mental illness and college struggles

Parents Forum
1

<p>Hi,</p>

<p>I’m in a conundrum and I need some advice. I go to an Ivy League school (entered Fall 2010) and I was struggling academically and socially for my first three semesters so I took my fourth one off – against my parents’ wishes. I ended up just hanging out at home doing nothing for a good chunk of my leave of my absence and with nothing but the bad memories of the struggles of my college life and hostile treatment from a family that did not want me back at home caused me to get depressed. I ended up going back to school in Fall 2012 (ran out of ideas and money) and surprisingly things started to go well – but I was so angry at the way my family treated me during my semester off that I stopped communicating with them during that whole semester. I ended up going home during Winter Break of this past school year (after not talking to basically anybody in my family for four months) and a long email sent by my Dad right before the Spring 2013 was to begin made me apologize to my family for essentially estranging my relationship with them – but the guilt of the email (he brought up a lot of family issues that had nothing to do with the past three years up that I thought we were past) was so much that I was crying the whole weekend that I was supposed to start my Spring semester and went into my adviser's office in tears on the first day of class saying that I had suicidal thoughts.</p>

<p>My adviser then gave me an ultimatum: either check myself into a psychiatric hospital or take a medical withdrawal. I took the former option and spent a week in a hospital where I was diagnosed bipolar II disorder. My college’s mental health department ended up making me take a semester off anyway “to stabilize on the meds” (read: absolving themselves of liability) so I ended up being at home again for what would have been my Spring semester. I worked on my relationship with my family and have been going through the motions of applying for readmission to hopefully return to my college this fall and graduate uninterrupted.</p>

<p>The problem that I have is that I don’t think I’m bipolar – there is no history of mental illness in my family and my symptoms do not match up with what I’ve read of this illness. I haven’t really gotten into all of the details of these past three years for obvious reasons, but I think I was just going through a lot and I incorrectly looked at suicide as the only option. To be honest, I just want to get off these meds, be back at school, and move on from all of this. I do not want to voice my “misdiagnosis” concerns to my therapist though because I’m afraid he’ll come up with a new mental illness to label me with and it will slow down the process of readmission. My family friend psychologist and parents agree with me but don’t really want to get into it. I’m also afraid of how this diagnosis will follow me into the future. </p>

<p>Do you guys have advice? Should I just suck it up and take the meds and accept the diagnosis for an illness that I don’t think I have? Should I tell my psychologist what’s really on my mind (ever since going to my advisor this past January, I’ve been very reluctant to “reach out” for help, afraid it’ll dig me into an even deeper hole), knowing that it will probably push back my re-enrollment even more? My original class year will graduate in 2014 – I want to have one year with the friends that I’ve made there. Or do you think I should do something else altogether? When anybody hears about my situation, they suggest transferring – but I finally feel like I got my act together and don’t want to lose out on the opportunities that I think an Ivy League degree can give me. Help!</p>

2

<p>Yes. Lots of people are misdiagnosed with bipolar disorder. The only question is how to deal with it. And, from what you say- maybe you have it, maybe not. </p>

<p>You could take the meds and see your therapist. Get back to school. Then, get a therapist and a prescriber near your school (but preferably not AT school). Once you are back at school and doing well, tell your prescriber that you aren’t sure you need this medication and you would like to taper off. Do it slowly. Continue to do well and communicate with your family. </p>

<p>It’s too late not to be labeled with this diagnosis. You got it from your hospital admission. So rejecting it now and cutting yourself off meds just puts you at risk of recurrence of symptoms. (Which can occur whether the diagnosis is right or wrong). So, go slowly and be honest with your therapist. You have nothing to gain from stonewalling your therapist.</p>

3

<p>Sounds like you don’t trust this therapist. You need to find one you do trust and level with him/her. Unlikely that the hole can be much deeper.</p>

<p>The Ivy League degree will be there. You need to be happy and stable and healthy. I wouldn’t go back to school until you are sure that’s what you are. Friends will stay friends, even if you don’t graduate with them.</p>

4

<p>It’s really tough for any of us strangers to give good advice. You might be in denial or you might be right. If you and your family feel the diagnosis is in error, by all means go get a second opinion. There aren’t any clear tests for mental illness the way there are for strep throat. Find a new psychiatrist and go in for an evaluation.</p>

5

<p>I am so sorry for all you’ve been through. I really commend you for reaching out to people here for ideas and advice.</p>

<p>First, I think you need to find a therapist (outside of the school’s own health system) who is a person you feel comfortable talking to about your thoughts, concerns, worries, stresses. At some point in everyone’s life, they need someone who is non-judgmental (and not a parent) to talk to. If this therapist thinks you would benefit from medication in conjunction with therapy, they will recommend someone they have worked closely with in the past.</p>

