach is that their experiences will have an n=1, so you'd have to listen to a lot of tales to triangulate an answer.

From my experience as a professor, supervisor and advisor to many students, I know that is that it is very common for graduate students to suffer from depression. For example, this article in Nature cites that

In a 2019 global survey of 6,320 PhD students, 36% of respondents reported seeking help for anxiety or depression caused by their studies

This is supported by my direct experience. When I was a graduate student at an R1 institution, almost every graduate student I knew was taking antidepressants.

In my experience as a professor, it is also very common for graduate students to share this with their advisors. I know, since I am known to be a good point of first contact for undergraduate and graduate students suffering from depression and other mental health issues, so I get to hear from a lot of students about their struggles. I am not a therapist, so the only "real" thing I can do is to refer them to the counseling center, but they come to me because they can expect a supporting ear and not judgement. So I can tell you that it is very, very common for students to both suffer from depression, and to talk to professors and advisors about it.

We still have a long way to go, but the days when admitting to depression made you look weak, or destined to a mental ward, those days are gone. Having said that, beware that if your advisor is an ass, they will be an ass about this too, so if your question is "should I speak with my advisor about my depression", the answer is "it depends on who your advisor is." But in general, you can expect that the majority of advisors will be sympathetic and supportive, because yours will surely not be the first case they hear about, and all of us went through grad school and know how stressful it is.

• 2 "It is very common for graduate students to suffer from depression" Citation needed. I'd guess you understand the difference between "feeling depressed" and clinical depression, but not everyone does, including many professors. –  Buffy Commented Aug 10, 2023 at 14:01
• 1 Sorry but this doesn't answer the question. –  user438383 Commented Aug 10, 2023 at 14:25

I have been very open with my mental health struggle with my supervisor ever since the start of my PhD. The situation I was in at the start was not something that was letting me work properly as I should have, and I felt like I needed to explain it.

I have ADHD and have been very productive during my undergrad and master (in CS), often hyperfocusing on coding, and the drop in my work output made me feel even worse and I felt the need to justify myself. I brought it up slowly, first explaining that I had trouble working sometimes. I mentioned related issue with it, such as my parent gambling addiction, and the toll it was taking on me as I was the only one supporting them. The fact that it was during Covid and lockdown didn't help, and I explained that staying at home all day was not helping.

Basically, I tried to not suddenly drop my entire life problem in the conversation, but over some meetings I explained some of the issue, and what were the consequences, at the time, on my work for example. It helped especially when I had very bad day and had to take a day off, not having to create a fake justification was very helpful. I tried to keep it related to the PhD, and not go too much into my personal life.

I never brought deeper issues, such as suicidal thoughts/attempts as: 1) I was not comfortable bringing it with anyone I was not very close. 2) I didn't think it would have helped the situation with my supervisor. 3) I feared it might actually change (in a bad way) our interactions.

I think I am lucky that my supervisor was very understanding during the whole time and offered me support if I needed ait. Like everywhere, with everyone, it mostly comes down to the person you are talking to. I slightly hinted at some issue I had, and the reaction my supervisor had made me trust I could explain in more details what the issues were. On the other side, I tried the same thing with my co-supervisor, and it became quickly apparent that for him, mental health issues were just something you had to motivate yourself to get over with.

Your university probably have a service here to support you in this type of situation/help with mental health, and they will be very understanding of any issue you have and should be there to listen to you. They may help you with how to discuss it with your advisor as well. In my case, I also contacted the administrative services of the research institute to document my issues, which helped me apply for extensions for medical reasons.

It's nice to know that academia has a few supervisors like Cheery.

Yet I feel that the majority - despite wanting to be positive toward the sufferer of depression - are not really equipped by nature, background, training or resources to be of much help with this.

I am sorry to tell you that in my own experience the personal/family/relational problems of graduate students are often issues that should never be discussed in any terms with professors in general, nor with fellow PhD students in general for the same reasons and also due to their self-focus during their program.

Only with those rare atypical individuals in academia can one open up like this. Yet even these can do little other than send you to the doctor or psychologist - something the guy next door can tell you.

My advice is to go to a health professional downtown (not the campus ones) and if he/she thinks you need some time off then they will write a note in general health terms to your HoD.

It's amazing how much harm people do when they are trying to avoid being seen as unsympathetic although that is exactly how they feel. So don't risk it unless the signs are very very good indeed.

Buona fortuna.

You must log in to answer this question.

Not the answer you're looking for browse other questions tagged phd health ..

• Featured on Meta
• Introducing an accessibility dashboard and some upcoming changes to display...
• We've made changes to our Terms of Service & Privacy Policy - July 2024
• Announcing a change to the data-dump process

Hot Network Questions

• Why did all countries converge on the exact same rules for voting (no poll tax, full suffrage, no maximum age, etc)?
• Safe(r) / Easier Pointer Allocation Interface in C (ISO C11)
• How can I pass a constructed image path to \lettrine?
• Low current continuity checker
• Fantasy book in which a joker wonders what's at the top of a stone column
• When are these base spaces isomorphic?
• If a planet or star is composed of gas, the center of mass will have zero gravity but immense pressure? I'm trying to understand fusion in stars
• Is Heaven real?
• Criterion for a rational variety being the projective space
• ULN2803 relay and led together
• Challenges to complete apple ID account to download Apps when in an unsupported country
• Adjust circle radius by spline parameter
• Match and replace strings containing ampersand (&) with biblatex
• Is there mutable aliasing in this list of variable references?
• How does one find historic prices for goods?
• Can a train/elevator be feasible for scaling huge mountains (modern technology)?
• Can right shift by n-bits operation be implemented using hardware multiplier just like left shift?
• What is so special about JUICE's flyby with Earth and Moon?
• Tic-Tac-Toe Console Game in Java
• How to maintain consistency when retrieving partial vs. full data in an API Resource
• Why would sperm cells derived from women's stem cells always produce female children?
• What is the most fuel-efficient flight profile for a small plane?
• What is this bracket on the side of my shower called? I believe it may have held a soap dish
• How do I turn off spell checking?

Jump to navigation

Search form

• Academic Resources
• Administration & Governance
• Business, Finance & HR
• Clinical Operations
• College Safety Information
• Communication & Collaboration
• EAC Faculty Toolkit
• Faculty Affairs
• Policies & Procedures
• Research & Scholarship
• Space & Facilities
• Staff Advisory Council
• Teaching & Learning

Two Wildcat Nursing alums and one PhD student to be inducted as AAN Fellows

Dawn Goldstein, PhD, RN, PMHNP-BC , and Tanya R. Sorrell, PhD, PMHNP-BC, MS, RN, FAANP , both alumna of the University of Arizona College of Nursing’s PhD program, along with current PhD student Jerrol B. Wallace, DNP, MSN, CRNA, FAANA , will be inducted into the 2024 American Academy of Nursing class of Fellows of nurse-leaders during the academy’s annual Health Policy Conference in late October in Washington, D.C.

“We are thrilled to have two former and one current student be named to this impressive honor,” said Brian Ahn, PhD , dean of the University of Arizona College of Nursing. “The ability to impact not only the health-care field but patient care around the country is a driving force for our DNP students. It inspires our faculty, staff and their fellow students.”

“The American Academy of Nursing admits Fellows annually to celebrate work that is high impact, meaningfully improves health and fosters policy change at a national or international level,” said Sheila M. Gephart, PhD, RN, FAAN , a professor and interim chair of the Advanced Nursing Practice and Science Division. “Having two of our alumni and one of our current students selected in this year’s class of Fellows brings our college community great pride. Their military service, national and international leadership, policy and research impact are impressive.”

