Tag Archive: depression

  1. Speaking Out

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    “My amazing psychologist knows that she is willfully violating your rules.”

    Caroline Posner ’17, buoyed by members of a nodding audience, challenged a panel of administrators, including Yale College Dean Jonathan Holloway. She explained that she had long since passed the 12-session limit imposed by MH&C.

    MH&C Director Lorraine Siggins pushed against the accusation.

    “We do not have an absolute limit of number of sessions,” she said, adding that each case is handled on an individual basis. “When someone comes back from the fall semester and things are still not going well in January, we would not stop treatment.”

    She asked that patients who have been given this misinformation reach out to her.

    Posner then addressed the audience, asking those same misinformed students to raise their hands. Roughly 50 hands shot up.

    Siggins began to explain that the MH&C website doesn’t mention any such limit, when a voice sounded.

    “My therapist told me in every single meeting where we were in our 12 meetings.”

    “Mine too.”


    “P-Set or Mental Well-Being”

    Eugenia Zhukovsky’s weekend has been a little surreal. She hasn’t been back much on campus since electing to take time off earlier in the semester. She decided she needed to focus full-time on managing her anxiety and depression. Technically a visitor, she has no ID card to access campus buildings.

    Seconds after being guest-swiped into her residential college dining hall, several of her friends materialize, and hug her.

    “How is it, being back in the hellhole?” one asks.

    Zhukovsky squints a little. “Weird.” She says she’s happy with her decision. “But it’s not fun. It sucks.”

    For Zhukovsky, being a Yale student and managing her mental health were mutually exclusive. Panic attacks, medication adjustments, subsequent side effects and bouts of depression — all with little help from relatively infrequent sessions with Yale Mental Health & Counseling — simply took up too much time in an unyielding, rigorous academic environment.

    “No one was explaining how I could do it at Yale,” she said, “We’re not given the ‘our health comes first’ [message] as directly as we have to be.”

    Instead of feeling that her health was of primary concern, she felt like it was another, unsolicited, course or extracurricular. She added that the same has been true for other Yale students; friends have admitted feelings of anxiety to her but added that they “didn’t have time” to see a counselor. Zhukovsky calls this notion absurd.

    Posner and Zhukovsky each described a “P-Set or mental well-being” dilemma: nights when they had to decide between sleep-inducing medication and studying. In other words, they had to choose between missing a deadline and facing the repercussions of a mental illness left untreated.

    In Zhukovsky’s eyes, Yalies are high achieving perfectionists. She likes that: their energy, success and drive drew her to the school to begin with. But that same energy can heighten the effects of anxiety.

    Julie* said that when she arrived on Yale’s campus last fall, she found her brilliant peers inspiring, but that they also caused her high school confidence to shrink. During her freshman fall, she began to doubt herself and started to experience intense anxiety.

    She described her daily routine: class, practice for her varsity sport, and then crying while doing her homework in her single. Meanwhile, she felt that everyone around her was gaining confidence and accolades. Julie felt increasingly inadequate, weak and alone — but she kept her feelings secret.

    Almost all of the students interviewed who have experienced anxiety or depression at Yale said that finding and maintaining a supportive social network was one of the most, if not the very most, important way to cope with mental illness on campus. But several have found that the majority of Yale students seem more focused on their own schedules than on the well-being of their friends.

    Monica Hannush ’16, who has experienced severe depression at Yale, has felt this on a personal level. In moments of profound despair, she has resorted to sending her friends desperate text messages. Those texts, she said, follow less desperate messages. Often, when she texts her friends less urgent messages about feeling sad, she receives ostensibly empathetic but distant responses: “so sorry! writing an essay, sending you hugs.” “About to go on a date, but you’re beautiful!”

    A News survey on mental health resources, completed by 233 students, found that although 61 percent of students have experienced symptoms of depression, anxiety or other psychological conditions, only 28 percent have sought formal treatment, either on campus or elsewhere.

    Julie recalled the moment in her freshman year when she felt like she couldn’t take it anymore. She decided to visit Yale Mental Health & Counseling. On her walk over, she was wracked with paranoia and shame. Afraid of being seen, she kept her head down in the waiting room — but she felt comforted by the presence of other people in nearby chairs. She was not alone.

    Breaking the Stigma

    Once, when Posner went to her chemistry professor to explain why she had been having particular struggles in the class, she ended up in tears. Posner said that when she told him about her severe anxiety and depression, he simply responded, “T.M.I.”

