Sometimes, sleep is the first symptom. While your classmates run on four hours a night, you find yourself in bed for twelve. It’s not a hangover. You’re not bored with classes. You just can’t get up.
Other times, it’s the lack of sleep. You spend days in a row awake. You can’t sleep, until you can, and then you can’t not.
Mental illness is capricious. It involves dozens of inscrutable factors. It looks different for every person, and it can force life to a halt. For students in the throes of a mood disorder at a school where halting is taboo, nothing seems worse than leaving Penn—except staying.
==========When Kate*, a sophomore, first came to Penn in the fall of 2012, she’d experienced depression before. During high school, “it was manageable. Very manageable.” Here, a combination of stressors triggered her depression, and by winter break, she found herself in a downward spiral.
“My parents saw I wasn’t doing well and was sleeping all day. They were like, ‘you can’t go back like that,’” Kate says. “But I didn’t believe them. I thought I could start over in a new semester. I came back intending on staying.”
Soon after second semester began, Kate went through a breakup and stopped going to class. Drop period hadn’t ended yet, so she told herself she still had time to catch up. She didn’t want to admit that anything was wrong. “I felt like a failure if I went home,” Kate says. “I didn’t want people to think I was weak.”
The choice didn’t come easily. “I felt like I’d be messing up my college career, like it was too out of the norm for me to make that choice comfortably.”
After three weeks of missed classes, Kate decided to leave. “I remember standing on the steps of College Hall after I signed the form, and it was snowy, and I was just like, ‘What am I doing? Where am I going? I don’t know if I’m ever coming back here. Maybe I’ll just never finish college.’”
==========Dr. Bill Alexander, Director of CAPS, finds that Penn students often fight the need to take time off. “A lot of students try and guts it out and get through [depression],” he says. As with a physical illness, a student with mono might be able to drag himself to class for a while, but eventually his condition would catch up. Students are inclined, at least initially, to push through.
Clinical depression, however, impedes that drive to keep going. The diagnostic criteria for a major depressive disorder involve at least five of eight depressive symptoms, which, combined, cause “clinically significant impairment in important areas of functioning.”
==========Sam*, a junior, began struggling with depression in January of 2013. “I came back to school and couldn’t get into a rhythm,” he says. “That was the first way I could explain what was going on. I felt strange. I called my parents a few times and said, ‘I don’t feel like myself.’ I didn’t know how to explain it.”
Sam did what many Penn students are inclined to do: he attributed his feelings to overcommittment. He left several extracurriculars. He dropped some classes. He didn’t feel any better. “It wasn’t that I was stressed about school,” he says. “I was just stressed about myself.”
Eventually, a therapist diagnosed him as clinically depressed. “I wasn’t convinced, because the connotations attached to depression are so vague,” Sam says. “People say, ‘that was such a depressing movie,’ but it’s more like you see that there’s no point in existing.”
Still, Sam resisted the idea of leaving. “I told myself that I’d be okay if I made it to spring break,” he says. By then, though, he’d lost all motivation. He decided to go home.
==========In extreme cases, students don´t get to choose to leave. “The decision will be made for them,” Dr. Alexander says, “because they’re going to flunk out.” The University intervenes when students have two or more incomplete grades; often, academic issues coincide with health issues.
Alex, a student currently on on his second leave of absence, went on a mandatory leave after freshman year. He had experienced depression in the past but hadn’t treated it. “Coming to college, and Penn specifically, led to some new problems I wasn’t really sure how to deal with,” he says. His grades plummeted, and the College told him that he had to take time off.
Unlike the majority of students on leave, Alex didn’t go home. His parents lived in Italy at the time; he figured he wouldn’t find much to do there, so he spent his year off living by campus, trying to find various jobs around Philly. For a while, he went to talk therapy once a week, but he didn’t seek extensive treatment.
Alex re–enrolled in the fall of 2012. By spring, he again found himself incapacitated by depression. He’d begun a medication regimen with detrimental side effects: one drug caused allergic reactions, another left him unable to read. During finals week, he checked himself into an inpatient psychiatry program—“basically to stop me from doing anything to myself.” When he got back to campus, he applied for a voluntary leave.
