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May 1 2013
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April 17 2013
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April 5 2013
More stories from Columbia’s military veterans
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Missed the Cliterary Open Mic? Check out the highlights here
March 29 2013
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It was Wine Monday, and I could hear my suitemates upstairs laughing at some YouTube video. Normally I’d never miss Wine Mondays—they’re my favorite part of the week. But last month I was hiding out in my room with just enough energy to sob into my pillow. I couldn’t face the rapid-fire conversation, the expectation of eye contact, or talking about small things as if everything were fine, the way normal people do. I had been off Zoloft for four weeks, and I wasn’t myself anymore.
I had always hoped that these would be the years to grapple with life’s great questions—Who am I? What am I doing here?—with a cappuccino and a few choice texts from the Core Curriculum in hand. Instead, like many of my peers who have struggled to beat back depression, anxiety, and other mental health demons, I have looked to other tools to understand myself: alcohol, Columbia’s Counseling and Psychological Services, late-night Google searches, mostly nonsensical self-help books, and, significantly, antidepressants.
College is a time for us to define ourselves. Will we still be those nervous high school kids who could hardly string a sentence together outside of class? Will we still barf in the bathroom after lunch? By my sophomore year at Columbia, I realized I had everything I wanted at that stage in my life—yet I wasn’t happy, nor was I the person I wanted to be. Like many other students, I began to wonder if there was something wrong with me and whether there was a pill to fix it. Is it scary that such a pill exists, and that I’m terrified about who I might be without it? You bet.
From Erik Nook, a senior in CC who took Lexapro for just a few months to treat a severe but fleeting episode of depression because his “biology needed a kick start,” to Jackie, another CC senior, who believes high-pressure coursework and busy schedules leave Columbia students with few other options, the reasons for turning to medication vary widely. Nevertheless, each of the ten students I spoke with say the decision to try or decline medication was one inextricably wrapped up in questions of identity. Struggles with mental health, as one student told me, are “who I am and who I’m fighting against with everything I have.”
Too Busy to Be Unwell
“We’re living in a time where we put so much pressure on ourselves that we can’t take care of ourselves anymore.”—Jackie
Despite increasingly frequent panic attacks and a family history of mental illness, Jackie was hesitant to take her therapist’s advice and start using a selective serotonin reuptake inhibitor, a class of drugs used to treat depression and anxiety disorders. She felt defined by the sad, tense periods in her life and didn’t view herself as ill.
“If I didn’t have these, then I wasn’t sure who I’d be anymore,” she says of those difficult episodes.
After years of resisting treatment, she recently began taking Zoloft for anxiety and clonazepam for sleep problems. Although she believes her depression is genetically determined, Jackie says she also believes her four years at Columbia may have exacerbated feelings of stress and hopelessness.
“I would really like to just do this mentally … like, if I had the time to just meditate, I feel like I could just pull myself out of this,” she says. “But I don’t have the time, and I don’t know when I will.”
Jackie has friends who meditate and exercise or meet more frequently with therapists to stay well, but, like many students, she says she has too many deadlines and projects to do before the year ends. She doesn’t have time to be depressed. Who does?
“Are we putting ourselves in a position where we have to do drugs?” she asks. “We’re living in a time where we put so much pressure on ourselves that we can’t take care of ourselves anymore.”
Dr. Richard Eichler, executive director of Counseling and Psychological Services at Columbia, says that no data indicates that psychiatric medication is used more commonly at Columbia than at peer institutions. Recent national estimates have indicated that 25 to 50 percent of U.S. college students seen in counseling and at student health centers are taking antidepressants. Health Services declined to provide statistics they have for Columbia.
“The majority of students seen at CPS are not prescribed medication, and instead receive treatment that is tailored for them, including individual or couples counseling, groups and workshops, among other services,” Eichler writes in an email. “We periodically benchmark our practices against both peer institutions and established best practices and found that we are consistent with both.”
Peter, a senior in CC, says he flatly rejects the idea that drugs are our only recourse in a high-pressure environment. Despite a host of difficult medical conditions and multiple “offers” (read: insistences) from psychiatrists, he does not use medication to address his mental health issues.