    Although diagnoses have been rising steadily for years — a Harvard study showed that the number of patients in the U.S. increases by about 20 percent each year — many still consider mental illness an uncomfortable, even taboo, subject. While 60 percent of the News survey respondents confirmed that they felt comfortable talking about their own mental health with others at Yale, 27 percent of survey respondents said that they were not at all comfortable with such discussions.

    And that mindset, according to Posner and Zhukovsky, perpetuates a culture of undeserved shame for the suffering. Anxiety disorders affect nearly one out of every five American adults, a 2014 statistic listed by the Anxiety and Depression Association of America.

    Zhukovsky feels that Yale, specifically, needs to better educate its students.

    “I didn’t really know what depression or anxiety were until I had them,” she said. “There was this time when I felt alone, and like there was nothing I could do about it, and it was the worst time in my life … it’s so important to me to talk about this, and to help people from getting stuck in that place. It can be treated. It can be helped.”

    Following the death of Luchang Wang ’17 in January, members of a shocked and grieving community have resolved to push for the changes they feel are necessary. Concerned students have been speaking up, demanding that Yale reevaluate resources and policies, and that the community take steps to break the stigma surrounding mental illness.

    Many have begun fighting for change on campus — friends like Posner, or like Geoffrey Smith ’15, who co-authored a pledge to boycott the Senior Class Gift along with six other seniors. Smith suggested that alumni and the administration regard participation in the Senior Class Gift as a bellwether for student opinion, and so he called on seniors to abstain from what he sees as an endorsement of University policy. Nearly 97 percent of seniors donated to the Gift in 2014. This year, 78 percent of seniors chose to participate.

    A few days after Wang’s death, Posner, Korbin Richards ’15 and Charlotte Storch ’15 created “Nox Et Veritas,” a Tumblr blog, where they publish stories, sometimes written anonymously, about MH&C, withdrawal and readmission. With this new forum, they hope to bring untold stories of mental illness to light and foster dialogue on campus. Already, seven entries have been posted, and Posner said that the blog has between two and three dozen followers.

    According to Richards, the problem is not that Yalies do not want to talk about mental illness.

    “Once the topic is introduced, everyone wants to join the discussion,” she said.

    Rather, she believes that the problem lies largely with the Yale administration. She feels that the administration has been less open and eager to converse with students. After Wednesday’s forum, she said she was proud of the active and vigorous student participation, but disappointed in the continued administrative distance.

    “If the panel’s job was to not answer questions, then they did exceptionally well,” Richards said.

    Even if students are engaged in the conversation on mental health, Genevieve Simmons ’17 worries the renewed discussion may be short-lived.

    “The prevalence of talking about mental health has been sensationalist — movements when we hear a horrible mistreatment about behind the scenes, or a loss of one of our peers,” she said. “Then the discourse fades into the background.”

    Moments like this have come before. MH&C Director Lorraine Siggins recalled, for instance, student meetings similar to Wednesday’s event that took place in the 1970s. She said that in her more than 40 years of working on campus, she has seen interest in mental health on campus wax and wane.

    To many students, like Zhukovsky, letting this moment of heightened discourse slip away is not an option. She said she could not overstate the importance of creating mental health reform: this, she said, is about quality of life, and life itself.

    Phone Tag

    When Richards was evaluated at MH&C during her freshman year, she only told one lie. She said that she hadn’t been having suicidal thoughts.

    She called this self-defense, as some of her friends had been sent home because they had expressed suicidal thoughts. These stories frightened her  — withdrawal was a financial impossibility for her family, and would worsen her condition. Richards says that the fear of MH&C forcing students to leave campus, or keeping them from returning, prevents those with suicidal thoughts from expressing them. And that, she believes, is dangerous.

    Holloway agrees that the fear surrounding the treatment policies of MH&C is unsafe. Before Wednesday’s panel, he told the News that he worries many public perceptions of treatment at MH&C are incorrect, and that he hoped the event would clarify misconceptions and alleviate unfounded fear.

    Richards told the panel about her lie. She explained that the fear she had felt was pervasive on campus — a statement echoed by the snaps around the room — and asked how the panel planned to address it.

