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IS SCHOOL DRIVING US CRAZY?

 

"FOR the last five years I've been on a roller coaster ride of emotions with manic highs and depressive lows. I entered my senior year of high school at the top of my class. I ended it barely graduating."

In Sept 2004, fifth year Stanford senior Adam Kahn addressed a new student orientation event focusing on diversity. He told the incoming class of '08 about the illness that caused him to be booted out of his dream university.

"The fall of my freshman year was rough," he reported. "I was overmedicated due to an incompetent psychiatrist back home. I was a zombie and could barely stay awake past 11 pm. I was out of practice academically given my disastrous senior year of high school. I was still not turning my papers in on time."

In his junior year, with mounting incompletes and failed course to his record, he was placed on academic suspension. At home, he went from bad to worse, and enrolled in a special treatment program.

"At times it felt like I would never make it back." he related. "At times it felt like I was too far gone." But slowly, based on skills he learned in treatment, he learned to take control of his life. He was able to complete some of his incompletes from home and prove to the school that I was well enough to return a quarter early. "More importantly, I was able to prove to myself that I was well enough to return a quarter early from my suspension."

This time there was no margin of error for screw-ups. "I'd be lying if I said life is easy for me," he confessed. "My bipolar disorder does a lot to make me who I am. On the other hand, it is not who I am. It does not define me like it once did. When I joked with a friend about how I was speaking today about being crazy, she said Adam, 'I know you're crazy, but there are many more things than just one that make you who are, and they all count.'"

Adam went on to graduate and enroll in grad school, with a brilliant life to look forward to.

My Parallel Account

My student journey was every bit as problematic as Adam's.

Depression had been a constant in my life since junior high, but no one back in the sixties thought kids could be depressed. The depressions worsened in college, around the same time my manias began to make an appearance. No red flags went off. To my teachers and parents, I was simply a lazy and under-achieving student.

College age is typically the age of first onset for bipolar, often brought on by social and academic pressures and lack of attention to sleep. In my case, the result was a lot of failing grades and incompletes and a fast-track to drop-out status. Six years in the wilderness elapsed before I resumed my studies.

 

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A Major Concern

Mental illness has recently become a major concern on college campuses in the US, especially in the wake of the well-publicized suicide of MIT student Elizabeth Shin in the early 2000s, and more recently the Virginia Tech tragedy.

Since 1950, the suicide rate has more than doubled for college-age women and tripled for college-age men. According to three surveys reported in US News and World Report, 30 percent of US colleges experienced a suicide over a one-year period, 9.5 percent of students say they have seriously contemplated suicide, and 1.5 percent have made the attempt.

The same article cites an American College Health Association survey reporting that 76 percent of students felt "overwhelmed" while 22 percent were sometimes so depressed they could not function.

The situation is borne out by a survey of counseling center directors, 85 percent who report an increase in severe psychological problems over the past five years. Students have grown up in an era of the disintegrating American family, the US News article notes, but they are also more used to therapy and are more likely to seek help. In the past, many kids with severe mental problems would never have made it to college, but today, thanks to new medications, they are potential clients of college counseling services.

Student depression is of particular concern. A National Mental Health Association survey reports that 10 percent of college students have been diagnosed with depression. According to Richard Kadison MD, chief of the Mental Health Service at Harvard, in an interview with Psychiatric News:

"So many students have their first incidence of depression while in college, and they are completely surprised by it. They think that it is just that they have become lazy or that they have a sleep problem."
Harvard is one of many colleges that have dramatically increased the budgets and staffing for their counseling services. Nevertheless, according to Mark Reed MD, director of counseling and human development at Dartmouth's College Health Service, in the same Psychiatric News article:
"College mental health is one area that is really underserved."

Counseling is typically limited to several visits, with students often not seeing the same psychiatrist or therapist twice.

Then there is the delicate issue of whether to include the parents in the loop. Colleges generally regard students as adults, with the counselor-client, psychiatrist-patient relationship as sacrosanct.
Yet, there is an obligation to break confidentiality if the client/patient poses a danger to him or herself or others. Federal law grants students rights of privacy, but also allows schools to contact parents if the health and safety of a student is at risk. MIT's decision not to alert Elizabeth Shin's parents may have been justified based on widely-held assumptions at the time.

But that was then.

Published 2000, latest revision, Jan 20, 2011, reviewed Dec 4, 2016

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