Content warning: The following text contains mentions of suicide and can be disturbing and/or triggering for some readers. Please find resources listed at the bottom of the article.
Suicide is not easy to talk about. Despite its prevalence (suicide is the second leading cause of death among those between 10 and 34), it’s still a taboo subject, usually spoken about in hushed tones. Often, we can’t even bring ourselves to use the term.
When Samantha*, a Wharton sophomore, went to Penn’s Student Health Service, she found herself speaking a coded language.
“I remember I was talking to my doctor at SHS,” she told me. “I was like, ‘I don’t want to come back.’” Her doctor thought she meant that she didn’t want to come back to Penn as a student. “But in my head ... I was planning on, over winter break, just doing something, and not coming back.”
At first, it started out slowly. She described it to me as gradual, initially “feeling like life [was] a drag,” and that it was a “chore to wake up.” She began to experience passive thoughts of suicide, saying “she wouldn’t mind if something happened,” but eventually she reached a point where she couldn’t take it anymore.
I want to make it clear: mental illness is normal. After all, as Jonah Lehrer writes in The New York Times Magazine, “The mind, like the flesh, is prone to malfunction.” Just like a runner’s hamstring is bound to sprain after a marathon, the mind, when placed under inordinate stress, will begin to falter. It can conjure anxiety and depression, it can construct unhealthy coping mechanisms and dangerous eating habits, and in extreme cases, it can convince you that life is so unbearable that you are better off not living it.
Late last month at Yale, mental illness precipitated into a tragic loss when Rachael Shaw-Rosenbaum, a first year, died by suicide. She was mourned by the Yale community, and her death ignited conversation about mental health care at the university. Notably, Yale received an “F” rating in a 2018 report from the Ruderman Family Foundation regarding the state of mental health on campuses, particularly with respect to the policies surrounding leaves of absence. Penn ranked higher than any other Ivy League institution, with a rating of D+.
Among college students, mental illness is staggeringly common. According to the National Institute of Mental Health, “30% of college students reported feeling ‘so depressed that it was difficult to function’” at some point in 2011. A 2014 study found that 11.9% of college students suffer from an anxiety disorder, 9.5% (and 13.5% of female students) suffer from an eating disorder, and approximately 20% “meet the criteria for alcohol use disorder.” Since the onset of the COVID-19 pandemic, things have only worsened. A study from September 2020 said that, of more than 2,000 students surveyed, nearly half had moderate to severe depression, approximately 38% had moderate to severe anxiety, and just under 20% had suicidal thoughts.
General understanding of college mental health essentially revolves around these statistics. If you search Google for “most depressed colleges,” you are immediately met with over seven million results. Click on the first link, and you will find that the number one school with the most depressed student body is the University of Pennsylvania. “And [based on] the following [search results], we're somewhere in the top five [or] top 10. Give or take a few spots,” said Darya Bershadskaya, a College junior and the external director for Penn Benjamins, a peer-counseling service on campus.
Read enough of these lists and you will find that Penn makes an appearance on all of them, and is joined by the same set of schools. To be fair, these rankings are often completely meaningless — the authors rarely cite any methodology and normally rely on anecdotal evidence or news articles, simply placing a number of highly ranked universities towards the top. Yet, there is something curious about these lists and the fact that the same schools appear on them with such regularity. We see mental illness as something that’s endemic to university life in general, a common side effect of being a student here at Penn.
Despite this, our campus-wide dialogue surrounding mental health is inadequate. Sure, we have wellness weeks, free food, and engagement days sprinkled through our semester, but seldom do we get real. "[Mental health] is a topic that floats around in the background, but we don't empathize about it, if that makes any sense," said Bershadskaya. "We talk about it, but we don't empathize about it." In other words, we don't allow ourselves to connect with one another on a deeper level, instead only discussing mental health on a superficial level. But sometimes, the superficial can be misleading.
If you looked at Penn student Maddy Holleran’s Instagram profile in the fall of 2013, you wouldn’t be aware of the depth of her struggles with mental health. Each photo she posted was joyful; she was grinning ear to ear, posing with friends and family. Those moments — a party, a track meet, a sunset — gave the impression that Maddy was happy, but a week into her second semester as a first year at Penn, she died by suicide. In “What Made Maddy Run,” journalist Kate Fagan writes about the real Maddy: the Maddy who struggled with both running on the track team and balancing her studies — the Maddy who didn’t understand why she was so miserable. This Maddy was only known to family and close friends. Fagan writes, “Everything was in her control, except the one thing that wasn’t: This pain that had embedded itself inside her, somewhere she could not find, and no matter how tightly she controlled everything else, it wouldn’t go away. Where she may have exerted the most control was ... [on] Instagram.”