    Siggins responded by pointing out that MH&C sees around 2,500 students each year, and that the vast majority of students who withdraw on medical leave do so voluntarily. Later, she described circumstances that might lead to a forced withdrawal. She said that a patient would need to have a plan for self-harm, as well as the means to execute it — “in other words, if we’re concerned imminently that this person in the next 24 hours may be at great risk.” She added that the individual in question would be hospitalized, and never simply sent home, under such circumstances.

    Zhukovsky, for instance, withdrew without any pressure from Yale administrators or MH&C clinicians. She said that MH&C could not provide her with weekly therapy, which she needed, and so she saw no alternative to leaving. It was not until she withdrew that her mental health began to improve.

    The thought of other students continuing to wade through the support provided by MH&C saddens her.

    “I know that they’re struggling, because I struggled through it, and it wasn’t helping,” Zhukovsky said. “The care I was getting was just okay, and ‘just okay’ is not an option.”

    Others remember experiences of MH&C therapy that were worse than mediocre.

    Richards called her first and only appointment after her initial consultation “one of the worst experiences [she’s] ever had with another person,” recalling how her doctor skipped the handshake in their greeting. “He didn’t shake my hand, didn’t ask about how I was doing. He went straight into ‘Why are you here?’ and then ‘When’s the last time you menstruated?’”

    Julie, initially comforted by the presence of other students in the MH&C waiting room, gave up on MH&C after a couple of unsuccessful visits. She said that the therapist she was assigned to was cold, clinical and impossible to open up to, and so she turned to long-distance communication with a therapist from home.

    Still, others have had positive experiences at MH&C.

    Adriana Miele ’16 has been regularly seeing the same therapist since the beginning of her freshman year, an experience that she said has “kept her afloat in a lot of ways.”

    MH&C also allows patients to request a change in therapist if they are dissatisfied, a process Posner went through at the beginning of this academic year. She’d seen a therapist throughout her freshman year, but found their sessions unproductive, so requested a change. Even though she had to wait for six weeks for MH&C to process her request, Posner said that her new therapist has made a tremendously positive impact on her mental health.

    On Wednesday, when Posner publicly praised her new therapist’s violation of the supposed 12-session protocol, snaps and murmurs of accordance echoed throughout the forum: evidence, perhaps, of her belief that MH&C’s largest problems have less to do with the quality of therapy that most of its practitioners provide than with its difficult bureaucratic system.

    As the MH&C system stands now, according to Posner, students must advocate for themselves in order to obtain quality care. She equated communicating with MH&C to a game of “phone tag,” with constant missed calls and miscommunications. At the forum, when Šimon Podhajskỳ ’16 asked why MH&C does not utilize email communication, students banged their desks in agreement.

    Siggins responded that she “couldn’t agree more” with students that communication between MH&C and patients needs to be improved. She explained that the system currently does not allow email correspondence because MH&C had been concerned about the security of emails, but that it was currently pursuing ways of legally incorporating email communication.

    She and Genecin have announced their commitment to reforms at MH&C. In an attempt to hear student voices, they held a series of “listening sessions” in the residential colleges last spring. Last week, Genecin sent an email to the College with a set of MH&C improvements, including an increased staff size and expediting the period of time between a consultation visit and a first appointment.

    In the News survey, 54 percent said they believed that Yale’s mental health resources are insufficient for those who use them, and 30 percent of students responded that they felt dissatisfied with the reforms described in Genecin’s email. One survey respondent commented that “there were no concrete numbers given to the proposals, which makes me deeply skeptical.”

    Indeed, it appears that students crave more numbers and facts from MH&C. At the forum, multiple students asked the panel for more statistics and greater transparency from administrators.

    Holloway and Genecin emphasized, though, that many specifics cannot be discussed because federal law mandates strict confidentiality. Holloway told the News that his inability to be fully forthcoming is “totally appropriate,” though he added that he is always as transparent as possible.

    For instance, Holloway said that the withdrawal and readmission committee he formed in January cannot disclose information about its discussions until the committee finalizes its recommendations. He expects this to happen in four to six weeks.

    Given such legal constraints, Holloway said that he did not believe assertions that the administration has been silent or unresponsive were fair.

    At Wednesday’s forum, English professor John Rogers, the chair of the committee, mentioned that one of its six members was a student. He also pledged to take seriously the recommendations and complaints that students had expressed to him.

