At the Jena University School for Microbial Communication in Germany, Hendrik Huthoff is responsible for the post-graduate life science and soft skills training. He leads several initiatives to improve mental health and wellbeing support in academia and coordinates the Mental Health First Aid programme.

In our first conversation with him, Hendrik and Jo talk here about how people who obviously struggle with mental health challenges can be approached to make it easy for them to accept the support and develop strategies to recovery.

Hendrik returns to this podcast to share with Jo what people with mental health conditions can do to get out of their situation.

To see all episodes, please go to our CONVERSATIONS page.

Which researcher – dead or alive – do you find inspiring? – Johann Wolfgang Doebereiner

What is your favorite animal and why? – Monkeys and donkeys. Monkeys because I am one (we all are). Donkeys because they are very intelligent and they don’t do well when solitary. They also are fiercely protective and a wolf would not have a chance in a fight with a donkey. Indeed they are commonly used to protect herds of sheep from canine predators. They have a calming effect on horses. Donkeys are awesome!

Name your (current) favorite song and interpret/group/musician/artist. – Elvis, Prince, Miles Davis, The Beatles, Tom Waits. Favourite songs (two of): O my stars by Michael Hurley and You doo right by Can

What is your favorite dish/meal? – Seafood

“[…] why not take 5 minutes to rock your mental health??!! Here’s a song I wrote with my buddy Maik Goth to support the work of Irrsinnig Menschlich e.V. in combating the stigma of mental health conditions. You can rock your mental health!”

Hendrik Huthoff

References

• Mental Health First Aid International: mhfainternational.org/

• Mental Health First Aid at Jena University: uni-jena.de/en/mhfa

TRANSCRIPT

Part 1: What it means to be a Mental Health First Aider

• Go to Part 2: “Yes, I had a mental health condition. Get over it, I did!”

Jo: Welcome to another episode of Access to Perspectives Conversations. Today we talk with or we have the great pleasure of having Hendrik with us. Hendrik Huthoff, who is the head of Education at Jena School for Microbial Communications in Germany and also a mental health advocate and public speaker, I guess mostly on that topic, but also versatile, interested in many different topics, some of which we hope we can also hear from you today. Welcome Hendrik. 

Hendrik: Hi, thank you for having me. 

Jo: It’s a great pleasure. And it’s also within the context of the Remo organization, the researcher mental health organization that I saw a talk by you where you talked about the mental health first aid program that you are also heading at Jena University, I suppose. So could you also talk about a little bit why you got engaged in that topic and also what the program is all about? 

Hendrik: Yeah, sure. So maybe a little bit of a long story, but I came to the University of Jena in 2017 to head or manage the graduate school in Microbiology, the Jena School for Microbial Communication that you already mentioned. And I had previously worked for 14 years at King’s College London, where I had started as a postdoc in virology and worked my way up to group leader and also lecturer. We don’t need to get into the details about that just now, but I was ready for a change in career and I thought science management really appealed to me. And then I got this excellent opportunity at the Schiller University in Jena and I suppose I got the job because I am of German heritage, but I had always lived abroad and I came to the University of Jena at a time when they were just preparing a massive application to the German Research Foundation to set up one of the excellence clusters that was eventually successful. And I was part of the team to draft and write this proposal. And it really was a spirit of innovation and ideas. And we did put together, I think, a really creative and innovative research program where we tried to study microbiomes really across the board. So we want to learn or see what we can learn from microbiomes that are present in humans but also on trees and in water and see if we can understand the similarities.

Jo: Sorry for interrupting. But can you just tell us what microbiomes are? For those of us who don’t know what it is.

Hendrik: So microbiomes are basically what we call the community or collection of microbes that live on or in a certain specified space. So for instance, your skin has a microbiome that’s a collection of microbes that live on your skin that protect us also from invaders and infections. And your gut has a microbiome, a collection of microbes that digest our food for us. We really wanted to elevate this kind of research away from looking at what is there because traditionally this kind of research was quite encyclopedic I guess by just looking at what is there and cataloging it. But we really wanted to move it towards a more functional understanding. And from that also sprang the idea. And I will never forget this in one of the brainstorming meetings when one of the professors said, well, the gut is just another aqueous environment. And this was a professor who studied marine microbiology, so the microbes that live in the ocean and I know I can talk about microbes forever, so I want to bring this a little bit to a close. But I wanted to say that it was a spirit of innovation and alongside the scientific part of the proposal, we also needed to present infrastructural innovations that we would bring to the university. And in my previous position at King’s College London, I had been a departmental well being officer for PhDs. I had also been a mentor for undergraduate studies and it was also 2017, around the time that Kate Warmald Watershed paper came out showing that pursuing a PhD is associated with a two fold risk in mental health or in having a mental illness or a problem with your mental health. I personally knew this to be true because I had a mental health condition myself when I did a PhD and had an anxiety disorder. We can talk in a bit more detail about that. So in drafting this proposal, I was very keen on trying to include what I thought were  really forward thinking ideas about how we can deal better with well being and mental health at universities, where I also felt that there wasn’t a whole lot available at the Friedrich Schiller University at the time. In the end, a lot of my ideas didn’t make it into the final proposal because as it goes with science, this is also always limited to certain page numbers. And then science, of course, gets precedent over what is seen to be marginal topics of interest. But nonetheless, that didn’t stop me and it kind of also prepared, I suppose, the leadership that these topics are important. And so regardless of whether we directly got funding for it, I started initially to just organize a couple of events informing about mental health because there had been signals from the PhD and postdoc community that there certainly was an interest and a need for it. Actually, in my first couple of weeks of taking the job, I had received an email from a postdoc who was struggling and I’ll never know why, but I somehow succeeded at getting Kate Warmald to speak at our university at that time. And this was really right off the back of her paper and she must have gotten invitations to speak everywhere in the world. And I don’t know why she answered positively to ours, but she made it all the way to Jena, and Jena is not the easiest place to travel to that we had a really full auditorium and it has to be said, though, that the resonance for the topic was primarily with postdocs and PhDs. I had invited the entire university leadership and nobody of them showed up, with the exception of the leadership of our graduates. 

Jo: Do you have a guess why that is? Is it because it’s the stigma around the topic? 

Hendrik: No, I have a little bit of theory about that. So the stark contrast that I experienced in moving from the UK to Germany in the willingness and openness to talk about these subjects. Where in the UK there are multiple charities dealing with mental health and there are very prominent people speaking about mental health and not in the least Prince William and Prince Harry. Who are very open about all what happened to them in the wake of the passing of their mother. Living a public life and so forth. So mental health is a far easier subject to talk about in the UK than it is in Germany. I also believe with some reference to that from personal experience, my parents were both German, but they moved to the Netherlands before I could even remember. But I did have German grandparents who lived in Germany and that generation had obviously gone through a traumatic historic event that was treated by not speaking about it. That was the way of dealing with Germany’s tragic past. You did not speak about that. At least that was my experience. 

Jo: I’ve been wondering about that also. Now, I’m also currently working with Ukrainian researchers, a small group who obviously go through all kinds of immediate challenges, most of which also ease into mental well being. So it’s heavy on them, but in the post war era there was nowhere to go, right? Other than like, oh, you’re also struggling, but what else could you do about it? And think that to move on one way or the other, otherwise you just sit and bury your head in the sand and then what? And maybe that’s also a copy mechanism to have to continue. If you want to live, you have to keep moving in the extreme scenarios.