“In electing Jerrol Wallace to be a Fellow in the AAN, the Academy acknowledges his outstanding accomplishments as a clinical expert and leader in anesthesiology nursing practice and education,” said Pamela G. Reed, PhD, RN, FAAN , a professor in the College. “Equally relevant to this honor is his potential, as a PhD student, to contribute to generating knowledge for nursing practice and health care policy.” 

The new cohort of AAN Fellows comes from 37 states, the District of Columbia, Guam and 14 other countries.

“Their expansive body of knowledge will soon bolster the collective impact of over 3,000 Academy Fellows, who together leverage their expertise to advance the Academy’s vision of healthy lives for all people. The 2024 Class of Fellows, selected from a competitive pool of applicants, represents a cross-section of nursing’s most dynamic leaders who are making positive change in their systems and communities to champion health and wellness,” the announcement said.

Below are brief biographies and comments from each of the new AAN Fellows with ties to the College.

Dawn Goldstein 3.jpg

Dawn Goldstein, PhD, RN, PMHNP-BC (Class of 2016)

On being inducted as an AAN Fellow: I am deeply honored to be selected as a Fellow of the American Academy of Nursing, the most prestigious recognition in nursing. This induction is a significant milestone in my career and aligns perfectly with my research and policy goals. It is both a humbling and motivating experience, signaling that I am on the right path and inspiring me to continue making impactful contributions to improve health by impacting policy through nursing leadership, innovation and science.

On the experience at the College of Nursing: It was instrumental in shaping my career. The rigorous academic training and supportive mentorship from faculty such as Terry Badger , PhD, RN, PMHCNS-BC, FAPOS, FAAN, Pamela Reed and Kathleen Insel , PhD, RN , as well as opportunities for hands-on research, provided me with the foundation and confidence to pursue my professional goals. The knowledge and skills I gained there have been critical to my current successes and will continue to guide my future endeavors.

Career path in nursing and nurse education:  My career in nursing and nurse education has been driven by a passion for advancing mental health care and developing future nurse leaders. I joined the U.S. Army Reserves as an officer with the Army Nurse Corps, commissioned in 2009. I reached retirement age in 2022 with a final rank of major. I earned a postgraduate certificate with a concentration in Psychiatric Mental Health Nurse Practitioner (PMHNP) in 2014, followed by a PhD from the University of Arizona College of Nursing in 2016. Since completing my education at the University of Arizona, I have held various roles in academia, clinical practice and the military. These positions have allowed me to integrate clinical practice, education and research, further enhancing my contributions to the field of mental health nursing.

I currently serve as a program director of the PMHNP Program and as an assistant professor at the Michigan State University College of Nursing. In this capacity, I lead the Psychiatric Mental Health Nurse Practitioner Program, mentor and advise students, and engage in research that aims to improve mental health outcomes and nursing practices. To that end, I am pioneering research initiatives with AI, providing interprofessional education in addiction prevention and increasing psychiatric providers in underserved regions. I have funding from the National Institutes of Health and the state of Michigan totaling $3 million.

jerrol head shot.jpeg

Jerrol B. Wallace, DNP, MSN, CRNA, FAANA (current PhD student)

On being inducted as an AAN Fellow: It means a lot to me to be inducted as an AAN Fellow. This is considered the brass ring of nursing, and all the advocacy, mentorship and leadership I have dedicated to the field of nursing are recognized in this honor. But this is where the real work begins, as I now mentor those who also desire to become fellows and want to continue to contribute to the field of nursing.

On the experience at the College of Nursing: Working on my PhD has put me in a position to continue to mentor students at all levels of academia with colleges of nursing. As I finish my PhD, it will allow me to become a role model to people who look like me and who never thought it was possible to achieve a practice and a research doctorate that can open more doors within leadership in nursing.

Career path in nursing and nurse education:  I have been a nurse anesthetist for 17 years and an anesthesia educator for 10 years. Currently, I am the Commandant for the Graduate School of Nursing at the Uniformed Services University of the Health Sciences, where I am the senior military leader for the graduate school of nursing for all programs (FNP, WHNP, PMHNP, CRNA, CNS and PhD students). I am a full-time PhD student, working full-time and on active duty. I was hoping to have finished my PhD already; however, I had two back-to-back deployments, the last one being in Iraq for seven months, which delayed my progress. However, I am back on track to complete my doctorate in 2025.

Tanya Sorrell.jpg

Tanya R. Sorrell, PhD, PMHNP-BC, MS, FAANP (Class of 2013)  

On being inducted as an AAN Fellow: This is such a great honor and recognition of the work that I've been dedicated to since my youth. As a Black woman from Louisiana, I saw the myriad disparities that people of color experienced   growing up and have always wanted to work to remediate them. At 5 years old, my grandmother said that I would learn many languages, travel the world and help many people, and I've lived up to that calling. At Rush University, we've developed a team to address the disparities that continue to plague the well-being of underserved groups and work to improve outcomes for those who have suffered from systemic oppression, health care negligence, and a lack of resources and access to appropriately   address their health care needs. This acknowledgment   shows that my work is needed, valued, and successful in fostering change at the individual,   the provider and at systemic levels.  

On the experience at the College of Nursing: My experience   at the University of Arizona College of Nursing was a wonderful challenge that allowed me to develop from my clinical background as a psychiatric nurse practitioner to a clinical researcher in translational sciences and outcomes research. The support from faculty mentors, all now retired, like Cathy Michaels, PhD, in research methodology and Janice Crist, PhD, and Marylyn McEwen, PhD, in Latino cultural care services, nurtured my development from a novice to an expert role in cultural care needs for behavioral health for Latinos and BIPOC communities. All my interactions with faculty at the college, from navigating the difficulties of working full time while taking doctoral training full time to fostering an independent spirit and perseverance   despite obstacles when dealing with the challenges of a doctoral program, were instrumental in my becoming the clinical researcher that I am today.    

Career path in nursing and nurse education:   When I started my doctoral program in nursing, I wanted to study Latino mental health services and the cultural care needs of that group. While living in Arizona, I was stung by a bark scorpion,   the deadliest scorpion in the United States. I had some residual medical issues, and my Latino friends took me to a curandera , from whom I learned about Mexican traditional medicine, a method of bringing culture and spirituality to health care. This was so impactful on my healing and knowledge of this underused method in health care that I changed my minor to Complementary and Alternative Medicine. I continue to research and incorporate culturally based care techniques into western medical care for behavioral   health and substance   use treatment for Blacks and Latinos.  

While in my doctoral program, I started a private practice incorporating those integrative care practices and continue to provide psychiatric integrated care to my second home, Yuma, Arizona. After completing my PhD, I was an assistant professor at the University of Colorado, Anschutz, studying Latino behavioral health in Colorado, and I became interested in how cultural care could be incorporated into substance use treatment. With a $3 million per year Colorado legislative funding initiative, we expanded substance use care in 25 rural Colorado counties with over 45 treatment facilities. That work led to my position as an associate professor in the Department of Psychiatry and Behavioral Sciences at Rush University, where we do   clinical research in cultural   substance use disorder care for Blacks and Latinos with race-concordant or bilingual providers. I am also the director of Rush's Substance Use Disorder Center of Excellence, training Illinois prescribers in Culturally based care needs and providing tailored outreach to BIPOC communities. I am the first nurse appointed to the board of directors of the Cook County Health System, the fifth-largest public health care system   in the U.S.

REVIEW article

A bibliometric analysis of anxiety and depression among primary school students.

