TRIGGER WARNING: This article discusses self-harm and suicide, which may be traumatic for some readers.

A mental disorder can be almost as difficult to spot as it is to live with. Many students who suffer from depression, anxiety, post-traumatic stress disorder (PTSD) and other conditions are doing so in silence, at Whitman and at schools across the country. These conditions can arise from a multitude of causes––some biological, some from experience, some compounded from other disorders––but all have one thing in common: When people realize they are struggling, their first instinct is to fight the battle alone.

The 2009 National Survey of Counseling Center Directors, collected by the University of Pittsburgh, recorded that 60 percent of college students have at least once felt too depressed or anxious to function. According to a recent Pioneer survey of 272 students, over one in four Whitman students has been diagnosed with depression, anxiety, PTSD or a panic disorder in their lives, and as many as two out of three believe that they have suffered from one of these but not sought medical attention. Out of 272 respondents, 39 percent report having had a panic attack, 22 percent have engaged in self-harm and 18 percent have suffered from an eating disorder. While these percentages may not be representative of the student body as a whole, the fact remains that mental health is a concern for a significant number of Whitman students.

A susceptible population

Junior Lara Tah* has suffered from PTSD, bipolar disorder and bulimia since before arriving at Whitman. She said starting college made her more susceptible to mental health issues because the unfamiliarity of her surroundings and the pervasive silence about mental problems caused her to regress from the therapy she received in high school. 

“Individual therapy was helpful for a long time, but it stopped being helpful in college when I was separated from my support network,” said Tah. “When I got to college it felt like many people were completely silent. So few people were willing to even acknowledge their struggles unless I opened up first.”

Tah continued her behaviors, including self-harm, in secrecy. She said that her downward spiral was exacerbated because she berated herself for not being able to defeat her disorders on her own.

“You suddenly are overcome with these feelings that you can’t do it and are not good enough,” she said. “You tell yourself you are a failure, you can’t do anything, you’re weak. Those thoughts are not only what cause the depression, they are what keep you there.”

Another leading cause of depression among college students is stress. The typical student lives under several simultaneous pressures: to keep up with an academic workload, to remain social and to prepare for his or her future. Of all these, none is so difficult as the pressure to make all of the other tasks look easy.

“I was one of those overachievers in high school. I was a perfectionist. I worked myself too hard, and the stress didn’t go away when I expected it to,” said first-year Arden Robinette, who has received counseling for stress-induced depression.

The stress eventually led to a breakdown.

“It was my junior year of high school. I thought I’d get through it and the stress would go away, but weeks before my senior year started, I freaked out and told my mother I couldn’t go back,” she said.

In other cases, students carry trauma with them from home and suffer as a result. Sophomore Emma Nye has been diagnosed with PTSD from a childhood trauma, and found the symptoms more difficult to bear when around people who weren’t familiar with her history.

“I’m very open about it, but there’s a difference between being open and being able to accurately convey what it’s like. Part of being depressed was feeling like nobody understood. I think it’s not that nobody actually understood, but I didn’t expect anyone to understand. My friends here are super sympathetic, but when you’ve only known people a year, it’s harder to explain,” she said.

Robinette, who describes herself as a private person, said that a different problem kept her from opening up to others. She believes that there is stigma surrounding those with mental health issues, especially those who seek counseling.

“It’s not something that’s socially accepted. It’s like if you go to counseling, you’re admitting you’re crazy. It’s sad because it could really help people, but it’s ingrained in our collective mentality.”

According to statistics from the Welty Counseling Center, 93 percent of college counseling center directors said in 2009 that students have been coming to them in greater numbers with more severe problems. Dr. Tracee Anderson, who works at the center, said that an increase in their number of clients reflects this trend.

“I’ve been here for 20 years, and every year we have had an increase in the demand for services,” said Anderson. “For example, last year, we saw 27.5 percent of the student body; in 2006, five or six years before, we saw 22 percent. This year, without a doubt, we’re seeing more than 27.5 percent.”