<p>My own daughter had a very bad time sophomore spring at a top 20 school. She had severe anxiety and sleeplessness, so she sought help from the school’s health service, who responded by putting her on some heavy duty sleeping pills which knocked her out for days at a time (thus making her miss class which only increased her anxiety about doing well). She thought of dropping out and coming home, but she told me if she did, she was afraid she would never go back. Meanwhile, a high school classmate of hers (and the only one who got into Harvard her year) dropped out sophomore spring because he was so stressed and unhappy.</p>

<p>I guess my point is: you’re not alone. And judging by my daughter’s experience, I think the college health service operates from a point of limiting liability first and foremost. If you want to find a professional who can help you understand what it is that is truly troubling you, you may have to go outside the school’s health system.</p>

<p>With the right therapist, you will be able to explore all the questions you posed in your original post. They will help you look at things objectively and evaluate your options. Leaving an Ivy isn’t the worst thing in the world. You need to decide what is best for you.</p>

<p>Please post again and let us know how you’re doing.</p>

6

<p>hellogoodbye–this must be challenging to not feel confident with the diagnosis and possibly the care you’re receiving. I have a question, since you are asking if you should continue with the medication and therapy, an important question is, do you think the medication is working, helping you with the symptoms of depression you were experiencing. Please let us know…</p>

<p>I would agree with other posters, it would be reasonable to seek a second opinion, with a psychiatrist of your choosing. A good psychiatrist will spend time doing a differential diagnosis and help you understand their findings. </p>

<p>Until you have a new therapist and diagnosis, it probably is best to continue the medication, as stopping antidepressants can create difficult side effects.</p>

7

<p>This is all complicated and a professional is your best direction.</p>

<p>If you are on meds now and don’t think you are bi-polar- well, it is common for the meds to mask or soften some of the issue. In theory, they are meant to reduce the symptoms. It’s not unlike people on blood pressure meds who see a series of good readings and may think there is no problem.</p>

<p>Yes, you can have another “therapist” offer a second opinion. Is this an MD? In the event you go off the meds there could still be an underlying issue- you should still be under a professional’s watch, on a regular basis, until some test period proves out. This also assures the college. </p>

<p>I am surprised an advisor could give you the ultimatum, hosp or leave. It’s more usual for someone up the ladder who is experienced and trained in these issues. So, proceed cautiously.</p>

<p>And, the family friend psychologist has evaluated you?</p>

8

<p>To clear up some questions:</p>

<p>Once I went back to school, my depressive symptoms went away within two weeks. That’s part of the problem that I have with my bipolar diagnosis: I’m pretty sure the psychologists at the psychiatric hospital used the “depressive” period that was my leave of absence as fodder for my diagnosis, but my family friend psychologist pointed out that it’s kind of easy to get depressed if you’re doing nothing for long periods of time, which is what I was doing during my leave of absence.</p>

<p>Another problem that I have is that many of the psychologists from my psychiatric hospital stay were alarmed by the fact that I can talk very, very quickly to the point that people cannot understand what I’m saying some of the time – a fact that has been corroborated by many people. I guess they interpreted my quick speech as racing thoughts, which is a hallmark symptom of bipolar disorder. The thing, I’ve always talked very quickly, so I don’t think it’s a new symptom is a mental illness that has suddenly developed – in high school, I gave a speech to a group of parents as president of an organization’s new member induction, and I remember I talked so quickly, the student body talked about it for days making fun of me. I’ve never felt my thoughts were going so fast that I’ve wanted to scream, I couldn’t sleep, or that I couldn’t get out everything that I wanted to say, which is apparently how bipolar racing thoughts are supposed to feel.</p>

<p>My family friend psychologist has not evaluated me and to be honest he didn’t even want to tell me that he didn’t think I was bipolar. He was using his medical knowledge to synthesize what he had already known about me and made it as a passing comment. It took lots of grilling after he had dropped that bomb (that I myself suspected) for him to articulate his reasoning and even then he didn’t really want to get involved in it.</p>

<p>Also, I am not taking antidepressents, I was prescribed to take Risperdal, an antipsychotic, at a relatively low dosage.</p>

9

<p>And your therapist is an MD/psychiatrist, qualified to prescribe and monitor?</p>