“If you’re basically saying I don’t care enough to put the time into it, so I’m going to take a pill and let it jigger with my brain ... that tells you that there’s a completely different set of issues there,” he says. He explains that for him, wellness is about staying productive, prioritizing time well, and stepping back from routines that don’t work.
If there is anyone on campus who should be stressed, it is Peter. Rattling off lines from his résumé would take up too much time and give away too much of his identity. The bottom line, he says, is this: Make time for yourself if you want to be well.
Nook says that with students’ limitless to-do lists, it can be easy to feel stressed and out of control at Columbia. He defines stress as the perception that you don’t have the resources to deal with the challenges that lie before you. Stress in his life comes from many different places.
“It’s my being a type-A person, it’s me setting certain goals for myself, it’s me being in a certain situation—namely being here at Columbia—where I feel like there is just so much opportunity for me to pursue those goals to the extreme in a positive way,” he says. “The more energy I put into the world around me, the more I find it coming back to me—and that really excites me but, at the same time, creates this kind of infinite limit where I ask myself why I can’t be doing more and more.”
That sense of possibility can be consuming, as Jackie suggests, and it’s easy to fall into a sort of passion-driven black hole.
Part of being well, as Erik and Peter advise, is choosing to prioritize your own mental health. Of course, one of the awful things about being depressed or anxious is that you more or less hate yourself—the last thing you want to do is treat yourself well.
But Louisa, a senior in CC, says that choosing to focus on her own wellness wasn’t always an easy conclusion to reach.
Louisa’s anxiety drove her to stack on extracurricular commitments and do well in school. She says that after looking back at that huge stretch of time defined by academic success after success, she realized she had to start putting herself ahead of her GPA. “I was like, wow. That really sucked. It just wasn’t worth it. Those good grades aren’t worth it.”
50 Milligrams Away from Boring
“Do you think Virginia Woolf would’ve ever written Mrs. Dalloway if someone had just handed her a Prozac at 20?” I ask a writer friend of mine one day on East Campus.
“No, she wouldn’t have,” he says, pausing. “But in the same vein, do you think [our classmates] could’ve gotten jobs at McKinsey without Prozac or whatever they’re all on?”
Growing up, Peter saw classmates turn to antidepressants, and sometimes it made them happier, but it always made them different from the way they were without the medication.
Friendships would evaporate with the coming and going of chemically manipulated serotonin.
“Depression played into how they had developed as people. They suffered as much as they were enriched by it,” he says, noting that it is very much a “new person” who will “pop out” once people begin popping brain pills.
Most people taking medication say they have worried it would blunt their personalities and replace creativity with drug-induced dullness.
Jackie, the CC senior who recently started taking Zoloft, says she worries about what the drug might do to her writing—a creative outlet she has used to manage anxiety since she was a child.
“I didn’t want to change who I was,” she says. “I was afraid that it would take away deep feelings that I had. Even though sad feelings were difficult, I felt like they helped me appreciate the deepness and complexity of life. I thought it was special to have a perspective on life that other people didn’t.”
Social scientists have long noted a unique connection between pain and creativity—any list of artists or poets with depression will tell you that.
Dr. David Kahn, a clinical professor of psychiatry at Columbia’s medical school, says that mental illness for artists is a double-edged sword. Severe mental illness cripples people—it gives musicians too much anxiety to go on stage, robs poets of the energy to write, and leaves painters unable to get out of bed.
“But at the very edges of unhappiness, or at the border of hypomania in mild bipolar illness, there can be great emotional intensity that can inspire an artist to translate what they feel into a medium others can understand,” Kahn writes in an email. “It’s a fine line, but once over the line make no mistake that serious mental illness is more crippling than generative.”
It was hard to tell, when I met Louisa on the grass outside the Northwest Corner Building, that she had battled generalized anxiety and recurring panic attacks for most of her life. Her long hair flew around her face in wisps, and she lay back on the grass, seemingly without a care in the world. Medication has worked out well for her, and she says that her biggest fear—that she would have to sacrifice her creative spark for stability—proved unfounded.