• 1 Teaching Center of Fundamental Courses, Ocean University of China, Qingdao, Shandong, China
• 2 Institute of Sports Science, Nantong University, Nantong, Jiangsu, China

Background: Rising anxiety and depression in primary school students adversely affect their development and academics, burdening families and schools. This trend necessitates urgent, focused research within this young demographic. This alarming trend calls for a systematic bibliometric analysis to develop effective preventative and remedial strategies

Objectives: This study aims to identify and analyze the prevailing research hotspots and emerging trends concerning anxiety and depression in primary school students, thereby furnishing a foundational reference for future academic endeavors in this area.

Methods: This study uses the Web of Science (WOS) Core Collection database as the data source, focusing on literature published between 2013 and 2023 concerning anxiety and depression in primary school students. An initial search identified 1852 articles, which were then manually screened to exclude duplicates, conferences, announcements, and unrelated literature, resulting in 1791 relevant articles. The analysis, executed on December 31, 2023, employed CiteSpace and Vosviewer tools to assess various bibliometric indicators including authorship, country, institutional affiliations, publication trends, keyword frequency, and citation analysis.

Results: The analysis revealed a corpus of 1,791 English-language articles, with a discernible upward trend in publications over the decade. The USA and China were the leading countries in this field, with 482and 272 papers, respectively. The research predominantly addresses the etiological factors of anxiety and depression, various intervention strategies, and the comorbidities associated with these conditions in the target population. Key research focuses have been identified in areas such as suicidal thoughts, bullying in schools, the impact of COVID-19, mindfulness interventions, and anxiety related to mathematics. Future research is projected to increasingly focus on the effects of mathematics anxiety on the psychological and behavioral outcomes in students.

Conclusion: This study provides a critical visual and analytical overview of the key research areas and trends in the field of anxiety and depression among primary school students. It underscores the necessity of concentrating on the underlying causes and potential interventions. Such focused research is imperative for mitigating the mental health challenges faced by young students and enhancing their educational and developmental outcomes.

1 Introduction

Depression and anxiety are prominent contributors to illness and disability in adolescents ( 1 ). In recent years, the prevalence of anxiety and depression among primary school students has been on the rise due to various factors such as family stress, social pressure and academic burden, which has become a global concern demanding significant attention. Research indicates a concerning upward trend in depression rates, escalating from 18.4% in 2000 to 26.3% in 2016 ( 2 ). A 2023 meta-analysis in China revealed that during the COVID-19 pandemic, both depressive and anxiety symptoms were prevalent at rates of 31% ( 3 ). Depression is expected to become the highest-burden disease worldwide by 2030 ( 4 ). Given that primary school students are undergoing crucial stages of emotional development, addressing psychological issues during this period is paramount, as they can have profound and enduring effects on their lives. The research indicates that the emergence of depression during primary school can lead to a series of irreversible adverse consequences, including social disorders, substance abuse (particularly alcohol abuse, internet addiction, and smoking), as well as severe obesity ( 5 ). However, it is essential to recognize that students’ anxiety and depression issues are not static; they are dynamic processes influenced by various factors over time. For example, during the COVID-19 pandemic, the probability of anxiety and depression in primary school students increased significantly, primarily due to social isolation ( 6 ). Recently, the anxiety and depression of primary school students in China have been attributed to excessive academic burden and insufficient sleep ( 7 ). Additionally, there is heterogeneity among different groups. Studies have shown that anxiety and depression levels are generally higher among rural primary school students compared to their urban counterparts ( 8 ). These differences are closely related to various factors, including family economic status, the availability of educational resources, family support systems, and differences in social environments ( 9 , 10 ). Thus, investigating the problems and interventions related to anxiety and depression in primary school students is vital for promoting their mental health, supporting their healthy development, and contributing to the harmonious progress of society.

There is a need to investigate specific hypotheses regarding the underlying mechanisms of these psychological issues and the efficacy of targeted interventions. Possible hypotheses for this study include: (1) family stress, social pressure, and academic burden significantly contribute to the prevalence of anxiety and depression among primary school students; (2) early intervention and targeted therapeutic approaches can substantially reduce the prevalence and severity of anxiety and depression. Additionally, cultural factors must be considered in the study of anxiety and depression among primary school students. Cultural considerations encompass family expectations, societal norms, and the stigma surrounding mental health. In many Chinese families, a strong emphasis on academic success leads to significant pressure on primary school students ( 11 ). Societal norms often discourage open discussion of mental health issues, resulting in a lack of awareness and support, thereby exacerbating feelings of isolation and helplessness. The stigma surrounding mental health issues can prevent students from seeking help, creating a cultural barrier that must be addressed in any effective intervention strategy. By incorporating these cultural considerations, this study aims to provide a comprehensive understanding of the factors contributing to anxiety and depression among primary school students and to develop interventions that are both effective and culturally sensitive.

VOSviewer and CiteSpace are advanced bibliometric tools that help researchers visualize complex data from scientific publications. VOSviewer uses Visualization of Similarities mapping to identify and display relationships between different scientific entities like countries, organizations, and keywords ( 12 ). Similarly, CiteSpace applies network algorithms to analyze literature trends and co-citation patterns, offering visual maps that highlight key themes and development trajectories in a field ( 13 ). Currently, this field lacks metrological studies. This study utilizes CiteSpace (6.3.R1 advance) and the VOSviewer to conduct a visual analysis of primary school students’ depression and anxiety, aiming to provide a foundational reference for future theoretical and practical research.

2 Materials and methods

2.1 data source and search strategy.

The Web of Science was utilized as the primary data source for this study, with literature being specifically collected from the core collection of the Web of Science database, spanning the period from January 1, 2013, to December 31, 2023. We used the PubMed database and queried subject terms through MeSH terminology, confirming the search terms based on expert knowledge. The search strategy employed was: TS=(“elementary school students” OR “primary school students”) AND TS=(“anxiety” OR “anxious” OR “nervousness” OR “apprehension” OR “hypervigilance” OR “depression”). The initial search yielded 1862 documents. To ensure the quality and reliability of our literature review, we used the filtering functions of the Web of Science to exclude certain document types, retaining only articles and reviews. We manually excluded 61 documents that were duplicates, off-topic, or did not meet the predefined selection criteria through a review of authors, keywords, titles, and abstracts. Ultimately, 1791 articles were included in this study. For further analysis, the selected literature was saved in “full record and cited references” format as txt files for subsequent bibliometric analysis using CiteSpace and VOSviewer. The article screening process is illustrated in Figure 1 . The specific exclusion criteria were: (1) articles not related to anxiety and depression in elementary school students (ages 6-14); (2) document types other than articles and reviews.

Figure 1 Data retrieval flow chart.

2.2 Data extraction

A standardized search strategy was employed by two researchers to extract literature, with synonymous keywords being consolidated; for example, variations of “primary school students” were standardized to “primary school students”, and different forms of “depression” were unified to “depression”. Discrepancies in keywords were resolved through discussions among the researchers and, when necessary, with the consultation of a third party. Literature was screened in batches according to the inclusion criteria to identify eligible studies. Authors were included regardless of their rank, and their contributions were referenced for the number of publications in this study.

2.3 Visualization analysis method and bibliometric analysis

Software tools such as CiteSpace (version 6.3.R1 advance) and VOSviewer were utilized for the bibliometric analysis of literature concerning the mental health of primary school students. Knowledge graphs were generated by these tools, focusing on word frequency, clustering, and citation analysis across modules such as authors, countries, institutions, keywords, and references. Leading authors, countries, and institutions in the field over the past decade were identified by the analysis. Additionally, dominant themes and burgeoning frontiers in the research of primary school students’ mental health were explored, offering insights into prospective research trajectories.

