Depression

November 2, 2009 9:08 AM

How do I explain to my mom and my therapist that I feel like my depression has come back and that I'm wasting my time at college?

For the past two years, I've been struggling with depression. What's bad is this has been pretty much my entire college career marred by this. This probably involves Asperger's syndrome to a small degree, especially since my sister is diagnosed as autistic.

I've fallen into a cycle. At the beginning of the semester, I'm somewhat healthy and able to pull of the chores I need to do around the house or the dorm (cook dinner, mow the lawn, etc) and get my work done. A few weeks later, I start to lose my sense of motivation and begin to lag behind. By the end of the semester, I'm a borderline recluse, only leaving the house/my room for classes that I'm convinced are essential, and even them I'm somewhat late. The best I can muster is Ds and low Cs, even though I was an honor roll student in high school and enrolled in the honor program at college for the first part of freshman year.

This has happened for the two years I was at a four year college (in a dorm), and it's happening now in the middle of the semester at the community college I transferred to in order to get my grades up.

My GPA is abysmal (think low 2.x), and I'm worried my life is stuck in idle. I feel like I've shredded any goodwill or credibility that my good grades from my high school career bought me.

I know the normal answer is to take a sabbatical, but my mom was against that. She said that she didn't think she could afford to have me be around the house for a semester, and that she didn't think I'd have the work ethic to hold down a job.

I've hinted to her that I am once again falling behind, and she's threatening to send me to this 6-month facility in Michigan that is for people with Aspergers and other ASD. I'm not sure I'm that far down the spectrum (I had friends in college, and I can understand social cues and empathize with people), but I am desperate for some form of structure to straighten me out. I've even considered enlisting in the Navy, as I don't want to be a fiscal burden to my family. She's also refused to acknowledge my depression as its own illness, saying that it is an outgrowth of my ASD. Thus, I've been seeing a therapist who specializes in Aspergers rather than depression, as she will not pay for any other therapist. I've been prescribed Effexor, which has helped my depression noticeably, but I'm either building a tolerance or getting more depressed because my depression is obviously back. I've been on a host of other SSRIs, Welbutrin, and amphetamines, so I don't know if I'd really need a change of meds at this point.

What's worse is that I'm worried I tend to be in denial and lie to myself and my therapists about the issues I'm facing. How can I work around this? I get really anxious when confronting the issues, so I get worried about asking my professors how I can make up missing work. It's taken me two weeks to build up the courage to email my chemistry professor about how I can make up an exam I missed.

At home, my mom is worried about choosing and paying for a college for my high functioning Autistc sister, moving away from NJ to a place with lower cost of living, upkeeping our home which is starting to face major repair issues as it ages, and her job as an administrative assistant, which pays her poorly and is very stressful as her boss pretty much forces her to do the job of an accountant. She comes home very stressed, and it is hard to talk to her. She especially gets frustrated with my tone of voice and affect, more so than people outside the family. The noise of fingers on a keyboard or the sound of a person drinking a cup of coffee can set her off, so I think she may have auditory issues. As she is very stressed, it takes very little to set her off. I don't know how I can ask her about making a major change to fix my depression rather than just sedating it.

Most conversations with my mom end up with her yelling at me that I need to straighten up or I will end up homeless or working for a gas station, which may be true. However, it does not fix the underlying issue. She has never had issues with motivation (according to her), and she usually tells me that when she was 16, she was already employeed doing audits for the state, which gave her a free ride at college. While I'm sure she thinks the story is motivating and inspiring, it does not help me. I'm very much aware of the good things that could happen if I were motivated, the issue is that I'm not motivated, and when I'm at my most depressed, I'm not even motivated to go out of the way to do something I enjoy (IE I find it takes too much effort to start and stay with a videogame, cooking or a book, so I'll just watch TV or sleep).

Sorry for the long post. I was just wondering if I could get some advice on how best to confront my mom about these issues, and how best I can look into moving forward. I want to break this cycle that's been killing my GPA.

posted by mccarty.tim to health & fitness (23 comments total)

she didn't think she could afford to have me be around the house for a semester

but

she's threatening to send me to this 6-month facility

This does not compute. 6 months of inpatient residential treatment costs the earth. Unless your mother has some kind of incredible gap insurance that covers something like this (which also costs a lot), it sounds like she's not thinking realistically.

Maybe you need more Effexor. Maybe you need the XR instead of the regular. I would start with seeing a psychiatrist and getting the meds adjusted, which might give you the energy to do better at coping with the other stuff.
posted by Sidhedevil at 9:11 AM on November 2

I've hinted to her that I am once again falling behind, and she's threatening to send me to this 6-month facility in Michigan that is for people with Aspergers and other ASD.

