My weeks in the middle of October are crowded with patients – often patients I am not supposed to see since they are over 18 and my program does not extend beyond 18 years. These patients, however, know me and I know them. They turn first to someone they know, and I have told them that, if they needed assistance beyond their 18th birthday, I would help them to find it.
These young people arrive distraught, disheveled and discouraged. Their eyes scan the waiting room restlessly. When I come to greet them, they stand up, eagerly at first and then their shoulders slump. They are ashamed. Occasionally, they will rush ahead of me to get to my office. I already know what is happening and I have learned to rush as well, bringing them quickly into a safe space where they can cry.
These October people are young people who have had to stop their post-secondary education because their mental health interfered with their success. Since these youth have been struggling with a mental health condition so severe that they have had to have treatment with a psychiatrist, one might think that they would realize that their illness could interfere with college or university. But you cannot see mental illness the way you can see a wheelchair. Despite our anti-stigma campaigns and our slogans, we still do not accept mental illness the way we accept diabetes or asthma. This is true for those who have a mental illness as much as it is for anyone, unfortunately.
Even worse, for a young person with an Anxiety Disorder or a Depressive Disorder, some of the negative thoughts that may be symptoms of their illness can emerge in an academic setting, where the amount and kind of studies may be more complex than they have ever had to face. Their concerns that they are not smart enough or that they are lazy may arise when they meet students who seem at ease and in control. The negative thoughts that fueled their illnesses can come back and with them, the symptoms of anxiety or depression. I will never forget looking at the pile of textbooks in front of me the week I started medical school and realizing with a sense of dread that I would never be able to read them all. Prior to medical school, I had read every textbook cover to cover. Even worse were the people in my class who were so knowledgeable that it seemed to me that they had already read the textbooks. These experiences have given me a sense of what my patients are experiencing.
On top of more challenging academic tasks, many young people in college and university are away from home for the first time. As well as the workload, they must also manage to prepare their own food, or figure out how to get around town. Many have no friends to be with in those first difficult days and weeks. All these stressors can affect whether a student will be successful in the first weeks of college or university.
All these students having to leave school is sad, but, after many years, I have learned a few things that can help these young people realize that this need not be the end of their academic career.
Here is what I’ve learned:
1. As soon as a student can manage it, they should meet in person or by phone with an academic advisor to understand their options for a return to school or a transfer closer to home.
2. Sometimes parents are equally discouraged when their child has had to leave school. I spend time and reassure parents also that this is not the end of the world, but I also remind them that this is not about them and that they must be part of the team that reminds their child that what is happening is a setback and not “the end”.
3. I remind young people and their families all the time that college and university are difficult for everyone, but they are even more difficult when you are managing an illness affecting your brain, the very part of your body that is supposed to be learning all that new stuff.
4. Sometimes one of the first realizations a youth may have when they are away from their family is that the career or area of study they are contemplating is not work they can see themselves doing forever. These young people are especially worried about disappointing others: parents and former teachers.
The last point is, in my opinion, the most important. Finding and preparing for work that you love is the goal of postsecondary education, and goodness knows the world needs all of us to be employed in the difficult tasks that must be done to build a better world. We can only do this if we love what we are doing on both the good days and the bad. I think Rupi Kaur says this better than me:
is not about how many people
like your work
if your heart likes your work
if your soul likes your work
it’s about how honest
you are with yourself
– Rupi Kaur in Milk and Honey