Silence

Almost all of the students with mental health conditions who responded to the survey described having hidden feelings from everyone or nearly everyone in their lives. While some said that trusted individuals are privy to these experiences, others said that they have gone through things about which nobody knows.

Even when people are able to be candid about their feelings, the struggle may not end. Although friends who hear somebody’s story are usually supportive, several misconceptions have become part of the common view of mental illness, even among Whitman students. Chief among these is the response that their issues are all in their head and that they should “buck up.”

Junior Matt Alder* has received this answer several times after opening up about his depression. He has had intermittent symptoms for around five years, and claims he has been depressed continually since arriving at college.

“I feel like, in the instances where I have opened up, people just have the same things to say in different ways. ‘Stop being depressed. Just act happy. Get over it.’ It drives me insane. I can’t act happy because I’m depressed,” he said.

Simply reverting to a scientific explanation for depression also bothers him.

“Another thing I hear a lot is that depression is simply a chemical imbalance in the brain. This one comes from counselors. I understand that they’re correct, but it’s not like the sudden realization that chemicals are screwing me over makes me feel any better.”

Alder has tried counseling and medication but has never been able to continue with either for very long. In his sophomore year, he began to contemplate suicide. He said that his claims that he thinks of killing himself have also not always been taken seriously.

“I think most people assume that I’m only using the word ‘suicide’ for attention. I’m not,” he said. “I’ve created so many plans and evaluated each and every single one for its possible lethality that I’ve developed a theoretical hierarchy of which method would be the best. I’ve evaluated the cost of some plans as well as the difficulty in executing others.”

Tah also said that she has heard things from other people that parallel the negative lines of reasoning she has said to herself in her darkest moments. A transfer student to Whitman, she spent a year at the University of North Carolina, where she opened up to friends about her history of self-harm. One day, a peer took her aside.

“She said, ‘I’m sorry, I want to help, but I can’t be around you because you’re so negative. You couldn’t possibly have tried everything. You need to work harder.’ That’s a really common message. I’ve had people claim I was just doing it for attention or that I should just choose to be happy. Some people honestly think that by being sad, you are choosing it, and that makes you weak,” said Tah.

Sara Williams* finds it almost impossible to share her experiences with loved ones because she is afraid they will treat her differently once they know. Williams deals with both chronic germophobia and PTSD from an abusive relationship. She said that people who have not gone through trauma or lived with phobias can never truly understand the sensation of something interfering with living your life the way you want to.

“I’ve grown up in a society that says it’s not okay to have these things or be affected by them,” she said. “Sure, I get a little more leeway with the trauma because you’re supposed to respect that, but basically, it’s almost like if I talk about them, I’m afraid that the person I’m talking to will treat me as subhuman. They’ll treat me in a way that they think they’re supposed to treat me, rather than as the person I am and they’ve known me to be.”

Some students choose to remain silent for reasons other than a fear they will be misinterpreted. Senior Walter Leitz, who suffered from anxiety and depression in elementary and middle school, has not required counseling or medication since eighth grade. He said he doesn’t talk much about it because he very rarely has days in which he is unable to function.

“My depression ties in with sleep deprivation, so I’m careful to get enough sleep,” said Leitz. “There are occasions where I don’t feel like doing anything because I feel really down and apathetic, but I rarely feel like it’s so bad that it starts screwing up my work habits.”

The students on the survey who said they elected not to seek counseling gave a variety of reasons. Of these, the most common were a belief that it wouldn’t be helpful or that their condition was not serious enough to merit counseling, as well as a fear of social judgment.

Leaves of absence

If students decide that their mental health problems are interfering with their ability to function in college, they can take a medical leave of absence. According to Dean of Students Chuck Cleveland, the procedure for this is similar to a medical leave for a physical illness or a major surgery.