<p>Thing is, whatever is going on, you need a doc you can relate to. One who specifically understands the issues of your age group (my kid’s psychiatrist deals exclusively with late teens and college.) If you hit it right, it is gold. If he/she doesn’t feel there is a diagnosable problem, you have a shoulder and someone to monitor as you go off meds. If you hesitate to work through your school’s health center, sometimes a call to another college can yield some leads.</p>

<p>I’m not a doctor. But, at the very least, some of what is normal to you, or that you feel you can explain, at least raised flags. In fact, sometimes our own perceptions of normal, we are used to them, we don’t always realize what the scale is. I wish you the best.</p>

<p>It is worth pursuing, for several reasons: to clear up your college status, to perhaps heal, if there is an issue (and explain the various Rx choices, work with you to fine tune or wean off) - or to learn the small tips that help you endure, as well as communicate.</p>

<p>Sometimes dumb things stop us in our tracks. At this point, where you are trying to restore, go ahead and take the positive steps, with professional help.</p>

10

<p>Well think about this- I understand that you’ve had several depressive symptoms in the past. However, the other half of the coin of bipolar is manic episodes. Yes, it is a little bit over-analytical to assume that you are bipolar because you talk too fast; a bunch of people do that and that is just a personality trait. However, have you ever felt more energetic than usual or felt that you were nearly euphoric? Those are feelings that often characterize bipolar. These manic symptoms can be on-and-off or can last for a longer while. Just think about if you’ve felt an unnatural “high” recently and if so, talk to your psychiatrist so you can figure out whether they are significant enough to mean something.</p>

11

<p>Bipolar disorder comes in different forms. Bipolar 1 involves manic episodes, sometimes psychotic, alternating with depressions, sometimes suicidal. Lithium, depakote, lamictal, tegretol, trileptal are typical meds: mood stabilizers and anticonvulsants</p>

<p>Bipolar 2 tends to involve more, longer, depression with some hypomania mixed in. Hypomania can look perfectly normal, and often comes in the form of creative energy, so may even be admired. </p>

<p>SSRI’s (and ADHD meds like stimulants) should be avoided by anyone with bipolar disorder unless a mood stabilizer of some sort is on board, and even then, they can be risky. If you have been on an SSRI and experienced sleeplessness or high energy, then that might mean you have a sort of hidden bipolar tendency that is uncovered by the meds, or it could mean that you just react in that way to the meds, in a way that is not diagnostic. Have you been on an SSRI for depression at all?</p>

<p>Antipschyotics like Abilify are sometimes used for bipolar 1, especially for the actual mania. Risperdal has a shorter half life and is not usually used unless there is some psychosis going on, or at least a need for sedation. Seroquel, another antipsychotic, has some antidepressant properties and is also somewhat helpful for sleep.</p>

<p>It sounds like they thought you had “pressured speech” which can be typical of mania, but if that is how you normally talk and it is not accompanied by a mood or thought disorder, then that “symptom” is a false one. It is also more typical of bipolar 1,though I suppose the hypomania of bipolar 2 might involve faster speech.</p>

<p>It is common for young people your age to have some depression that is a result of transitions and “adjustment disorders.” There is no need to pathologize you. Find a therapist who will start with the idea that you do not have any disorder at all, but are a young adult dealing with leaving home and studying at a rigorous college. Ivy League schools are full of kids like this, just like most colleges. I have read that 50% of Harvard students seek counseling at one point, and that 30% are on antidepressants.</p>

<p>That said, if you DO feel there is a problem, you are being medicated in a very strange way for bipolar 2. Or for depression. Risperdal is sedating and slowing. Someone maybe prescribed this because of your fast speaking style? What are the effects for you? Do you find it helpful in any way? Does it affect functioning?</p>

<p>Anyone reading this needs to know that if you say - to anyone- that you are having suicidal thoughts, or answer their question about it in the affirmative, SOMETHING WILL HAPPEN. MD’s and therapists inside and outside of academia have liability concerns, for one thing. Guaranteed, you will either have to leave or go to a hospital, so they don’t suffer any lawsuits. Now, if you ARE suicidal, by all means say so and get help. </p>

<p>I don’t know what hurdles the school has for you in order to get back, but most Ivy League schools will do almost anything to help you graduate eventually. You need a second or third or fourth opinion until whatever the therapist or MD or psychologist says sits well with you and those who know you well. A psychiatrist would be best. </p>

<p>Is the school requiring that you work full time for 6 months or that you meet with their doctor/psychiatrist or what?</p>

<p>Perhaps you should meet with a psychiatrist at your school to expedite things. Tell him or her what you have written to us and mention the fast speech issue. The university psychiatrist could be helpful to you in dealing with the bureaucracy of reentrance to the school.</p>

