College daze

Following on yesterday's post, I found this interesting: Back to School With Bipolar?

I'm not sure why we think that 17-18 year olds are instant adults, even when in robust mental health. I cannot tell you how often I hear from parents that they are feeling helplessly worried about a kid at college who is in fragile mental health. The pressures on families to let a kid go to college, and then the pressures from the college to back off, can really be overwhelming. College is not, for most students in 2009, a community environment where people are living and studying with a tight cohort of peers and watched over by seasoned and attentive adults. Students are largely on their own, only as connected to others as their social ability and health allow. Colleges are environments where isolation is largely treated by way of alcohol, and teachers don't know the students by name until the third year. Mental health services must be actively pursued by the student - something both unfamiliar and unlikely for most young adults.

Parents play a much larger role in the daily life of students these days, right up until Freshman Orientation. What was normal in June is Helicopter Parenting in October. I think we need to empower ourselves and change that, especially when a loved one has a history of mental illness. That change is going to have to come from us.


  1. I think psychiatric advance directives are helpful, including those for college students.

  2. I definitely do not think that I should have been kept from college.....


    I do know that the "shit hit the fan" with my eating when all of the sudden I was totally in charge and able to control everything I (didn't) consume.

    And, when you're on the other side of the country from your parents while at college, it's really easy to conceal a lot too.

    I had friends calling my parents on several occasions over the course of a few years, telling them "she's not eating." I had my parents calling my friends back (not me). i had my parents calling my professors (not me). Finally they called me. I simply told them "Everything's fine." And then I simply told them that I wasn't coming home that break because I was staying at school to work on a project - all to avoid them having to see me (thus keeping up the lie that all was fine). When eventually, I did come home and my parents commented on how I was "too skinny," they saw my reaction and, not wanting to make me feel bad, changed their statement to be "you're doing a great job at eating so healthfully." They didn't want to hurt me more, so they applauded my consumption of green beans. (Al in an effort to keep me happy I think... some twisted effort, but they did the best they could). My parents, wanting to believe I was okay, smiled at hearing me tell them all was okay.

    Eventually, after too long of this and too many physical changes/troubles, my parents begged me to get help from my college mental health services. I agreed, to appease them. Them knowing that I went to talk to a nice woman (therapist) once a week put them at ease, which got them off my back, which game me more freedom to continue to control my environment and "get away" with my eating disorder. (I never once talked ever about eating with this college therapist. We just chatted like two women friends. Actually, somehow I felt like I was more her therapist. She told me all about her ED years as I listened).

    With college, kids have...
    1. a lot of control
    2. a lot of ability to conceal

    I'm not really sure why I'm writing all of this... maybe just to share my story of how autonomy in college leads to 4 full fledged years of really messed up behaviors. Had I been more supervised (not like it's anyone's fault but my own), I probably wouldn't STILL be workign on straightening out this eating business. Had I been caught and more monitored right away, I'm sure this whole "Recovery" process would be way easier. (I hesitate to write this because my ED is NO ONE'S fault besides mine - not the college's, not my parents... I know, technically it's not my fault but I still feel like it is. Because it is. I should just eat better. End of story.)

  3. Now,

    First of all: NOT YOUR FAULT.

    Second: you've articulated all the reasons why your being away at school hurt you and your family. Reading your description all I hear are the reasons why your family needed to be together and working together with a clinical team WITH you to understand the illness and support you to real recovery.

    You describe an illness in control - and parents and a patient being controlled by ED.

    I can't understand your first statement!

  4. Thanks for sharing this article. My D went off to college and bipolar disorder manifested at age 18 while there. She wasn't officially diagnosed until age 20, after having to leave school. She still struggles with bipolar and an ED.

    When a person becomes mentally ill while away at college, it takes such a long time for the parent to really become aware of the problem. It would be so wonderful if there could be early detection and early treatment, but the way things are in college, a person has usually spiraled down pretty far before there are any consequences. So sad.

  5. I just figured out what you meant when you said "I can't understand your first statement!" You were referring to my statement that I should not have been pulled from college, right? This is why I think that:

    1. I'm really grateful to have a college degree and a job now, even if food is still a daily issue for me.

    2. Had I left college, "recovery" would not have happened instantaneously - so, what, would I be like 30 by the time I got to go back?

    3. It's unrealistic to think that my parents would have known what to do. You have a lot of faith in parents (it seems) - more so than I do. I believe that it's not parents' fault. I'm with you there. But my parents have seen me "relapse" and thought the solution would be quitting therapy and "just thinking harder about how to eat well." In order to be effective at all, my parents would have had to have been sat down by some good professional and been told the reality. Where was this professional supposed to come from? My parents were not seeking them out. And my parents thought (and still think) they know better than any professional. My parents thought they knew better than my friends. When my friends called and said, "she's not eating," my parents thought, "we know our daughter best and we know she doesn't have problems so that can't possibly be true." And I sure as heck was not about to let a professonal talk to my parents. So what I'm saying is that had my parents pulled me from college, what would they have done? I have very little faith that being at home with them would have made things better (when I went home for breaks in college, I ate in an entirely differnet way when I was home to prove to them there was no problem.... and then I majorly cut back when I returned to school to make up for my liberal eating at home).

    I guess I'm saying is that, ultimately, I agree - the ED was in control. It would have been best for a clinical team t be working WITH me and WITH my parents all together.

    I just don't know how you get tot hat point? The patient has rights when they're over 18 and they can check the little box that says "don't talk to parents." If the parents are in denial, they don't seek this clinical team out.

    So how does this all work when the person with the ED is over 18 and when the parents are in denial and think they know best (when, really, they too uneducated to know best in this situation)?

  6. The unsatisfying answer, I'm afraid, is that we have to change the way ED is treated. We have to improve the public understanding of ED, better educate parents, and do a better job of diagnosis.

    I have little patience for parents in denial or for the tyranny of 18. But I also know that it is ED that makes these things hard, and not the patient's job to negotiate it. You should not have been in charge. College could have waited. Your family needed better support. The solution is not to leave it to patients, it is to educate parents!

  7. Educating parents is a good answer. Parents in denial - that was totally my parents. I am still in 2x week therapy, 1x week nutritional appts and my parents are, for the first time, really hearing what I and others are telling them. They're trying. Educating parents to lessen their denial would be a good step.

  8. In relation to college students and ED, Eating Recovery Center, an eating disorder center in Denver, just released research showing that the transition to college, with its inherent pressures and changes, can increase the likelihood of eating disorders in young adults. Go here for the complete report:


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