Welcome to our new section, Thrive on Campus, devoted to covering the urgent issue of mental health among college and university students from all angles. If you are a college student, we invite you to apply to be an Editor-at-Large, or to simply contribute (please tag your pieces ThriveOnCampus.) We welcome faculty, clinicians, and graduates to contribute as well. Read more here.
For privacy reasons, names have been changed. The following article contains discussion about suicide and mental illness which may be triggering for some readers.
My phone illuminates with his name. I don’t need to answer to know what the call is about. Our relationship is parasitical; each of us feeding on another for support, our connection providing a precarious backbone for her to rest on. I know how this conversation will go. Yet I am in denial. I answer.
“Mithara, Andrea is in the hospital again.”
“How? I saw her Monday? She seemed fine,” I begged.
It was Thursday.
“We talked about her brother,” I went on. “And her calculus teacher. And she gave me advice on college applications.” I grit my teeth to stop the tears.
“She cried too, but she said she felt better than before.”
Silence from his end.
“I don’t know much; I just know she’s safer in the hospital. I think you know that too. We’ll talk later. I just wanted you to know.”
I hang up. A part of me wish I never answered to begin with.
How could she have relapsed again? How? She was doing everything she was supposed to have been doing. She liked her new therapist. She said her new medication wasn’t as blindingly numbing and far more alleviating than the last one. She was going to her classes and was wearing clothes that boasted color, and occasionally smiled at me with her pearl white teeth, and one of her friends told me she went to a party last weekend and smiled there too, and she was going to an elite college in August and — of course I knew how. Andrea was highly skilled at fabricating a mirage of contentment and happiness. She hadn’t yet accepted that the long-term effects of cloaking her mental health issues and trauma under a false veil of contentment was draining her far more than the arduous work it would take to go to a recovery center for her eating disorder, depression, and anxiety. It didn’t matter even if she did because here we were again, another phone call, another near suicide attempt, another hospital.
I met Andrea during my sophomore year of high school. She was a grade older than me, and we met through a mutual friend. Our friendship was not the immediate blossoming that is portrayed through cliché movie montages and short, skimmed-over book chapters, but rather a slow, nurtured one that at times was desperate and hesitant. We bonded over our mutual love for documentaries such as Exit Through the Gift Shop and discussed recent fashion trends. We loved learning beyond textbooks and there was never any competition between us. We taught and learned from another. We laughed at each others jokes. What we bonded over most overbearingly, however, were our shared feelings of inadequacy. I was at a very vulnerable stage of my own recovery journey, having spent the last year tirelessly working on alleviating the pain that comes with depression and an eating disorder. Talking to a therapist has and still is a necessary part of my recovery but finding a friend who could empathize with my experiences and feelings was refreshing and validating. The problem was that sometimes there wasn’t a grounded voice to correct our misguided and depleted feelings of self-worth.
As Andrea opened up more to me, I learned how sick she really was. Her untreated depression and anxiety led her to turn to her childhood vice: food. She would regularly binge on over 10,000 calories (yes, binge eaters often binge upward of 5,000 calories in a single sitting). Her fragmented sense of body image depleted her self-confidence, and the cycle of starve, binge-eat, self-loathe, and starve again became routine for her. I did my best to be her backbone and regularly texted and checked in on her, thinking that might be enough to curb her temptation to binge. I constantly complimented her. I tried giving her self-affirmations to follow. I even gave her a folder of the coping mechanisms that my therapist had taught me. She regressed. I hadn’t yet accepted that I could only support her — not heal her. As I felt myself progressing through my recovery, guilt seemed to tug me back toward familiar habits. How could I leave her behind to suffer alone? Misery needs companionship.
Her mental health plummeted during my junior year of high school. Her binges got worse and she started cutting as a way of self-medicating. She admitted to me that she was having suicidal thoughts. I begged her to seek treatment, and thankfully, she finally started seeing a therapist and psychiatrist. By now, our relationship was stripped of laughter, learning, or any color. It was just me and Andrea’s sickness. I felt that I couldn’t distance myself from her because, truthfully, I was afraid what would happen if everyone else fell for the mirage that she was creating. I was afraid I would lose one of my best friends.
I should stress that Andrea never was manipulative or burdening with her mental health. In fact, she began to isolate me from what she was going through as a way of protecting herself and me. A year before I met Andrea, I lost a close friend of mine due to a heart-related condition. Andrea knew that the collateral damage from her death left a monumental impact on me. But how do you let go of someone you care for who is suffering so deeply? There is the unsaid act of betrayal of knowing someone’s deepest secrets and walking out of their life because it is to painful to see them self-destruct. I equated establishing boundaries with giving up on her. I learned later that establishing boundaries isn’t as black and white as I had thought.