<p>I believe it is very possible that you have been misdiagnosed and are being mis-medicated, so to speak. It is your right to question this and get yourself to proper help. Do you have an adult or parent who can be involved? And figure out this fast speech issue, which, along with some possible depression (clinical or not)no doubt led to this idea of bipolar 2.</p>

<p>I will PM you or you can PM me.</p>

12

<p>ps You should be seeing a good psychiatrist, not a psychologist. It often takes a few different appointments with different psychiatrists to find a good one, though often the psychiatrists at Ivy League schools are quite good. You can also be evaluated in a bipolar clinic, often for free. Because they are doing studies, they aggressively weed out those with questionable bipolar diagnoses.</p>

<p>Your university wants you to be in good mental and physical health while on campus, for many reasons, including legal ones. They don’t care what the diagnosis is or what the meds are. They usually want some evidence of better functioning and well-being, such as work or volunteering consistently. You do not have to take Risperdal to prove stability. It is not the taking of the meds per se but the results, and if you can attain “stability” by doing, say, for the sake of argument, Tai Chi every day, that would be fine too. As long as you have a professional who can document and vouch for you.</p>

<p>Be aware that some of the best psychiatrists do not take insurance. University psychiatrists also do not need to deal with insurance.</p>

13

<p>First, I commend you for reaching out and seeking advice about your situation. Facing something like this is monumental.</p>

<p>Unfortunately, you have left out a lot of information about your past that you do not see as relevant to your current situation that a psychiatrist/psychologist would have access to in order to make a proper diagnosis about your current situation. It’s easy to understand why you want to displace your anger onto your parents, especially when it sounds like there were past struggles with your family, but please understand that this is as hard on them as it is on you, and perhaps they are at a bit of a loss about what to do. Also, the university really had no choice about your leave - you were suicidal. </p>

<p>Going to seek another opinion from a trained professional is a very good idea. Bipolar is a tricky diagnosis. Some individuals experience more depressive type symptoms. It is on a continuum - not a checklist of characteristics. When you are placed on medications, often the symptoms “go away” and it is common to want to get off of them. </p>

<p>Please know that there are people that want to help you and that you are loved by them. Please keep an open mind about treatment. I wish you well.</p>

14

<p>I did find some studies on Risperdal and bipolar 2 and some people find it to be mood-stabilizing, however, it is usually used to calm down mania or sometimes hypomania (or a “mixed episode,” which means depression and hypomania mixed.)</p>

<p>Lamictal is a good medication for someone with either form of bipolar, who suffers mainly from depression. Lithium can also help with depression, and is a know anti-suicide med.</p>

<p>I am not a medical professional and just wanted to make sure to add a post clarifying that Rispderdal IS used, and only you and your doctor know if it is appropriate. I would get more opinions. You know yourself and chances are your doubts have some foundation.</p>

<p>Here is a pretty good article on bipolar disorders:
[url=&lt;a href=“http://www.moodtreatmentcenter.com/Bipolar2.htm]Title[/url”&gt;http://www.moodtreatmentcenter.com/Bipolar2.htm]Title[/url</a>]</p>

<p>“Bipolar for Dummies” is excellent, believe it or not.</p>

15

<p>Youve gotten good advice- considering we don’t know you- but not Drs.</p>

<p>I agree that psychiatrists are going to be better at prescribing medication for mental illness than your general practioner- BUT, psychiatrists are generally in a " medication management" mode and will be much more interested in writing scrip, than in counseling and alternatives to medication.</p>

<p>You should still be working with your regular Dr because they know you and can perhaps have an idea just how big a problem this is.
Medication may help you get to the point where other therapies can start working, but whatever you do- do not try and wean yourself off the medication.
Psychoactive meds often have a rebound effect and you can feel much worse than you did before, if you suddenly stop taking them.
So dont do that. </p>

<p>But do get a physical to make sure there isn’t any underlying illness or nutritional deficiency that is compounding your symptoms.
You might ask your Dr about Latuda. Its a newer antipsychotic with fewer side effects than Risperdal for some people.</p>

16

<p>Anytime anyone thinks that suicide is the best, only, a serious option, it is a serious problem. When you think that way, you have just entered the category where you are a DANGER to yourself and/or others. Anyone who know you “have gone there”, should get you mental health care. Those in certain fields or positions are required to report you and see that you directed to care. You can be committed involuntarily if there is sufficient proof of that state of mind. </p>

<p>I am saying this so that you are fully aware of where you have gone when you truly felt that suicide was the only way out. Once you have stretched to that area, the chances are better than that of others, that you will revist that thought again, and things should be done to lower those chances. That those things actually will lower the chances for you, whether you truly would have done this sort of harm to yourself, is immaterial because at this point it cannot be measures. Only large group probabilities and statistics can studied and the do not always apply to the individual.</p>