==========Despite the severity of mental illness, its stigma persists: that students leave because they can’t handle Penn; that the environment caused them to crack; that they´re escaping the source of their problems.
Sindhu, a senior who took last year off to deal with depression, faced those assumptions when she decided to leave. “I had a lot of people tell me I was running away,” she says. “But I knew whatever I was running away from was inside of me. I had to go to a quieter place to deal with it.”
Anna, a 2013 graduate who took the 2011—2012 school year off, found that her peers often didn’t understand why she went home. “If you tell Penn students you took time off, they think you were doing an internship,” she says. “I needed time off, so I went home and hung out. If people judge me for being unproductive, that’s fine.”
Many misconceptions around mental illness stem from the idea that all Penn students are, to an extent, unhappy. But to label depression as yet another side effect of Penn culture is to overlook the disorder’s actual gravity. While mental illness can be triggered or compounded by a high–stress environment, it’s rarely the only factor.
“We’ve kind of normalized this act of whining,” Sindhu says. “With depression, getting out of bed becomes a hugely impossible task. That’s much different from this Penn mainstream mentality of always complaining about what’s wrong with our lives.”
==========Amanda*, a student currently on her second leave of absence, became aware of the symptoms of bipolar disorder in 2010 during her first semester of freshman year. At the same time, her body shut down. She spent a week in her room, unable to leave, until her house dean took her to the hospital.
After sitting in the emergency room for eight hours, the doctors told Amanda she was fine. Her dean then took her to the psychiatric ward.
“I walked through these doors and they told me, ‘you’re now a ward of the state, you’re not allowed to leave,’” Amanda says. “You look around and it’s all gray. The walls are all padded. There’s this guy who’s been sitting in the emergency room, he’s drooling all over the place, he obviously has issues, and I’m like, ‘really, we’re in the same place?’”
Amanda stayed at the mental hospital for ten days before returning home. She spent a year undergoing various treatments and re–enrolled for the spring of 2012. Her routine changed drastically from before: she had to sleep for twelve hours a night, she lived a rigidly structured life and she successfully made it through the semester.
The following fall, Amanda again found herself unable to function at Penn. “It just didn’t work,” she says. “I would get depressed and try to bring myself back up, but with bipolar disorder, it’s really hard to just do that.” She decided to take another year–long absence.
==========The first month away usually involves little activity, shuttling from home to the psychiatrist’s office and back. After a while, a student on leave may pick up a job or take a class at a local college—CAPS recommends an activity that can simulate the pressure of Penn.
For some, time off allows for resolution of an isolated depressive episode. Sindhu returned feeling completely recovered. “I don’t go for therapy anymore. I don’t take any kind of medication anymore,” she says.
Kate felt that her absence prepared her to settle back into Penn. “I learned a lot about letting go of what people think,” she says. “It’s not the end of the world to take a semester off.”
For other students, mental illness never really goes away. They simply learn to live differently, maintaining medication and therapy regimens.
Sam continues to take the medication he was prescribed last spring, and he sees a therapist regularly. Since May, he’s felt like himself again. During the worst parts of his depression, “I wasn’t able to think that well.” After going into treatment, he says, “I felt like I could think again. Not being able to think the way you want to is not pleasant.”
On his second leave, Alex is focusing on getting better. He sees a therapist each week and takes medication; still living near campus, he tries to occupy himself with things he used to enjoy. “A big part of depression is the lack of motivation. I remember the things that I enjoyed doing, but I don’t want to do them,” he says. “So now I’m trying to do stuff like read and play music, things I know I’ll start enjoying.”
==========It’s hard to illustrate the severity of a mood disorder. It’s internal; it’s chemical; it’s isolating. The hardest is when it’s insoluble.
Resolution doesn’t always come from CAPS, a parent’s kitchen or a fluorescent–lit ward.
Time away can weed insidious roots; but some of them can grow back.
Madeleine Wattenbarger is a sophomore from Philadelphia, PA, studying English and Gender Studies. She is an Arts Editor for 34th Street Magazine.