    Zhukovsky worried that administrators would view Wednesday’s event as a way for complaints to be aired, rather than attempt to get to the roots of the grievances. She simultaneously felt that complaints alone would not lead administrators to make changes.

    “I’m all for talking,” she said. “I just think that there has to be more push from students to make a specific change. There’s been a lot of reaction, and a lot of opinion, but there needs also to be initiative.”

    Alternatives, and new options

    Natalie Wolff ’14 suffered from depression between the ages of 13 and 21, and credits her recovery in large part to the care she received at MH&C while she was an undergraduate. At Wednesday’s event, she presented a list of 10 recommendations to streamline MH&C’s system — recommendations that included using the medical program MyChart to schedule appointments, administering screening questionnaires and hiring more secretaries to field more phone calls.

    The panelists expressed gratitude for Wolff’s recommendations, asking for her written list, but Siggins noted that some of the items, such as mandatory follow-up phone calls if a patient misses an appointment, are already MH&C policy. She encouraged students whose therapists have broken MH&C policy by sharing misinformation to contact her. She said that, in those cases, she would remedy the misunderstanding.

    At the same time, several students said that MH&C policy was so obscure that they would not know if their therapist had misrepresented it. Siggins admitted that MH&C has not done an adequate job in the past of educating Yale students on its policies, but she added that administrators are working to increase transparency. She then cited the MH&C advisory committee, a liaison between the department and students convened at the beginning of the spring semester in 2014.

    Corinne Ruth ’15 and Olivia Pollak ’16, currently serving on the committee, seconded Siggins’ view. Pollak recognizes that communication between students and MH&C can often seem “starkly two-sided,” but hopes that both sides can listen to each other.

    “They [MH&C] want students to be happy, they want them to be successful, they want them to come back. The discussion then comes to … how do we best listen to each other?” Ruth said.

    The Mental Health Advisory Committee began at the end of last spring, as part of the Coalition for Mental Health and Well Being, a larger umbrella student organization. The committee members convey to the administration their impressions of campus culture.

    She cites the coalition as key, a way to bring together students in organizations concerned with wellbeing. Last year, the committee updated the YCC resource sheet and the FAQ section of the MH&C website.

    Ruth and Pollak assert that the relationship between MH&C and students is a difficult one to navigate — they echoed Holloway’s comment on confidentiality, as did the forum’s panelists, but asserted that some channels between the administration and students have opened in the past few years.  Ruth cited last year’s listening sessions with Dr. Genecin, which fewer students attended than was expected.

    Ruth and Pollak also pointed to resources outside of MH&C that they feel are underutilized, notably Walden Peer Counseling, the Chaplain’s Office and the Peer Liaisons.

    One day in the fall of 2014, as Natalie Rose Schwartz ’17 wrestled with new symptoms of depression amid long-standing anxiety, her mother told her over the phone that she had to find someone to be with, if she could. Schwartz’s dean, who had been very helpful during regular weekly meetings, was unavailable, so she walked into the Chaplain’s Office. Schwartz knew Sharon Kugler, the University chaplain, from “Cookies and Coloring,” a weekly study break held in the Welch basement.

    “I just went to her office, and she happened to be free, and she immediately took me in, and hugged me, and let me talk,” Schwartz said.

    In the News survey, only nine students reported they had used the Chaplain’s Office as resource, while 72 students had gone to MH&C and 82 had relied on residential college deans, masters and freshman counselors. Twelve students had gone to Walden Peer Counseling as a resource.

    Pollak believes Walden’s minimal visibility on campus is a necessary result of its policy of anonymity. Because confidentiality restricts peer counselors from reaching out and putting a face to their services, students may have misconceptions about the issues that Walden addresses. Pollak worries that students think they shouldn’t call Walden unless they have a very acute problem, although she asserts that this is not the case.

    Zhukovsky, on the other hand, said that while Walden allows students to reach out to peers, peer counselors could not and should not replace mental health professionals. She has suggested that Yale implement a its own version of “Let’s Talk,” a drop-in program started at Cornell University, and that 25 other universities have adopted.

    Like Walden, “Let’s Talk” offers drop-in hours for students to talk or seek advice. Unlike Walden, though, “Let’s Talk” employs certified counselors. This would provide immediate professional advice — on medication, for instance — that Zhukovsky believes MH&C does not currently offer and that a peer counselor cannot give.

