The year was 1982. Cosmonaut Valentin Lebedev, about five months into his 211-day mission on the Salyut 7 space station, began to notice that as his time spent aboard the station grew longer, the state of his mental health grew worse. In his journal, he described counting the days until the mission was over, becoming increasingly irritable with his fellow crew members and mission control — even when they were just asking, “How do you feel?” — and even losing his desire to look out the window. Lebedev’s fight with depression called attention to the need for more research into how the experience of space travel affects astronauts psychologically (Potter, 2008). Although there have been considerable advancements in space exploration since Lebedev’s mission, our understanding of space psychology still has a long way to go. Dr. Tyler Moore, a psychiatrist who has worked with NASA, explained in an e-mail to the author, “The main things that need investigation are all behavioral aspects. We’re pretty well prepped when it comes to the engineering…but the biggest unknown with potential to cause mission failure is the human factor” (Moore, 2018). An astronaut struggling with a behavioral health issue could make a mistake that jeopardizes the success of the mission or even the lives of crewmates (Caddy, 2018).
One major way in which space travel affects astronauts’ mental health is by disrupting their sleep schedules, a phenomenon MIT research scientist Dr. Andrew Liu has studied extensively. According to Liu, “Once you go up into space, there won’t be the same 24-hour clock necessarily that you get here on Earth…. So without that you have to either [set a sleep schedule] artificially or figure out some way to kind of maintain and ensure that people get enough sleep” (Liu, 2018). Because of their orbit around the Earth, for each 24-hour Earth day, astronauts on the International Space Station (ISS) see 16 sunrises and sunsets (NASA, 2018b). However, a drastic change in dark-light cycles isn’t the only cause of the disruption of astronaut sleep patterns; the other major culprit is the station’s artificial light. According to Liu, the artificial light on the station is largely made up of a specific wavelength of blue light. Unfortunately for the astronauts, “when you’re exposed to the blue light late at night, your body starts thinking, ‘Oh, you want to stay up later,’ so it tends to try and keep you up, so you don’t get the release of melatonin that helps you go to sleep….” (Television screens and computers also emit blue light, which is why watching these screens late at night can disrupt your sleep.) Liu also explains that people who consistently lose sleep tend to have decreased executive function, or the set of mental processes involving concentration and decision-making. When people consistently sleep fewer hours than needed, their performance on mental tests tends to decline, even though after a while they usually feel they have adjusted to the lack of sleep (Liu, 2018). A poor sleep cycle can be counterproductive for astronauts, whose tasks can include anything from conducting experiments to repairing satellites, and it can also be potentially damaging to an astronaut’s mental health. For example, when Valentin Lebedev was showing signs of depression, he also had a disorderly sleep schedule (Potter 2008). An astronaut suffering from a poor sleep cycle could also be potentially dangerous to the rest of the crew; for instance, an astronaut piloting a craft while sleep-deprived could end up putting his crewmates in peril.
However, when asked what aspect of space travel is potentially the most harmful to an astronaut’s mental health, Dr. Moore argues that it’s probably exposure to radiation. Earth’s atmosphere keeps us safe from most harmful radiation hurtling in from space. However, in space, astronauts have a higher chance of exposure to this radiation, which can cause radiation sickness or nervous system damage, and can even increase their chances of getting cancer (NASA, 2018a). Moore alludes to reports of astronauts “seeing ‘flashes’ while going to sleep,” which he says is likely due to particles “tearing through” their eyes and brains (Moore, 2018). Liu also explains that the effects of increased radiation exposure is one of the least understood dangers of longer missions: “The one wild card factor is probably radiation. Like, if there weren’t any radiation damage, you could probably get a good sense of how people would react to being on that mission and controlling their [blue] light exposure [for sleep].” (Liu, 2018). Since missions to Mars and beyond will be significantly longer than current space missions, the effects of radiation on astronauts require more research to be adequately understood.
In addition, outer space isn’t just a physically demanding environment, but a mentally and emotionally demanding one as well. Crew members are forced to live in a confined space, away from their families for long periods of time, and perform difficult tasks like satellite repairs with their work constantly examined by experts on earth. Sometimes the pressure gets to them; in the 1980s, Chinese payload specialist Taylor Wang threatened to not come back to earth after his experiment failed (NASA, 2016b; Morris, 2017). Other times, fear of the dangers of space can compromise a crew member; astronaut Harry Hartsfield said of a crewmate, “We had one payload specialist that became obsessed with the hatch. ‘You mean all I got to do is turn that handle and the hatch opens and all the air goes out?’ It was kind of scary…so we began to lock the hatch” (Morris, 2017). There was even report of an instance in which the entire crew of a mission might have shared the same delusion; in 1976, the Soviet Soyuz 21 mission had to be terminated after the crew complained of an awful smell. However, the cause of the smell was never found, and a recent NASA report proposed that the crew had simply imagined the smell (NASA, 2016b).
