“Oh, she’s crazy.”
“Fuck her but don’t date her, she’s crazy.”
“She’s my friend, but she’s completely batshit.”
I don’t remember when I first started to notice, but it was hard to stop hearing these things once I did. I was hearing this word, I was hearing it everywhere and I had next to no idea what it actually meant. On a campus full of people with bizarre study habits and sleep schedules, what does it take to get called “crazy”?
In an unscientific survey conducted in Blue States and dining halls, students told me they think we’re all very sensitive when it comes to talking about our peers’ mental health. Conversations about mental illness take place in hushed tones, full of sympathy and euphemisms. They do not involve big, loud words like “crazy.”
“I think in my experience when I talk about people with mental illnesses, it’s pretty sympathetic,” said Maggie Zhou ’15, a member of my random sample. “The enemy is always Yale Health.”
Students I spoke with had a wide range of horror stories about Yale Mental Health Services: waiting up to four months for an appointment, encountering therapists who didn’t recognize their patients, who cut them off in the middle of sentences when their time was up, who pushed medication on them after two sessions, who prescribed the wrong kind of medication, who made them feel judged.
On the surface, we’re trying to fix this. Every Yale College Council presidential candidate in recent memory has made improving Yale’s mental health resources a prominent part of his or her platform. When Cameron Dabaghi ’11 jumped off the Empire State Building in the March of 2010, we wrote op-eds and talked about boosting access to mental health services. When Zachary Brunt ’15 committed suicide two years later, we did much the same thing.
We hear that Yale’s mental health services are failing us. The failures are big and gaping and scary.
But we also hear about the stigma that makes so many students reluctant to seek help, or even articulate their suffering in the first place. The source of this stigma seemed a little mysterious to me at first. Yale is famously inclusive, extremely PC. But then there’s the hard truth that based on the numbers, at least one in every two people we have no problem calling crazy on this campus have visited Yale Mental Health at least once during their Yale careers.
We hear that we don’t talk about mental health enough. But maybe we need to listen to what we’re saying.
* * *
Abigail*, a junior who has struggled with clinical depression, insomnia and anxiety during her time at Yale, can describe, immediately and at length, the kinds of qualities that comprise craziness here.
“I hear the words ‘chill’ and ‘crazy’ so much at Yale, and it’s a problem I have had for a very long time,” she told me. “Crazy has the connotation of a girl who doesn’t really have a handle over her emotions … and chill is the positive way to be, if you can be chill and act like things don’t affect you.”
Thirteen students interviewed were unanimous about one aspect of “crazy”: Girls get called crazy more often and more casually than boys do. Many identified strikingly similar characteristics that mark a “crazy” Yale woman. Eleanor Michotte ’15 said it can mean going out too much or not enough. But she said that it’s applied especially often to girls who exhibit too much “clinginess” in romantic situations. Andrea Villena ’15 told me “crazy” is typically used to refer to girls who seem overly dramatic in dealing with their relationships. Abigail said these are girls who seem immature or insecure, who publicly and dynamically react to things. They are clearly socially anxious. They don’t seem chill.
Jay Pabarue ’14 said the word is used so much and so generally that it’s hard to identify just one meaning. But he too associates the term with girls who seem to have a “pathological way of dealing with social scenes.”
The only guy Abigail has heard called crazy at Yale is “legitimately crazy,” she said. Several students said that calling a boy crazy is more serious than calling a girl crazy: It suggests more about their actual psychological state. When asked why they think so many girls do get called “crazy,” many blamed unjustified cultural stereotypes about girls being more neurotic and hysterical.
But the World Health Organization tells us women are far more likely to be afflicted with anxiety and depression. And they are twice as likely to develop generalized anxiety and panic disorders as men, according to the Anxiety and Depression Association of America.
These disorders are also more tied to external influences than any genetic or internal predisposition, which means the environment we collectively create on campus each day matters. Psychology professor Tyrone Cannon, who is presently teaching a course on the neuroscience of mental disorders, said that depression and anxiety are only 35 percent determined by genetic factors, with environmental influences accounting for the remaining 65 percent. He contrasted this with disorders not particularly associated with one gender over another, such as schizophrenia and bipolar disorder, which are 85 percent determined by genetic factors.
“I think the mechanisms are similar across men and women,” Cannon told me. “The question is, are those environmental factors experienced differently by genders, and the answer is probably yes.”
According to June Gruber, one of Cannon’s colleagues in Yale’s Psychology Department, girls begin to experience the social world differently at a very young age. Their parents encourage them to express their emotions. Girls mature more quickly and develop a strong social orientation earlier. They tend to be more ruminative. But all this introspection comes at a cost: Girls are much more likely to become depressed as they grow.
