Jeffrey Herman, Lehigh Carbon Community College
Tony appeared like any other student on campus, so when he came to see his advisor to drop a class it wasn’t considered unusual. Two weeks later he wanted to drop another class, claiming he was too busy with his part-time job to do the work required in this course. A week later, he returned saying he couldn’t concentrate and was missing classes because of difficulty getting out of bed. A discussion on attendance policies, scheduling later classes, and balancing work and college was mostly met with silence. When asked if he ever had similar problems, Tony revealed he had been treated by a psychiatrist and counselor while in high school. He saw college as an opportunity to put high school and a diagnosis of bipolar disorder behind him. Tony wanted to be “normal” so he stopped taking his medications and, motivated by his father’s belief that he wasn’t sick–just lazy, he enrolled at the local community college.
While some may consider college a refuge from the rest of the world, it is also a place where students struggle with finances, loss, career choices, unhealthy relationships, and a myriad of other concerns. Still others, like Tony, cope with a diagnosed or undiagnosed mood disorder including depression, bipolar I disorder, bipolar II disorder, dysthymia, or cyclothymia. The student with a mood disorder might visit an advisor for excessive absences, tardiness, repeatedly dropping courses, or poor academic standing. These students may believe they are failures, appear overly sensitive, pessimistic, dependent, irritable, or even hostile. Some have problems with concentration, motivation, indecisiveness, or being overly ambitious despite a lack of accomplishments. While none of these behaviors is proof of a mood disorder, it provides academic advisors with an opportunity to speak with students about support services available on their campus. In addition to giving guidance about a study skills class, time management workshops, or tutoring, advisors could inform students about college counseling services to increase their awareness. Sharkin, Plageman, & Coulter (2005) cited the importance of informing students about the benefits of counseling as a preventive measure before a crisis develops.
One in twelve American college students make a suicide plan and more than 1,000 successfully complete suicide every year (National Mental Health Association, 2002). Praag (2002) notes that depression is a major precursor to suicide, and half of those who complete suicide have had a depressive episode. Schwartz (2006) states that the presence or history of a major psychiatric illness, including depressive disorder or another mood disorder, increased the risk of suicide in both men and women. A study by Kansas State University found that between 1989 and 2001, the number of students with depression doubled, students considered suicidal tripled, and those taking psychiatric medications rose to 25 percent from 10 percent (Hoover, 2003). It should not be surprising that many of these same students report substance abuse problems given the academic and social pressures of college. The evidence appears to demonstrate that advisors will encounter students with these disorders during their career. Whether a student has a diagnosed mood disorder or is among those with symptoms who have delayed treatment, advisors should have some knowledge of these illnesses and an awareness about how to respond when confronted with symptoms.
The value of a college degree has not been lost on those with a mental health diagnosis, their families, and advocates. The Individuals with Disabilities Education Act (IDEA) and Americans with Disabilities Act (ADA) have opened the door to college for people with disabilities. Better psychotropic medications and community based treatment options have allowed more individuals with mood disorders to enter college. Thousands more receive support from governmental agencies such as the Veteran’s Administration and the Office of Vocational Rehabilitation to pay for college as part of their vocational rehabilitation plan. Advisors should expect the number of students with mental health disorders to increase as the result of all these forces.
A brief description of mood disorders will only be possible in this article; advisors can find further information in publications such as the Journal of College Counseling and the Journal of Counseling & Development. The Web site www.jedfoundation.org is an easy-to-use resource for additional information on mood disorders. Depression, probably the best known of the mood disorders, is distinguished by a depressed mood most of the time over a period of two weeks. The person experiences a loss of interest or pleasure, may sleep too much or too little, has feelings of worthlessness or guilt, and can be indecisive due to a diminished ability to think (American Psychiatric Association [APA], 2000).
A person diagnosed with bipolar I disorder has had one or more major depressive episodes and at least one manic episode that can result in a euphoric mood for up to a week (APA, 2000). This person may take on too many projects, miss class, be easily distracted, and believe that their ideas are brilliant. Bipolar II disorder is distinguished by the presence of at least one depressive episode and one episode of hypomania, which has a shorter duration than a full manic episode (APA, 2000). These students may be diagnosed as only being depressed but are often described as irritable, angry, or sensitive by others. They may do poorly in social situations due to fluctuations in their demeanor with school truancy and failure being common.
A person with dysthymia has had a depressed mood on most days for at least two years (APA, 2000). They might be viewed as having a personality problem, so this illness often goes undiagnosed. These students may want to flee situations when overwhelmed and are described as dependent, sensitive to criticism, and indecisive. The student with cyclothymia has had periods of depression and hypomania for at least two years (APA, 2000). They often have an unstable record at school, show poor judgment, and have an inflated self-image despite few accomplishments.
Even with these brief descriptions, it becomes evident many advisors have encountered students who demonstrated these characteristics and behaviors. To support these students, listen carefully and use “I”, not “you”, statements to address concerns. Try to give students a choice instead of an ultimatum to increase ownership of the problem. Do not assume anything, be non-judgmental, and understand how stereotypes about mental illness shade our perceptions. If you encounter a situation that appears to be escalating in its intensity, consider speaking in a calm, quiet manner. Advisors should always maintain professional boundaries and set limits to avoid misunderstandings. Finally, know your college’s code of conduct and keep a list of community and college resources nearby to better educate your advisees.
Whether a student discloses a mood disorder or you suspect as much, advisors should know that relationships make a difference in the lives of students. As an advisor you are often the first contact for a student. The development of an encouraging relationship provides us with the opportunity to guide students to the most appropriate services, give support, and leave the door open to their future success.
Lehigh Carbon Community College
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Hoover, E. (2003). More help for troubled students. Chronicle of Higher Education, 50, A25-26.
National Mental Health Association. (2002). Safeguarding your students against suicide: Expanding the safety net. Proceedings from an expert panel on vulnerability, depressive symptoms, and suicidal behavior on college campuses. Alexandria, VA: Author.
Praag, H.M. (2002). Why has the antidepressant era not shown a significant drop in suicide rates? The Journal of Crisis Intervention and Suicide Prevention, 23, 77-82.
Schwartz, A.J. (2006). College student suicide in the United States : 1990-1991 through 2003-2004. Journal of American College Health, 54, 341-352.
Sharkin, B.S., Plageman, P.M., & Coulter, L.P. (2005). Help-seeking and non-help seeking students’ perceptions of own and peers’ mental health functioning. Journal of College Counseling, 8, 65-73.
Cite this article using APA style as: Herman, J. (2007, June). The student you've met but may not know. Academic Advising Today, 30(2). Retrieved from [insert url here]