“Are you thinking about a PhD?” The truth was, I had never imagined I would end up in Sweden, much less complete a graduate degree in a Nordic country. A PhD felt like a distant, unlikely idea. So I answered, “I’m not sure.”
An associate professor overheard us. She turned and said discreetly:
“You need to be 110% certain. There are happy doctors, but there are no happy doctoral students.”
Recent data suggest she wasn’t wrong.
A nationwide longitudinal research studying the impact of PhD studies on mental health, tracked over 20,000 PhD students in Sweden between 2006 and 2017, has shown that doctoral training itself is linked to declining mental health. Using health records, psychiatric medication prescriptions, specialist care visits, and hospitalizations, the study was able to avoid reliance on self-reported stress or even fear from judgement allegations, while capturing real care-seeking behavior.
These studies found that before starting a PhD, students used psychiatric medication at rates similar to graduates who stopped at the master’s level. Medication use rises sharply immediately after beginning the PhD. By the fifth year, prescriptions for psychiatric drugs are roughly 40% higher than pre-PhD levels. After graduation, medication use declines substantially. These patterns are consistent across disciplines, genders, and backgrounds, except for medical and health sciences students, whose clinical duties provide different support structures.
This is not new in Sweden
This is not the first study to report similar results. In 2022, the Research Institute of Industrial Economics (IFN) found in this study that roughly 7% of PhD students receive treatment or a diagnosis for depression, and 5% for anxiety, in any given year. While these numbers are lower than earlier survey-based estimates, they are still higher than those of peers not pursuing a PhD. IFN researchers concluded that this mental health decline develops during the PhD program, indicating a causal effect of doctoral studies on wellbeing. Factors such as high expectations, lack of formal training, social isolation, and financial insecurity contribute to the manifestation and diagnoses of mental health conditions.
Likewise, the Swedish Public Health Agency (Folkhälsomyndigheten), found that in 2023 mental health-related stress, burnout, and antidepressant use rose among young adults, with school-related stress particularly affecting girls. By that time, universities acknowledged gaps in mental health support, while national reports continued to show increasing rates of anxiety and depression among young people.
In the case of PhD students, they are particularly vulnerable because they are both students and full-time employees. Several studies have investigated how this impacts their mental health, revealing concerning patterns. These studies suggest that it is the doctoral program itself and not a preexisting vulnerability, that drives this deterioration in their mental health.
Add the immigration stress factor
There are other factors that can contribute to this diagnosis, as international students face additional hurdles. The SULF Doctoral Candidate Association (2025) reported in this other study that non-EU/EEA PhD students face structural obstacles that can amplify stress: long residence permit processing times, unclear criteria for permit assessment, and limited options for appeal. These rules often prevent students from traveling for conferences, fieldwork, or personal reasons, restricting mobility and professional development. The report highlights a double dependency: students rely on their supervisors and universities to maintain their legal status while simultaneously meeting strict thesis deadlines. Delays caused by migration procedures can reduce the time available for research, forcing compromises that other doctoral students do not face.
These findings resonate with broader media reporting in Sweden, which has increasingly highlighted unclear expectations, power imbalances with supervisors, academic isolation, and a culture of overwork within doctoral programs. For international students, these pressures are compounded by relocation challenges, cultural adaptation, and social isolation.
“So much depends on your supervisors,” said Amira Perez, a PhD candidate in Stockholm University. “When you’re an international student dealing with homesickness, cultural barriers, or even the death of someone back home, having supervisors who understand is crucial. In my case, I went through personal tough moments that led to a burnout. I’m grateful that my supervisors understood and recognized what burnout and depression looked like. But I know I was lucky, and that this isn’t the case for many international PhD students in Sweden.”
Both studies also indicate that non-EU and non-Swedish PhD students are particularly vulnerable, as they are often less familiar with their rights and may not always recognize when a supervisor’s behavior has crossed a professional boundary.
Taken together, the evidence paints a consistent picture: doctoral studies in Sweden carry a substantial mental health burden, particularly for international students navigating both academic and migration systems. These studies underscore the need for targeted mental health support, clear institutional guidance, and policy reforms to reduce the psychological toll of doctoral education while supporting Sweden’s goal of internationalizing its higher education system.
The thin line between endurance and resignation
The researchers of these studies note that these findings are not just descriptive but also a call to action. They argue that the mental health strain experienced by PhD students in Sweden needs to be recognized as a structural issue, not an individual failure of resilience.
In other words, this is not a matter of students needing to “cope better,” but of universities and policymakers needing to provide clearer expectations, more stable funding, better supervisory support, and accessible mental health resources.
If Sweden wants to continue attracting international researchers and developing high-quality academic work, the conditions under which doctoral students live and work must be taken seriously as a matter of policy, not personal endurance.
How to cope with the stress of a PhD
Annika Wappelhorst, a PhD student in Media and Communication Science at Jönköping University is in her third year, but from the beginning she was mindful that maintaining her well-being would be essential to succeeding in her studies. Outside academia, she teaches yoga, enjoys reading fiction and non-fiction novels, and takes long walks around the nearby lake. Based on her experience, she shared a few strategies that have helped her maintain a healthier balance during their studies such as establishing clear work hours, staying organized and planning ahead, among other things.
“I don’t want people to think that pursuing a PhD in Sweden is the worst decision you can make,” Annika says. “What’s important is that you know your rights, how to identify unkind behaviours in supervision, and understand where to turn for help if something doesn’t feel right.”
If you feel that your PhD studies are affecting your mental health, there are several resources you can turn to for support. In an emergency, contact a psychiatric emergency room or call 112. For guidance on where to seek care or advice about available services, you can call 1177. Most universities also offer support through a PhD student ombudsman or their occupational health service. Additionally, the Swedish union for doctoral students (SULF) offers support, advice, and advocacy to help PhD candidates have good working conditions at universities across Sweden.
The evidence is clear: Swedish universities must treat doctoral mental health as an institutional responsibility, not an individual challenge. Until then, knowing your rights and where to find help isn’t optional—it’s survival.