3.1 Overall characteristics of publications

As illustrated in Figure 2 , the publication trend of articles has been segmented into two periods. In the initial phase (from 2013 to 2017), a slow fluctuation in the number of publications was observed, indicating modest scholarly interest in the mental health of primary school students. During this period, research was primarily focused on exploring basic concepts without extensive in-depth investigation. However, in the subsequent phase (from 2017 to 2023), a rapid increase in publications was noted, signifying that anxiety and depression among primary school students have emerged as significant research topics, with related studies entering a phase of rapid development.

Figure 2 Annual number of English articles published on anxiety and depression in primary school students from 2003 to 2023.

Moreover, a consistent rise in the overall volume of literature on anxiety and depression among primary school students from 2013 to 2023 was observed, particularly notable between 2017 and 2023. This trend suggests a likely continuation in the increase of relevant literature in this area, reflecting the growing academic focus in recent years on the study of anxiety and depression among primary school students and underscoring its increasing relevance.

3.2 Analysis of authors and co-cited authors

Putwain, David W. (n=7), and Ginsburg, Golda S. (n=7), are the two most prolific authors. There were two authors who were co-cited more than 150 times: COHEN J. (n = 167) and HU LT. (n = 151) ( Table 1 ). These authors can be considered leaders in the field of anxiety and depression research among primary school students. In the visual knowledge map of co-authors, depicted in Figure 3 , the size of author nodes is shown to be proportional to their publication output, and the connecting lines represent collaborations between authors. Significant collaborative networks among several researchers have been identified. For instance, collaborations between Tim Dalgleish, Mark T. Greenberg, and Darren Dunning, as well as active work between Catherine Crane, Jennifer Harper, Elizabeth Nuthall, and others, indicate robust cooperative relationships within this scholarly community.

Table 1 The author of the study on the anxiety and depression of primary school students with the most frequent publication.

Figure 3 The visualization of authors on research of anxiety and depression among primary school students.

3.3 Analysis of country

As illustrated in Figure 4 , the leading three countries in terms of publication volume have been identified as the USA (482 publications, 26.91%), China (272 publications, 15.19%), and Australia (141 publications, 7.87%). In terms of centrality, the USA (0.37), England (0.18), and Australia (0.09) are ranked as the top three, respectively. The graphical analysis has revealed a global distribution of research literature on anxiety and depression among primary school students, with dense interconnections between countries, indicating a robust international collaboration network and highlighting extensive cooperative relationships in this research area across numerous countries.

Figure 4 The global distribution of anxiety and depression among primary school students.

3.4 Analysis of institution

The top five cited institutions have been identified as the University of California System, University of London, University of Melbourne, Beijing Normal University, and State University System of Florida ( Table 2 ). These institutions are depicted as pivotal nodes within the global cooperation network, engaging in extensive collaborations both among themselves and with other global entities. They are actively involved in research on anxiety and depression among primary school students, yielding significant outcomes. Additionally, in the institution co-occurrence knowledge map ( Figure 5 ) illustrates that institutions both domestic and international have established broad cooperative relationships, highlighting the global recognition and attention garnered by this research.

Table 2 Top 10 countries and organizations on the research of anxiety and depression among primary school students.

Figure 5 The visualization of organizations of anxiety and depression among primary school students.

3.5 Analysis of references

A co-cited reference is one that appears jointly in multiple publications, thereby establishing it as a foundational element within a specific research domain ( 13 ). Among the top ten co-cited references, the most cited article was cited 139 times, the least 61 times, and the average number of citations was 83 times( Table 3 ). As shown in Figure 6 , “hu lt, 1999, struct equ modelling” demonstrated robust co–citation relationships with “hembree r, 1990, j res math educ”, “richardson fc, 1972, j couns psychol”, “ramirez g, 2016, j exp child psychol”.

Table 3 Top 10 co-cited references on the research of anxiety and depression among primary school students.

Figure 6 The visualization of co–cited references of anxiety and depression among primary school students.

The dynamic characteristics of a research topic are manifested by a significant increase in the frequency of citations in the literature. These highly cited documents, referred to as ‘burst literature’, represent the current hotspots in academic research within their respective fields. In CiteSpace software, the display option “Burstness” is configured and initiated by clicking “View” to identify significant citation bursts within the literature on anxiety and depression among primary school students. In the emergence map of cited literature, the red line segment represents the explosive citation time of the corresponding year ( Figure 7 ).

Figure 7 Top 25 references with strong citation bursts of anxiety and depression among primary school students.

3.6 Analysis of keywords

Keywords are the essence and focal points of an article, encapsulating its content and key themes. In a specific field, the prominence of a keyword, as indicated by its co-occurrence frequency and centrality, reflects its significance as a research hotspot.

By analyzing keywords, we can swiftly identify the evolving frontiers and hotspots in the research on anxiety and depression among primary school students. In this domain, notably, ‘mental health’ emerges as the most frequently mentioned term, alongside ‘depression’, ‘children’, ‘adolescents’, and ‘anxiety’, which collectively delineate the principal research directions in this field.

Using VOSViewer and CiteSpace for visual keyword cluster analysis, the results depicted in Figure 8 reveal three distinct clusters representing specific research directions. The keywords in the red cluster focus on interventions for anxiety and depression, the blue cluster addresses the mental and behavioral effects of these conditions, and the green cluster explores their formative factors. These clusters underscore the primary research themes: interventions, mental and behavioral impacts, and causative factors of anxiety and depression in primary school students. As a complement, Figure 9 illustrates the 11 hot keywords in the field of anxiety and depression in primary school children, which were #0 math anxiety, #1mindfulness-based intervention, #2 preventing depression, #3 early elementary school, #4 psychosocial well-being, #5 COVID-19 pandemic, #6 resilient children, #7 student-classroom, #8 medical student, #9 achievement goal orientation, #11 approach, #12 bullying behavior.

Figure 8 The visualization of frequency keywords on research anxiety and depression among primary school students.

Figure 9 Keywords cluster analysis co-occurrence map.

4 Discussion

4.1 general information.

In the first period (2013-2017), 443 articles were published, with an average of 86 per year. In the second period (2018-2023), 1478 articles were published, with an average of 246 per year, which is three times that of the first period. Indicated the research on anxiety and depression of primary school students has become increasingly popular, and anxiety and depression of primary school students has attracted increased attention. This phenomenon may be related to a major report (Global Accelerated Action for the Health of Adolescents: Guidance to support country implementation) published by the World Health Organization in 2023 ( 14 ). Additionally, the significant increase in publications during (2018-2023) may be attributed to the outbreak of the COVID-19 pandemic ( 15 , 16 ). The pandemic has had a profound impact on mental health globally, bringing issues such as anxiety and depression to the forefront of academic and public health discussions.

According to the analysis of authors, Putwain, David W from Liverpool John Moores University and Golda S. Ginsburg from the University of Connecticut, both ranked first with seven publications. Committed to the field of educational psychology, Putwain, David W has recently focused on studying the role of achievement emotions in primary school mathematics, the relationship between test anxiety and emotional disorders in primary school, and methods of protection against test anxiety, offering further guidance for school educators to prevent mental health issues ( 17 – 19 ). Unlike Putwain, David W, Ginsburg, Golda S has conducted research on the role of teachers in student anxiety ( 20 ). Furthermore, Ginsburg, Golda S has conducted research on preventing the onset of anxiety disorders in the offspring of anxious parents over the past decade ( 21 ). Following Putwain, David W and Ginsburg, Golda S, Irene C. Mammarella from the University of Padua was the third most active author with six publications. Recent studies have focused on the differences in visuospatial memory in children with mathematical learning disabilities and on visuospatial processing in students with non-verbal learning disabilities who do not have an intellectual disability ( 22 , 23 ).

