The Toilet Paper

“How is your thesis going?”

Many PhD students suffer from mental health issues. This study investigates the underlying reasons and explores potential interventions.

Steven He’s emotional damage skit

Studies show that anxiety and depression have become more common, especially among people working in academia. PhD students in particular are affected by mental health problems: one study showed that graduate students are more than six times(!) more likely to experience symptoms of depression and anxiety than the general public.

The authors of this paper conducted a survey among 589 PhD students at a public research university in Germany to investigate the causes of these mental health problems.



The survey consisted of a quantitative and qualitative part.

Quantitative answers


Only 7.6% of the study participants were permanently employed. The majority either had temporary employment (65.5%), a scholarship (12.1%), or were not employed at all (6.5%). Nearly a third of the participants worked 45 hours or more, with over a fifth working 50 hours or more. Job security is a concern for more than 80% of the participants.

Participants also reported higher stress levels and lower job satisfaction compared to their peers in the industry and similar countries.

Results from the survey suggest that a third of all participants are at risk of depression. Moreover, as a whole, the group had mild levels of anxiety. These findings should not come as a total surprise, because approximately 20% of the participants had already been diagnosed with a mental disorder.

The majority of PhD students feel supported by their supervisors, although about a third had negative experiences with their supervisor. Participants reported meeting anywhere from once a month to less than once every six months.

An analysis with linear regression models suggests that:

  • Job satisfaction, life satisfaction, perceived stress and negative institutional support are predictors of depression.

  • Job insecurity, life satisfaction, negative institutional support and perceived stress are predictors of anxiety. The first three are also significant predictors of perceived stress.

Qualitative answers


The survey included three open questions:

  • What is/are the cause(s) of your stress? Participants most frequently mentioned workload and time pressure (amount of work and deadlines), self-perception (a perceived lack of competences or other personal doubts, concerns and worries), job insecurity (contract length and future employment), social integration and interactions (sense of belonging), and supervision quality and quantity (lack of support and frequency of meetings).

  • What would need to change to improve your mental health status? Most answers referred to supportive supervision, followed by job security and contract length. Other topics include manageable workloads, compensation and financial security and less additional tasks (like teaching).

  • What could be done to improve your situation? According to participants, the best way to improve students’ mental health are job security and compensation (increase the chance of getting a long-term job in academia), supportive supervision (regular meetings), services and support systems (university psychologists, stress management courses), decreased pressure to perform (less “publish or perish”) and manageable workloads (normal working hours).

Practical implications


Identifying problems is easy, solving them is not. For now, the authors suggest that possible interventions can be grouped on four levels that can influence each other:

  • PhD students can work on their project management skills, self-reflection or mental health awareness. This should prevent the development of mental health problems and strengthen the resilience of PhD students.

  • Supervisors are the most urgent and promising target for improvement of PhD students’ situations, as they are responsible for setting the workload and time constraints. Possible interventions could target their personnel management skills. University-imposed guidelines may also help (as long as they’re not ignored or implemented improperly). Finally, additional external supervision may provide opportunities, especially when it allows students to voice concerns without the fear of affecting the personal relationship with their supervisor.

  • Universities or research institutions could provide support to students by raising awareness about mental health problems, and by offering and promoting mental health services. Students should be reminded to strengthen their social relationships and pursue hobbies that are not work-related.

  • Finally, changes are needed in the greater political context and academic culture. These changes include a fair payment system, more control over contract lengths, and more perspectives for long-term positions in academia. “Publish and perish” should also become a thing of the past.


  1. There are many factors that contribute to depression and anxiety in PhD students

  2. Interventions are needed to improve PhD students’ mental health