All through high school, 2013 grad Jessica* dealt with anxiety and insomnia. The summer after her freshman year at Yale, she found herself having panic attacks and even more extreme anxiety. She took a year off. Jessica doesn’t think her experience of depression and anxiety can be divorced from her gender and the way she grew up because of it. It’s something she’s been thinking about a lot post-Yale.
Jessica began feeling “very body conscious” at age 10 — and the feeling never went away. She believes those concerns helped feed her anxiety at Yale. When she was 20, she went to the beach and a male friend made a rude comment about her body. Jessica remembers going home, sitting on the floor of her bathroom and crying for hours.
“I think there are these social expectations for girls to be a certain way, to act a certain way, to not be weird, to be attractive. A part of the education as a preteen girl is to learn how to be attractive to boys. A lot of my friends and I are going through this experience where we’re unlearning that,” she said. “Definitely there is a direct physiological connection to my mood and my body consciousness and anxieties about being a woman.”
Such feelings may be exacerbated on campus. Michotte said people at Yale, and girls especially, seem much more intense about their appearance than in her native England (an issue she discussed in one of her “Crit from the Brit” columns for WEEKEND). “I think there’s appearance inflation. As everyone grooms more, works out more … suddenly everyone falling short of that standard stands out, and the collective average creeps up and up,” she said.
Abigail thinks a lot of the girls she knows who get “crazy” thrown at them probably have mental health issues that people too easily overlook. She doesn’t think she’s crazy; she thinks she’s someone who feels things deeply and has problems with her brain chemistry that she’s working hard on.
“I’m sure people call me crazy, though no one’s ever called me crazy to my face,” Abigail tells me suddenly, 20 minutes into our conversation at the Hall of Graduate Studies dining hall. She sounds as though she is articulating this thought to herself for the first time.
In a culture where there’s so much silence about people’s diagnoses, it’s hard to know who might be suffering. Pabarue cited one girl he knows who often gets called crazy in an unsympathetic way by people not aware that she has a problem.
After a bad breakup her freshman year, Abigail found herself breaking down and crying multiple times a day, for several months. It never occurred to her that she was “actually depressed”; she thought she was just another girl who had been dumped. She’s always been someone who experiences higher highs and lower lows than other people, and the line between grief and illness wasn’t obvious.
“When your boyfriend and you have a really bad breakup, the time when you’re crying and mourning that’s not called clinical depression,” she said. “I thought I was just really sad.”
But though few students interviewed believed girls were legitimately at a greater risk for developing any mental disorder, society has no problem making judgment calls based on gender when it comes to one commonly reported disorder: eating issues.
When Sally*, now a junior, developed Crohn’s disease her freshman year, she lost 18 pounds in a month and was constantly vomiting. Yet as she sought treatment, she found herself under attack from all sides.
“Everyone was saying I was anorexic,” Sally said. “People at Yale Health, people at Yale. People just wouldn’t believe me when I was saying I was in pain.”
Sally had friends trying to force her to eat, commenting on how skinny she was and telling her that it “didn’t look good.” She knew that people were talking about her behind her back. The experience made her close down and withdraw into herself. She began simply avoiding people altogether.
Pabarue experienced the opposite problem when he developed anorexia as a freshman in high school. For months, he saw his pediatrician in a clearly unhealthy state. He remembers being told to drink more Boost and Ensure and that it seemed like his metabolism was simply getting faster. He was 6 foot 1 and 112 pounds when he fainted in the shower and was rushed to the emergency room.
* * *
In her first year at Yale Law School, Elyn Saks LAW ’86 remembers thinking that she could kill hundreds of thousands of people with her thoughts alone. The TV was giving her commands. Throughout all this, she believed that she alone had a “special premium on the truth.”
For years, she struggled against receiving medication for her schizophrenia. She was very reluctant to accept the diagnosis of being mentally ill and “needing a crutch,” but now she looks back on accepting her diagnosis as the key to liberating herself from the disease.
“For me, a schizophrenic episode is like a waking nightmare, but you can’t just open your eyes and make it go away,” Saks said.
As a law professor at the University of Southern California studying the treatment and rights of the mentally ill, Saks lives a life her diagnosis had once seemed to preclude. There’s nothing she prefers about her unmedicated state.
But for others, navigating the threshold between normal and not normal is much less clear, and accepting a diagnosis an ongoing struggle. The language we use to discuss mental illness — or the lack thereof — only makes this process harder. “People who are sensitive and well-meaning and would never use racial slurs, use the words ‘nutcases’ or ‘looneytunes,’” Saks said. “I’m happy to be called a patient. I have an illness; the words people use are hurtful. Even just changing that would be a small change to changing the culture around mental health disorders.”