The United States (482 publications) and China (272 publications) lead globally in the volume of research outputs, significantly outpacing other countries. Among the top 10 research institutions, half are based in the United States, indicating robust national research capabilities. There is notable international cooperation, especially between the United States and countries like China, Canada, the United Kingdom, and Australia. In addition, there are robust connections among developing countries. Particularly notable is the collaboration between India, Thailand, and South Africa, which indicates that Asian scholars place significant emphasis on mental health issues. Furthermore, research in this field reveals regional connections, characterized by close cooperation between neighboring countries. This is exemplified by the Asian collaboration network led by China and the European and American collaboration network led by the United States.

Prominent research institutions, including the University of Melbourne, University of Oxford, and Harvard University, have established substantial collaborative networks, engaging with over seven institutions each. Our analysis reveals that these collaborations predominantly involve partners from developed countries, with significantly fewer cooperative engagements with institutions in developing nations. Furthermore, the pattern of collaboration among these institutions tends to be relatively static. To dismantle research barriers and foster a more inclusive global research environment, we advocate for the strengthening of trans-regional cooperation among institutions worldwide. This approach is essential to ensure a broader and more diverse contribution to the critical field of anxiety and depression among primary school students.

4.2 Hot spots and trends

Research hotspots are defined as fields that capture significant academic attention during specific periods, particularly due to their relevance to contemporary issues ( 13 ). These areas not only mirror the literature that has engaged scholars but also contribute to a cohesive research network. The clustering of keywords effectively summarizes these hotspots, clearly delineating the prevailing topics within the field of anxiety and depression among primary school students. Each cluster identifies a distinct area of focus, enriching our comprehensive understanding of the domain. Through an analysis of high-frequency keywords and their clustering, we have identified dominant themes such as math anxiety, science anxiety, achievement, mindfulness, physical activity, bullying, intervention, COVID-19, suicidal ideation, and gender differences. These themes currently shape the research trends in anxiety and depression among primary school students, highlighting the field’s dynamic and evolving nature.

4.3 Intervention

Intervention is a frequent high-frequency word and a trend topic from 2013 to 2020. Among the interventions, mindfulness and physical activities are recognized for their efficacy as gentle treatment options. The emergence of depression and anxiety typically during childhood or adolescence underscores the importance of early intervention.

Research into intervention strategies reveals ongoing exploration with diverse approaches and variable efficacy. A 2013 evaluation indicated that the AOPTP program did not alleviate anxiety and depression in primary school students, though it significantly reduced ADHD prevalence ( 24 ). In contrast, a 2015 study demonstrated that school-based cognitive-behavioral therapy (CBT) interventions significantly ameliorated test anxiety, with the most effective strategies being a blend of skills-based and either behavioral or cognitive therapies ( 25 ). The educational setting has been identified as an advantageous venue for implementing mental health interventions. A 2017 study assessed the CALM-Child Anxiety Learning Module, a concise nurse-managed intervention based on cognitive-behavioral strategies, noting substantial reductions in anxiety, somatic symptoms, and attentional disturbances ( 26 ).In more recent developments, mindfulness-based interventions have gained traction. A 2021 meta-analysis affirmed the effectiveness of these interventions in reducing mild-to-moderate depressive symptoms among adolescents aged 10 to 19 years ( 27 ). Further empirical research supports that mindfulness training not only lowers anxiety but also enhances social orientation, positive emotional states, and attentional focus in children ( 28 ).

Furthermore, it is noteworthy that the application of artificial intelligence (AI) for the early identification and intervention of anxiety disorders and depression has gained widespread popularity ( 29 ). AI applications such as chatbots and virtual assistants conduct initial screenings and symptom assessments through personalized interactions, while wearable and mobile sensors collect objective data like sleep duration, activity levels, and heart rate to inform treatment plans ( 30 , 31 ). AI algorithms analyze this data to propose personalized treatment strategies, and remote monitoring and support systems aid in detecting depression and providing continuous support, thereby enhancing treatment adherence and engagement ( 32 ). Additionally, AI-driven digital therapeutic interventions offer cognitive behavioral therapy (CBT), mindfulness practices, and other evidence-based methods for self-managing depression and anxiety ( 33 , 34 ). Despite these advancements, challenges remain, including issues of accountability, the need for standardized ethical and legal frameworks, and concerns over data privacy ( 31 ). Addressing these challenges is crucial for the responsible and effective use of AI in mental health interventions.

4.4 Suicidal ideation

In light of the substantial body of research, it is evident that suicidal ideation (SI) among elementary school students is a critical concern, particularly as it serves as a precursor to suicide attempts and completions. Previous literature identifies SI as a key predictor for such outcomes, emphasizing the need for early and effective intervention ( 35 ). The multifaceted nature of risk factors for suicide includes substance abuse, early childhood trauma, stigma associated with seeking help, barriers to accessing care, and availability of means to commit suicide ( 36 ). A significant independent factor contributing to SI in children is a contentious home environment children from such backgrounds are at a 3.7 times higher risk of developing SI compared to their peers from harmonious homes. This risk increases dramatically to 27 times in depressed children living in discordant homes compared to non-depressed children in harmonious settings ( 37 ). Furthermore, gender-specific analyses reveal that girls typically exhibit higher rates of SI, particularly when exposed to high levels of perceived environmental stress, authoritarian parenting styles, and multiple stressful life events ( 38 ).

The correlation between depression and SI is notably strong, with anxiety and sleep disturbances contributing indirectly through their impact on depression ( 39 ). Additionally, the relationship between academic and social anxiety and SI underscores the importance of supportive educational and familial environments in mitigating these risks. Conversely, factors such as self-esteem, life satisfaction, and academic achievement serve as protective buffers against the development of SI ( 40 ).

Given these insights, it is recommended that schools implement robust support systems to prevent SI in students experiencing high stress or depression. Parents and teachers should vigilantly monitor for any signs of emotional distress and educate children on how to alleviate worries and grievances. Additionally, promoting core self-evaluations in students could serve as a preventive measure against SI, as higher self-esteem and self-worth are associated with lower risks of depression and suicidal thoughts.

4.5 COVID-19

COVID-19 is the hot key word for 2020-2023. COVID-19 triggered a pandemic just months after it was first reported in 2019, with more than 774 million confirmed cases globally by 4 February 2024 ( 41 ). During the COVID-19 pandemic, the prevalence of anxiety and depression among students has increased due to the lockdown policy and panic without specific drugs. According to the research, during the COVID-19 pandemic, 88.4% of students have experienced anxiety, 72.1% have been diagnosed with depression, and 35.7% have experienced moderate to severe stress ( 42 ). These issues were particularly acute among females, older students, and those from larger or low-income families, exacerbated by pandemic-related economic and educational disruptions ( 3 ). The correlation between increased anxiety and depression symptoms and pandemic stressors is clear, while social support has proven to mitigate these effects ( 43 ). The transition to online learning and reduced social interactions further compounded these challenges, affecting students’ mental well-being and their ability to adapt to traditional learning environments ( 44 ). Addressing these issues requires a collaborative approach involving educational institutions, healthcare providers, and policymakers to integrate comprehensive mental health strategies within educational settings. This includes enhancing online learning environments with mental health resources, improving access to psychological counseling, and building robust community support systems to help young learners navigate these unprecedented challenges effectively.

