Editor's note: We're pleased to present two powerful pieces on mental health in college, one from a student (below) and one from a professional. Depression has become all the more common on college campuses, and if you're experiencing it, you're not alone. Please read these pieces and seek help if you need it.
You might know that girl. If you don't, you definitely know people like her. These chilly, winter days, you see her at Starbucks or Book Trader Café, working on papers and looking up to chat with people she knows. She makes intelligent-sounding comments in seminar and the professor nods, but you can see that she's checking her email--you wonder how she's following the conversation. She greets friends on the way to class, stopping to give bear hugs to people she hasn't seen in a while. An activist, a musician, a traveler, a risk-taker--after a few months of knowing her, you'll probably find out something else incredible that she was too modest to tell you. Friends confide in her, and she feels in her element when giving advice. On a Saturday night now and then, you might see her flirting and dancing at a party--perhaps not always in good taste, but a part of you still admires her carefree nature, and you smile to yourself when you see her the next day in the library, working away diligently.
Then there's that girl who can't remember the last time she didn't have a knot clenched firmly in her stomach. It seems that her anxiety clings to anything it can grasp. Some days, it's her schoolwork or the fact that she still has no idea what she wants to do with her life; others, it's just a vague, ominous fear of life in general. She's constantly rushed and continually worried--on bad days, she feels the tears welling up and threatening to spill over. But she's a tough one, and she has too much pride to let anyone see her crying--that most vulnerable, weakest, ugliest of states. She arrives to seminar a little early and goes in the bathroom stall to sob for a few minutes, immediately quieting if anyone comes in. She takes a few deep breaths, tells herself to pull it together, and feels thankful that her eyes aren't too puffy when she returns to class. She constantly observes those around her--in class, around campus, when she goes out--and she envies their happiness, their confidence, how it all seems so easy to them. Before going to bed, she takes her Zoloft and a sleeping pill. In bed, she writhes in hot, silent tears, white-knuckled, feeling like she could scream. Scream and cry forever. But she doesn't want to be a burden or to be even more ashamed of this weakness than she already is. She doesn't make a sound.
Those girls are me. I came to Yale University with a history of insomnia, anxiety, and mild depression, but optimistic about my ability to move beyond it. During freshman and sophomore years the problem persisted in waves, but at most to a degree of severe discomfort--not disability. I decided to take a leave of absence during the fall semester of my junior year to confront these issues, hoping to come back to Yale headed in the right direction. When people ask me what I did during my semester off, I tell them that I lived in Peru for a month and spent time at home volunteering at a school, and they usually don't question further. But I was also going to therapy twice a week, journaling, doing yoga, and building a fragile foundation centered on making myself feel better. That foundation crumbled instantly when I returned to Yale.
January and February of 2010 were the most painful months I have ever experienced. The previous symptoms of anxiety and depression not only worsened, but took on new components. I routinely cried myself to sleep, only to wake up the following morning in tears. I felt more overwhelmed by schoolwork than ever before, despite cutting my course load and removing myself from non-academic responsibilities. Normally a relatively social person, I only wanted to be around two close friends. I often ran into people who, with the best of intentions, would say, "I feel like I never see you--where have you been?" I never responded, "Well, I've been alternating between attempting to write papers in a foggy state of mind and crying alone in my room," because to be honest would be to give myself away. I had succeeded all of my life, and suddenly I was quickly falling. I could see no way out of this suffering.
I couldn't have been more mistaken. Courtesy of therapy, medication, time, and more than anything, affirmation that I need to take care of myself before anything else, I am feeling much better. I sleep at night, spend lots of time with friends, enjoy my classes, and am glad to be a student at Yale. That's not to say that everything is perfect--there's still a knot in my stomach, and I still speak regularly with a therapist. But the persistent crying, the isolation, and the feelings of helplessness and hopelessness have gone away, leaving me wanting to prevent myself and others from feeling like I did last year.