What we see about other people isn’t the whole picture, and what other people see about us is equally incomplete. “Even if Madison was not having the college experience everyone told her she should be having, she could certainly make it seem like she was,” Fagan writes.
Like Maddy, Samantha, the Wharton sophomore, was struggling silently but managed to keep up that facade. On the outside, it seemed like she was doing fine, but in reality, she had never been worse. She ended her first semester with straight A’s, but for her, the culture outside of academics was overwhelming. “I was doing well, even though I was struggling ... but it was more just the competition at Wharton, and feeling like everyone has their shit together, and feeling like you have to prove that you have it together, as well.” The constant pressure of applying for clubs, interviewing, interviewing again, applying for internships, and hearing about everyone else’s successes instilled in her a potent case of imposter syndrome.
Having never come from a business background, Samantha recalled feeling like she never really belonged in Wharton. In one particularly mortifying moment, she remembers going to Target to purchase business casual clothing for a networking event, because she didn't have anything appropriate to wear. At the event, students were adding each other on LinkedIn, and Samantha panicked, because she didn’t have one. “I Googled it, and under the table, made a LinkedIn, so that person could add me, and I didn’t want anyone to know I didn’t have one.”
As a Black student, Samantha found solace in minority programs, where she found a community of students that understood what it meant to feel like you didn’t necessarily belong in an environment characterized by a culture of legacy. “I would look in a class and be one of only two Black people, but I would know that Black person,” she told me. She described being fortunate to have “found her niche” through these programs, but they weren’t enough to allay the gnawing feeling that she didn’t belong.
Amid all this, her mental health was deteriorating, and she was struggling with what turned out to be an eating disorder. After working with Counseling and Psychological Services, SHS, and Student Intervention Services, Samantha decided to take a leave of absence and enroll in residential treatment. However, the unrelenting pain inside Samantha was masked by layers of appearances that she kept up. “Even my suitemate had absolutely no idea what was going on,” she said.
“When your mind tells you that you weren’t cut out for Penn, you desperately protect yourself from others finding out. The last thing you would do is reveal that you cannot handle this place and risk being seen as weak,” 2020 College graduate Lucy Hu writes in a brilliant column from 2017. “The facade of being OK manifests as a shield for your reputation.” Samantha desperately wanted to convince everyone that she was doing okay precisely because she was deeply insecure about her own worth as a student — and it worked. However, the insidious thing about Penn Face is that it’s a two-way street. We have to keep in mind that when we look around, the people we envy for being put-together could actually be struggling beyond belief.
Malcolm*, a Wharton junior, describes his brain as one that doesn’t have an off switch. It has to react to something; it has to think; it has to move; it’s never satisfied.“It’s kind of like a hell of complexity and infiniteness,” he said. Malcolm was diagnosed with obsessive compulsive disorder, a disease characterized by recursive thinking and anxieties. “It’s like you’re always walking around with a 20-pound or 30-pound backpack.”
If you’re a finance major, you may know Malcolm. However, you almost certainly don’t know that he has OCD. “I don’t think people really get it,” he admitted. In fact, he didn’t really get it either — despite experiencing anxiety in high school — until his first year at Penn. After visiting SHS in fall 2018 for a cold, he casually mentioned that he experienced stress from time to time to his physician, who referred him to CAPS for anxiety. Eventually, after a series of cognitive tests, he was diagnosed with OCD. “So from that point on, for the last year, I've been going to therapy, virtually.”
Despite a pervasive culture of Penn Face on campus, Malcolm doesn’t see his illness as a source of shame. “It is really stressful, and I think that it is kind of stigmatized, but I feel like it's something really important,” he said. “So I'm very open about it with my friends.” Yet, he laments the fact that at a larger scale, discourse on campus surrounding mental health is sparse, or at times, simply performative. It’s easy to post on your Instagram story in support of mental health, but actually bringing up those issues in conversation with your friends is much more difficult. Malcolm was most disappointed in the absence of campus-wide discourse surrounding mental health after the death of Dr. Greg Eells.
Dr. Eells was the director of CAPS for six months when he died by suicide in fall 2019. “It was extremely shocking,” said Dr. Michal Saraf, the senior clinical director at CAPS. “It was unanticipated ... and something that we had to wrestle with for some time.” His loss was devastating on many levels; he was new to the Penn community and was himself a mental health professional, highlighting the fact that those who dedicate their lives to treating psychic pain sometimes cannot escape their own.
