Back to school with bipolar?

How college can unleash mania

Without treatment and support, bipolar college students face higher dropout rates, drug and alcohol abuse, and even suicide.

Michele Hoos, CNN Health

“The rituals of college — making new friends, studying until dawn, excessive partying — can stress out any young adult. But students with bipolar disorder, or those at risk for the condition, are even more vulnerable in a college environment. Academic pressures, social concerns, and sleep disruptions can lead to bouts of depression as well as mania, the euphoric, revved-up state characteristic of bipolar disorder. Without the right treatment and support, bipolar college students face higher dropout rates, drug and alcohol abuse, and even suicide.

“The new structure and new stresses for [bipolar] students who leave home to go to school sometimes can trigger problems and relapses,” says Dr. Richard Kadison, M.D., the chief of mental health services at Harvard University and the author of “College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It.” These stresses, he adds, can also trigger mania in students who have an underlying vulnerability to bipolar disorder. “Oftentimes, the first manic episode occurs in college,” Kadison says.

At its most severe, bipolar disorder is a dangerous condition that can lead to psychotic episodes and hospitalization. Milder forms of the disorder can cause problems as well, and can interfere with academic success.

Students with bipolar disorder can survive — and even thrive — in college, but doing so requires a plan. Taking the proper medications, arranging for the appropriate counseling and medical care on campus, avoiding drugs and alcohol, maintaining a steady sleep and study schedule, and finding sources of peer support are all crucial and can make the difference between achieving your goals and dropping out.

Numerous aspects of college life can trigger a manic or depressive episode. Sleep deprivation and the keeping of irregular hours — both common practices on college campuses — are known to trigger mania, while binge drinking and the use of substances such as marijuana can cause depression.

Stress, whether it stems from the pressure to succeed academically or to fit in socially, can trigger mania as well. According to Russell Federman, Ph.D, the director of Counseling and Psychological Services at the University of Virginia student health center, the desire to fit in and conform to the college lifestyle can cause some bipolar students to abandon healthy behaviors — even their medications.

College life often reveals the symptoms of bipolar disorder for the first time, particularly for those at risk of the condition who have not yet been diagnosed.  Federman says that the symptoms of bipolar disorder do not appear spontaneously. “The lifestyle irregularities and the stresses of college life don’t in and of themselves cause bipolar disorder,” he explains. “You need a genetic vulnerability for bipolar disorder to emerge. But if you’ve got that vulnerability, the lifestyle irregularities of the first and second year of college can certainly be a precipitant.”

Students who have been diagnosed with a bipolar spectrum disorder can take steps to minimize the risk of a relapse and stay balanced. Perhaps the most important step is to make sure you have a support system at school, which usually means connecting with the medical and counseling staff on campus.

Students who attend school away from home may choose to maintain contact with their existing psychiatrist, but experts urge students to also make contact with campus health services.

And if a student with bipolar disorder is looking at a college in a rural community, they need to be proactive about what their local access to psychiatric care will be.” Having a psychiatrist close at hand isn’t important only for emergencies. In fact, bipolar students who have been stabilized on medication while at home may need to fine-tune their prescriptions while at school.

Campus health services also provide counseling, which can help students cope with the emotional stress of living with bipolar disorder. Just as important, counseling can teach students everyday strategies for managing their symptoms. In his 2010 book, “Facing Bipolar: The Young Adult’s Guide to Dealing With Bipolar Disorder”, Federman outlines what he calls the “four S’s of bipolar stability”: structure, stress management, sleep management, and self-monitoring.

This framework entails setting — and sticking to — a regular schedule of studying and sleep, and learning to recognize the signs that you are beginning to drift into mania or hypomania. Dealing with depressive episodes in college, Stacy never knew when she was going to crash, so she made sure to do her assignments well ahead of time. She also talked to her professors on the first day of class about her mental health and documented her case at disability services on campus.

Students tend to associate such resources with physical disabilities, but these centers often help students with mental health disorders as well. Other sources of support on campus In addition to campus health services, peer counseling can be a valuable source of support.

In addition to NAMI, an organization called Active Minds is trying to open the dialogue about mental illness on college campuses. Founded by Alison Malmon in 2001, following the suicide of her older brother, the organization now has more than 200 chapters nationwide.

Active Minds organizes events such as National Day Without Stigma and has partnered with the Depression and Bipolar Support Alliance to create peer support groups on college campuses.

Michele Hoos, CNN Health

often, college friends should be the first to consult,

if you suspect your college kid might be bipolar.

Each year, more and more college students began

to become medicated for bipolar disorder.

Get help, before it’s too late.