<p>STONY BROOK, N.Y. Rushing a student to a psychiatric emergency room is never routine, but when Stony Brook University logged three trips in three days, it did not surprise Jenny Hwang, the director of counseling. </p>
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<p>Stony Brook is typical of American colleges and universities these days, where national surveys show that nearly half of the students who visit counseling centers are coping with serious mental illness, more than double the rate a decade ago. More students take psychiatric medication, and there are more emergencies requiring immediate action.</p>
<p>Its so different from how people might stereotype the concept of college counseling, or back in the 70s students coming in with existential crises: who am I? said Dr. Hwang, whose staff of 29 includes psychiatrists, clinical psychologists and social workers. Now theyre bringing in life stories involving extensive trauma, a history of serious mental illness, eating disorders, self-injury, alcohol and other drug use.</p>
<p>We used to call it adolesence and now we call it mental illness.</p>
<p>Add all the pressure to succeed, the fear of making even one mistake, even just look at this nutty college application process…Remember when the “senior slump” was just something that happened? Now it is something to avoid. I’m not surprised our kids are getting crazier.</p>
<p>The culture is getting crazier by the minute.</p>
<p>Sometimes these types of things “come on” in college, but a huge number of the issues are there before college and yet the kids still head off right along with their eating disorders, cutting disorders, anti-Ds etc. What are parents thinking? College is stressful enough without heaping that on a student with existing mental problems. </p>
<p>Unless the student is at a university with a medical center the affected student will be sent home or somewhere else. Most colleges do not and most likely will not support emergency mental health care. The statistics are alarming: </p>
<p>In my family, we used to drink ourselves to death at an early age. Now we take medication and live productive lives.</p>
<p>The idea that once upon a time there were far more happy, well adjusted teen agers is, to put it bluntly, bs. Teens are far less likely to suffer in silence. It’s a good thing.</p>
<p>It’s also very difficult for those who are not mentally ill to understand and to dismiss.</p>
<p>I’ve seen this tendency first-hand working as a professor since 1981. In the early 80s when a student was having problems with, say, depression and I would recommend that he or she see a counselor, it was often the first time the kid had considered the option. Now, in the same circumstances, the kid will tell me s/he has been in therapy since age 8.</p>
<p>However, I have a more optimistic view of the matter than barrons and other posters. Because of better drug treatments, many students can attend college who would in earlier decades would have been prevented by their illness from doing the work. Both my husband and I, for instance, have recently mentored pretty seriously bipolar students–one of whom has just finished a PhD. Every so often their meds get out of balance and they have issues, but most of the time they cope pretty well. I think it’s great that these kids are living fulfilling and constructive lives.</p>
<p>i actually agree with both poetgrl and kate. we have ‘pathologized’ the normal emotions of adolescence to a degree, while at the same time greater access to/support for mental health care is progressive. </p>
<p>how many times have u heard someone describe themselves (or a friend) as ‘depressed’, when in actuality the person had every reason to be experiencing sustained sadness (due to the death of a loved one or some other significant event)? </p>
<p>but no, there probably weren’t fewer people with mental illness back in the day–the topic was just considered unspeakable.</p>
<p>“how many times have u heard someone describe themselves (or a friend) as ‘depressed’”</p>
<p>I don’t assume that when someone says “I’m depressed,” they mean “I meet the DSM criteria for a psychiatric diagnosis.” That word has both a medical meaning and an everyday, vernacular-speech meaning. Feeling depressed is not the same thing as having clinical depression, and most people I interact with get the difference. This isn’t pathologizing normal emotion.</p>
<p>i disagree. many people feel uncomfortable with normal, human reactions to events and the emotions that spring from them. the everyday vernacular can make it very hard for a person to experience a normal reaction (in their own way, and resolve it in their own time) without outside, societal pressure to ‘move on’ or experience the all-important (and somewhat elusive) ‘closure’.</p>
<p>if we (as a society) didn’t pathologize normal emotions, would there be so many people on anti-depressants?</p>
<p>Americans are obsessed with being happy and feeling emotionally comfortable all of the time. We believe to be unhappy about unhappy circumstances is something to “get over.” This fight against natural human emotions actually creates a tremendous amount of anxiety and discomfort.</p>
<p>Do I believe that it is better that people are seeking counseling? Absolutely. Do I believe that the number of people on drugs is way too high? Absolutely. Teenagers, in particular, experience emotional discomfort as “something’s wrong with me.” Teenagers also experience somebody looking at them strange as, “She doesn’t like me.”</p>
<p>We have pathologized grieving. We have pathologized feeling uncomfortable in new situations, which is simply a “normal” survival instinct.</p>
<p>Three weeks into college kids want to come home because they haven’t found any friends, yet. Kids being homesick is not depression or anxiety, it’s adjusting. We have pathologized adjusting, for crying out loud.</p>
<p>AND there are people who are truly mentally ill.</p>
<p>Twenty years ago, it was verboten to ever seek counseling / therapy and you just gutted through problems by yourself, self-medicating if need be through alcohol or drugs. Nowadays, there is a raised awareness that mental health is as important as physical health. I think this is a positive development, not a negative one.</p>
<p>BTW, for those longing for the “good old days,” think what a gay teen had to deal with 20, 30 years ago. He or she couldn’t possibly come out and admit such feelings. Nowadays, there are GLBT support groups, a supportive administration, and while that’s not to deny there isn’t still prejudice or that it’s an easy path, it’s a thousand times better than it was back then. That’s a good thing.</p>