“There would be creative moments for me,when I felt like I was on the verge of understanding something big … the ups feel different [now], but I don’t think they’re gone at all,” she says. Louisa says she now enjoys these creative moments without being scared of going crazy.
“I’m not afraid that my head is going to explode anymore. I may have given up some edge, but I like not feeling like my head’s going to explode.”
I’m not as lucky as Louisa. There’s a file box in my closet back home in California of diaries I wrote in on a near-daily basis from first grade to junior year of college. Like Jackie, I was proud of my writing. I still am. I dreamed of becoming Virginia Woolf, even if things didn’t turn out so well for her. I wanted to transform my own bourgeois suffering into something beautiful.
I more or less stopped writing after I started Zoloft. But as soon as I tried tapering off my medication in December, I bought a new journal and started scribbling again. I was excited to see my creative interest and energy return, but maybe I was really just looking for a non-chemical way to get the unceasing slideshow of my life’s great mistakes out of my head and onto a page. Still, I sometimes feel like I face a choice: to be talented and tortured or to be simple, happy, and mediocre. Would Virginia Woolf have written Mrs. Dalloway if she’d been on Prozac? No. But maybe she would have survived her demons. What’s better?
Choosing and Refusing Medication
“I remember the nurse practitioner asked if I wanted to go on an antidepressant, and I literally burst into tears. I was like, ‘I’m not depressed—I just have some issues with food.’ ” —Susan, a junior in CC, about the first time she was offered medication.
It’s usually easy enough for people who have struggled with mental illness to pinpoint the moment they realized they were definitely not fine. For Nook, who was inducted into the academic honor society Phi Beta Kappa earlier this year, that moment came during the summer after his freshman year. He hadn’t felt like his usual present, optimistic self for weeks, but when he hit a car crossing a T-section because he was stuck in a downward spiral of obsessive thoughts, Nook says he knew something was seriously off.
“I was in my little bubble and I was feeling very bad,” he says. “I couldn’t be there for my family. I was really at rock bottom—they had never seen me like that before.”
Nook, a certified massage therapist with an unmistakably soothing presence, says medication was always a last resort for him—he had trouble believing that it worked. At the time, he says, part of him was relieved to find a scientific explanation for his sadness and a medical solution to take care of it. But Nook says another part of him will always be wrapped up in “this thing we call the human spirit,” or the emotions and experiences that can’t be explained by science. Despite hesitations, Nook wanted to be present again for his family, so he went for it.
“I couldn’t see that the world that I had buzzing around in my head is not the only world. I had to take that step which I had been saving as a last straw … I wanted to feel better and more in control again, more me.”
Nook weaned himself off his medication after a few months and has had few problems since. He meditates, sleeps well, reads Eastern philosophy, and continues to work with Stressbusters to orchestrate interventions for others. It’s an antidepressant fairy tale with a happy ending. Nook says his biology “needed a kickstart” at the time, but he now copes with anxiety in more natural ways.
Admitting she was in trouble was a bit trickier for Susan, a junior in CC. Like many who struggle with mental illness, Susan was reluctant to call herself depressed. She says that in high school, she was always so busy trying to control everything about her schoolwork, her ballet, and her food that she didn’t give herself time to think about who she was or why she was so nervous all the time. She said she started thinking about suicide in fourth grade and began struggling with eating disorders in high school. Those problems came to a head during her first year of college.
“I couldn’t stay in class anymore. I couldn’t concentrate between the anxious thoughts I was always having and being light-headed from hunger. I just knew that I couldn’t go on that way.”
Susan, a transfer student, went to her school’s counseling center and asked to be seen for an eating disorder.
“I remember the nurse practitioner asked if I wanted to go on an antidepressant, and I literally burst into tears. I was like, ‘I’m not depressed—I just have some issues with food.’”
Last year, Louisa received prescriptions for Prozac, Lexapro, Celexa, and Adderall. She says that she has come to view her experiences with anxiety as going through something tough, not as an illness or a label.