“Students have a right to take a leave as long as they’re in good standing,” said Cleveland. “The board of review approves virtually all of them. If they’re on probation, they’re not supposed to take a leave, but mental health reasons are a mitigating factor. Often there is a relationship between psychological health and academic trouble, and the board understands that.”

He stressed that the college never sends students away as a disciplinary action, but can grant them leave if they are “not acting as a student” by not attending class or by disrupting their residence hall. In some cases, the administration requires clearance from a medical professional to allow a student to return; this is usually asked in response to concern from the student’s parents.

Depression is the condition most commonly cited by students looking to take leave. In a survey conducted by the Office of Institutional Research of the incoming freshman class in 2012, 47.1 percent said they had felt depressed occasionally in the past year. 6.7 percent said they felt depressed frequently in that time span. This is significantly higher than the percentage of working adults with the same problem: In a 2010 survey done by the National Institute of Mental Health, only 9.5 percent responded that depression had kept them from functioning.

“There’s nothing inherent in being a student that causes depression, but being depressed makes it difficult to be a student,” said Cleveland. “Medications enable students to come to college who couldn’t have 15 or 20 years ago. Sometimes students stop medication because it interferes with how they want to live.”

The difficulty of reconciling academic life while fighting mental illness on the inside led sophomore Kristen Wiseman to request a medical leave last semester. Like Robinette, Wiseman found that the emphasis on achievement in high school and college engendered depression by forcing her to put herself second to her efforts.

“I didn’t want to bring depression with me, and the way I decided to do that was to not talk about it. But the things that triggered me as a senior triggered me again freshman year,” said Wiseman. “It can be paralyzing. Writing papers was really triggering for me because it was part of me––my thoughts on paper. If you’re constantly putting down your academics and how you’re thinking and your abilities, writing a paper is not easy.”

At last, Wiseman decided that she needed to take time off from school if she was ever going to put her mental health before her work. At spring break last year, her doctor told her that her depression would become harder to manage if she returned to school. Due to the administration’s clearance policy, her doctor’s approval was required for Wiseman to be able to return, and her doctor ended up making the decision that she should remain on leave for the rest of 2012.

“I’m changing 18 years of habits and thinking. A couple months of practice helped, but it wouldn’t be super effective,” Wiseman said. “I took a semester off to focus in on coping skills and DBT (Dialectical Behavioral Therapy, a type of psychotherapy that incorporates meditative techniques). I did as much as I could at home, but I knew I had to come back.”

Despite the fact that taking leave wasn’t originally her decision, Wiseman ultimately found the time she took off helpful to her well-being. Senior Jessica Asmus, however, took her leave of absence under rougher circumstances. Before her leave, Asmus developed a habit of using anxiety medication to sleep for days on end. She was sometimes rushed to the hospital because friends were unable to wake her up.

“I know that a lot of other students were worried and others had talked to the administration about being worried,” she said. “Their reaction was asking me to leave so I wasn’t disrupting other students.”

However, Asmus’s circumstances were complicated: She grew up in foster care, and did not have a home to go back to. Despite knowing this, the administration insisted she take a leave anyway. Asmus recalled being escorted to her room by security and given 20 minutes to gather her belongings.

“I left campus with literally nowhere to go, and that made everything so much worse,” she said. “That definitely made it worse and ultimately is what made me enter an inpatient facility. At the University of Washington Medical Center, I did a lot of behavioral therapy. It taught me how to deal with things better on my own instead of trying to get angry or self-harm.”

After three weeks at the inpatient hospital, Asmus lived for the rest of the semester with a couple who worked with one of the programs that helped pay for her education. Even after undergoing effective treatment and counseling during that time, she said that the college was reluctant to let her return.

“The school required me to get medically cleared by a doctor. I was cleared at UW before I was discharged,” she said. “When I gave them that paperwork, they required me to be psychiatrically cleared. Margaret and Greg (the couple she stayed with) took me to a counselor, and I was psychiatrically cleared. Then the school said it wasn’t a good idea. Margaret and Greg said they didn’t have that authority.”