As I talk to more and more of my peers and learn about the inner workings of the university's mental health resources, I am confronting an unfortunate reality: there are many students who have or are currently dealing with mental health issues in one way or another, be it anxiety, depression, eating disorders, relationship issues, family problems, or otherwise. That is not to say that everyone goes to bed crying at night--these issues manifest themselves in different ways and come in different extremes. But still, nearly half of all students go to Yale Mental Health and Counseling at some point in their college career, while others see outside therapists.
What is far more worrisome than the number of students who struggle with mental health is the fact that so few talk about it. This culture of silence--the expectation that despite any problem you may have, you must come across as happy, productive, and successful--leads students to believe that mental health problems are embarrassing and that admitting to them is a display of weakness. As a result, students struggling with mental health issues often feel alone or not good enough for Yale's standards. When combined with the already intense and competitive nature of Yale, this culture of silence creates an awful environment in which to be unhappy.
I first realized that mental health problems were more common than I had thought when I started talking to people about my own struggles. I have always been hesitant to tell people about my anxiety and depression--some part of me still believes people will judge me, see me as a burden, or worst of all, feel like they haven't been getting to know the real me. Part of what makes something like depression so complicated is that it's not as simple as being fundamentally sad and masking it with happiness--often, both the laughing with friends and the tears in the bathroom ten minutes later are genuine. I have always feared that people won't be able to understand that, and that on some fundamental level, their view of me will change. Yet, as I speak more openly about my own struggles, I am finding that the people I talk to--be it students, professors, or family members--not only understand, but often respond with accounts of their own mental health problems. Some of the most well-known, successful people I have met here see therapists, are on medication, or seek other solutions to these challenges. As one of my best friends--and perhaps the most outgoing and well-regarded classmate that I know--said after an extended conversation about his inability to connect with people at a deeper level, "Everyone has a battle they're fighting, Lurie."
This realization that my peers are, indeed, human has made me question the honesty of Yale students in public, social situations. I particularly noticed this a few weeks ago when I went to Mory's, a restaurant and social club at Yale, for the first time. The crowd, dressed up and slightly tipsy, was making small talk and passing around large, silver goblets of various mixed drinks. Looking around, I had one of those, "There's no way I'm good enough for these people" moments; these were the people who write books and run businesses, the people who win Class Day awards and Rhodes scholarships. But on top of that, they made it look easy. After all, they weren't writing business plans or books at the moment--they were getting drunk at Mory's on a Friday night. At a glance, these were perfect people: smart, talented, and social.
But everyone has a battle. When I walked into the bathroom, I found a girl talking on her phone. I had seen her outside just a minute before, dressed gorgeously and laughing with friends. Now, she sounded miserable: "I'm at this...drinking club thing. And everyone's having fun, and I just...I don't know. I'm just tired. I don't want to be here. Should I leave? But if I leave, everyone's going to think I'm lame..." A couple hours later, I found myself at my house with two friends who had melded in with the rest of the crowd at Mory's. One admitted that he had had a panic attack in the middle of the event because of all the work he had left to do, and was only just calming down. The other had just broken up with his boyfriend, an event he framed as an add-on to what's proven to be an anxiety-ridden semester. He recently scheduled his first appointment for counseling.
The more people I become close to, the more I realize that the people who I know are talented and who I have always assumed are happy aren't so one-sided after all. That's not to say that everyone has deep, dark secrets, or that everyone is having panic attacks all the time, but rather that we build images of people around us based on their public appearances, and these appearances don't tell the whole story. For all we know, the people who we think are perfect think that we're perfect too.
While Yale is the college environment that I have experienced, I have no doubt that it is not alone in its culture of silence. Colleges foster intensive academic, professional, social, and personal growth, and with this growth naturally comes a degree of anxiety. Many articles in recent years have proposed that colleges today are particularly stressful given the pressure to flawlessly balance schoolwork, extracurriculars, jobs, and social activities. These responsibilities, combined with the fact that mental health issues often hit during late adolescence, make it no surprise that according to the American College Health Association, 19 percent of college students have sought professional help for mental health problems in the past year.
