School has always stressed me out. I love it, I’m really good at it, but my mental health often gets in the way. I have a BA in English and History and I almost completed a Master’s in Medieval Studies, but I got so depressed that I couldn’t write my final thesis and so I withdrew from the program. In college I withdrew twice, once in my sophomore year and once in my senior year. In both instances I was so depressed and dysfunctional that I couldn’t get my work done.
Now, nine years after graduating from college, which I ultimately did with honors, I have gone back to University as a postbac premed student to study for nursing school. Since I was a humanities focus I don’t have the science prerequisites that I need, so now I am collecting them in advance of applying to nursing programs.
Going back to school as a 31-year-old student is daunting. Going back to school as someone with mental illness is daunting. Trying to balance schoolwork, home and social life, and my ever fluctuating mental health is like standing on a diving board, wearing roller skates, trying to hold a bucket of water above my head without spilling it. But it’s not impossible, and there are a lot of things that I do to help maintain my momentum and psychic balance.
For me, the most important thing is that I stay in therapy. I talk to my therapist (PhD Psychologist) at least twice a week, and usually speak with my psychiatrist once a week or every other week. There is something about expressing my anxieties and frustrations that keeps them from building up into something overwhelming or dangerous. It’s important to me that I’m very honest about everything so that they can help me to their fullest ability. I do fight the urge to withhold information because sometimes I’m afraid of how they will react, but I try not to let that fear win. Mostly I succeed.
I am on an intense medicine regimen, so I always make sure to take my meds. Even if I miss one night’s dose I can feel a chemical difference and physical side effects. Additionally, I am not afraid to question my regimen, make changes, and ask for help from my psychiatrist. Because I’ve been out of an academic environment for about five years, I was not sure how my brain would handle schoolwork. In the interim I had a long course of ECT, cycled through at least a dozen different medications, and tried to kill myself by jumping off a ledge on to my head to break my neck. I broke my neck and my back but I lived, as you can see.
I spent the last year recovering both mentally and physically. At first my memory was severely affected and I had little to no real short-term memory. It has improved a lot since my last ECT session, but I do think that it had a lasting impact on how I remember things. I know it has had a positive lasting effect on my mood, so I will absolutely take the memory loss as a side effect.
What I noticed when I started classes three weeks ago was that I couldn’t focus. I would try to read or pay attention in class and my brain would wander off to places unknown until I shook it back to the present. I was just so out of practice. I hadn’t done anything like this with my new brain (my post-ECT, properly medicated brain), and I wasn’t sure what was at play. I remembered taking Adderall in college because I encountered the same problem, though under different circumstances, and it was helpful. Sometimes people with Borderline Personality Disorder and Bipolar (I have Bipolar 2) can become seriously unfocused as a result of mood. It’s possible I have some underlying ADD but I think it’s more linked with the BPD than anything else.
I asked my psychiatrist if that might be a good course of action to try. He agreed, and we did and it has been tremendously helpful. We were concerned that I might have breakthrough mania, but my cocktail is great and has kept me stable throughout. The takeaway here is that it is important to advocate for the medications you think will help you and discuss them with your Dr. If you don’t, they’re often not going to bring it up. And do your research on meds so that you can be informed about what you’re taking and what you think might help. You don’t have to be a doctor to have a basic understanding of psychoactive medications.
What I have discovered about school work is that I need to schedule it. I am a morning person. I get up between 5 and 8 every day, take an Adderall, drink something caffeinated, check my social media, and start working on something. My psychology professor shared an experiment with us about how people study, whether in bits and pieces over a long period of time, or cramming right before an exam. We generally believe that cramming is the better way to study, but actually people who space their studying out over time have better test results. Moreover, providing yourself with practice tests is more effective than simple review over time.
For those of us with mental illness, time management is crucial because we never know when our moods or issues will flare up. That’s why I always start to work first thing in the morning and continue as long as I can. I know that I am the most awake and thoughtful then and I know that later in the day I might not have the same capacity. Carpe diem, as they say, because you never know what’s going to happen tomorrow. If you have an assignment due in a week, it’s better to start on it right away and work on it in chunks than to put it off just “because you have time.” I think this is also an effective method to prevent becoming overwhelmed because you waited until the last minute and now you’re stressed out.
In the past I rarely asked questions, I rarely went to study groups, I did not follow my own advice and I suffered for it. Now, I ask questions when I want clarification, I employ tutors to help me outside of class, I go to study groups and review sessions, and I do my work in advance. I’ve been making a study guide for my psych exam this Wednesday for the past week and some. In the process, I slowly review everything as I make each flashcard and as a result I already feel prepared to take this exam. I have more studying to do, but if I stopped here I would get a respectable grade. The same with my math class. I’ve been working on practice problems a little bit every day just to keep my brain fresh and familiar with the material.
I am studying the sciences now but I spent so much time in the Humanities that I know this can be applied in a similar way. If you have a paper due, start working on it right away. You don’t have to finish it quickly, but if you work on it a little bit at a time it is less likely to overwhelm, and then if for some reason you’re having a rough night before it’s due, you don’t have to power through the mental duress just to churn out an average paper. For large amounts of reading I’d recommend the same thing. Do it early, get it out of the way, leave yourself space if possible. Sometimes it’s not possible because you just have so much work to do that you’re constantly working. In those cases, try to cycle through projects so that you never get too caught up in one thing. I think that is an easy way to burn out and become numb to whatever you’re studying, reading, or writing.
On a more technical note, if your school has an Office of Disability or Disability Services they can be a great resource should you need extensions or to withdraw or whatever else. Professors are not always understanding, which isn’t surprising, but there is recourse. Additionally, if you don’t have a regular therapist, most schools have counseling services for you to use for free. I know it can be difficult to get appointments sometime because there is such high demand, but don’t be afraid to try. It can’t hurt, it can only help. If it is a crisis, tell them and hopefully they would respond accordingly.
Going to school with mental illness is difficult but not impossible. It just requires a little forward thinking and a lot of health maintenance. Things like exercise, meditation, yoga, pilates, or active hobbies can all be extremely helpful. It’s important to get enough sleep because it contributes so heavily to mood. Eating properly will help your body become resilient to stress and give you more energy. But mostly be aware of yourself. Try to notice patterns in your moods or episodes and recognize when they’re beginning so that you can work around them. Work ahead of schedule and whenever you feel well. Leave the slacking off for times when you’re not feeling quite right. If you’re not feeling quite right all the time, tell a professional. There are solutions. We can do it.