Cleveland said that a leave of absence has never been worked out between only the student and administration. In situations in which a student does not have parents, the terms of leaving and returning are discussed with a relative, guardian or significant other. He stressed that the college is not exercising power over students trying to return to campus, but is involving them and their support networks in a cooperative endeavor.

“I’m not comfortable categorizing what’s going on as a power relationship,” he said. “The goal is to help the student face whatever issues there are and come back strong. There’s all kinds of people involved, including significant others, the student themselves, sometimes the counseling center and sometimes the health center.”

With Margaret and Greg advocating on her behalf, Asmus was permitted to return to campus. Since then, things have dramatically improved: She now sees a counselor once every six weeks, accepts more help from her friends and no longer requires medication.

Recovery

About half of survey respondents have sought counseling at some point in their lives, and one-fifth have been prescribed psychiatric drugs. A vast majority, 75 percent, of those who sought counseling described it as “effective,” and 65 percent of those who took medication said the same. However, there are some exceptions.

Asmus’s current therapist works off campus, and she acknowledged that she still has trouble with the counseling center at Whitman.

“I sought counseling off campus because I was embarrassed walking into the counseling center. I was stressed going there and stressed leaving. I think that’s why I didn’t get better with that help,” Asmus said. “Sometimes there are other students there and you think, ‘you are also here because you have issues.’ It’s a really awkward atmosphere, especially because you see them later.”

While some students avoid on-campus counseling, others have had positive experiences. Nye said that the counseling center has “helped her a lot.” In particular, visiting new director Thacher Carter, whose specialty is therapy that teaches patients to accept and overcome trauma, has aided Nye in her dealings with PTSD.

Though Robinette has never sought counseling on campus, choosing instead to take advantage of a program in her hometown in Oregon, she was effusive about the boon that a therapist can be to one’s mental health.

“Usually, I have to reach a critical level before I feel like I have to go back. It’s when it gets to the point where I feel I can’t handle it on my own anymore,” she said. “Over the summer, a couple weeks before I came to Whitman, I was really stressed about it. I was worrying about every little thing that could go wrong. So I went back to counseling and sat down for half an hour and cleared everything up.”

Tah, too, got to a point at which she had to seek intensive psychiatric help. She joined a partial-day group program and a week-long treatment program which focused on the role of family and birth order in the development of disorders. For the first time, she began to feel like she was not alone.

After that, she checked into residential treatment in Chicago for a 30-day stay. While there, she witnessed the state of the American mental healthcare system firsthand, as one-third of the 36 patients on the ward were sent home when their insurance companies withdrew coverage.

Since attending group treatment, Tah has continued to participate in 12-step programs. She has been clean of self-harm for nine months, and of bulimia for six; she is also currently taking medication for bipolar disorder. She said that the view of the American public parallels the view on college campuses.

“The reality is that a good chunk of us are faking being happy, doing well and feeling fulfilled. It creates an atmosphere that isn’t real,” she said. “What our campus needs to acknowledge is that a lot of our students are struggling with mental health issues, here and everywhere.”

In order to expose the illusion, Tah, Robinette, Wiseman, Nye and others are attempting to open a local chapter of a national organization called Active Minds. The purpose of an Active Minds support group is to open conversation and alleviate the pain of suffering in silence with a mental disorder.

“I’m hoping to work on the feeling of not having anyone who’s been through the same situation or who really understands how dark your life can look,” said Nye. “Bipolar made it harder to get up, literally and figuratively. Just knowing you have people that completely understand what you are going through is such a motivating thought.”

Wiseman, who said that her life at Whitman is gradually improving and teaching her not to isolate herself, is involved in the club to foster connections between individuals who went through the same things she did.

“It surprises students that they’re not alone,” she said. “There are so many people coming out of the woodwork, people I’d never have expected to have mental problems. No matter how much you think you can do this by yourself, you can’t.”

*Names have been changed