Hendrik: I’m not here to explain history, but it is of course also true that we know in retrospect, the Nazis didn’t go away. A lot of them were still in public office, a lot of them had a very dubious past and didn’t want people prodding around in it. Only very few of them actually were presented with any legal or punitive consequences to their behavior and involvement. And then, of course, now I live in the east of Germany. There was a whole other cultural traumatic experience that happened there as well. And I also was not quite prepared by moving here, how the east of Germany is still substantially different from the east of Germany 30 years later, after the reunification. And again, I feel there’s a lot of trauma that isn’t talked about. I’ve come to view that, but that’s my personal view as a kind of a German way. We don’t talk about that, but here comes the big bar. The Pandemic has massively changed that. I noticed that with the Pandemic, suddenly the willingness to speak about mental health has taken a complete u turn. And of course, my involvement with this preceded the Pandemic. And thank God, because we established our mental health first aid team at this university kind of in the middle of the Pandemic, and there was really quite a lot of demand for that. But I also then noticed that that changed attitudes and people who had previously told me, this isn’t a problem, don’t go creating one. Suddenly also, we’re very supportive and said to me, like, you were absolutely right and I’m so glad you’ve carried on with this and perhaps this is a good moment to at least mention to our listeners what it is that we did. So here at the Friedrich Schiller University in Jena, we set up the first mental health first aid team at a German university. Mental health first aid is something that was developed by the Australian Public Health Services. It’s an evidence based intervention for people in acute crisis or stuck in a rut with their mental health, their well being. And it’s analogous to first aid for physical medical problems. So the equivalent of learning CPR. But for somebody who finds themselves in a mental health crisis, it’s not a form of therapy, it is not a way of diagnosing. As someone who is a mental health first aid is not a trained psychologist and doesn’t need to be. But what you learn is you get given the tools and the structured way of leading conversations with these cases, with these people in distress, to arrive at what can be the best possible solution for that person. And then in most cases, that means passing on or referring to specialists if there’s a need for therapy. But a lot of cases don’t need therapy or don’t have a need for therapy. And in particular during the Pandemic, we noticed a lot of people just needed someone to listen to them. And a lot of people, when you give them the opportunity to speak about what’s going on, what’s wrong, will find their own solutions when they are presented with somebody who will listen. So that’s what we did. And part of the reason why it took till the end of 2020 and the beginning of 2021 is there wasn’t an accredited provider of mental health first aid in Germany until that time. And so they were established at the end of 2020, and that is the Central Institute for Mental Health Research in Mannheim under the guidance of Professor Deutschler, and he set that up. And since then, mental health first aid has been steadily growing in Germany and the courses are almost always fully booked. 

Jo: Are the team already in touch with Australian founders? 

Hendrik: They have to be, yes, the accreditation to deliver the mental health first training in Germany is by applying to Mental Health International, which is a Mental Health first aid international which is seated in Australia. And so this is a lengthy process of getting that accreditation and that’s why it took some time to get that sorted in Germany. Now, there are lots of different countries in the world that haven’t got an accredited mental health provider. Mental health first aid providers yet, for instance, in the entire Spanish speaking world, there isn’t yet an accredited mental health first aid provider. So there’s an opportunity out there for somebody.

Jo: I guess. Yeah, I guess. On the mental health first aid website, right, they probably have an overview of the existing institutions. 

Hendrik: Yes. The easiest way to find that is to Google Mental Health First Aid International. That’s when you land on the Australian Homepage, the umbrella organization for this, and they are the ones that provide the accreditation and make sure that all the standards are adhered to. And that’s where you can apply to become a national provider. And so training within Germany can only be offered by the German accredited office. Likewise in the UK and in France, Netherlands, India, those are a couple of the countries that I know off the top of my head that do have mental health first. And that has really proven quite successful in two senses that we experience, that there is definitely a lot of demand for it. So people are taking up this opportunity to come speak to a mental health first aid and we make it absolutely clear on our website that everything is confidential. So we don’t share any information unless the person who contacts us expressly asks us to contact somebody else on their behalf, which has happened in the past as well. And so it is successful from that perspective. We get a lot of interest in it. It is also successful from the other angle. We find a lot of the employees of the universities are very, very keen to become first aider and to help in that capacity. So we have, since the beginning of this year, implemented the training in house. So we’ve got some of our university staff trained to be trainers. And we can now offer the mental health first aid courses in house to our university employees. And those courses are almost immediately, fully booked the moment we announce them. And if I’m not mistaken, we’ve now had two editions of 20 participants each. So we’ve educated about 40 mental health first aiders at our university. But not everybody wants to be publicly listed on our mental health first aid web page as such. For instance, there are some who see this more as a support to the work they are already doing, such as our umbitz, persons, for instance. I know that a couple of them have had this training also with the people who are generally in the student advisory or counseling services, where students come with all sorts of questions. And indeed when we first launched this mental health first aid team we didn’t have the in house training yet that started with a group of volunteers who all were in the managerial or counseling layer of the university and part of their responsibilities included being a contact person for students or PhDs to speak to. Almost without exception these people would say, including myself. PhDs come to us with all problems whether it be they don’t know how to register for a certain course at the university for their defense or getting their residency permit or finding a flat or having an issue with their supervisor or having generally a wellbeing issue. So those people with those problems would come to us anyway. And we were not fortified, we were not trained to deal with some of the issues that people would present us with. And prior to having been trained as a mental health first aider it would quite frequently happen to me that someone would come to me and open up about their problems and I would do the best I could. But afterwards you still have them this nagging feeling of did I do the right thing? Did I advise them properly? I hope they’re going to be alright and I hope I didn’t say anything wrong. And the good thing is that as a mental health first aider you are trained in how to deal with these situations. You follow a certain protocol and when that intervention is over you know you’ve done the right thing. So I have no more sleepless nights, I don’t lie around worrying about these people. And of course you can’t help everybody. But that also helps me distance myself from it, even if an intervention didn’t go well, I know that I’ve done the best I could. And in the end it is always down to the individual whether they want to accept help, whether they are willing to accept that they might have a problem. Some people might not accept that they have a problem. I can’t make them accept that they have a problem. And one of the worst things you can do is to say to somebody it looks to me like you’ve got a problem. You should speak to a psychiatrist or psychologist. 

Jo: But that’s the first thing that comes to mind that you want to say though before the training program. 

Hendrik: Exactly. And what you learn in the training is to listen and from there identify and just ask small questions that guide the discussion in a certain direction and thereby to ascertain how willing the person is to accept help and how far they are in the process of realizing that they have a problem or not. The funny thing as a mental health first aider and we also learn because there’s always a question: what is mental health and when does it become a mental illness or a problem with your mental health? And the definition that I’ve learned is the moment it impacts on the quality of life of that individual, it becomes a problem. But so long as the individual does not observe or experience it as a compromise of their quality of life and for them there isn’t a problem. And then there is no point in you telling them that there is a problem. You’re not going to achieve anything by it. And that’s not your role. Your role is to support somebody who wants to be supported. You wouldn’t give CPR to a random person on the street. You think their speech is a bit slurry.

Jo:  From your experience. First of all, I like to know now that the mental health office, I guess it’s well known across institutions, so people who think they might help can seek help and probably also do. How many inquiries do you get per month or per week? 

Hendrik: Currently, in the summer months it’s very quiet and in the winter months it gets really busy. So in the busiest time of year I get about two or three requests for meetings per week. And I’ve had weeks when it comes close to Christmas where I’ve had an intervention almost daily. 

Jo:Is this mostly for international students who struggle with the darkness? 

Hendrik: No. I mean, it is noticeable that there is an over representation of international students, but it is by no means limited. And quite a few of the German nationals have come to us as well. But I would say that was probably more during the time when there are still lockdowns. Right. And I guess in that context we all were faced with the same struggles, but we get both. And the interesting thing actually that I should mention is when we set up the mental health first aid team at the university, it came from a group of volunteers who were basically all connected with PhD programs at the university. And in fact, the original study by Kachalivec also specifically addressed the mental health of those pursuing a PhD. Now that we have our mental health just 18 operational, I noticed that the majority of cases that request help, our masters actually much more so than PhDs or postdocs. It’s the master students that want to help.

Jo:  Is there more there off at the university? 

Hendrik: I don’t know. I mean, of course, when you’re a master student, it’s in early adulthood. This might be a lot of people who for the first time are not living in their parents house anymore. So it’s a period of great transition of trying to find your own feet in this world. We know that mental illness or any sort of mental health conditions primarily arise during the ages of 18 and the late 20s. That is the age bracket where you’re at greatest risk for developing a mental health condition. And it really starts to kick off just about at the age of 18. And I can make sense of that, but it’s a personal point of view. It is the transitory phase where you are leaving childhood behind and trying to find your own identity and find your own place in this world. And yes, that comes with all sorts of struggles, pressures, anxieties, questions. And so it’s perhaps not a surprising thing, but I think the important thing to realize there is this age bracket is precisely the clientele that we have at universities. Those who study and work with us as PhDs or postdocs are between 18 and late twenties. And so from the age demographic they are the highest risk group for incidence of mental health conditions. And this is precisely what happened to me. Another very sad statistic is that it takes people on average eight years from the onset of their mental health condition to the point where they are ready to seek out help or therapy. And that is what happened to me as well. So my mental health condition, which was an anxiety disorder and that means fear, anxiety might sound like it’s not so serious a problem, but it meant extreme fear. I was at times unable to leave my room because I was afraid of just about anything. Retrospectively, it’s very clear to me that that developed when I first went to university. That’s when the onset was. But it’s gradual and it gets worse and it got to a crisis point when I came to the end of my PhD. And of course that is a very stressful situation when you hand in your thesis and you have to write your thesis and defend your thesis. Right around that time is when it really came crashing down around me and that’s when I decided to look for help. And that’s when I recognized this had been going on for a long time. This hasn’t come out of the blue. So I’m a very classical case. Anxiety started just around the age of 18. I’ll also not make a secret of it. I moved to university in Amsterdam and of course there were lots of illicit chemicals, how do you say, recreational use going on in that time as well. Which certainly didn’t contribute to my wellbeing,

Yes, that’s where I can retrospectively completely recognize that’s where it started going wrong. Jo: I’ve struggled with depressive episodes also. It’s not uncommon that you experience several. It’s not symptoms, but illnesses or what categorizes illnesses. 