<p>And I echo the concept that we haven’t “pathologized normal emotions.” People go on anti-depressants for real, medical issues – not because they’re sad over the everyday things that get us down. Some of the attitudes on here are precisely the attitudes that kept people with mental health issues “in the closet” for so long, and that’s shameful. When will you get that these issues are as real as, say, diabetes or asthma? When will you get that there is a real difference between sad-because-my-goldfish-died and clinical depression?</p>
<p>By “drugs,” do you mean, well, drugs like cocaine and LSD and heroin and so forth, or by “drugs” do you mean properly prescribed antidepressants? Because that’s precisely part of the problem, to refer to antidepressants in that scornful way as “drugs” as if they were any more shameful than, say, insulin for diabetes or whatever-one-takes for allergies or asthma.</p>
<p>Unless you are a physician with intimate knowledge of someone’s health status, I really don’t see how anyone has much insight into whether someone else “should” be on medications for mental health issues or not.</p>
<p>By “drugs” I mean illegal substances. However, I can also say with great conviction that the number of people addicted to perscription pain releivers is absolutely through the roof and a massive issue, right now.</p>
<p>If I had meant anti-depressants, I would have said anti-depressants.</p>
<p>But, yeah, thanks.</p>
<p>I happen to have a PsyD. I happen to see the pressure being put on kids this age. I happen to know that “burn out” is not depression nor is it a mental illness. If you think this culture isn’t getting crazy with the pressure it is putting on teenagers? Think again.</p>
<p>The reason for the rise in diagnoses is not just because there is more disclosure or more mental illness, it is because parents and the culture want to label things and “fix” everyone. Junior doesn’t want to go to college because he hates school, he must have be depressed. Nope. He just doesn’t want to go to college.</p>
<p>THAT is what I am talking about. Agree or disagree. The pressure on these developing minds, which will not fully grow in until 25, the OUTSIDE pressure, is unbearable to many. And, that might create a mental illness, but the reaction of shutting down in the face of so much outside pressure is, actually, not a mental illness.</p>
<p>I think it’s difficult to predict what kids will fall apart and which ones won’t…which kids will take their meds if they are supposed and those that will play with their dosing…which kids have kept problems hidden and which ones will develop new problems. I think what is important is that colleges are not in the business of staffing up to deal with these types of issues unless they have a medical school or hospital affiliation. I hope colleges drop a courtesy call to the “in case of emergency” contact when students end up in a triage situation such as described in the article. </p>
<p>It’s fair to compare people with diabetes as a health issue and people with mental illness as a health issue…in many cases both are treatable with drug therapy. But then again, any illness that requires drugs also requires awareness by the person with the illness what is wrong, why they are taking the drug and what lifestyle adjustments needs to be made. I sometimes think there is desire to trivialize when young people require drugs to function. They grew up in this environment – got a cold or earache, give them antibiotics. Don’t eat vegetables, give them a vitamin. Got a headache, take Tylenol. Got acne, get a drug. Got heartburn, take prilosec. They grew up living a life where if something wasn’t quite right physically you injest something. </p>
<p>I am optimistic because I think that there are kids who are achieving great things that several decades ago they could not have achieved but on the same hand I think there is a alarming rising tide of students who do not have things under control that are landing in colleges or are taking perscription drugs and have no clue what that means or entails.</p>
<p>I do think anti-depressants are probably overprescribed (most are prescribed by primary care doc’s who have usually little training in psychological/psychiatric differential diagnosis and tend to equate “sadness” with “depression”… some are much better, of course, but many do tend to throw anti-depressants at anything that involves dysphoria). My abnormal psych instructor in undergrad (a clinical psychology PhD student) told us a million times over that sadness was not depression and that not being happy all the time didn’t equal depression. </p>
<p>That being said, I’m kind of shocked by some of the comments on this thread, which same to be dismissing serious mental illness as “pathologized adolescence” or the result of whiny kids, cell phones, and helicopter parents! Really? What a good way to continue to stigmatize mental illness and seeking mental health care. :(</p>
<p>The nature of what you are looking for will determine what you see.</p>
<p>If you think, because somebody else said I was calling someone a whiny kid, I might have been, then you will see that in my post. That is, in fact, not what I said.</p>
<p>I’m glad to hear your abnormal psych teacher saying this. You do understand, given your major, that insurance covers medication but not counseling? You do realize, that given the way insurance has dictated the treatment of every disease in this country, it has also dictated the way we ‘treat’ emotional discomfort?</p>
<p>I don’t happen to consider dysthemia or mild anxiety to be mental illnesses. The only reason for the DSMV is to create ways to label things in order to get it covered by the insurance companies. I expect to see massive changes in the ways these things are treated after 2014.</p>
<p>You don’t think dysthemia is a mental illness? That is low level depression for two years or more, right? Then what is it? Let me guess, “emotional discomfort.” </p>
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<p>I’m not shocked. I find that dismissive attitude to be nearly as prevalent among professionals who work in the field of mental illness as those who do not. I find it to be a difficult field to find providers who are both competent and compassionate. Since we move so much, I often have to settle for simply competent.</p>