    Other students are also considering ways to widen the University’s network of resources. Joseph Cornett ’17 has recently proposed an initiative in a News column to implement mental health fellows in residential colleges. Representatives from MH&C, masters and deans would select upperclassmen to serve as fellows. The main job of a mental health fellow would be to refer students to mental health resources, explaining their nature and functions.

    “The mental health fellows should be someone who everyone knows they can talk to about emotional health.” Cornett said. “It will end up normalizing discussion about mental health and destigmatizing it, much in the way CCE’s have destigmatized discussion about sexual health.”

    At the forum, Wolff proposed a safe space to discuss mental health, in the vein of the Sexual Education Literacy Forum, a suggestion greeted with snaps and applause.

    Ruth and Pollak believe that friends sharing correct information with each other may be the most long-lasting, effective improvement to the current mental health climate.

    Smith believes that while friends can complement professional help, they cannot replace it.

    “Friends will ideally be capable of listening and providing love and kindness, but it is too much to expect them to … provide serious help with a specific condition,” he said.


    After reading out her ten recommendations at Wednesday’s forum, Wolff turned to the audience.

    “Anyone can be an advocate. You also need to be an advocate for yourself. So when they tell you that it’s going to take two months to switch your therapist, say no,” she said. “Just don’t give up.”

    The applause was deafening.

    But before Wolff’s recommendations, and before the applause, Holloway opened the forum. He explained that he wants to close an information gap between students and the administration, to make sure that students have enough faith in the system to get help when they need it, instead of being afraid.

    “The floor is now yours,” he said. “Raise your hand. Speak loudly.”

  2. Of Mind and Mountain

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    Left, right. In, out.

    That’s all there is when you’re on the mountain. The steady rhythm of your feet. The soothing sound of your own breath. Just your body and the trail ahead of you.

    I write this atop East Rock looking down on New Haven, the hazy blue sea to my left, an endless stretch of autumnal trees to my right. There’s an adorable elderly couple a little ways away, chatting, laughing and holding hands — something I normally wouldn’t care to notice, given my perpetual state of hustling to my next class, the library or Blue State for that necessary caffeine hit. But up here, far from the seemingly never-ending rush of campus, I can see a little more clearly.

    Before fall break (oh hey #5dayWKND), I was a mess on the verge of a breakdown. I felt suffocated, inundated in a wave of work and entangled in the web of my personal problems and the ones of others. I know, of course, that I’m far from the only one — we’re all lost in our own heads, attempting to navigate our own tempest. But this solidarity, while comforting on its face, seems to make it all the harder.

    My depression, for a while dormant, had once again reared its ugly head to drag me under. I was drowning. So I decided to hike.

    It wasn’t a decision I arrived to on my own — my friend chose this time to invite me to stay with her up in Vermont, in a house obscured by trees of every shade of autumn, virtually secluded from the rest of the world. Whether or not she knew it then, this trip would prove the life raft that pulled me out from beneath the murky waters in which I had struggled to stay afloat.

    I rose Friday morning for my first full day and, as quite the delightful contrast to New Haven, wasn’t woken up by the excruciatingly loud beeping of rubbish trucks or the obnoxious gunning of a motorcycle engine. I stepped outside, the only sounds to be heard the light chirp of a blue jay and the wind whistling through the leaves, which at this time of the year were barely clinging to the trees.

    As we embarked on our first hike of the trip, up Belvidere Mountain, I still struggled to quiet the swirl of infinite thoughts in my head, going round and round and round again. But the further up the mountain we climbed, the easier it became to let go. All I could think about was putting one foot in front of the other and measuring my breath. As we marched onwards and upwards, I watched the browned autumn slowly turn to a winter wonderland, a virgin layer of snow covering that dying season.

    Gradually, my mind began to resemble the snow on the path: clean. Clear. The troubles that had so haunted me in New Haven became suddenly manageable as I grew completely absorbed in my body and the mountain. Left, right. In, out.

    Coming down, the browned leaves that had so reminded me of death before were beautiful, creating a multicolored carpet that crunched ever so satisfyingly underfoot as we made our way back out of the forest.

    I was worried that on my return to New Haven this state of clarity would leave me and I would be left once again to face my demons alone. I lay in bed Sunday night remembering all the things I had to do this week. Write a paper. Study for a test. Organize a fundraiser. Organize gear orders. Write another paper. Start research for a final paper. Write this column. And most importantly: Find a Halloween costume (in case you were wondering, I settled on hipster Minnie Mouse).