Having more precise language to talk about mental health isn’t just about sensitivity — it’s also about helping inform people who may be vulnerable. Jessica did not have the words to describe what was wrong the first time she started crying for no reason. It was the middle of the day and she was sitting in a café. The experience terrified her. After searching her symptoms online, she concluded that she was probably bipolar. This diagnosis did not prove to be correct.
“I felt like my feelings weren’t justified, and I didn’t have the language to express that,” she told me says. “I didn’t know what was happening, I didn’t have a language for understanding it. I thought something was wrong with me, that something was very, very wrong.”
Now she realizes that her diagnoses are not at all uncommon. The more she talks to people, the more she realizes how many people have similar stories. She doesn’t feel so abnormal anymore.
Alison Greenberg ’14, who has struggled with depression at Yale, said the prevalence of terms like “crazy” has to do with the fact that people’s ideas about mental health are vague at best.
“Crazy is sort of a catch-all term for not normal, and normal at Yale is I think very different from normal in the real world,” Greenberg told me.
While Jessica was struggling with depression and anxiety at Yale, she found herself constantly worried about trying “to appear normal.” She felt she was doing everything she could to hide: She was seeking help, she was accepting all kinds of medications and therapies. At one point, she was on five types of medication. It seemed excessive, but she did what her doctors told her to so as to appear “alright.”
Ellen*, a junior who has received many diagnoses over the years, said that the social norm at Yale is to appear high-functioning even when we’re “hanging by a thread.” In a culture of glory tales and desperate work ethics, it’s easy for someone who is really suffering to think that their suffering is normal, too. Among her group of friends, a normal state of mental health could include low-level depression, or mania or suicidal thoughts.
Within these standards, labeling someone as “crazy” ends the conversation about him or her, Pabarue said. It’s a way to explain someone else’s behavior without engaging with what might be driving it. It lets you put a label on them, and move on with your own, non-crazy life.
“I think a lot of the failings are among us or born out of the way we talk about things,” Pabarue said. “It’s too easy to blame the institution alone.”
Ellen says she won’t get offended when someone sad tells her that they’re feeling depressed. She understands words can take on different meaning in a casual context. Still, she has occasionally been upset by the glib way many at Yale discuss mental health.
“The casual context mental health is treated can hurt, anything that’s internal, anything people can’t see on the outside, can make you feel undercover in enemy waters,” she explained.
Crazy sets up a dichotomy between normal and everything else. For many at this school, deciding where you fall on this spectrum can be very difficult. Ellen said she feels herself intellectually and emotionally pushing back against the idea that the various mental health diagnoses she has received over the past four years — clinically depressed, bipolar 1, bipolar 2, anxiety — are legitimate. She doesn’t like the idea of the boxes these words create.
Some abandon the pursuit of normal altogether. For his entire freshman year, Charles* said he threw himself into the prescribed way of experiencing life at Yale. He described buying into the “cultural hegemony” of what a weekend is supposed to look like, of how he should be dealing with drinking, sex and drugs.
“There’s kind of a dominant narrative of what your first year is supposed to be,” he said. “You’re shopping classes, you’re shopping friends, you’re shopping organizations. You’re kind of walking around the campus consuming everything. … It’s very oppressive. I’m saying all this because I was the first to do it.”
All through freshman year, Charles was also taking medication which treated his narcolepsy and hypomania (a milder form of bipolar disorder). The medications made him feel dull, productive and “sterile” throughout the year. He did his reading. He did what he was told to do. But when he ran out of pills one week his sophomore year, he decided to see what would happen.
That spring semester Charles wrote all five final papers — about 80 pages — without sleep, as though in a trance. He described the papers he wrote that semester as “the greatest work I’ve ever done.”
When he’s in a low phase, he can barely bring himself to do any schoolwork at all.
Still, he prefers this to the “stale,” consistently productive feeling he had on medication.
“It makes for a really intense form of existence. I know I suffer because of it. I know I could have a more tranquil, sterile kind of life,” Charles said. “I don’t want to be told that I’m sick; I think my life is so beautiful.”
After going on and off multiple medications, Ellen said she has come to accept that medicine can improve her quality of life. Now she is on a daily medication that changes her mood and behavior. She said she has had to learn to accept some degree of uncertainty in not knowing if what she’s doing is right.
“A lot of us have been given diagnoses … but not too many of us trust those diagnoses. There’s this terrible uncertainty in terms of if what you’re doing is right when it comes to your own mental health,” Ellen said. “Finally settling down with a treatment and accepting that as part of who you are is a really adult struggle, one that people don’t really talk about.”
*Name changed to protect source identity/privacy