“No one realised how much my friend was struggling until she attempted suicide”

When Dr Emilia Molimpakis was at university, she discovered her friend after her attempted suicide. In a powerful first-person piece for Processing, a Frame Of Mind series, she shares how the trauma inspired her to use her work as a neuroscientist to help people better spot the signs that someone is seriously struggling. 

Content note: this article contains references to suicide that readers may find upsetting.

In 2018, when she was just 26, my best friend tried to take her own life.

We had plans to meet one afternoon, and she didn’t show up. I went to her flat, just 30 minutes from where we were supposed to meet, and I found her. The emergency services saved her life that day, but things were so close to turning out differently.  

My friend and I met at halls of residence whilst we were studying for our master’s degrees. She was incredibly endearing, yet outgoing and eccentric, always saying what she thought regardless of how it might sound. She was a breath of fresh air.

Yet under the bubbly surface, I knew she was struggling. She felt culturally isolated and unhappy in the UK, having moved to London from China in 2013. And despite having a small but close circle of friends at university, she had experienced bullying and often felt as though she didn’t fit in. 

In 2015 we started our PhDs, and along with so many of our peers, we found the transition difficult. We’d gone from being bright-eyed master’s students with top grades, scholarships and fellowships to suddenly entering a new side of academic life, one in which we were at the bottom of the food chain.

We’d been vaguely warned that studying for a PhD can lack structure and academic support. But I was still shocked when I learned that my two supervisors were on leave for the first 12 months of my PhD. The familiar territory of tutor meetings, lectures, exams and regular praise had been replaced by three to four years of blank space, which we needed to work out how to fill to produce a thesis.  

“In 2015 we started our PhDs, and along with so many of our peers, we found the transition difficult.”

For many of us, getting to grips with this new reality triggered anxiety, stress and even led to depression, a reaction that’s distressingly common: more than a third of doctoral researchers consider ending or taking a break from their studies due to poor mental health, and 42% of PhD students see developing a mental health problem as a ‘normal’ part of the process.

When we saw my friend showing symptoms of depression, we thought it was par for the course. But what she was actually contending with was far more serious.  

My friend first went to see the university therapist about how she was feeling in 2017, but the university wasn’t equipped to help in the way she needed. She was entitled to five therapy sessions with the campus therapist and, once those were done, she joined the NHS waiting list, where she was told she’d have to wait six to nine months for help. As a stop gap, the NHS offered access to group therapy in eight weeks’ time, but it couldn’t deliver the level of care she needed. Eventually she decided to pay for her own psychiatry appointments.

But that support, when it came, offered too little, too late. Like lots of bright, capable women, my friend was incredible at keeping up appearances in public while her mental health was crumbling in private. The psychiatrist she saw clearly couldn’t see how bad things had become.  

“When we saw my friend showing symptoms of depression, we thought it was par for the course. But what she was actually contending with was far more serious.”

At her first appointment, she was diagnosed with major depressive disorder (MDD). Globally, more than 60% of individuals who have attempted suicide struggle with MDD, and people with MDD have a 20-fold increased risk of suicide than the general population.

But they sent her on her way with a prescription for antidepressants and a follow-up session scheduled for the next month. Just two days later, she tried to take her own life.  

“How did so many people, including me, fail to see how bad things had become?”

In the days that followed, among the trauma and guilt swirling around my head, I kept thinking the same thing: how did so many people, including me, fail to see how bad things had become? The people she’d spoken to and the forms she’d filled in had all failed her. The system wasn’t set up to help doctors spot the warning signs or to understand just how bad someone’s symptoms might be.

And my academic’s brain started whirring, wondering how we could do things better. I started to talk to psychiatrists and therapists, piecing together that at least one of the failure points in the system was a lack of objectivity in mental health assessment. Doctors were relying on observation skills and questions that were frequently biased, hoping that an individual will be self-aware enough to explain how bad things might be. 

My own research had been focused up until that point on looking at how biomarkers – the tiny signals that make up features of our speech and behaviour – show up differently across different patient populations. I started thinking about how we could use these to help us spot when patients might be suffering with mental health conditions such as depression much sooner and with greater accuracy.  

This idea, paired with the expertise of my co-founder, Dr Stefano Goria, an expert in AI, laid the foundations for a new tool that uses video game-style technology to help professionals identify and monitor conditions such as depression. After years of work, it’s now being rolled out to mental health professionals across the world, with research also taking place to assess the impact it can have on spotting conditions such as dementia.

My hope is that we can spot the micro signals that someone is in distress sooner, so that people can’t spiral dangerously far down the dark chasm of depression without somebody spotting it and stepping in.  

“Each of us has the power to prevent others from suffering alone.”

I wish solutions like mine weren’t needed. But the reality is, we’re living through a mental health epidemic. One in six people in the UK are currently experiencing depression, which is higher than pre-pandemic levels. One in five people have suicidal thoughts and one in 15 will actually attempt suicide.

Meanwhile, waiting times for mental health care on the NHS are at their longest in decades, with almost a quarter of adults with mental health problems waiting more than 12 weeks to start treatment, and others are turning to A&E in search of help. With private therapy costing around £70 per session and psychiatrist appointments easily costing upwards of £300 per hour, it is not an option for many. We need new solutions to enable earlier intervention and ease pressure on services, so more patients can access care. 

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We also need to get better at talking about mental health, particularly in academia. We should not live in a world where one in four PhD students experience feelings of suicide or self-harm. Universities need to recognise how the culture of perfectionism that plagues academia can have devastating consequences and they must do more to ensure academics at every level feel emotionally and mentally anchored, not least because the nature of their discipline means they must relentlessly seek to enter uncharted territory without a map.

My experience with my friend has taught me that depression and suicide is not always visible. But each of us has the power to prevent others from suffering alone. I am determined to change how we diagnose depression for the better. But everyday actions can be just as powerful. If you’re concerned about somebody, speak to them, encourage them to let you in. Remind them that there is help available; they only need to be brave and remember to ask for it. 

If you’re in crisis, you can call the Samaritans on 116 123, or text SHOUT to 85258. Let somebody in. And let them stand right beside you until you feel strong enough to stand on your own. 

Frame Of Mind is Stylist’s home for all things mental health and the mind. From expert advice on the small changes you can make to improve your wellbeing to first-person essays and features on topics ranging from autism to antidepressants, we’ll be exploring mental health in all its forms. You can check out the series home page to get started.

If you or someone you know is struggling with their mental health, you can find support and resources on the mental health charity Mind’s website and NHS Every Mind Matters or access the NHS’ list of mental health helplines and services.

If you are struggling with your mental health, you can also ask your GP for a referral to NHS Talking Therapies, or you can self-refer.

For confidential support, you can also call the Samaritans in the UK on 116 123 or email [email protected]. In a crisis, call 999.

Images: Emilia Molimpakis

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