Who Gets to Be Sad?
Comparing Depression Rates in Academia, Medicine, and Sports
Perfectionism, pressure, and the mental health crisis in high-performance professions
“You have tenure. Why are you sad?”
It’s a question that no one asks out loud—but many think.
Academia, to outsiders, often looks like a dream job: flexible hours, intellectual autonomy, and book-lined offices. But inside the system, the story is different—and for many, deeply painful.
A 2018 Nature Biotechnology study found that nearly 40% of PhD students experience moderate to severe symptoms of depression—six times higher than the general population average of ~6–8%.
And they’re not alone. Doctors and elite athletes—two other professions typically seen as prestigious and rewarding—also show strikingly high depression rates.
So what connects these worlds of science, care, and sport?
This post explores an observational comparison, not a causal claim—but it suggests that the structure of academic life may be uniquely damaging in ways that merit deeper attention.
📊 Depression by the Numbers
🎓 Academia
39% of PhD students report moderate to severe depression symptoms (Evans et al., 2018)
36% of PhD students globally sought help for anxiety or depression due to their studies (Woolston, 2020)
Over 50% of early-career researchers reported worse mental health during the pandemic (Woolston, 2021)
⚕️ Medical Doctors
27% of medical students experience depression symptoms, but only 15.7% seek help (Rotenstein et al., 2016)
20–30% of practicing physicians report depression (Mata et al., 2015)
⚽ Elite Athletes
19–34% of athletes report anxiety or depression, especially during injury recovery or retirement (Gouttebarge et al., 2019)
🧠 Common Traits Across Fields
These professions differ in form, but share some deep psychological stressors:
1. Over-identification with success
A rejected paper, a botched diagnosis, or a lost match can feel like a collapse of identity. These careers demand that you become your work.
2. Delayed rewards
All three fields involve years of preparation, sacrifice, and uncertainty. Whether it’s a PhD, a medical residency, or athletic training, the payoff is distant—and often not guaranteed.
3. Silence around mental health
Despite rising awareness, stigma persists. Admitting you’re struggling can feel like professional suicide. So many suffer quietly.
🧩 Does Academia Cause Depression?
Let’s be clear: this is not a definitive causal analysis.
But the pattern is hard to ignore.
While all three fields involve ambition, pressure, and delayed gratification, academia stands out—not for higher performance demands, but for less institutional support.
Where doctors have residency programs, clinical teams, and formal oversight...
Where athletes have coaches, teammates, and monitored performance...
Academics, particularly PhDs and postdocs, are often left to navigate stress in isolation, with precarious contracts, minimal mentoring, and little psychological scaffolding.
So while depression may partly stem from self-selection (e.g., introspective or perfectionist individuals drawn to academic life), the structure itself seems to intensify the risk.
Ambition and pressure may be constant across elite professions—but academia uniquely combines them with instability, isolation, and silence.
🔍 Compared to the General Population?
The contrast is stark.
ProfessionEstimated Depression RateGeneral Population~6–8%Academia~39%Medical Doctors~28%Elite Athletes~34%
Academia tops the list—not because it’s more demanding, but because it lacks the support structures others rely on.
🧩 What Should Change?
We need to stop assuming that prestige protects people from suffering.
Depression isn’t a contradiction to success—it’s often the consequence of how we’ve defined it.
What if our systems rewarded collaboration, mentorship, and care—not just output and prestige?
Because if depression is the cost of brilliance, something in the structure is broken.
📚 References
Evans, T. M., et al. (2018). Nature Biotechnology, 36: 282–284.
Woolston, C. (2020). Nature, 575: 403–406.
Woolston, C. (2021). Nature, 595: 611–612.
Levecque, K., et al. (2017). PLOS ONE, 12(3): e0177383.
Rotenstein, L. S., et al. (2016). JAMA, 316(21): 2214–2236.
Mata, D. A., et al. (2015). JAMA, 314(22): 2373–2383.
Gouttebarge, V., et al. (2019). BJSM, 53(11): 667–672.