4.6 Bullying

bullying is a serious global issue within the educational sector, affecting not only the academic achievements and social capabilities of victims but also inflicting profound psychological impacts on children ( 45 ). Bullying behavior has been extensively studied and linked to a variety of psychological health issues. Of particular concern is the relationship between bullying and anxiety and depression among primary school students, which has garnered widespread attention in the field of mental health. In 2018, Bayer conducted a survey across numerous primary schools in Australia, revealing that a significant 29% of students frequently faced bullying, with physical bullying affecting 13.8% and verbal bullying 22.7% of students ( 46 ). Subsequent research by Shayo linked bullying to increased instances of suicide, identifying it as a significant predictor, especially among victims exhibiting suicidal ideation and a heightened likelihood of attempting suicide ( 47 ). Complementarily, Diana’s study established a positive correlation between exposure to school bullying and the development of depression, significantly highlighting that bullying escalates the risk of depression in primary school students ( 48 ). Further investigations have shown that bullying victims also suffer from higher levels of anxiety, Internet gaming disorder, and mobile phone addiction ( 49 ). These findings underscore the critical need for comprehensive anti-bullying strategies that involve families, schools, and societal interventions to effectively mitigate the adverse mental health impacts of bullying on children.

4.7 Future research trend

4.7.1 math anxiety.

Math anxiety, a complex state elicited by math-related stimuli, represents a considerable source of distress among elementary students, encompassing cognitive, emotional, behavioral, and physiological aspects ( 50 ). Notably, this anxiety is widespread among primary students, whose neural development is not yet fully mature, making them especially vulnerable to anxiety when grappling with abstract concepts. A study involving 1,327 children from grades 2 to 5 revealing that over 15% reported experiencing math anxiety ( 51 ). The research further indicates that math anxiety emerges from the early stages of schooling, with first-grade students exhibiting mild anxiety that escalates at the beginning of the academic year; while the majority of children experience low levels of math anxiety, a minority report higher levels, often linked to the fear of failure, task difficulty, time pressure, and concerns over poor grades ( 52 ).However, Nathan conducted a global survey across various countries and age groups, uncovering significant disparities in the relationship between math anxiety and mathematics performance, thereby highlighting the crucial role of educational and cultural backgrounds in comprehending the impact of math anxiety on academic achievement ( 53 ). Contextual and linguistic teaching methods have been found to evoke math anxiety less than traditional symbol-based instruction, suggesting that the teaching approach plays a role in the development of this anxiety ( 54 ). An eye-tracking study investigating the inner workings of math anxiety revealed that students with this condition frequently exhibit inadequate attention control when solving math problems ( 55 ). Gender differences in math anxiety have also been documented, with Perez’s research demonstrating that girls generally exhibit higher levels of math anxiety than boys, a gap that increases with age ( 56 ). These findings underscore the multifaceted nature of math anxiety and the necessity for tailored educational strategies to address it effectively.

4.8 Advantages and shortcomings

The bibliometric analysis conducted in this study demonstrates unique strengths. Firstly, there is currently a lack of research employing bibliometric methods to address anxiety and depression issues among elementary school students. This study examines the research landscape surrounding multimodal imaging tools using bibliometric methods. We utilized two different types of bibliometric software for bibliometric and visual analysis, synthesizing relevant publications on anxiety and depression among elementary school students over the past decade. The entire analytical process was conducted rigorously and objectively, resulting in credible findings. Additionally, this systematic analysis provides comprehensive guidance to scholars in this research domain, offering a more objective and comprehensive presentation of research hotspots and trends compared to traditional reviews, along with predictions for future research directions. It is important to note that this study solely relied on the Web of Science Core Collection as its source of literature, which may introduce certain limitations in terms of literature sources. Additionally, the use of bibliographic co-citation analysis inherently poses some challenges, particularly regarding the citation frequency of newly published papers. To address this shortcoming, this paper analyzes and summarizes the hot spots and emerging trends of anxiety and depression among primary school students by using keyword co-occurrence clustering. Future studies, while ensuring the quality of literature data, could expand the scope of data retrieval, innovate in related analytical methods, and strive for a more complete and accurate portrayal of research progress in this field.

5 Conclusion

The escalating number of articles published annually on elementary students’ anxiety underscores the intensifying global focus on this issue. Putwain, David W., is the most prolific author in this field, while COHEN J. is the most cited. The United States and China dominate the publication landscape in this field, yet their collaborations are predominantly with economically and technologically advanced countries. To elevate the caliber of global collaborative research, fostering enhanced cooperation among nations and institutions is crucial.

Present investigations into anxiety and depression among elementary students concentrate on intervention strategies, mental health, and the precipitating factors and intrinsic mechanisms of these conditions. Current research highlights include studies on suicidal ideation, bullying, the effects of COVID-19, and mindfulness interventions. Future research is poised to delve into the impact of mathematical anxiety on the psychological health and behavioral patterns of primary school students. Additionally, our findings indicate that family stress and academic burden are significant contributors to the prevalence of anxiety and depression among primary school students. There is notable heterogeneity across different groups and cultures. Specifically, in Asian populations, academic burden are identified as the primary factors leading to anxiety and depression in primary school students. This study not only furnishes a benchmark for current hot topics and emerging frontiers in the realm of elementary students’ anxiety and depression but also forecasts pivotal research trends, thereby providing valuable guidance for ongoing scholarly inquiry.

Author contributions

JF: Writing – original draft, Software, Investigation, Conceptualization. WY: Writing – review & editing, Supervision, Methodology, Data curation. SL: Writing – review & editing, Supervision, Data curation. WS: Writing – review & editing, Supervision, Methodology, Data curation.

The author(s) declare financial support was received for the research, authorship, and/or publication of this article.

This study was supported by the Qingdao Philosophy and Social Science Planning Project (grant number : QDSKL2201013).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

1. World health organization. Mental health of adolescents (2021). Available online at: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health .

Google Scholar

2. Li Z, Li J, Liang J, Qian S, Lia R, Wang Y, et al. Depressive symptoms among children and adolescents in China: a systematic review and meta-analysis. Med Sci Monit . (2019) 25:7459–70. doi: 10.12659/MSM.916774

PubMed Abstract | CrossRef Full Text | Google Scholar

3. Deng J, Zhou F, Hou W, Heybati K, Lohit S, Abbas U, et al. Prevalence of mental health symptoms in children and adolescents during the covid-19 pandemic: a meta-analysis. Ann N Y Acad Sci . (2023) 1520:53–73. doi: 10.1111/nyas.14947

4. Ferrari AJ, Santomauro DF, Herrera AMM, Shadid J, Ashbaugh C, Erskine HE, et al. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990 - 2019: a systematic analysis for the global burden of disease study 2019. Lancet Psychiatry . (2022) 9:137–50. doi: 10.1016/S2215-0366(21)00395-3

5. Hogg BM, Gardoki-Souto I, Valiente-Gomez A, Rosa AR, Fortea L, Radua J, et al. Psychological trauma as a transdiagnostic risk factor for mental disorder: an umbrella meta -analysis. Eur Psychiatry . (2023) 66:S982–83. doi: 10.1192/j.eurpsy.2023.2089

CrossRef Full Text | Google Scholar

6. Tang S, Xiang M, Cheung T, Xiang Y. Mental health and its correlates among children and adolescents during covid-19 school closure: the importance of parent-child discussion. J Affect Disord . (2021) 279:353–60. doi: 10.1016/j.jad.2020.10.016

7. Cao X. Sleep time and depression symptoms as predictors of cognitive development among adolescents: a cross-lagged study from China. Psychol Rep . (2023) 127:338642791. doi: 10.1177/00332941231175833

8. Wen F. Depression among schoolchildren and adolescents aged 9-17 years during the outbreak of covid-19 in Beijing: a cross-sectional online survey. Psychol Health Med . (2023) 28:148–60. doi: 10.1080/13548506.2022.2058029