“A lot of people don’t try out medication because they see it as admitting that they’re sick,” she says. “The cool thing about the doctor I was seeing at CPS was that he never said the word ‘diagnosis.’ He said, ‘This thing might help you with the way you’re feeling now.’”
You Are What You Take?
“A lot of the time, it was the inability to maintain control over my own thoughts, the nagging presence of a little partial voice in the back of your head that drives you on with the constant message, “Kill yourself, kill yourself, kill yourself, kill yourself,” droning on …. Lots of people have that baseline somewhere in their heads, but when you can no longer control that voice, that’s when it becomes a problem.” —Peter
Like many of the students I interviewed, I was nervous and melancholy in high school. My parents and friends always assumed it was because I was a very particular brand of introvert genius. I figured I was just frustrated with middle school and then high school in a shiny, happy, plastic suburb.
Then I got to the nirvana I had longed for: college. I was at UC Berkeley during my freshman year, and I was as sad and socially anxious as ever. That wasn’t how things were supposed to be. I figured that was because I didn’t go to Columbia—there were just too many frats and football games at Berkeley for my snooty self. I decided to transfer to Columbia.
But after another sad, friendless school year at Columbia, I felt more insecure and alone than ever.
One night I decided I wanted to drop out. I looked at my bank account and saw that I had enough waitressing money to move to a beach in Thailand. But even there, I reasoned, I would still feel like shit. There was something wrong with me, with my brain, not with the cities I happened to live in. I never dropped out, thank God, but I knew things needed to change. Since junior year I’ve taken Zoloft as a slightly uncomfortable but necessary evil.
Listening to Peter talk about his resistance to psychotropic medication to combat a depression that sounded incredibly overwhelming and self-destructive was a little excruciating. He says he believes we have power over ourselves and who we choose to be. No chemicals needed.
“For me it’s an issue of, you’re putting a chemical in your brain, and it’s fucking with your neurochemistry. To some extent, I do believe that’s messing with what’s making you you,” he says. I gulp, and my eyes dart around the room. These are all of the thoughts that terrify me. “How much of it is wiping out who you actually are?”
I sit there wondering if I’m feeling tense because I’ve forgotten to take my little white pill that morning. Peter says mental health care has to be redefined—right now it’s more about efficient treatment than about genuine solutions and understanding who we are. He thinks the cultural reliance on medication is a symptom of that desire for expediency.
“If you’re goal-oriented and your goal is to eliminate that negative feeling and you’re not looking to redefine yourself in a holistic way … then it [getting medicated] is going to be really appealing to you,” Peter says.
After our interview, I sit outside on a bench in the East Campus courtyard. I look up at the barren tree branches and gray sky and wonder if I am that person Peter described. Am I sad, weak, and just looking for a quick way to spirit away bad feelings? Or am I someone going through a rough time? Or am I sick? I just don’t know.
A few years ago Katharine Celentano, a student in GS, wasn’t sure if working a minimum wage job was a reasonable life goal for herself. At the rehabilitation center, where she spent two years being treated for anxiety and trauma, her doctors doubted that she’d ever be able to live alone.
Things are different for her now. Last week at Joe, Celentano, who has thrived as president of the Columbia chapter of Students for Sensible Drug Policy, laughed breezily about the cocktail of ever-changing medications she’s been on throughout her life. Her diagnoses have shifted as often as the meds doctors have prescribed. She says she looks back sometimes at the people she was in inpatient care with. She wonders who’s still at that facility, who’s out, who’s dead, and who’s better. Although she’s puzzled about how she managed to do well in the world, she knows resilience drove her forward.
“Resilience is about finding a pattern of interacting with unexpected things that come your way that will allow you to keep somewhat of an even keel,” she says. “Medication doesn’t give you that nuance. It may help you by providing a little bit of stability, but resilience is something you need to find and empower within yourself.”
Susan, the transfer student with eating problems, says she’s in no hurry to get off her antidepressants, but that doesn’t mean she considers herself depressed.
“When you’re in the throes of something like that, I wasn’t able to enjoy my life or acknowledge all my other identities, so it [depression] did define me even though I was struggling so hard to push it away.”
Now, she says, she can truly be herself.
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