Hendrik: They are symptoms. They are definitely symptoms. 

Jo: I think the effect on our bodies and our well being or not so well being is the same. Like I couldn’t leave the house. I felt like what am I doing here? I worked so much and so little outcome I developed over the years. I was seeking help with several specialists and therapists that I think it’s pretty normal to have a precondition. One of my doctors said it’s just another organ, the brain. And of course it can dysfunction and of course it can get to its limits. So I’m coming towards the question: what do you think is specific?

It’s also gradual progress, as you said, to talk about mental issues or mental health issues, mental disorders, mental illnesses. When is it an illness that needs extra treatment with medication?

Hendrik: The easy answer to that is I can’t answer that last question because that requires a specialist.

Jo: I was trying to say when we talk about mental well being and mental health in this context now so with the first aid process that you’re practicing with your team okay, so rewinding a little bit. So what are the symptoms that people come with when they realize I need to talk about what I’m experiencing and I can’t quite figure out if it’s anxiety or depression or whatever it might be. But I know I have an issue.

Hendrik: That is so diverse for each individual and something might be unacceptable to someone and they might be willing to step up to the plate and not leave it for eight years like I did. But I think you raised a really interesting point there. Namely when I speak about mental health and I’m very open about my previous issues with that. What I find interesting is that almost everybody will say well yes, I’ve also experienced episodes of depression and I think that probably almost everybody does. I think it is kind of ridiculous to expect us to be mentally healthy all the time. And what you said is absolutely right. Our brain, our mind is another organ which will sometimes not be in great health just like some of the other organs. We all certainly in this day and age take it for granted that we will have an illness of one form or another at some point and then we will just have to lie in bed for a week or so and then we feel better. Now, that’s not necessarily the way you fix a mental health problem or a well being condition. I believe that those are usually sorted by speaking about them. But the bottom line is that we can’t expect ourselves to always be mentally fit and always mentally healthy. And that’s another reason why I think it is so important that we reduce the stigma about it and that we stop. And that’s I think particularly prevalent in Germany or used to be this really negative language associated with mental health where it’s often easily spoken as a world where you belong in an institution or you’re crazy and that kind of stuff. We don’t do that when somebody has an illness and broken a leg, we don’t say, well, he’s a cripple for the rest of his life and I’m sorry and I really don’t want to offend anybody who has a chronic condition with their legs or anything like that. But we tend to be much more careful in our language when it comes to physical health and wishing people the best in their recovery and a quick recovery. And when it comes to mental health, there is very quickly, quite negative language associated with it which prevents people from seeking the help that is out there. And that doesn’t need to mean institutionalization for sure. It doesn’t need to mean a chemical or pharmaceutical intervention. It can sometimes mean speaking to a first aider for just 1 hour. I have had several cases of people who came to me at their wits end and we spoke for an hour and they said fabulous. I won’t go as far as to say the problem was solved, but maybe a week or so later I might have gotten an email and they said this has helped me so much.

Jo:  It’s good probably also to know that you’re not the only one. Like there was an eye opener for me, like well, I’m not the only one experiencing these feelings of insecurity and loneliness and whatever comes together to make you feel awful. It’s actually normal. And especially under the pressure that we live with academics, it must be anticipated to some extent because we are expected to work more than 100%. I myself didn’t even think about taking holidays, even though in my working contract I was entitled to take holidays. But then you constantly think oh, I don’t have enough results or personal needs to accomplish that before I can even start thinking about and then asking my boss and my boss was probably very practical on that, but I don’t allow myself a holiday or weekend off or anything like that. So the work, the pressure that we put on ourselves and scholars with the expectations and dismantling there are much of the last lead until mental health is faced.

Hendrik: I believe so. And also the perception that the academic career trajectory is somehow the softer one compared with business. I don’t think it’s true. Yes, I know a lot of people in the business sector who work very hard, but it is also very clear that when they’re on holiday, they’re on holiday. Don’t call me on my holiday. And I’ve started to adopt that as well. And yeah, when I was still in research, if I went on holiday, well, a sizable portion of my suitcase was allocated for the papers I printed out to be reading on holiday and all the paper to be working on while I was on holiday. And so really taking a break is something that’s quite rare for academics, I think. And I think there is a lot to be gained in how we approach working culture in academia to normalize just taking a holiday and saying I’m really not available. I’m really not available to do any peer review, I’m really not available to write another paper or to read papers. I’m on holiday.

Jo: I also mentioned that in any of my training, scientific writing or research data management. To remind people when we talk about time management, make sure you take holidays. And then some people say but I have lab animals to take care of. But then managing that there’s other people who will be at the institute around that time. You can dedicate towards it. It’s just a management question and speaking up that you need assistance. You cannot be there 24/7.

So there are solutions that are readily available, but oftentimes there’s a feeling that I need to fix it myself. I should notice myself, I’m now pitched soon, I must know this, but I don’t. The vicious cycle starts.

Is there anything in particular that you see specific to academics that is being mentioned as a cause or a trigger? The workload, the publication pressure?

Hendrik: Those are two key points. I think another one that is causing a lot of people anxiety is job insecurity. We are always dealing with short term contracts. Open-ended or permanent contracts are a rare thing and by the time you’ve achieved it, you’ve kind of had to elbow your way up a significant part of the ladder. Anyway, before we start talking about any sort of permanent contracts, I believe that academia is suffering because I do believe we need much more positions where a permanent position really doesn’t happen unless it’s a professorship. Right? And I think we also need more perspectives in academia for people who say, I don’t want to be at the top of the pyramid, but I would like to remain a researcher and do research without having to worry about every three years to get another grant in. I just want to work in the laboratory. The irony is that laboratory I say that because that’s where I come from. I want to do research in libraries and look at all texts or whatever do field work, if that’s what you love. The irony is if you pursue that, the lifespan of that phase of your career is very, very limited indeed because in order to stay in that industry, you need to progress beyond it, where you become a professor. And a professor is essentially a manager without any management training and you don’t get to do what you love doing, which is working in the laboratory or in the field. And I think that leads to a lot of the problems we are faced with in academia. One of the solutions I can see is to create more positions for people to do the actual lab work, field work, literature, research that they love, without having to progress to a leadership role for which, by and large, most people who arrive at that point have had no training whatsoever. And so you get brilliant chemists who are suddenly, without any prior preparation, having to deal with managing a group of 34 people and they don’t know how to do that. Some people do that. I’ve seen brilliant scientists who are natural leaders. Yes, they are out there, but that does not excuse us from targeting this problem structurally and not assuming that because you are a brilliant scientist, you automatically are also a natural leader because most of us need to learn It. 

Jo: You mentioned earlier, that most people that come to your office and seek assistance from your team are early career researchers, master and PhD, and also postdoc real estate. What about the seniors? Are they approaching you sometimes during lunch, like the unofficial pathway? 

Hendrik: No. I’ve also had senior group leaders requesting mental health first aid, a meeting with me. Primarily very few of them have spoken to me about their personal problems. Mostly it was when they were concerned about somebody in their team and they didn’t know how to deal with it. I think it might still be difficult to accept, perhaps for somebody in a leadership position to speak to a peer or God forbid, somebody who in the hierarchy is below them and open up about their mental health. That might be a hurdle that is slightly too big for some people to take. But I have had group leaders who were concerned about people in their group and wanted advice on how they can best support them, how they can best deal with that. And we’ve actually also had training for our group leaders precisely on that subject. So we got a trainer in. So what do I do to support the well being of my team members? 

Jo: So what do you do? Can you share one, two or three things? 

Hendrik: Again, it’s mostly about listening. It’s similar to what I’ve said before, saying that, hey, looks like you’ve got a problem. You see, a psychologist is really not going to work. And so when you see that somebody isn’t functioning very well and to come in and say, well, this is not working, what’s going on here is perhaps not the right way, but this is not working, you should do it differently. It could be well meant, but it’s not likely to fall on fertile ground with the person being spoken to. So always the best thing is to ask. And so if you notice that somebody in your team is despondent or not showing up or always being late for meetings is to just say, hey, I noticed you were late for meeting again this time is anything the matter? We can talk about it if you want and we can see if we can maybe change something in your working schedule that will make things easier for you. If there’s something that’s preventing you from being on time in our meetings, what can we do to make it better? It’s about being open, listening and not dishing out advice too quickly. 