    I could feel myself beginning to panic, that intermittent cycle creeping back into light. So I made a pledge: “Allie, tomorrow you are going to hike to East Rock.” Though comparably small next to the sprawling, majestic mountains of Vermont, that brief hike still provided me with that calm that had so relieved me up north. Left, right. In, out.

    I’m not one to run away from things. I know that my problems won’t just magically disappear every time I go for a hike — they’ll still be waiting for me at the bottom. But with clear eyes and a clear mind, the kind only found in a trek up nature’s walkways, I know I can tackle them. I know that I am stronger than them.

    If you ever want to join me on a hike, just hit me up. Monday afternoons and weekend mornings, rain or shine. Providing there isn’t over a foot of snow on the ground, of course. Ain’t nobody got time for that.

  3. CRAZY

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    “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

  4. S.A.D.: Seasonally Affected David?

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    This is the second time I bought a pair of shoes and regretted it. The first time was in middle school. I showed up to the first day of basketball tryouts in a pair of beat-up blue Vans. Little did I know that Nike Air Force 1s and Jordans were the prerequisite to play ball. As a new seventh-grader — I had just moved back to the Bay Area and switched schools — I was psychologically and physically ill-prepared for that first day. I was the white boy who wasn’t “fitted” and had no “shoe game.” It didn’t help that I couldn’t shoot a free throw.

    Tired of being bullied for being uncool, I dragged my mom with me to buy my first pair of Jordans: red 14s. They were the most expensive shoes I had ever owned. Did they help ease the transition into my new school, dunk like Mike or make the friends I so craved? The short answer is no, so I gave up on fitting in. The next year, I made varsity like all of the eighth-graders. But more importantly, my classmates began to like me for the quirky, annoying kid that I couldn’t help being.

    When I arrived on campus this fall, I shopped around for my first pair of boots. As a transfer student from Southern California, the perils of the East Coast winter took on mythological proportions. People made it seem like frostbite was a natural occurrence. This time, I was convinced the boots were necessary. Yet when I received that thin, long, yellow slip for the package containing my Sorel boots, I already knew deep down that the East Coast winter wouldn’t live up to the hype I had fabricated. Even when I count my post-Nemo escapades, I wore my only pair of “East Coast shoes” a handful of times. My perception of how I would adjust to Yale was as skewed as my image of a New Haven winter.

    What my Sorel boots couldn’t have prepared me for was the shitty weather inside me. I can’t pinpoint when I started to feel depressed. It may have been when the temperature first dropped below San Diego’s average of 70, and I had to throw my sandals and shorts under my twin bed. More likely, it was seeing the leaves outside my window turn brown and then be ripped to shreds by the December winds that tipped off my consciousness. But it wasn’t the winter’s fault that I was feeling down and out. As much as I’d like to blame it on the weather, the roots of my melancholy lay elsewhere. I missed the life I left in San Diego (there were thoughts of sandy, warm beaches); some of my classes seemed dull, and many of my peers disengaged; I was lingering at the tail end of an unhealthy relationship. I put so much thought into preparing for the weather — buying boots, warm socks, thick padded jacket and let’s not forget the long underwear — as a coping mechanism for dealing with the emotional strain of transferring. I overestimated both the snow, and my ability to transition into Yale.

    The changing of the seasons wields an odd power over some, perhaps many, maybe even most of our campus. On the surface, there are the observable differences between fall and winter: the lack of people lounging on Cross Campus in tanks and salmon-colored shorts, the piles of snow strewn on the sides of York Street which make it difficult to jaywalk, and the vast emptiness of those competing frozen yogurt places.

    But the more important, and insidious, changes are happening internally and most often unseen. Many hibernate and find themselves unable or uninterested in getting out of bed. Mood lights flicker on, and antidepressants are prescribed. Comments like “the weather sucks” are uttered frequently, often in place of “I’m feeling crummy.”

    I complained about the weather too, but I was kidding myself. The snow and the cold were some of the least painful elements I braved this winter. While I feel a bit silly for buying boots better suited for the Alaskan tundra, there’s no shame in my game. You know what, I don’t regret buying those Jordans anymore, either! If I had to buy a pair of shoes for every formative experience, then I’d be content with a closet full of shoes I never wear. Luckily, I have all the shoes I need for this spring.