December 8, 2006
Troubled Children
Off to College on Their Own, Shadowed by Mental Illness
By LYNETTE CLEMETSON
Her mother called it a negotiable proposition. But to Jean Lynch-Thomason, a 17-year-old with bipolar disorder who started college this fall, her mom’s notion to fly from their home in Nashville to her campus in Olympia, Wash., every few weeks to monitor Jean’s illness felt needlessly intrusive.
“I am so totally aware of the control you have over me right now,” Jean said, sitting in her parents’ living room one evening last June, before coolly reminding her mother of her upcoming 18th birthday. “In a few months the power dynamic is going to be different.”
For Chris Ference, 19, who is also bipolar, the fast-approaching autonomy of his freshman year held somewhat less appeal. His parents had always directed every aspect of his mental health care. Last summer, over Friday night pizza at his home in Cranberry Township, Pa., he told them that assuming control felt more daunting than liberating.
“If it was up to me, I would just have it so you could make those decisions for me up until I was like, 22,” he said. “I mean, you’ve raised me well up to now. You know me better than anyone.”
The transition from high school to college, from adolescence to legal adulthood, can be tricky for any teenager, but for the increasing number of young people who arrive on campus with diagnoses of serious mental disorders — and for their parents — the passage can be particularly fraught.
Standard struggles with class schedules, roommates, and sexual and social freedom are complicated by decisions about if or when to use campus counseling services, whether or not to take medication and whether to disclose an illness to friends or professors.
Keeping a psychiatric disorder under control in an environment often fueled by all-night cram sessions, junk food and heavy drinking is a challenge for even the most motivated students. In addition, the normal separation that goes along with college requires new roles and boundaries with parents, the people who best know the history and contours of their illness.
Like Jean and Chris, young adults approach the move to a new life differently, some with defiant independence, some with avoidance. Each approach, say psychiatrists, counselors, dormitory assistants and other campus leaders, comes with its own risk. The students who are most dependent on their parents may be dangerously unprepared for the inevitable stresses of college life. On the other hand, students who are adamant about doing everything on their own may be afraid to reach out for help when they stumble.
For parents, the anxious pride at seeing children go off to college is often tinged with fear that their child might fall apart, spiraling into depression or becoming suicidal. Are they going to therapy as they promised? Are they taking the right dose of medication at the right time? Should they as parents inform the school that their child has an illness? Is a fight with a roommate part of a normal transition to college life or a sign of impending trouble? Does an emotional e-mail message written at 3 a.m. represent a transitory moment of turmoil or a reason to get on an airplane?
Once teenagers legally become adults, which in most states happens at age 18, they, not their parents, assume control over decisions about therapy and medication. If trouble arises, parents may or may not hear about it because college counselors are bound by confidentiality when dealing with adult students.
The Trauma of Separation
For Jean, as for many teenagers coping with mental disorders, just getting through high school was an ordeal. After experimenting with home schooling, a high pressure prep school and an outdoor learning academy geared to nature activities, Jean, a bright student with inconsistent grades but high SAT scores, decided to forgo her senior year and find a college that would take her without a high school diploma.
She was accepted at Evergreen State College in Olympia, Wash., a nontraditional college of roughly 4,400 students that issues written evaluations in place of letter grades.
Evergreen’s environmental focus — the campus has its own organic farm, composting program and a contest for commuters who bike, walk or carpool to campus — felt like a good fit for Jean, who is passionately committed to the environment and social justice.
A consciously quirky teenager who sews her own clothes (to avoid crass consumerism, she says) and who prefers bus trips to flying (to avoid contributing to the pollution caused by air travel), Jean is disarmingly straightforward and self-aware.
She said she stopped taking medications when she was 14 because the side effects left her feeling “out of whack and emotionally inauthentic.”
She is determined to stay off medications during college, and she devoted considerable advance thought to possible triggers for her illness, like the long rainy winters of the Pacific Northwest.
“I don’t feel vulnerable about this transition because this is very much my decision,” she said. “This is a very autonomous move, very much me structuring my own life. I feel like I am putting myself in a situation with really clear intentions.”
Jean’s parents, Amy Lynch, 52, and Phil Thomason, 53, were hesitant when Jean, the younger of their two daughters, refused to take medications after eighth grade. Her childhood and early adolescence had been a whirlwind of depression, rage and experiments with different medications and treatments.
But when Jean was about 14, Ms. Lynch and Mr. Thomason said, she began to seem more stable. Her developing coping skills, combined with reports about negative side effects of psychotropic drugs in children, persuaded them to acquiesce to her demands to ride out the swings of her illness drug free.
They said they believed Evergreen would be a good college for Jean. Still, the move — to someplace so far from home — made them anxious. In the months before Jean left, Ms. Lynch said she wanted her to go back on medication to smooth the adjustment to college life, a suggestion that Jean adamantly rejected.
Ms. Lynch worried that Jean took for granted the tacit stability of being at home.
When Jean’s depression sets in, she tends to close herself off from people. At home, Ms. Lynch said, “I can look at Jean and know in five minutes what’s going on with her and how to respond to it.”
At such a distance it will be difficult to catch the signs.
“I feel like we’re doing a high-wire act,” she said, “and I am not sure we have a strong enough net.”
Rummaging through the accumulated possessions of adolescence in her bedroom over the summer, Jean singled out the items that she could not leave without: her sewing machine, her coffee maker, the social justice posters that covered her wall.
With her mother out of earshot, she acknowledged that she understood her parents’ angst. “I get that this is intense for everyone,” she said. “I do.”
Hesitant to Leave the Nest
The uncertain months between high school and college were also anxious ones for Chris Ference and his parents.
Still groggy from an early morning drive to campus, his husky 6-foot-2 frame jammed into an auditorium chair in the student union, Chris shifted uncomfortably as a freshman orientation coordinator welcomed new students and their parents to the Behrend College, a Pennsylvania State University satellite campus in Erie, Pa.
“Today really is the first day of your freshman year of college,” the cheery administrator told the group on a June morning more than two months before the start of fall term.
Chris had initially been reluctant to go away to college. Though eager to leave the rigid structure and peer pressure of high school, where he told few friends about his illness, he preferred the idea of living at home during college and commuting to an engineering program in nearby Pittsburgh.