As nearly inhospitable as space is from a physiological health perspective, space itself may not be intrinsically dangerous to mental health (except for possibly radiation exposure). NASA psychiatrist Dr. Gary Beven asserts, “One misconception is a concern or theory that the spaceflight environment may be inherently harmful or hazardous, from a psychological standpoint…. Any previously reported behavioral health problems have appeared to occur because of common earthbound issues” (Inglis-Arkell, 2012). In fact, under two percent of medical issues reported on the 89 shuttle missions between 1981 and 1998 were due to behavioral health, while more than 40 percent were issues with adjusting to the lack of gravity (Morris, 2017). Beven also points out that these “earthbound issues” — such as having crew members with clashing personality types in a confined space — could have been the reason behind many of the psychological issues of the Mir and Salyut missions (Inglis-Arkell, 2012). For instance, tensions were reportedly running high between the cosmonauts of the Soyuz 21 mission to the Salyut 5 station – the same mission that was terminated after the crew reported a terrible smell (NASA, 2016b). Also, according to Beven, some NASA astronauts aboard the Mir space station struggled with depression and feelings of loneliness (Inglis-Arkell, 2012).
Surprisingly, some studies suggest space travel can actually be good for an astronaut’s mental well-being. In a 2007 study, psychiatric researchers Dr. Jennifer Ritsher, Dr. Nick Kanas, Dr. Eva Ilhe, and Stephanie Saylor conclude, based on a group of previously conducted surveys, that space missions provide an example of salutogenesis, a process in which people are positively impacted by having to adapt to a harsh and stressful environment. This same phenomenon happens to some individuals in similarly nigh-uninhabitable environments, such as researchers at polar stations or people who travel in submarines. Researchers measured the subjects’ stress levels before and after they adapted to their respective harsh environments, and the experience of adaptation actually seemed to reduce their stress levels. Surveys suggest that many astronauts undergo the same kind of adaptation (Ritsher, Kanas, Ihle, & Saylor, 2007). In one study, Ritsher, Ihle, and Kanas sent anonymous surveys to 175 astronauts; of the 39 who returned the survey, all reacted positively to the experience of spaceflight, leading the researchers to conclude that “being in space is a meaningful experience that makes an enduring positive impression on astronauts and cosmonauts” (Ihle, Ritsher, & Kanas, 2006). The authors caution, however, that these conclusions “must be considered tentative given the small sample size and the potential for self-selection bias” (Ihle, Ritsher and Kanas, 2006).
Another survey of 54 astronauts reported that the “shared experience and excitement of space flight” helped improve their communication with both mission control and their fellow crewmates (Ritsher, Kanas, Ihle, & Saylor, 2007). Another team of researchers analyzed the memoirs of U.S. astronauts John Glenn, Gordon Cooper, “Buzz” Aldrin, and Michael Collins; the team noticed that all four astronauts reported that their experiences in space increased their spirituality (Suedfeld & Weiszbeck, 2004; Ritsher, Kanas, Ihle, & Saylor, 2007).
Surprisingly, one factor that likely contributes to this salutogenic effect is astronauts’ recognition and acceptance of the potential for danger. Retired astronaut Marsha Ivins explains, “We understand the danger involved in human spaceflight, and we accept the risk because we feel the reward of human space exploration is worth taking that risk.” She goes on to explain that even though training and spaceflight forces astronauts to spend years under intense pressure, “the experience overall is one of a mental high” (Ivins, 2019). Unfortunately, this emphasis on success under pressure can deter some astronauts from seeking psychiatric help when they need it; these astronauts may feel they can handle issues on their own and believe seeking psychiatric help indicates a weakness (Hylton, 2007). Still, according to NASA psychiatrist Gary Beven, astronauts aboard the ISS generally adapt to the environment after about six weeks, and many want to stay in space even longer. Beven maintains that “with six properly selected and well trained crew members in a relatively large living and working space, astronauts and cosmonauts truly thrive in such a spaceflight environment” (Inglis-Arkell, 2012).
Despite some evidence of space travel promoting salutogenesis, however, the lack of data on the behavioral side of space psychology means that the positive and negative effects of space travel on behavioral health are still inadequately understood. Many of the studies exploring astronaut mental health have relatively small sample sizes, as research is limited by the number of people who have travelled to space (Ritsher, Kanas, Ihle, & Saylor, 2007). The lack of information available in the field of space psychology becomes an even more pressing issue when one considers the fact that we know even less about how astronauts will react to longer missions. Lebedev was struggling with depression after only seven months; a roundtrip mission to Mars would take about 18 months (Liu, 2018). Even Ritsher, Kanas, Ihle, and Saylor concede, “The level of stress is expected to be even higher on the planned expedition class missions to Mars. Therefore, the risk of negative mental health effects… is not negligible and poses a serious threat to mission success” (Ritsher, Kanas, Ihle, & Saylor, 2007). Understanding the nature and causes of these potential behavioral issues and creating measures to mitigate them is of the utmost importance if we want to send astronauts to Mars and beyond.
Fortunately, NASA is making efforts to decrease mental health risks for astronauts. A large portion of these efforts include designing realistic simulations of space missions here on Earth. In 2014, NASA debuted the Human Exploration Research Analog (HERA), a habitat at Johnson Space Center designed to simulate a variety of missions, including a journey to an asteroid. HERA replicates the isolation and confinement of space missions, as well as other aspects of life in space. Just as on a real mission, HERA “astronauts” adhere to strict sleep schedules and mainly consume freeze-dried foods. The crew is also kept in constant contact with mission control, but just as on an actual mission of this magnitude, communications suffer from a 10-minute delay (NASA, 2019; Mallonee, 2017). Missions can last for up to 45 days (NASA, 2019). Though HERA is not a perfect simulation — as HERA cannot, for instance, replicate microgravity — the habitat does have virtual reality helmets onboard, allowing the astronauts to simulate tasks such as piloting the craft and walking in space. The nine video cameras onboard and the biometric trackers worn by the participants allow NASA to constantly monitor the crew (Mallonee, 2017). HERA is just one of many analog missions helping NASA to better understand how the confinement and isolation of space travel affects astronauts psychologically (NASA, 2016a).
Furthermore, potential NASA astronauts are required to undergo extensive psychological evaluations and training to even be considered for the astronaut program (Lewis 2014; Clay 2016). The evaluation process begins with a preliminary set of interviews, followed by a set of psychiatric interviews. A psychiatrist examines applicants for factors that could potentially disqualify them, such as mental illness or even marital problems (Lewis, 2014). Applicants deemed to have the highest chances of having a behavioral emergency in space are disqualified. Astronaut candidates are also scored based on “personality, emotional stability, interviews, assessed performance in the field exercises, and family demands” to determine their suitability for space travel (NASA, 2016). In addition to these assessments, candidates must perform a series of field exercises at Johnson Space Center designed to replicate the conditions of a real mission (Lewis, 2014). Potential astronauts are given training to strengthen skills that are imperative to mission success, such as conflict resolution, leadership, and stress management (Clay, 2016). Since people can change over time, the psychiatric evaluation and training process is imperfect and can become less accurate as more time passes (NASA, 2016b). Nevertheless, thorough psychological evaluations are a necessity for the success of future missions and for minimizing mental health risks in space.
Mission crews also have medical countermeasures in case a behavioral emergency arises. On the space shuttle, medical kits contained medications for depression, psychosis, anxiety, insomnia, fatigue, pain, and space motion sickness. The current medical kit on the ISS includes two antidepressants, two antipsychotics, and two anxiolytics (to treat anxiety). (Unfortunately, there isn’t much data on how these drugs would affect a human body in microgravity.) Additionally, crew medical officers and flight surgeons have access to sedatives and physical restraints in the event that a crew member’s behavioral emergency threatens the safety of the rest of the crew (NASA, 2016b).
Another way to decrease mental health risks is to increase the crew’s chances of undergoing a salutogenic experience (Ritsher, Kanas, Ihle, & Saylor, 2007), which is exactly why NASA has a Behavioral Health Team. The Behavioral Health Team tries to do everything it can to keep these spacebound astronauts feeling grounded, including remotely checking crew members’ behavioral health, consulting to help create safe work-rest schedules to prevent overworking, and working with clinical psychiatrists to provide aid should any mental health issues arise. They also encourage crew members’ families to make care packages (or they make some themselves), and they send them up to the International Space Station. A team of psychological support coordinators also helps astronauts video conference with their families. According to Beven, astronauts on the ISS are given “adequate sleep, healthy and good tasting food, exercise, meaningful work, leisure time, the availability of social and recreational events – music, movies, contact with family and friends – privacy, adequate space, and a supportive ground team” (Inglis-Arkell, 2012). Scientists are even looking into different kinds of lighting that will hopefully be less harmful to astronaut sleep patterns (Brainard, 2018). While the uncertainty concerning the psychological impacts of longer missions still remains, developments like these provide hope for maintaining the mental health of astronauts in future space travel.
Imagine the year 2032. A crew of NASA astronauts are about five months into their 18-month mission to Mars. The journey isn’t perfect, but everyone on this crew knows that they have extensive resources for emotional support if anything goes wrong. Space is enormously stressful, but they’re all braving it together. They’ll adapt. They’ll roll with the punches. And thanks to the hard work of space psychologists, all of them will be the better for it.
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The research for this article involved both primary and secondary sources. The author conducted an e-mail interview with psychiatrist Dr. Tyler Moore and a face-to-face interview with MIT research scientist Dr. Andrew Liu.