Malcolm was appalled by our community’s silence afterwards. “I don't know — no one talks about it,” he said. “Everyone kind of forgot about it, like three days later.” But this apparent fizzling out of discussion may stem from a very real concern about the nature of mental health. “As you know, part of what we also have to think about as therapists is just worrying about contagion,” said Dr. Batsirai Bvunzawabaya, the director of Outreach and Prevention Services at CAPS. Contagion is the phenomenon by which exposure to suicide (including through the media) results in increased deaths by suicidal or suicidal behavior in at-risk individuals. Yet, Malcolm is right: Dr. Eells’ passing is very metaphorically resonant because he was tasked with addressing our mental health on campus, but the needle has barely budged with respect to how we talk about mental illness as a community.
At the end of her column about Penn Face, Hu asks, “Is there hope?” Over the past month of working on this article, I’ve wrestled with this question as well. The attitude that many Penn students have is that the mental health crisis is perpetrated by University administrators who don’t have students’ best interests at heart. The issue is simply that there aren’t enough therapists at CAPS, that there aren’t enough breaks, that professors assign too much work. While these might be true, it’s not the complete picture.
The truth is that there are an abundance of resources available for students on campus 24/7. “People want to share — people want to get support,” said Dr. Bvunzawabaya. Yet, they often don’t, perhaps because CAPS is demonized for only being short-term and for being difficult to access.
These are complaints that both Samantha and Malcom find absolutely maddening. “CAPS saved my life,” Samantha told me bluntly. If it weren’t for the counselors and psychiatrists who worked with her and encouraged her to seek further treatment, she might not be here.
“I remember, it always felt like a breath of fresh air walking out of CAPS,” said Malcolm. He acknowledges that other students might not be as fortunate as him and understands that people can have bad experiences there. “But for me, it was, I think, a really good gateway. And it was very helpful for me.”
For students uncomfortable with the idea of seeing a therapist, there are plenty of other resources on campus that are peer-run. “Our mission is to listen,” said Bershadskaya. Peer counselors aim to make students feel heard in the moments where they’re overwhelmed. They don’t try to solve your problems, they just want to remind you that you’re not alone. But for some students, even Zooming with a peer counselor can be overwhelming. Penn’s Reach-A-Peer helpline (also known as the “RAP Line”), a 24/7 text-based support line, can be a good alternative for students that are struggling. “And it's really just for, you know, any students who want someone to reach out to have a conversation anonymously and confidentially,” said Jennifer Ben Nathan, a College sophomore, who is the president of Penn’s RAP Line.
Professors can do a better job of integrating those resources into their syllabi and making a concerted effort in acknowledging that students struggle. In fact, the RAP Line has conducted trainings for teaching assistants in some CIS courses. “We started off doing it because it’s very common that students in those classes have very, very high stress,” said Ben Nathan, who hopes that such programs can go even further. “I feel like the same thing could be done with pre-med courses, like large STEM courses that are just difficult, stressful, [and] where people are really struggling to find their place.”
Those resources can help, and they have helped thousands of students. But addressing our mental health is a deeper issue, and goes beyond simply treating students. “Maybe we're focusing too much ... on the relationship between the student and the institution, rather than the student and the student,” said Bershadskaya. At its core, Penn Face arises from a fear of judgement — we pretend we’re okay because we’re terrified that everyone will view us as ‘less than’ if we’re honest about how we’re doing. Penn Face has nothing to do with CAPS or the University itself — it has to do with us. So, is there hope?
“I want to think yes,” Hu writes. “But the solution would have to overcome something so intrinsic to competitive environments. It would have to change who we are as the student body. It would have to be stronger than our ambition, our intellect and our drive.” She’s right. But what comes with that is the sense of community and a feeling that you’re not alone.
I was having dinner with a friend recently and brought up this article. We sat outside talking about Penn Face and our impressions of other people. She was jealous of the way I seemed so laid back and at ease, and I was jealous of the way she always seemed motivated to keep up with her classes. Then, I told her about the moments of overwhelming anxiety I experience and she told me about her history of academic struggles. For a brief moment, both of us felt just a little bit less insecure.
Ultimately, that’s how I think we improve our mental health. It happens at the individual level, through moments of shared vulnerability. The less we view each other as one-dimensional, the more we can understand that we’re not alone. It’s a process that won’t happen overnight and, like Hu lamented, requires a monumental shift in culture. But I’m confident that it can happen, not least because it already is happening. In places like the r/UPenn subreddit, anonymous members of our community are quite open about their experiences with mental illness. A 2019 project, “The Other Side of Me,” featured students sharing personal stories, often about struggles they don’t share with anyone else.
But we can do more. The next time you’re talking to someone, go beyond the superficial and ask how they're really doing. You might find yourself and your friends in a surprisingly powerful moment of candor, and you might feel a little less alone.
*Name has been changed for privacy reasons.
VARUN SARASWATHULA is a College junior studying neuroscience and health care management from Herndon, Va. His email is firstname.lastname@example.org.
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