Jo: And then also like, I’m trying to think about my relationship with my supervisor and when I realized things are not working, my brain is not functioning, I can’t concentrate. And you don’t want to necessarily share that with your boss or with your PI. We had regular meetings and then I just found myself retracting myself more and more. So I don’t know. Whatever. I mean he said a few things. I don’t know if there would have been anything that would have been solved in a reasonable timeframe. The situation eventually got solved, and I got my PhD back. But it’s been a training process, I think, for us both. 

Hendrik: But that’s precisely where I think an institution, a university, can really help by creating a space where it is easier to talk about this. We have a mental health first aid team. People know this, they’ve seen that in the newsletter, every diversity market, every induction week for students and PhDs and postdocs. I’m there with my poster to remind people we have mental health first. aid team, don’t suffer in silence, come speak to us. That’s what we’re there for. And I think that helps create a culture, an environment where people hopefully feel safer to speak about this. I imagine when you did your PhD, nobody was speaking about this and therefore it then becomes more difficult to say to your supervisor, you know what, I might be struggling with my mental health. This is all a bit too much for me. And I hope that by these kinds of measures we also create an environment where people do have the courage to say that and where we normalize saying that. Because in the end it helps productivity if you just gotta keep carrying on and say no, I have to do that paper anyway, I have to do this experiment anyway. Guess what? Your experiment is going to fail. It will be rejected at one journal or another before it gets published. We all have those experiences. Just banging your head against the wall and pushing through isn’t always the answer and sometimes taking a step back is the answer. And so I hope that that is apart from whether people come speak to us, I hope that a secondary effect that we achieve is just to normalize these conversations about it and empower people to say yes, I am going to look after my mental health. It’s important. 

Jo: Yeah. Some things that we’ve also identified in previous episodes of the podcast on mental well being is that we can preserve mental wellbeing by eating healthy, making sure we have breaks, don’t even think about working 24/7, which easily happens, maybe the 24/7, but like beyond regular working hours because these working hours have been are in place ever since industrial times. Because our body needs to recover from work and so does our brain as we identified it as just another organ that needs a break to recover, to settle. But I’ve also experienced, and I think many listeners will probably also relate to that. When we walk sometimes in my workshop, I also have a session where I send out people when the weather is nice, send them out for a walk to discuss the topic. And that’s when ideas come and spark and that’s when you have the best ideas for our next research project. That’s when you can connect the dots of what’s been discussed during the workshop session. So our brand needs nutrition and workout, like physical workouts to be functional and brakes to recover. 

Hendrik: And also this really nice five step program. This is from the New Zealand public health authorities. Five ways to well-being is called. And you’re absolutely right, sleep and physical activity are two of them. Connecting, not being in isolation, but not isolating yourself, being in a social environment but not being alone is one of them. Being challenged is one of them. If your job is sitting in a factory and just doing this, putting something into a box or something, that’s not going to keep you mentally healthy. So we also need challenges and diverse challenges. So it’s not that we just need to switch our minds off, we also need to use our minds to remain mentally healthy. The fifth one they mentioned is also to be part of something bigger. I think they have the most succinct way of phrasing it. Yeah, to have a purpose, to belong. I think it’s mostly part of belonging or having dreams or having aspirations. That’s what they name it in the five Ways to well being. And if you give to others, if you give your time in supporting others. I find, for instance, my work as a mental health first aider extremely enriching. And that gives me, if I didn’t already have one, I did. But it makes me feel good about myself. Also work with a mental health charity in Germany called Irzanihmensley, that roughly translates as madly human. We go into schools and universities and inform people about mental health. It makes me feel like I am part of something bigger. It’s not just about me. I have a mission and that enriches my life as well. So these are the five things to give to connect, sleep, physically active and forget and to have mentally challenging aspects. I also forgot the clever one word description they have for it. But these are things that we need to keep in balance for our mental health to be as good as it can be.

Jo: It sounds a little bit like staying human despite the academic challenge, like in connection with others, learning, thriving from each other and also really what good scientific practice is all about at the end of the day. And many of the research principles that certain institutions have and their staff and what we also know as best practices and principles for open science. I believe personally that’s also why I’m so, I think it makes a lot of sense for me to be working with open science because if we are reenable as researchers to work purposefully. Transparent manner that fosters and serves research integrity as in accordance with our values as human beings. Which the current publishing pressure system conflicts with. I think then that’s also when we can ease a lot of the pressure that eventually some of us drive into mental health issues.

Hendrik: I think so too. And what that requires, I think we really need to step away and that it requires a realization that the traditional view that science is the product of one or two brilliant minds is outdated and we need to stop and get away from it. Because the reality is, look at any Nature or Science paper. It’s got 30 authors on it. Why? Because the reviewers, they want the genome sequence. They want the animal model experiments, they want the full knockout library and whatnot. And this is humanly impossible for even a small team of researchers to do. When I did my PhD in the late 90s, early 2000s, it was still possible. I had one or two papers just with me and my supervisor. I was doing biochemistry, and that was okay. But by the time I start supervising PhDs with the siRNA experiments that needed doing and the animal experiments that needed doing and whatnot, somebody gets to be the lucky first author. But it’s the luck of the draw. And so what are we going to do? We’re going to give all the credit to that one person up front, and then there’s 30 other names on there. It doesn’t work that way anymore. Science is now fundamentally a collaborative process. And I know that there are smart minds thinking about this and we haven’t cracked it yet. But we need to come at a different system of evaluating that when it also comes to promotions and how we move people forward. The days of Watson and Crick writing their own Nature paper with stolen data are over. It’s all big teams now. 

Jo: Yeah. My personal dogma is it shouldn’t matter where you publish, but what you publish, as long as it’s discoverable in the digital system. That’s not perfect as we have it now, but it’s getting better by the day because as you said, many people organizations are working towards making a globally inclusive, digitally ensuring digital discoverability. There’s so much research being produced on a daily level that not one researcher can possibly identify all the literature which would eventually be relevant to our work. So we also need machine learning to make sense of it. And what you just mentioned for research assessment, there is a SFDORA, the San Francisco Declaration and Research Assessment, which is trying to get away from the journal impact factor. My training is also geared towards societal impact, not journal impact. And that’s also what every day when we as researchers want to achieve, many of us actually want to make the world and leave the world a better place than we found it. And without blaming preceding generations, or some of us are blaming, some of us are stuck in the system, but some of us are trying to fix the system. I feel like we could continue for hours to talk about the various aspects. Hendrik: Of course, and we wouldn’t fix it. 

Jo: Let’s just fix it along the way, but the alternatives are readily available, which is also what I want to showcase through my training and workshops and materials, most of which are also great.

Hendrik: But the competitive nature of science still prevails. And what I advocate is that we embrace it being a collaborative thing, and maybe we should start looking at alphabetical listing of authorship rather than other types. And yes, there are moves into more clearly defining who did what. And I think it also ties in that we need these positions of people who say, hey, I love working in a sequencing lab. Let me do that for the rest of my life. Please don’t pressure me into having to become a professor or an institute leader or whatnot. And in that capacity, they can be part of as many scientific factors as they want. Great. Everybody wins.

Jo: Yeah. I think there’s much room for diversifying the job market around academia, and there is already a few available where they can suddenly be specified further and made more readily available and discoverable for early career researchers before they feel, oh, I have to become a professor, otherwise I’m going to be a taxi driver. That’s usually the two options that you see early. 

Hendrik: Well, look, if you really want to dedicate your life to research and development, then actually industry is the place to go. That is where you can be an active lab researcher to the end of your days if that’s what you want. Lots of universities.

Jo:I also have a brother who’s a taxi driver, so that’s also an option. It doesn’t have to be the worst.

Hendrik: As long as that is a career that’s fulfilling for you, it’s all good.

I’ve known many of my peers that I worked with in academia that have gone on to do very different things. A chat that I did my PSB with, he’s a motivational speaker.

And in this week’s Science, I read a very encouraging article, the Working Life Series, about a lady who had always been an artist on the side, did a lot of drawing and also realized after her postdoc that this trajectory into a faculty position wasn’t for her. And it took her a while to find her feet, but now she’s a scientific illustrator.

