It could happen anywhere. In class. At home. Even while making coffee at the Target Starbucks on Franklin Street.
Alexandra Smith’s body wilts like a parched plant in the midst of a drought as another depressive episode begins. Her head feels heavier and even the smallest things, like sitting in class or taking a shower, feel impossible. She loses interest in her schoolwork, friends, and clubs — all things she loves — and prickling numbness spreads from her head to her toes.
She is hyper-aware of her body, and that it feels out of place. She musters up the energy to go through the motions of the things she usually enjoys — making dinner, painting with watercolor and walking. When that doesn’t work, one emotion pierces through the stupor: Frustration.
She collapses onto her bed the moment she gets home, where she sometimes stays for days, waiting for relief to come. Not crying. Not showering. Not eating. When the depression eventually recedes, she resumes normal life.
“It feels like I’m an empty shell of myself and the weight of my depression crashes down on me,” she says. “As I move out of the episode, I just try to pick up the slack of whatever I missed … just kind of trying to piece everything back together.”
Smith, a senior studying journalism and Hispanic linguistics, has depression and anxiety. Like other students with mental illnesses at UNC, she struggles to balance her mental health while still succeeding academically. The academic rigor of college — evident in its competitive culture, the pressure to always be busy and strict attendance policies — can be overwhelming for students. As a woman of color, issues such as Silent Sam and sexual assault on campus add to her increased anxiety.
This can make UNC a triggering place for her, and one she sometimes feels doesn’t value the mental health of students enough.
“UNC as a whole is trying,” Smith says. “But it most definitely has a lot of room for improvement.”
‘Addressing the breadth and depth of the issue’
At colleges and universities across the country, campus counseling services are being used at an increasing rate as students experience greater distress, according to the April 2019 Report of the Mental Health Task Force at UNC. These trends are seen at UNC, too, the report shows.
UNC currently offers several mental health resources, including Counseling and Psychological Services (CAPS), Student Wellness, UNC Accessibility Resource & Services, and the UNC Office of the Dean of Students.
“Mental health is an increasing area of concern for the undergraduate and graduate student populations,” the report says. “Current approaches to mental health treatment, policy creation and application, and the campus culture around wellness are not sufficient for addressing the breadth and depth of the issue.”
Since the report was issued, two of its recommendations have been implemented: CAPS 24/7, which allows students to call the regular CAPS number at any time, and the mental health recommendation implementation team, which meets every two weeks.
To accommodate the growing number of walk-in students — 50 to 60 on average last year, opposed to 30 four years ago — Dr. Allen O’Barr, director of CAPS, said the majority of new resources go to walk-ins. But they’re also trying to add resources for therapy, something many students request.
“Money is hard to find. We’re trying to get there,” he said. “Everybody at the University knows this is a problem, knows it needs more resources and we’re just trying to figure out the best way to do that.”
UNC senior Carolyn Mitlehner went to therapy for the first time at CAPS as a sophomore and was surprised by how pleasant the therapy sessions were.
“It was weird — it was not what I expected at all, the therapy thing,” she said. “He more so listened to what I had to say, he didn’t always have advice.”
Mitlehner had written suicide notes to all of her friends when she received an unexpected email from the Dean of Students. Another student had sent a copy of a post from Mitlehner's Facebook — a plea for help.
The meeting with the dean helped Mitlehner feel like things could get better, but discussing accommodations such as medical withdrawal added to her sense of anxiety.
“I just wanted to make it through,” she said. “I didn’t want to be behind anyone else, and if I did make it to graduation, I wanted to be able to do that with friends.”
‘I felt like I was an alien’
Starting college was a source of anxiety for UNC first-year student Maya Tadross. Tadross, who was diagnosed with obsessive-compulsive disorder, depression and anxiety when she was 15, said her parents forced her to follow through with coming to UNC.
She grew up in Long Island, New York, and is still able to see her therapist from home through Skype one to two times a week.
“It has been hard,” she said. “The type of therapy I do has homework, so that can be hard on top of college homework. Sometimes that’s been pushed to the backtrack – there have been times where I’m very overwhelmed trying to balance both.”
Tadross said most of her anxiety comes from periods of time without much structure, like the weekends and social situations. These stressors, she says, are harder to get accommodations for.
Social situations also became difficult for Mitlehner, who, at the start of her junior year, began frequently cutting herself and binge-drinking. She was no longer going to therapy at CAPS but was taking Zoloft to treat her depression and anxiety.
In November of her junior year, a night out drinking with friends ended with them calling 911 after she said she was suicidal and ran away from the bar they were at. Mitlehner was taken in an ambulance to UNC Hospitals. She said it was the worst night of her life.
“I felt like I was an alien or something – like I was not a person,” she said. “They were not treating me like I was somebody that was hurting and needed someone to be there for me, they were treating me like I’d done something wrong.”
Interim Vice Chancellor Jonathan Sauls said seriously examining mental health will require looking critically at UNC’s environmental factors. While these changes are less tangible and take time to implement, Sauls said UNC has to be committed to doing the work to see change.
“It may not be tomorrow or the next day, but we want to make sure those recommendations don’t sit on a shelf,” he said, regarding the report by the Mental Health Task Force.
'Mental health is necessary'
Many available resources require students to reach out to professors and the University during times of distress. Smith said this can create a heavy burden of emotional labor for students.
“It can be incredibly exhausting to almost have to ask permission to get an extension or not miss class when I’m already in such a down-mind place,” she said.
Understanding this pressure, UNC public policy professor Douglas MacKay implemented a policy that gives every student five late days to use on assignments throughout the semester.
He makes a point to emphasize that additional extensions are not only for physical illnesses but for mental illnesses, too.
“Usually on the first day of class I talk about my own experience with mental illness as a graduate student,” MacKay said. “Mental health is necessary to do well academically.”
This year, Smith’s depressive episodes have been occurring more frequently, which she said caught her off guard. An intern at the National Alliance on Mental Illness, president of the yearbook and She’s the First club at UNC, and full-time student, Smith is working hard to find better ways to navigate her depression.
Some days are harder than others. On those days, she said it helps to have friends who talk and care about her mental health and well-being.
“I just wish people at UNC realized it’s something that shouldn’t be stigmatized,” she said. “It’s something that should be normal and prioritized just as much as your physical health is.”
To get the day's news and headlines in your inbox each morning, sign up for our email newsletters.