9. Fan F, Su L, Gill MK, Birmaher B. Emotional and behavioral problems of Chinese left-behind children: a preliminary study. Soc Psychiatry Psychiatr Epidemiol . (2010) 45:655–64. doi: 10.1007/s00127-009-0107-4

10. Zhao X, Selman RL, Haste H. Academic stress in Chinese schools and a proposed preventive intervention program. Cogent Educ . (2015) 2:1000477. doi: 10.1080/2331186X.2014.1000477

11. Liu C, She X, Lan L, Wang H, Wang M, Abbey C, et al. Parenting stress and adolescent academic burnout: the chain mediating role of mental health symptoms and positive psychological traits. Curr Psychol . (2024) 43:7643–54. doi: 10.1007/s12144-023-04961-y

12. Kokol P, Kokol M, Zagoranski S. Machine learning on small size samples: a synthetic knowledge synthesis. Sci Prog . (2022) 105:312000273. doi: 10.1177/00368504211029777

13. Chen CM. Citespace II: detecting and visualizing emerging trends and transient patterns in scientific literature. J Am Soc Inf Sci Technol . (2006) 57:359–77. doi: 10.1002/asi.20317

14. World HO. Global accelerated action for the health of adolescents (aa-ha)!: Guidance to support country implementation . Genève: World Health Organization (2023).

15. Xue Y, Xu Q, Wang J, Lin H, Wang C, Lou X, et al. Prevalence and associated factors for elevated depressive symptoms in 386,924 primary students during the covid-19 pandemic normalization in China. Int J Environ Res Public Health . (2022) 19:3406. doi: 10.3390/ijerph19063406

16. World HO. Mental health and psychosocial considerations during the covid-19 outbreak. Geneva: World Health Organization (2020). Available at: https://iris.who.int/handle/10665/331490 .

17. Putwain DW, Wood P, Pekrun R. Achievement emotions and academic achievement: reciprocal relations and the moderating influence of academic buoyancy. J Educ Psychol . (2022) 114:108–26. doi: 10.1037/edu0000637

18. Putwain DW, Beaumont J, Gallard D. Adaptability vs. Buoyancy: which offers the greater protection against test anxiety and could relations be reciprocal? Learn Individ Differ . (2023) 101:102247. doi: 10.1016/j.lindif.2022.102247

19. Putwain DW, Jansen IDWJ, van Alphen T. Academic buoyancy: overcoming test anxiety and setbacks. J Intell . (2023) 11:42. doi: 10.3390/jintelligence11030042

20. Ginsburg GS, Pella JE, Chan G. A pilot rct of a teacher delivered school-home intervention to reduce student anxiety. School Ment Health . (2024) 16:314–30. doi: 10.1007/s12310-024-09638-w

21. Ginsburg GS, Tein JY, Riddle MA. Preventing the onset of anxiety disorders in offspring of anxious parents: a six-year follow-up. Child Psychiatry Hum Dev . (2021) 52:751–60. doi: 10.1007/s10578-020-01080-8

22. Mammarella IC, Cardillo R, Orefice C. Trajectory assessments of cognitive, visuospatial, and academic profile in nonverbal learning disability ( visuospatial developmental disorder ). Res Dev Disabil . (2023) 139:104540. doi: 10.1016/j.ridd.2023.104540

23. Mammarella IC, Cardillo R, Zoccante L. Differences in visuospatial processing in individuals with nonverbal learning disability or autism spectrum disorder without intellectual disability. Neuropsychology . (2019) 33:123–34. doi: 10.1037/neu0000492

24. Rooney RM, Morrison D, Hassan S, Kane R, Roberts C, Mancini V. Prevention of internalizing disorders in 9-10 year old children: efficacy of the aussie optimism positive thinking skills program at 30-month follow-up. Front Psychol . (2013) 4:988. doi: 10.3389/fpsyg.2013.00988

25. Yeo LS, Goh VG, Liem GAD. School-based intervention for test anxiety. Child Youth Care Forum . (2016) 45:1–17. doi: 10.1007/s10566-015-9314-1

26. Muggeo MA, Stewart CE, Drake KL, Ginsburg GS. A school nurse-delivered intervention for anxious children: an open trial. School Ment Health . (2017) 9:157–71. doi: 10.1007/s12310-017-9211-x

27. Reangsing C, Punsuwun S, Schneider JK. Effects of mindfulness interventions on depressive symptoms in adolescents: a meta-analysis. Int J Nurs Stud . (2021) 115:103848. doi: 10.1016/j.ijnurstu.2020.103848

28. Poli A, Maremmani AGI, Gemignani A, Miccoli M. Randomized trial on the effects of a mindfulness intervention on temperament, anxiety, and depression: a multi-arm psychometric study. Behav Sci (Basel) . (2022) 12:74. doi: 10.3390/bs12030074

29. Zafar F, Fakhare AL, Vivas RR, Wang J, Whei SJ, Mehmood S, et al. The role of artificial intelligence in identifying depression and anxiety: a comprehensive literature review. Cureus . (2024) 16:e56472. doi: 10.7759/cureus.56472

30. D'Alfonso S. Ai in mental health. Curr Opin Psychol . (2020) 36:112–17. doi: 10.1016/j.copsyc.2020.04.005

31. Cao XJ, Liu XQ. Artificial intelligence-assisted psychosis risk screening in adolescents: practices and challenges. World J Psychiatry . (2022) 12:1287–97. doi: 10.5498/wjp.v12.i10.1287

32. Abd-Alrazaq A, Alhuwail D, Schneider J, Toro CT, Ahmed A, Alzubaidi M, et al. The performance of artificial intelligence-driven technologies in diagnosing mental disorders: an umbrella review. NPJ Digit Med . (2022) 5:87. doi: 10.1038/s41746-022-00631-8

33. Adelman CB, Panza KE, Bartley CA, Bontempo A, Bloch MH. A meta-analysis of computerized cognitive-behavioral therapy for the treatment of dsm-5 anxiety disorders. J Clin Psychiatry . (2014) 75:e695–704. doi: 10.4088/JCP.13r08894

34. Mehta A, Niles AN, Vargas JH, Marafon T, Couto DD, Gross JJ. Acceptability and effectiveness of artificial intelligence therapy for anxiety and depression (youper): longitudinal observational study. J Med Internet Res . (2021) 23:e26771. doi: 10.2196/26771

35. Groholt B, Ekeberg O, Wichstrom L, Haldorsen T. Young suicide attempters: a comparison between a clinical and an epidemiological sample. J Am Acad Child Adolesc Psychiatry . (2000) 39:868–75. doi: 10.1097/00004583-200007000-00015

36. World HO. Suicide in the world: global health estimates. Geneva: World Health Organization (2019). Available at: https://iris.who.int/handle/10665/326948 .

37. Lin F, Lin J, Hsieh Y, Chang C. Quarrelsome family environment as an enhanced factor on child suicidal ideation. Res Dev Disabil . (2014) 35:3245–53. doi: 10.1016/j.ridd.2014.08.007

38. Huang H, Peng W, Lin Y, Lee C, Hu C, Huang S. Gender-specific factors associated with the suicidal ideation of children in Taiwan: a large-scale cross-sectional study. Int J Psychol . (2019) 54:53–60. doi: 10.1002/ijop.12438

39. Tang W, Xu D, Li B, Lu Y, Xu J. The relationship between the frequency of suicidal ideation and sleep disturbance factors among adolescent earthquake victims in China. Gen Hosp Psychiatry . (2018) 55:90–7. doi: 10.1016/j.genhosppsych.2018.09.013

40. Zhu X, Tian L, Huebner ES. Trajectories of suicidal ideation from middle childhood to early adolescence: risk and protective factors. J Youth Adolesc . (2019) 48:1818–34. doi: 10.1007/s10964-019-01087-y

41. World HO. Covid-19 epidemiological update. edition 164. Geneva: World Health Organization (2024). Available at: https://iris.who.int/handle/10665/376163 .