I wanted to be a scientist once I’ve committed to that trajectory, that’s what I wanted, and I wanted to switch into science management. I suddenly realized, hey, this is much more me. I was able to use my communicative skills much more than I would in science. And my creative skills, you know this, Jo, but I’m working on a documentary film about microbes at the moment as well. So I’m making a movie right now. And so moving into science management, whereas at first it felt like, well, I’m giving up a lot because I had so much invested in setting up a research group and getting grants and all that. I found it extremely liberating, and for me, it’s very easy. 05:00. Working day is over. See you tomorrow at nine. Of course there are exceptions to this. There are still deadlines to meet. There are always exceptions to these things. But my working life is far more structured. I spend no weekends in the lab anymore. It makes me very happy. And my wife too, I can tell you that.

Jo: Yea, it’s much more family friendly too. 

Hendrik: So I think a lot of scientists might also be scared about the unknown of what might happen when they leave academia. And I think a lot of them don’t realize the riches that are out there. One of the PhDs from my program that I manage, she is due to defend her PhD in February, and she’s walking straight into a consultancy job with a top consultancy firm. She took part in a mentoring program. She walks into a salary that is more than her current jobs, straight as her current boss, straight out of a PhD. And I say this to PhDs and postdocs out there because I also do training for job applications and stuff like that, which I developed together with a lady from the firm called Size, based here in Jena. And a lot of them started from people asking me for advice with job applications and so on, and turned that into a workshop. And what I notice happens quite often is that people come to me and say, well, look, this job looks really interesting, but they’re asking for project management skills, and I haven’t got any project management skills. And I always say to them, well, hang on, you’re a PhD researcher, right? And you’ve got a research project, right? Yeah. Who’s managing? You are a project manager. So I tell you that now at our inductions for PhDs, you are all project managers. You might not have thought about it much. You will need to do project management training to think about it in a bit more detail. But project management is all about organizing your work, and that’s what you do. As a PhD student or as a doctoral researcher, you are a project manager. So next time you see an advertisement that says project manager, you know you can apply to it.

Jo: That’s yours. Yeah, that’s also what I found. Nobody told me, but I eventually got to myself screening job applications, not job postings I could possibly apply to. I was like, well, nothing is for me. And I’m like, Wait a minute, couldn’t I name it as a project manager after all? Like I managed to get a bloody PhD. Like, hello? 

Hendrik: Exactly. Maybe you managed your supervisor. That’s an important skill to have. 

Jo: It’s been a real pleasure talking to you. Let’s continue the conversation in a future episode. Hendrik: Okay, that’s cool. Yeah, sure. I’ve also really enjoyed this and I’m always happy to talk about mental health, anything that I can do to normalize that as a topic. And I probably didn’t speak as much about my personal experience as I could have. So maybe we can do that on a future occasion. 

Jo: Yeah

Hendrik: Because I find that sometimes it really helps people because I, you know, I was down in the pits at some point and sometimes people might find it hard to believe, but I could barely make it out of bed for weeks on end. That’s where I’ve been. Very dark places. Yeah. Not to dampen the mood at the end of the session.

Jo:  You get out of it sometimes. 

Hendrik: Good for people to hear that and you can come out of it. What I’d like to say then is that when you overcome it, you’re stronger for it. Really overcoming a problem that you have. There are a few things in life that make you feel good about overcoming a problem. Like when I had my anxiety disorder, there was no way I could have had a conversation that I knew was going to be on the internet like we’ve had today. So that is one of the benefits you can reap from overcoming your mental health problems and maybe that’s a good way to end it off. 

Jo: Same here. Also recently I started talking about it and I’m also using this podcast to make it more of a topic, to foster the conversation around it. And also, as I said, to normalize, like it’s normal to sometimes not be capable of doing certain things. And we need brakes and I think it’s like our brain pulling the brakes. Like, wait a minute, you work so hard.

Some people call it burnout and it’s probably one of the symptoms that are connected to mental health issues. Others say burnout is just another word for depression or whatever, disorder, mentally.

Yeah. So basically it’s normal. As I said, let’s treat it as such and let’s figure out ways to be there for each other, for others who run into episodes of some sort or also to prevent anything like that from happening too seriously. And when he feels the science, that’s also what I’m continuing to do, learning. When is it time for me to take a break so that it doesn’t get so serious again? But that’s for a future episode. 

Hendrik: Okay, happy to do that. 

Jo: Yeah. And I can probably also put together your resources. I’m in the process of putting up a page on my website as a resource page for mental well being. And that will also be shared in Show Notes. So you can just click Find the link underneath the Play button on this episode. Hendrik: Excellent. 

Jo: See you in a future episode. 

Hendrik: All right. Thank you. 

Jo: Bye.

Part 2: “Yes, I had a mental health condition. Get over it, I did!”

Jo: Hendrik welcome back to Access 2 Perspectives conversations our podcast show primarily equally about open science topics and also mental wellbeing in academia, as well as career opportunities and research, management and other topics that are of interest to researchers. Welcome back. It’s great having you again. 

Hendrik: It’s really great to be back with you. I really enjoyed our previous conversation and I look forward today to go a bit more into depth about personal experience, about mental health, which is what we didn’t really have time for last time, right? 

Jo: Yeah. And there should be more than enough time. Well, there should be. We will have time for this today. And last time for those who didn’t have the chance to listen to the previous episode with you just yet, but you can of course go back and listen to it after this one. We talked about your role at Jena University as a mental health first aider and what got you interested, why you’re interested and so passionate about the topic, some of the questions you receive and the support you can give to people who find themselves in difficult situations, oftentimes not really being aware that they have a mental health condition of some sort. And oftentimes I’ve experienced stress – born, but of course it’s multi factual.

Hendrik: Yes, that’s it. 

Jo: And today you and I committed to talking about our personal experience. Yes. So would you mind giving it a head start? I’ve already given some teasers in previous episodes with yourself and also with other guests on the show. But yeah, please tell us about your journey. 

Hendrik: Just to tie that in with last time, we talked about the mental health first aid work I do at the university and a lot of stigma reduction work that I do. And I found that it’s incredibly important that people speak up with their own testimonials. That is something I found that really resonates with people that often people say, oh, that is so brave to talk about it. I don’t consider it like that anymore because for me it’s become really easy to talk about because I see the positive effect it generates in others. It invites others to reflect on themselves and say, hey, well, if this guy acknowledged that he had a problem, maybe I should be looking at myself as well. And so I think we cannot really have enough role models, and I don’t wish to qualify myself as a role model. There perhaps, but examples of people, particularly in academia, who speak out about it and who are also seen to have successful careers. Right. The example I always like to give is that Sir Isaac Newton probably had a mental health condition. He was probably bipolar, it is now thought, and also Charles Darwin had a mental health condition. So having a mental health condition or illness does not preclude you from being successful in science or in any profession. And I think we need more examples of that. In order for people to be able to overcome their own barriers. 

Jo: One doctor once told me when I was concerned about his diagnosis, like he just bluntly said you know what, the brain is just another organ and it can dysfunction at times. If it’s triggered or malnourished with certain nutrients or whatever triggered by too much stress, then it’s an organ which has sometimes issues and some of these issues can be fixed and oftentimes it’s just giving yourself enough of a break and time to heal and structure your life in a way that’s more by looking after yourself, by having enough room to recover from the daytime stress. But when he said that, I was like no, the brain is like my personality. I felt I wasn’t really myself. And because you mentioned the stigma, there’s not much talk about mental health conditions in society. It’s increasing. Like in Germany, there’s now a few more or less famous people who spoke up about it. Otherwise it’s a constant stigma. Some people brag about having a broken arm and then get signatures on the cast. But how would you do that with your mental health? 