<p>Since you have “gone there”, what you now need to do is to get with the program and slowly work your way out. If you don’t like the mental health therapist you have, try to switch to one that you can work with better. Whatever your issue is, certain very important bases do have to be covered, and no legitimate doctor or therapist is going to let you get away with backtracking and taking back what was said in terms of self harm.</p>

<p>Please, also understand that many, many mentally ill, mentally unstable, bipolar, whatever the diagnosis is, people do not believe they are ill. It’s a major stumbling block to treatment. So what you are saying really cannot be believed. Precautions, treatment, wait and see procedures have to be done. This is all to help you in case you are a danger to yourself as you said you were. That you no longer believe this or feel this way is beside the point because too many who are in danger also feel that way when the don’t want to continue with treatment. We all want to be safe rather than sorry</p>

<p>Now to address your family situation. This is a rough thing to have to say to a lot of you young people. You are legally an adult at age 18. Many young people think this means they are now free of their parents’ wishes. What is more important is that your parents are now free of their obligations to take care of you. They no longer have to even feed, clothe you, take care of your medical needs. They certainly do not have to pay for your college and anything else. It’s ALL on you. If they should so please, they can continue to do so, and most college going kids are lucky enough to have parents who retain some modicum of support in their kids’ lives. But it’s all up to them. If you don’t do what they say, if it’s too much for them, then you are on your own. </p>

<p>If you are one of the privileged who have parents or a college or anything paying for you in these early adult years, you are very lucky. But if you don’t, and you cannot find a job, a place to live, you go into a homeless shelter and navigate what’s there in terms of social services for the unables in your area.</p>

<p>College is a place to get an education. They are not going to take care of you more than what is in place, and once you have any issues, that go over those boundaries, it’s out you go. </p>

<p>My suggestion is to work with the therapist as you look for someone who would be more flexible and get on a balance. If you think you can do it , go back to school, but be fully aware that they may not take you back if you cannot prove to them that you are ready, and that you may not be. You may well go back into a funk, and college just may not be for you. You may need time to get yourself into a balance where you can live your life independently. Something you need to understand, is that your parents have their limits on what they want to handle or can handle and if you cannot make the standards they have placed, you may have to work with the alternatives that are left to you. If you need/want from others, you have to accept their conditions, because other wise those are alternatives not available to you. </p>

<p>Adulthood is very difficult when you are doing it on your own.</p>

17

<p>Talk to the current prescribing doctor (hopefully a psychiatrist with experience with young people, that you have been seeing for awhile, or has your inpatient and outpatient records, and consults with your therapist) about the risk and benefits of your current meds, given YOUR history, and not just your diagnosis.</p>

18

<p>Unfortunately, people who have bipolar disorder can have anosognsia - a lack of insight into their condition. Why comply with treatment/take medication when there is nothing wrong? It’s impossible to tell whether that is present here, but it is something that needs to be considered by the treating mental health professionals.</p>

19

<p>It is also true that bipolar disorder is overdiagnosed, and many college students, most of whom are not mentally ill, entertain suicidal thoughts (as opposed to intentions) at one time or another. Again, a second opinion would be really helpful. </p>

<p>Ivy League schools will do a lot to keep students, w/all kinds of problems, on the path to graduation. The graduation rates are very high.</p>

20

<p>Do not transfer schools. This school is invested in you and your graduating, you won’t have the same level of loyalty from a new school perhaps. The school will be on your side as long as you are actively taking care of yourself in this matter. Read Prozac Nation by Elizabeth Wurtzel to see how Harvard helped her and let her stay despite outrageous behavior at times. Your school gave you the proper options and you likely chose the best thing to do for yourself at the time.</p>

<p>Don’t be in such a rush to get off medication and don’t be overly concerned about the current diagnosis. Focus on what to do to get healthy and able to resume student life. See a doctor regularly while you are at school, for the support and so that the medication can be monitored and adjusted or changed if that’s best. Be open to trying other meds, sometimes one can do miracles when others are ineffective for you.</p>

<p>I have a close friend who was depressed for years and only got relief when she was diagnosed with bipolar and had more appropriate medication given. She is very intelligent (went to grad school at Cal Tech). She never had such high highs and low lows as are usually thought of with bipolar. But she was depressed and her ‘manic’ episodes were more on the line of constantly buying stuff online to get a bit of a shopping rush, or obsessively concentrating on her hobbies.</p>