Yet, the stressful environment of colleges is only part of the problem. Arguably the bigger issue is that, like the culture at Yale, norms of American culture implicitly encourage us to maintain the appearance of being relatively happy and put together. We are embarrassed to say that we see therapists or take medications, or even to admit to friends that we're upset about something or having a bad day. We're asked how we're doing countless times a day; rarely do we think twice before responding with some variation of "fine."
This year, I have had the opportunity to see a little bit of the other story--the confidential, "hidden" story--as a campus peer counselor. At a recent peer counselor meeting, we discussed anonymous individual counselees, and patterns quickly emerged: there were a lot of Yalies with eating disorders, Yalies concerned about potentially suicidal friends, Yalies overwhelmed by work, Yalies confused about sexuality, Yalies upset with their relationships, Yalies who couldn't sleep. But regardless of the issue that they were dealing with, almost all of the Yalies felt that they were alone. Many said that they had friends and support nets, but they couldn't talk to them about these issues because they would feel judged, embarrassed, weak, and vulnerable. They would feel stigmatized.
We are facing an ugly feedback loop. Many of us have mental health issues of some kind, yet very few talk about them openly, causing those who are struggling to struggle in silence. Our perfectionism about our academic and professional lives has worked its way into our personal lives; we are not only supposed to have attractive resumes and transcripts, but we're also supposed to be social, happy, and relaxed. We are supposed to maintain an image of control, when in reality, none of us are always in control. We are human, and in the long run, we will all be much happier and healthier if we can let our guards down and transform our culture of silence into a culture of honesty.
We will each have our own ways of being honest. Maybe it means responding honestly when someone asks how you're doing, or telling a friend that something's on your mind. Maybe it means telling your roommates that you see a therapist, or letting them comfort you if you're not feeling good. I am not calling for everyone to divulge private information, but rather, as we go through our busy days, to stop and ask, "Is this real?"
But students can't do this alone; college administrations need to prioritize the mental health of their students by making changes at a higher level. Freshman orientations should not only introduce campus mental health resources, but should give the opportunity for older students who have had experience with mental health problems to tell their stories. The goal is not to scare freshmen, but to introduce the topic so that if mental health does become a problem, they know how to respond.
Administrations also need to make mental health services accessible to all students. While some colleges, including Yale, guarantee free counseling to all students, many colleges only offer therapy as part of expensive health plans. It may be costly for colleges to offer complimentary mental health services, but the benefits directly serve the missions of virtually all institutions of higher education: to enable students to reach their academic and personal potential. If students are struggling, they do not need the further stress of trying to figure out who to talk to and how to pay for it. Mental health departments need to be resources that students can rely on.
Finally, administrations and student groups need to help reduce the stigma of mental health problems. Many colleges offer safety nets to those who seek them, including freshmen RAs or counselors and peer counseling services. But at least at Yale, there is no point during the year in which the college focuses on promoting awareness of these issues. Every two years, the university holds "Sex Week at Yale," a week in which speakers, from sex therapists to porn stars, talk frankly about sex. Thousands of students attend these workshops, and the effect is that sex a little more normalized and a little more acceptable to talk about. A mental health equivalent of Sex Week, while maybe not quite as catchy, would be certainly as applicable--every student would be able to find a topic, speaker, or event that applies to his or her life. The more that mental health issues are out in the open, the more we will recognize how normal they are.
It has not been easy for me to tell this story. It highlights aspects of my history and my personality that I find embarrassing and unattractive. To tell this story is to take a leap of faith, so that college students understand the importance of honesty, call for improvements in their mental health services, and feel a little less ashamed to give their own accounts of struggles with mental health. But more than anything else, I tell this story so that those among us who are currently struggling know that they are not alone.
Postscript: I first wrote this as an essay for an English class last fall and it was first published in the Yale Herald. The idea of Yale's "culture of silence" had been on my mind for a long time and I had talked about it with friends, but I hadn't fully appreciated how pertinent the topic was until publishing the essay in a weekly campus newspaper in November and receiving hundreds of emails from Yale students saying that they could identify in some way. I have changed the article slightly to taper it to a more general college audience, though many of the same themes apply to people outside of the college setting as well. I hope that the article will encourage readers to reflect, even just for a moment, on their own mental health and the approach to mental health in their communities.