Hendrik: Well, I think going out there and saying hey as today’s title I believe is hey, yes, I’ve had a mental health condition. Get over it. I have. And that perhaps is the virtual cast that you can get signatures on in the sense of people coming back to you and saying this has really helped me, thank you so much. So without further beating around the bush, I had an anxiety disorder. And in a fairly typical fashion I left it way too long until I was ready to accept therapy. This is something also I’ve noticed and something that I had forgotten about myself. A lot of people are kind of afraid of psychotherapy. They don’t know what it is. They think they will get branded as crazy. They think a therapist is going to take their personality apart and say there is something wrong with you. We have this imagery of being put in a padded cell with a jacket that closes around the back and in the worst case you might be put into some asylum to rot away for eternity. And then people have problems or fears about medical treatment as well because it is so closely linked with our personalities. For me, talking about mental health becomes so normalized that I’ve almost forgotten my own fears about this when it happened to me. And this is what probably leads to what is a quite eye watering statistic that on average sorry, people need seven to eight years from the onset of their mental health condition until they are ready to accept or seek out help. And this is classically what happened to me. So when I had an anxiety disorder, that reflected back on. It happened when I started going to university. So I was fine in high school, not a problem. And then a major life change happened. And psychologists will tell you that this can be one of the triggers of a mental health condition. So my life changed completely. I was independent and able to do whatever I wanted and perhaps I didn’t always make the right choices. And then looking back, I’m pretty sure that’s when it happened, I wasn’t ready to accept that something was wrong until I was at the end of my PhD. So roughly eight years later, and when I was writing my thesis. And that’s really when I fell into a hole where things fell apart and I had to accept, something’s got to give, this is not right. And I went to see my house doctor, something I want to say about anxiety disorder. And of course, my condition got gradually worse. It didn’t quite start out that way, perhaps, and that’s maybe also why you don’t recognize it necessarily early on. But I think there’s a lot of misconception about anxiety disorder as there are misconceptions about many mental health conditions. For instance, the misconception that being depressed is just being like this. A lot of depressed people, like Robin Williams for instance, are very smiley on the outside, but very depressed indeed on the inside. And I think a misconception about anxiety disorder is that people think, oh, you might be anxious, you might be a bit nervous about certain things and wind yourself up, perhaps a bit too much. But it goes far further than that. It escalates to absolutely debilitating fear, where in my worst episodes, I simply was unable to set foot outside my bedroom door. I just couldn’t get out of my bed or God forbid, out into the street to go to the supermarket to buy food. And the supermarket was not even five minutes walk from my place. And I was just irrationally, but completely afraid of being among people and to such an extent that I would avoid it. And until I really had to say, well, if I don’t go now, I’m going to stop. So what’s the worst of the two evils here? So really incapacitating fear, where you build that fear up inside yourself so badly that you start to get physical reactions. And so I would get stomach cramps and that would lead to the fear of throwing up. And of course that was then one of my fears. If I were to go in public, what if I threw up on a bus or in a tram or in the supermarket? That’s so embarrassing. So I would avoid those situations. And if I had to go somewhere, I would avoid eating. I would avoid having something in my stomach because my stomach would be so painful when I went into these situations that the solution to that was don’t eat. You don’t eat. You can’t throw up and your stomach cramps are less. So I was really thin as a student and yeah, I had all these excuses for when I would get invited to this or that by friends. I’d always often drop out at the last minute, not go to stuff that all my other friends did to make up some excuse. I’m sure that lots of my friends had an inkling something wasn’t right, but you tell yourself that they don’t. You think that everybody buys your excuses. I’m sure my family had an inkling something wasn’t right, but it’s a difficult one to address.

That’s the point I did want to make about anxiety disorder. It’s not just being nervous, it is absolutely being scared to death of everyday things stepping on a bus.

Jo:  And is it possible to pinpoint what you’re scared of or is it something to fear?

Hendrik: I think the best way to describe it is I want situations where I felt I was not in control over my choices, whether I wanted to be somewhere or not. That would freak me out. I guess there is an element of claustrophobia there, of being locked up. So, like the example of the bus I gave, the minute those doors of the bus closed, you can’t go anywhere. You can’t say, I’m out of here now until the next stop. And the two minutes to the next stop would seem like an eternity to me. And then the doors open, I’d be, Am I going to get out or can I make it to the next one? That’s how every train journey was for me. University lectures, being in a huge room with lots of students. And then if I felt that I needed to leave the room, that would have been obvious to everybody, that would draw attention to you. So if I went, I would stay at the back of the room, near the door, if I went at all. So not being in control of situations, of whether I chose to be there or not, is, I think, the most easy, straightforward way I could describe it. But it was a bit more complicated than that. 

Jo: Yeah, I can relate to that. Not with anxiety. I have a friend who surfaced from anxiety episodes. She also found a way to manage it, but that’s also what she describes.

She was just scared and then could also name a few things she was scared of. But for somebody who is not in such a state of mind, like in this case, myself, it was hard to empathize. I mean, I felt sorry on her behalf, but not to be confused with pity or anything like that. But yeah, it was difficult to understand, really, what that’s like.

In my case, it was depression and I’m sure there’s also mixed anxiety and depression conditions and in my case it was more like I lost belief in myself. Like self worth was almost gone or declining. And I’m sort of like, what’s the use of me being on this planet after all?

Hendrik: I recognize that, too. And I think a lot of these things I was, sorry, diagnosed eventually when I did come to my breakdown, probably describe that later as having an anxiety disorder. But I am absolutely convinced that I also had episodes of depression.

Jo: It often goes together. 

Hendrik: Exactly. So you think I’m so useless, I’m so worthless I can’t even go to the supermarket. What is the matter with me? What is the point of me? Would anybody even care if I wasn’t here tomorrow? And I wouldn’t say that I was ever actively suicidal, but I certainly thought at occasions, what’s the point of this? What’s the point of life if it is like this? So I do think that it’s sometimes difficult to draw the line and say, okay, you’ve got an anxiety disorder. I think it often comes hand in hand with other things. I think we should definitely talk about depression as well. In describing anxiety disorder, I just remembered there’s a song by Lou Reed, and it’s called Waves of Fear. It’s on. The Man With the Blue Mask. Or no, The Blue Mask album of Blue Reed. Maybe you can put a link underneath.

That is a song that I think really, for me, resonates with these feelings of absolute fear of anything. I think he says in the song, he says, what’s that noise? Who’s that outside? What’s that thing on the floor? I hate my own breath. I can’t stand myself in a matter of three minutes or so. Really captures, I think, me at some of my worst moments. And as art can often do, right, can really make these things come to life. For anybody interested to get an idea of what a panic attack or severe anxiety might feel like, I can really recommend that song by Lou Reed based on Fear from The Blue Mask album. 

Jo: Thanks for mentioning that. I found it and I added it to the reference list. Yeah. 

Hendrik: Okay, continue. Tell us a bit more about your depression, then. 

Jo: I think that’s how it started. I think maybe some of us have. I think some of us, especially researchers, have access. I think people will seek into certain professions. This is my personal observation. Are predestined to sooner or later run into mental health episodes or issues? 

Hendrik: I wouldn’t say predesign is probably a bit strong, but perhaps there is a bit more. I think if your career is really kind of tied up with a calling in life and with your identity and it doesn’t always pan out. And a scientific as well as an artistic career are not easy parts. And so when those difficult career paths are very much aligned with how you identify as an artist or as a scientist, I think that could lead to increased incidence of self doubt and along with that, anxieties, depression, that kind of stuff. 

Jo: Yeah.I don’t know why I started with it. I think I didn’t want to isolate myself and describe what I went through rather embed myself into a whole group of people. 

Hendrik: It is true. It is extremely common among academics. 

Jo: Yeah

Hendrik: We know that, right? 

Jo: Yeah. 

Hendrik: From the scientific studies triggered by the work of Cady Lovec. 

Jo: Yeah. And I’m also finding ourselves in a very demanding working environment and stressful environment. Competition. I think competition is healthy to a very low extent and then it becomes poisonous when we are forced to work against each other where we meant and wire to actually collaborate, which is also what researchers intuitively want to do and generally want to do. But then the system is demanding competition of us and forcing us into that.

Hendrik: That’s a whole other kind of work material.

Jo: That’s a whole other kind of work. Plenty of science materials.

Hendrik: Science should be this objective thing where through reason we uncover the mysteries of the universe when in reality, it’s like a personality cult who gets the Nobel Prize. So there’s a lot of ego tied into it and competition, and that’s not very objective. And there are ample examples, starting with Watson and Crick, of questionable assignment of the Nobel Prizes as well. So objectivity and science are not necessarily directly related. 

Jo: True. Okay.

Hendrik: Let’s not go there. 

Jo: I’m trying to set the stage for describing myself. I’m just diverting into other topics, but here it comes. So I think when I look back, when I put myself back into my own childhood, I think I was always I wouldn’t call it anxious, but cautious of other people. And sometimes as a child also, I would have kind of moments where I was scared to meet new people. Maybe that’s also normal for some children, those who are outgoing and those who are more reserved. As a teenager, all of a sudden I was more outgoing and curious and happy to meet other people. And then during, what is it, high school, I got totally obsessed with the wars that were going on and also famine like ecological disasters to the extent where I said I can’t go to school anymore. This is way more serious and like it really got to my skin. What happens in the world. What I also want to add is that people who have a lot of empathy and curiosity in other people and things in the world to study, I think that also comes with a sensitivity which can then easily be overwhelmed. But it’s just my personal observation. 