42. Radwan E, Radwan A, Radwan W, Pandey D. Prevalence of depression, anxiety and stress during the covid-19 pandemic: a cross-sectional study among palestinian students (10-18 years). BMC Psychol . (2021) 9:187. doi: 10.1186/s40359-021-00688-2

43. Balkundi S, Fredrick SS. Students ' perceptions of covid-19 stress and internalizing problems: is social support a buffer? Contemp School Psychol . (2024) 28:3–14. doi: 10.1007/s40688-023-00457-5

44. Selvakumar V, Venkata TP, Venkata TP, Singh S. Predicting primary and middle-school students ' preferences for online learning with machine learning. S Afr J Child Educ . (2023) 13:A1324. doi: 10.4102/sajce.v13i1.1324

45. Cosma A, Molcho M, Pickett W. A focus on adolescent peer violence and bullying in Europe, central Asia and Canada. Health behaviour in school-aged children international report from the 2021/2022 survey . Copenhagen: World Health Organization. Regional Office for Europe (2024).

46. Bayer JK, Mundy L, Stokes I, Hearps S, Allen N, Patton G. Bullying, mental health and friendship in Australian primary school children. Child Adolesc Ment Health . (2018) 23:334–40. doi: 10.1111/camh.12261

47. Shayo FK. Does bullying predict suicidal behaviors among in-school adolescents? A cross-sectional finding from Tanzania as an example of a low-income country. BMC Psychiatry . (2019) 19:400. doi: 10.1186/s12888-019-2402-2

48. Doumas DM, Midgett A, Peck M. The association between internalizing symptoms and witnessing school bullying and defending behavior: an analysis of gender differences among elementary and middle school students. Children (Basel) . (2023) 10:1199. doi: 10.3390/children10071199

49. Gao T, Mei S, Zhou X, Cao H, Liang L, Zhou C, et al. Latent classes of bullying perpetration and victimization among adolescents: associations with problem behaviors. Child Youth Serv Rev . (2023) 150:107013. doi: 10.1016/j.childyouth.2023.107013

50. Orbach L, Fritz A. A latent profile analysis of math anxiety and core beliefs toward mathematics among children. Ann N Y Acad Sci . (2022) 1509:130–44. doi: 10.1111/nyas.14720

51. Sorvo R, Koponen T, Viholainen H, Aro T, Raikkonen E, Peura P, et al. Math anxiety and its relationship with basic arithmetic skills among primary school children. Br J Educ Psychol . (2017) 87:309–27. doi: 10.1111/bjep.12151

52. Szczygiel M, Pieronkiewicz B. Exploring the nature of math anxiety in young children: intensity, prevalence, reasons. Math Think Learn . (2022) 24:248–66. doi: 10.1080/10986065.2021.1882363

53. Lau NTT, Hawes Z, Tremblay P, Ansari D. Disentangling the individual and contextual effects of math anxiety: a global perspective. Proc Natl Acad Sci U.S.A . (2022) 119:e21158551197. doi: 10.1073/pnas.2115855119

54. Li T, Chen C, Zhou X. How are different math knowledge presentations associated with math anxiety? Ann N Y Acad Sci . (2023) 1520:153–60. doi: 10.1111/nyas.14951

55. Li T, Quintero M, Galvan M, Shanafelt S, Hasty LM, Spangler DP, et al. The mediating role of attention in the association between math anxiety and math performance: an eye-tracking study. J Educ Psychol . (2023) 115:229–40. doi: 10.1037/edu0000759

56. Perez Mejias P, McAllister DE, Diaz KG, Ravest J. A longitudinal study of the gender gap in mathematics achievement: evidence from Chile. Educ Stud Math . (2021) 107:583–605. doi: 10.1007/s10649-021-10052-1

Keywords: anxiety, depression, primary school students, bibliometrics, CiteSpace, VOSviewer

Citation: Fu JN, Yu WB, Li SQ and Sun WZ (2024) A bibliometric analysis of anxiety and depression among primary school students. Front. Psychiatry 15:1431215. doi: 10.3389/fpsyt.2024.1431215

Received: 11 May 2024; Accepted: 17 July 2024; Published: 02 August 2024.

Reviewed by:

Copyright © 2024 Fu, Yu, Li and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Wen Ze Sun, [email protected]

†These authors share first authorship

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• CAREER NEWS
• 14 December 2021

Depression and anxiety ‘the norm’ for UK PhD students

• Chris Woolston 0

Chris Woolston is a freelance writer in Billings, Montana.

You can also search for this author in PubMed   Google Scholar

PhD students in the United Kingdom are more likely than other educated members of the general public to report symptoms of depression or anxiety, according to a survey.

Access options

Access Nature and 54 other Nature Portfolio journals

Get Nature+, our best-value online-access subscription

24,99 € / 30 days

cancel any time

Subscribe to this journal

Receive 51 print issues and online access

185,98 € per year

only 3,65 € per issue

Rent or buy this article

Prices vary by article type

Prices may be subject to local taxes which are calculated during checkout

doi: https://doi.org/10.1038/d41586-021-03761-3

Hazell, C. M. et al. Humanit. Soc. Sci. Commun. 8 , 305 (2021).

Article   Google Scholar  

Levecque, K., Anseel, F., de Beuckelaer, A., van der Heyden, J. & Gisle, L. Res. Pol. 46 , 868–879 (2017).

Article   PubMed   Google Scholar  

Satinsky, E. N. et al. Sci. Rep. 11 , 14370 (2021).

Download references

Related Articles

Scientists are falling victim to deepfake AI video scams — here’s how to fight back

Career Feature 07 AUG 24

China’s robotaxis need regulation

Correspondence 06 AUG 24

How South Africa can move on from power cuts

World View 06 AUG 24

Why I’ve removed journal titles from the papers on my CV

Career Column 09 AUG 24

Hybrid conferences should be the norm — optimize them so everyone benefits

Editorial 06 AUG 24

Slow productivity worked for Marie Curie — here’s why you should adopt it, too

Career Feature 05 AUG 24

Why we quit: how ‘toxic management’ and pandemic pressures fuelled disillusionment in higher education

Career News 08 AUG 24

The Recruitment of Fuyao University of Science and Technology

This recruitment of Fuyao University Technologyof Science andUcovers 7 departments including the 6 Schools and the Faculty of Fundamental Disciplines.

Fuzhou, Fujian (CN)

Fuzhou FuYao Institute for Advanced Study

Educational Consultant

You will build and maintain strong relationships with local representatives, key distributors, schools, Ministries of Education, etc.

Riyadh - hybrid working model

Springer Nature Ltd

Senior Marketing Manager – Journal Awareness

Job Title: Senior Marketing Manager – Journal Awareness Location(s): London, UK - Hybrid Working Model Closing date: 25th August 2024             A...

London (Central), London (Greater) (GB)

Faculty Positions& Postdoctoral Research Fellow, School of Optical and Electronic Information, HUST

Job Opportunities: Leading talents, young talents, overseas outstanding young scholars, postdoctoral researchers.

Wuhan, Hubei, China

School of Optical and Electronic Information, Huazhong University of Science and Technology

Laboratory Head in Cellular Therapies

Bring your passion for cancer research to an Institute committed to delivering better health and wellbeing through impactful medical research

Herston, Brisbane (AU)

QIMR Berghofer

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies