Author: Richard Dodd // Editor: Erin Pallott

I’ve just entered the last six months of my PhD, and I would be lying if I said I wasn’t stressed. I feel like there’s far too much to do and far too little time to do it. But multiple people have told me that this is the normal way to feel, which is (somewhat) reassuring. I attended a talk at the beginning of my work where the next three years were described as like being on a rollercoaster, and in terms of my oscillating between confidence and despair, they weren’t wrong!

I have OCD, a condition that affects 1-2% of the population, and can have a crippling effect on the ability to live one’s life. In my case, it manifests as a fear of taking actions that could lead to my own death. For example, when waiting at a level crossing for a train to go past, I will have the image of me standing on the tracks getting hit by the train, and I will get the urge to get out of the car and run away from the crossing, along with an incredibly unpleasant feeling of anxiety. The urge to escape from anxiety is very strong, and the relief when you do can feel like a drug being injected into your vein, but every time you perform a compulsion or other reassurance-seeking behaviour, you strengthen its hold on you and make the anxiety even worse next time. By seeking reassurance, people slowly shrink their comfort zone until everything causes anxiety even simple activities like getting dressed can take hours of rituals. But there is another way. Every time you face your fears, you weaken their hold on you and make it easier to overcome them in future.

For me personally, I find I am much more able to face my fears when I have higher self-esteem. And doing a PhD to help patients at a respected institution with capable passionate supervisors should help, right? Thankfully, yes it has, although it has not all been plain sailing. I came into the project with a strong set of technical skills, but deficiencies in softer skills like time management and self-motivation, in addition to a lack of understanding about what research in digital health actually is. I look back on my first year, or even first 18 months, with great frustration at the slow pace of progress. But I cannot judge myself with hindsight because I’ve learnt so much in that time, and of course if I started again I would do much better. Again, I think this is normal for a PhD. But there have been times when I felt unqualified to do the work I was doing, and I was aware of my self-doubt starting to sap my motivation and affect my productivity. Another problem is, because a thesis is an individual’s work, a PhD can be a lonely pursuit, which can again interact negatively with one’s mental health. I ended up taking an interruption of 3 months for stress, and I think this time was essential to deal with early setbacks and reset myself for the work ahead.

One surprising positive note for me has been Covid-19. From the beginning, I’ve had to do my PhD from home because coming into Manchester is just not something I can do on my own right now. I’m very appreciative of my parents, who have acted as carers bringing me onto campus when there have been events to attend, sacrificing a lot of their own time. And I’m also grateful to my supervisors for taking me on in spite of my problems. But I was always on the outside, because I didn’t work in the office with the others, didn’t go out for lunch, and didn’t have all the small informal interactions that build friendships. Then it got to March 2019, and suddenly everyone was in the same boat! All the seminars that I wanted to attend but couldn’t were suddenly online. In some ways I feel guilty here, because I know Covid has caused immense suffering to others who were not used to this level of restriction, but for me I went from being a weird outsider to someone who was the same as everyone else. I was also probably the best equipped out of anyone for lockdown, since I’ve been in a sort of self-imposed lockdown for many years. It was also a chance for me to ride the wave of easing restrictions, and use the collective coming out of lockdown to make progress with my own illness, and to an extend I’ve been successful here. Many naturally reticent people have struggled to re-engage as restrictions have eased, and I’ve been able to use my decades of experience to help others adjust back to normality. Another boost to my self-esteem.

So now I’m into the last six months. I’m definitely behind where some other students are or were, and there are times when this makes me doubt myself, but I now have a definite plan for what I’m doing, and I do have a brittle confidence that I will be able to finish it in the time remaining. If I do manage to pass, it will be the single biggest achievement in my life thus far, and I will be proud at the graduation of just how much ground I’ve had to cover. But getting there is by no means a certainty, and there is a lot of work to do between here and there.

Hope you enjoyed reading this, and that it gave you a small insight into what it’s like working around a disabling limitation like OCD. But for me, work beckons. Best get back to it!

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