Hendrik: There’s really very valid things. 

Jo: And then the worst episode where I thought, okay, there’s no way out of here, was during my PhD. And then also shortly after the peak or midterm where I realized many of us PhD students like, oh my God, more than half of the time is already gone. And how little results do I have and how did I waste my time with that? What I then thought before, I was like, oh, it’s good to have a healthy work life balance kind of activities besides research. So I went scuba diving. I did horse riding and natural exercises just to keep myself out of the level at times and not so obsessed with research. Twenty four, seven, and because that also interested me. But then all of a sudden, I got a feeling of guilt that I spend too much time outside, even though I would still work 50 hours that is normal and some academics and many work more than that. But then I felt okay. I didn’t take holidays. I did spend some time with horses and scuba diving. And now what, I don’t have enough results. And then what did I do? To my PI, to my supervisor, because he clearly also depends on me being efficient. So then I developed this feeling of guilt. It’s not only a failure for myself, but also a failure for other people. And I was like, what did I do? And that’s when I ran into a depressive episode of Totally Lost and, oh my God, I’m totally useless like you described previously. And the worst feeling also, I don’t think I was really suicidal, but the feelings of, what if I took my life and I was going through scenarios and whatever scenario I could think of. No, that’s just causing a mess. And those poor people who are going to find me like, no, I can’t do that to them. So I think people are really suicidal. Don’t think of other people who would then have to clean up that mess. It totally went around. When I thought of my parents, I was like, my friends will never get over it. They have other friends. But to my parents, my dad was still alive. I was like, no, I can’t do it to them. And also not to myself. Really thinking about it, but life is too precious. But the depression was so severe that I thought I would never get out of it. And then I found a place of acceptance. Okay, so then this is the state I’m in for the rest of my life, and I just keep pushing. And also from the scuba people, I had friends who would eventually realize, like, oh, Jo’s become really quiet. She’s not joining the training sessions anymore. What’s going on? So they were calling me and stepping up at my door and forcing me, taking me on a holiday and dragging me out of it. And that also helped me to resocialize after isolating because I would still go to work, but really just sneak around. I wasn’t capable of doing anything meaningful for my research. And I was just trying to show presence as much as possible and working really hard or working on inside like nobody could see. But it was so hard to try and be productive where there was no energy really to be productive. 

Hendrik: That lack of energy I also recognize, actually.

Jo: The feeling is so bad because I have it in me, but where is it? I used to be capable of doing so many things, and now nothing like, can I not even do this one thing, this one experiment? 

Hendrik: I found it quite interesting what you mentioned when you thought about your feeling inadequate in doing your PhD work. And this is a discussion that has become quite prominent also with the imposter syndrome. The funny thing with me is that I never really had that for me, in a sense, my PhD, which I was doing while I had my anxiety disorder, and while my anxiety disorder was probably at its peak, my PhD was, I guess, a bit of a saving grace because I was in the natural science. I was working in a laboratory. A laboratory is an environment where I am in control. I designed the experiment. I decide when the time points are taken. And I was really engaged with that. I was doing something I loved. That was fine. I had a mission there. So that was always something I was very committed to. What was difficult for me were group meetings. If we would have Monday morning group meetings or so, ten people in a room, and you’d have to sit there watching somebody present. I don’t have to go back to the details. That was what was really hard for me. But the work of doing the PhD, the actual research, was something that gave me a purpose and perhaps eventually also would help me accept that I needed therapy. Because the moment I can quite accurately pinpoint when I had my turnaround moment, and it was when I handed in my PhD thesis. I had done months and months of working, writing, writing. Finally, my supervisor, and I must say I had a super fantastic supportive supervisor, said it was okay. So he handed it in, and that’s when I could do whatever I wanted. I was free to do it sort of in a moment of celebration. And in fact, I had planned to go on a backpacking trip with my brother to China, and we had the visa arranged and such. Everything. A lot of organization went into that because China, this was in the late nineties, was also far more closed country than it has since come. And I realized I couldn’t face that trip. All of these fears. Imagine how many buses and airplanes and whatnot you have to get on to get to China. I thought, no way. I can’t do this. I freaked out at the thought of it. And so I had to say to my brother, I’m at rock bottom here, and I can’t do this. And that’s when I went to see my house doctor. And the house doctor said, sounds like an anxiety disorder. Sounds to me like you might benefit from psychotherapy. Here’s the number of a clinic nearby. But mind you, it might take a month or two or three because of waiting lists. And I remember I was just on the phone, so nervous to make a phone call to make an appointment with the psychotherapist. I must have sat in front of their phone for hours before I was able to dial the number. 

Jo: But that’s the moment of exposure, right, exposing is that of needing help. 

Hendrik: Yeah. And I guess it becomes real that you might be branded as crazy. Right. You’re going to talk to psychologists and you think that psychologist is going to say you’re crazy. No, that’s never going to happen. I was actually very lucky because that clinic had just taken on a new psychologist just out of training. They said, we can give you an appointment right away, but we want to be upfront with you. This is someone who’s just starting and doesn’t have a whole lot of experience yet. And I said, okay, well, if I can come next week, I can come next week. That therapist then gave me two options and said, we can go down the route of psychoanalysis and try and find out what the root of your problem is, or we can go down the cognitive behavioral therapy, which disregards entirely what the reason for the problem is, and builds for you the tools to manage your problem. And I said, I don’t care what the reason for my problem is. I want this dealt with. So we went cognitive down the cognitive behavioral therapy route, and I’m really grateful I did because and I don’t remember exactly how long, but three or four months of weekly sessions and I was done. I had my anxiety under control. I still have a latent anxiety disorder that are still, to this day, things that make me very anxious. But I have the tools to deal with that. And not always I’m not always able to deal with it. There are two things that I avoid if I get anxious, but it’s effectively under control. But that fear of a therapy, of what that might mean, is something that I mentioned earlier I recognize and suddenly remember how difficult it was just to make that phone call. That was almost more difficult than accepting that I’ve got a problem.

Jo: Talking about that makes me worried. I feel like cognitive behavioral therapy is a little bit like life coaching. And the life coaching is not as medical or with a medical background. Like, life coaches have not studied medicine or psychology or anything like that. But I feel the tools that are being transferred to the patient or the client are very much similar in equipping us to deal with fear, to deal with uncertainty, to get into action, to have structure in our daily practices. So I’ve done both, and I’ve found that life coaching sessions with self declared or actually educated coaches have helped me equally well as compared to therapy sessions. And therapy sessions are much harder to get, whereas life coaching sessions, you have to pay for your own pocket. So there’s always a trade off. Hendrik: That’s another interesting point, I think, to put out there. It always depends on how well you connect with the therapist. So for somebody who is listening to this and says, maybe, hey, I should do this and maybe I want to look for therapy now, it doesn’t necessarily mean that you match with your therapist very well. So I do know people with long term mental health conditions and who have changed therapists several times until they finally found somebody that worked for them. So I was really lucky that I found somebody that matched very quickly and we went down the path that worked for me very quickly and then it was solved in a couple of months. I don’t want to put that expectation out there. That is the case for everybody. And certainly there are also rope elements among therapists or coaches. So if you feel uncomfortable with somebody, you are perfectly within your rights to change therapists as well. 

Jo: It’s a very personal project to engage in and it matters tremendously to have what you might call the right person in front of you, but somebody you can trust and who understands and doesn’t label you as just another patient. But has a genuine interest in helping and seeing as a whole person and not like a clinical case and statistics.

Hendrik: I think that again, depends on how well the two individuals are matched up. I think a therapist must have a distance. And when I finished my therapy, I was so grateful to my therapist and I said, I finished my therapy in the time between a hand and in my thesis. And I was doing my defense. And doing my defense was something I was extremely worried about. I mean, anybody would be worried about that, but throw in a bit of anxiety disorder into the mix and that was a whirlwind of emotion. So through the therapy, I was able to face that. And I was so thankful to my therapist, I wanted to invite her to my defense saying, I wouldn’t have been able to do this without your work. And she was very clear and said, no, this is a professional thing and we are not taking that into the private sphere at all. I am your therapist. That’s a professional thing I do. I am not coming to your life events of graduating from the PhD, which I was a bit disappointed with at the time, but I completely see the importance of maintaining doing that.

Jo:  That’s a very thin line and probably a line to work, the trust, billing and engagement with another person, but also keeping a professional distance for everybody’s safety and well being also in the process. 