When Andrea first went to the hospital for her suicidal tendencies, I wasn’t surprised. A sad part of me knew I would get that call eventually. Still, knowing that the storm will come doesn’t make it any less merciless. When she came out of the psychiatric ward, she seemed more defeated than ever. She wasn’t sure how to go on. She wasn’t sure she had the strength to. I assured her that she did, but I wasn’t sure if I was trying to convince her or myself more. That year was a blur of Andrea relapsing and getting better:
Andrea goes to college
Andrea’s second major relapse that landed her in the hospital was a partial trigger for my own relapse. It’s important to understand that people struggling with mental illness never intend to hurt others, and as much as it affects the people around them, the burden of mental illness falls most heavily on those suffering. Still, mental illness has a reverberating effect. Even now, I still feel the pulsating fear rise in my stomach and choke my windpipe when I see Andrea’s and my mutual friend’s name light up my phone. He was the messenger of her agony, and I catch myself every time when I realize it is a just a text checking in about school.
Our individual desires to feel understood and thoughtfully loved is what I thought made Andrea and I gravitate us towards another. Indeed, our friendship was and still is special. But, at times, our magnetic connection was bred by a need for someone to justify our feelings of inadequacy. We saw ourselves in each other and that made it okay to fall into old habits. It’s the same dynamic that is found in addicts and alcoholics during the vulnerable stages of their recovery, and it is often why they are discouraged from cultivating intimate relationships at first due to the likelihood of also creating an enabling relationship. It isn’t that people who are plagued with similar diseases cannot form meaningful and supportive relationships. It would have been far more difficult for me to have successfully gone through recovery without meeting people who also struggled with similar mental health issues. I cannot understate how much wisdom and compassion Andrea possesses. I truly wish that everyone has the chance to befriend someone like her. But it is foolish to overlook how shared pain and struggle can implode when it is allowed to fester under the guise of a friendship.
It took me a long time to write this. It’s quite an ambivalent period of reflection to realize that you both hate and love someone. What’s comforting is knowing that my feelings are not isolated. I’ve been lucky enough to have met many people who have struggled with mental illness and addiction, as well as the outer circle of people who have been touched by their diseases. The similarities between those who struggle with addiction and those who suffer from mental illness is striking. In fact, some researchers even argue that the neurological mechanisms between addicts and mental illness sufferers is acute. A girl whose brother was a heroin addict told me, “I hated him at times. When he would go into rehab and then relapse, sometimes I wish he would just overdose so I didn’t have to keep hoping he’d recover. It was so exhausting. My family and I never gave up on him, even though we knew that our faith in him might not even matter at the end of the day. It was liberating to remember that. Today he’s five years sober, but we still worry that we might get that dreaded call from him again, when he’s high on it. But at least I have my brother back for now.”
At times, I used to think back to when I first met Andrea and wish that I never did. It might have saved me from a lot of pain. But it also might have meant that I wouldn’t have had some of my best laughs. I would have missed out on a lot of enriching and intellectual conversations. I might not even know who Banksy is. What I do wish I would have done is establish boundaries, especially because I met Andrea during a pivotal moment of my own recovery. What I think Andrea wish she told me, what I wish I told my own support system is that to some degree, a recovery journey should be separate from a friendship. Boundaries protect ourselves and others. They prevent dependence from ensuing and force those struggling to take accountability for themselves. They empower people struggling to take control of their own recovery rather than be micromanaged by others. Accepting that you can be there for someone while simultaneously understanding that your support might not matter is key to maintaining a relationship with someone struggling with mental health issues.
College is a confusing and sensitive time. You are thrown into a wildly independent and new environment. Some may feel more connected to themselves than ever while others may feel more disconnected and lost than ever before. If you didn’t prior to college, you are bound to find people who struggle with mental health issues during this tectonic shift in your life. Some may have bear the esteemed badge of “recovered,” others the coveted “in recovery,” and some may not have a badge to bear yet at all. They may just be struggling. Sometimes, there isn’t anything you can do other than cling on to hope, provide people a life raft, and pray to God Almighty that they make it to shore; you can be the lighthouse but even then, you cannot control the currents. A relationship built on a foundation of boundaries, independence, and hope is a relationship that cannot be pummeled by the pernicious reach of mental illness.
After my first semester of my college, I saw Andrea for the first time in over eight months. A few months after her second relapse, I established some boundaries that allowed each of us to focus on our own recovery journeys; texts here and there to check in, but room to breathe again. She was doing well in school, she smiled with teeth, she told me about her one relapse during those eight months. She said she picked up the pieces again. I think I believed her. The prospect of another relapse in Andrea’s future seems plausible, but I always hope for the best. For now, I have a dear friend back. I missed her.
Relationships — no matter how close — are constrained by the fact that they lack a professional basis. If you know someone is suicidal or you fear for their safety, tell somebody and visit https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml. If it means losing a friendship temporarily or losing a friend permanently, always chose the friendship. They’ll thank you later.
I would like to thank “Andrea” for whom without this article would not have been written. This is for you.
Subscribe here for all the latest news on how you can keep Thriving.
More on Mental Health on Campus: