We study the mental health of graduate students at eight top-ranked economics PhD programs in the United States using clinically validated surveys. We find that 24.8 percent experience moderate or severe symptoms of depression or anxiety—more than two times the population average. Though our response rate was 45.1 percent and sample selection concerns exist, conservative lower bounds nonetheless suggest higher prevalence rates of such symptoms than in the general population. Mental health issues are especially prevalent at the end of the PhD program: 36.7 percent of students in years 6+ of their program experience moderate or severe symptoms of depression or anxiety, versus 21.2 percent of first-year students. Of economics students with these symptoms, 25.2 percent are in treatment, compared to 41.4 percent of graduate students in other programs. A similar percentage of economics students (40–50 percent) say they cannot honestly discuss mental health with advisers as say they cannot easily discuss nonacademic career options with them. Only 26 percent find their work to be useful always or most of the time, compared to 70 percent of economics faculty and 63 percent of the working age population. We provide recommendations for students, faculty, and administrators on ways to improve graduate student mental health. (JEL A23, I12, I18, I23)