Hendrik: Because I’ve noticed in recent times with people I speak to right through my work from a mental health perspective, there are a lot of misconceptions about therapy, a lot of fears about therapy that we’ve mentioned before. Perhaps describe a little bit about what it means to do cognitive behavioral therapy, because when I did it, And my therapist would ask me, can you please describe what happens to you when you have a panic attack? And so I would start describing the sort of situations that gave me a panic attack as I did before getting on a bus, sitting in a lecture room, the prospect of doing a trip to China, these kinds of things. And she said, no, that’s the situation. I want to hear your internal process. What is the sequence of your thoughts that end up in this whirlwind of fear? And I found that very difficult to articulate in these sessions. So it became an exercise of waiting for such a panic attack to happen in order for me to be able to record what my internal stirrings were so I could describe them to my therapist later. And then a very interesting thing happened that the kind of the one thought replaced the other as I was trying to analyze my train of thought that would spiral interfere. It would break that train of thought, spiraling interfere. So that’s probably the best way I can describe how cognitive behavioral therapy works for me with an anxiety disorder, which is very different perhaps from the kind of perception that people have, what this kind of therapy might be. So there is nothing to be afraid of there as somebody sitting in front of you teasing your personality apart, that isn’t at all what happens. So I want to dispel that myth and take away those reservations from people who might be listening. 

Jo: Yeah, I think there’s also many tools and practices that therapists can dig into as they work with a patient, because they would always ask me. I also had several, some of which I had really difficulties with because there was one where I felt like you’re not really listening and I didn’t feel understood. And it might just be like many therapists likely overworked: there are way too many patients, there’s no real matchmaking, way too few therapists based in Germany, but what I have in other countries, way too many people who would benefit from therapy sessions. But then it was a mix of they would always ask, how are you doing? And when I was in the middle of an episode, it was always empty. What should I say? Like the same save or I don’t know. And then giving tools or sharing tools, like structure your day, what are your practices, what are your achievements of the day? Celebrating small wins. And if it’s just so I managed to brush my teeth before midday today. And that can be a huge achievement.

Hendrik: I know

Jo: In that sense, I think some of the therapy sessions I went through were similar to what I’ve then learned. Also life coaches too, like in Structuring, the day celebrating wins, not obsessing about failures, but drawing, learning from the failures and learning and focusing on wins. Just out of my own experience and interest, I would like to ask why anxiety and depression come with a lot of negativity. And then there’s the other extreme of the whole scene of well being, self awareness. Like there’s a trend of mindfulness and all of these live tags which focus on what some people would argue too much positivity because I kind of need both. But I’ve heard people say, but also, again, what’s wrong with being positive about life? What’s wrong with sharing positive ideas and thoughts and trying to turn around the negative thoughts into learning that you can then have a brighter light? Hendrik: Well, let me turn that question around a little bit. But I have become a very optimistic person, which I never was before I had my mental health therapy. I’m now very solution focused. And when a problem emerges, I don’t worry about it, trust you me. I have spent the majority of my life to my mid 30s or so, which is when I did the therapy for my anxiety disorder, I would worry about just about anything. And now I look at problems that present themselves as opportunities to find solutions, and I have become really confident that I will find solutions. Whatever life throws at me, the worrying aspect has gone and it has really changed my identity in some way, that I’ve gone from somebody who expects the worst, and I guess I do still expect the worst and plan for it. But when it happens, I’m able to look at it quite solely and say, right, okay, how are we going to fix this now? 

Jo: Not to get drawn into it and freeze on it. 

Hendrik: Yeah. 

Jo: And also that any of these super positive people deny the negativity that we see in the world. But what does it help to worry the world might end tomorrow. 

Hendrik: Worrying helps you nothing, and then it changes nothing. That’s what I’ve learned from my anxiety. I spent my life worrying and it does nothing, does nothing for you, it does nothing for others. It doesn’t make the problem go away. It doesn’t make the problem worse or better. It’s just you sitting there worrying. So it’s easy to say stop worrying, and it’s not so easy to achieve that. And cognitive behavioral therapy can definitely work with that. Really because I know that we are coming towards the end of our time slot today. We both have busy schedules today with other meetings.

Jo:  But it doesn’t mean that we cannot continue some other time. There’s always more episodes to come.

Hendrik: Right. But I do want to get another really important point in, which is not from my own experience. But I’m involved with several mental health projects and schemes and initiatives and whatnot. And I’m talking with lots of people. And I’ve recently spoken with two people. A friend of mine who had a very severe depression and recently a lady who had anorexia and actually during my university as a very close friend of mine. Anorexia what these three people have in common is that they were actually instituted what we describe as institutionalized. They went into a clinic and they stayed there indefinitely until the condition was fixed. Particularly my buddy who had severe depression, he told me in very plain terms that was the worst case scenario. That was the thing he feared most, to be taken up into a psychiatric clinic. And I think a lot of people fear that. The pad itself that I referred to earlier, this perception that that’s how we deal with the severely mentally ill. We lock them away, never to be seen again, and we view that as an endpoint. He said to me very clearly, and so did these two ladies who were in the clinic for anorexia in the end, it was the best thing that could happen to them because it gave them the time, no timeline set, no deadline set to deal with air conditioning and you go out when you’re ready. And that turned his life around. So the thing he feared most, which was being taken into the clinic, turned out to be the best thing to turn his life around. 

Jo: Yeah, I’m taking away from all the triggers that might drag you down again.

Hendrik: Yes, people are reluctant to a large extent about psychotherapists, but certainly people are fearful of the prospect of being taken into a clinic. And I also want to take that message out there. That is not the end. That can be the start of a new beginning, that can be the liberation of your life, not the entrapment that you think it looks like. 

Jo: Yeah, thanks for adding that, because as you said, the worst case scenario is actually a best case scenario in many instances. And people save their life and turn their life to the better again. Hendrik: What a great way to end it all, because that’s what it’s all about, right? We can accept the help that is out there to turn our lives around for the better. And that is a possibility. And guys, it’s science based. It’s evidence based. If this is no Hocus focus, you will not be branded. You will not be locked away, never to be heard off again. You can get the help that you deserve, so reach out for it. That is the one message that I always want to get out there. It has completely turned my life around. So, hey, as we said, yes, I’ve had a mental health condition. Get over it. I did. 

Jo: Yeah. And also I want to add, like what I described earlier, the worst episode ever where I thought I would never get out of it. I eventually did. So the title of this episode also applies to myself. And then when I ran into another episode, I was like, well, this is not very comfortable. It’s actually quite uncomfortable. But I know it will end at some point. I know it’s just an episode, and if it takes a week or two or three or a month or two, but there’s statistics like what’s the longest possible period it might take? And there’s also medication where you can get out sooner. But for that I would clearly also suggest to see medical advice before taking anything, especially not subscribe. But there are solutions out there, and we are not fewer, rather many of us. And I think it’s also normal for people to be more cautious, and people to be more sensitive. Society needs a diversity of personalities, and it’s a matter of us looking out for each other. And one episode I would like to talk to you about in another chapter and another opportunity is how is it for people in our vicinity, how is it for our parents, how is it for our partners? And what are the experiences that maybe you and I and what we’ve heard of others made with people in their surroundings? How can people who are not affected at the time where we find ourselves in a condition deal with it and best support us? We had a little bit of this in the first conversation we had, you and I. We can go into a few more details and examples of how we can look out for each other at a work placement within families, and especially for those who might think they don’t have a social network they can fall back to. There’s still people in your surroundings you can reach out to see how they are. 

Hendrik: So many things to discuss, still and I’ll be happy to do them in the future. I think my wife sometimes gets exasperated exactly how positive and solution focused I am. And every time there’s an issue, I’m like, yeah, we’ll find a solution to it, don’t you worry. And she’s like, how can you always be so positive?

Jo:It was great

Hendrik: If you think you have a problem and you’re willing to accept the help, you might be surprised. The thing I feared the most, a full auditorium with lots of people. Now I relish standing in front of that auditorium giving presentations. I love giving lectures, I love teaching at university. The irony is I almost never went to lectures as a student. And now, of course, we have the pandemic losses online. But in my academic career, I found that giving lectures and giving presentations to students is the part I really love. It would have been inconceivable when I still had my active anxiety disorder. So I’ve discovered new superpowers. That’s what I always say. You might discover that your weakness is actually a strength wanting to blossom.

Jo:  I think like some traditional coaches I just might say it’s just a transitional phase. Like you are entering a new level and your purpose on being on this planet is to help others, to spread the word, to fix the issues that we see as human societies. So yeah, until another episode. 

Hendrik: Okay.

Jo: Thanks for joining us today, and we’re looking forward to the next one. 

Hendrik: Thank you, Jo. Me too. 

Jo: Bye.