I can't answer your main question, but this really jumped out at me. Whatever happens, remember that you're an adult and under no circumstances should you let someone else check you into any sort of facility that you don't want to be in.
posted by 256 at 9:13 AM on November 2

I'm on Effexor XR.
posted by mccarty.tim at 9:14 AM on November 2

Well the one good thing about being in school right now is that they probably have free counseling you can take advantage of for the time being. I don't like that your mom dictates what kind of counselor you can see just because she's paying. If you broke your leg would she insist that you see a cardiologist? The counselors at your school are going to be very experienced with this kind of burnout/depression you're going through.

Also, your mom doesn't think you have the "work ethic" to hold down a job (which is a terrible thing for her to say), but do you think you could handle it? Do you think you could handle becoming independent of your mom and supporting yourself? I think it would be good for you to get out from under her because she sounds like she's not helping the situation at all.
posted by amethysts at 9:23 AM on November 2 [1 favorite]

It sounds like you need to stop living by yourself. Can your mom come and visit on the weekends or can you find a great community living situation near your campus?
posted by parmanparman at 9:31 AM on November 2

Be honest with the therapist, including all the info about your mom's reluctance to acknowledge your depression. The therapist can't communicate what you say back to your mom unless you have signed a release to allow it, and the therapist needs you to be honest in order to really help you with what's going on. And try to trust that your therapist, while specializing in ASD, is capable of helping you with the depression if you just open up about it. The vast majority of therapists work really well with depression no matter what their specialty, because it's the absolute most common complaint that people present with, and we all have a lot of experience with it (generally).
posted by so_gracefully at 9:31 AM on November 2

She said that she didn't think she could afford to have me be around the house for a semester, and that she didn't think I'd have the work ethic to hold down a job.

There are many issues in your question that I can't really address. But I can share one experience that I think might help.

First, some background. After my first year of college, I found myself in a situation very much like yours. Eventually, I was forced to take a year-long leave of absence from school. For a variety of reasons, I did not feel like I could go back home for the year. So, despite the violent protests of my family, I decided to get an apartment and a job and support myself. I was a mess, and I was terrified, and I didn't know what I was doing, but it ended up being the best decision I could have made.

During that year, my family gave me no financial support except for $400 that my mom lent me to use as a security deposit on my small apartment. Believe me, that's really cheap compared to the cost of an inpatient facility. And my simple job provided me enough money to not only pay the rent, but to find myself a therapist who had a sliding scale. If you're still on your school's or your mom's insurance, then you can probably use that for medication, but I highly recommend paying for therapy out of pocket if you can. It was a real relief to me to know that my therapist was mine, unconnected with my family, and that my parents couldn't just call her up for progress reports whenever they wanted. And just so you know, after that year, I was able to return to school and do much better.

So, here's the main thing I wanted to tell you: having a job feels COMPLETELY DIFFERENT than being in school. If you're having trouble with depression and procrastination in school, that doesn't necessarily mean you don't have the "work ethic" to hold down a job. School is an infinite set of tasks -- it expands to fill all the time you have -- and it has all kinds of identity struggles attached to it. The criteria for success are extremely subjective and the consequences feel huge ("Am I smart?" "Is everybody else better than me?" "Am I a failure in life?"). A simple job, on the other hand, is very limited. You show up for a certain number of hours, you do the work in front of you as best you can, they give you some money, and then you're done for the day. So I'd say it's very, very worth it to try getting a simple job -- you may find that it's the perfect way to build up your confidence in your own abilities.

Anyway, I know this doesn't answer all your questions, but I did want to just share my experience and give you a little bit of hope that you might be able to support yourself.
posted by ourobouros at 9:35 AM on November 2 [6 favorites]

I'm commuting from home to community college. I live with my mom and sister right now.
posted by mccarty.tim at 9:35 AM on November 2

I know the normal answer is to take a sabbatical

I completely disagree. Depression is an obstacle to accomplishing things, not an excuse not to try. You are currently in a low moment and everything that you are ignoring has negative repercussions which only feeds into your depression.

Thankfully, you have taken the first of two necessary steps to get out of this depression. First is being completely honest about where you're at. Congratulations.

The next step is being completely honest with your therapist. Realizing how depression is affecting your life is an important step on the road to recovery, but now is the time to share those feelings with a professional who is trained to help. I'm not usually a fan of the "print out this question and bring it with you" answer but in this situation you've done such a good job of laying out things that I think bringing a printout of this question with you to your next session is the way to go.

Just start there. I know it seems like there's a lot of other things you have to fix, but you're not going to get everything fixed at once.
posted by turaho at 9:43 AM on November 2

Tell your shrink that the medication's kicking out on you so he or she can make the proper adjustments. Today. Just go and phone up the office. They'll take care of you, and once your meds are stabilized, you'll feel better.

My mother also threatened to screw up my life for me-- in my case, by making a lot of big talk about having me declared legally incompetent-- and my response was to move the hell out. You have Asperger's, you're not dangerous to yourself or others, and you seem to be pretty aware of your overall socialization and behaviors. You probably need more structure, more support, and clearer expectations from your work (school or employment), and less interpersonal pressure from your family, not an inpatient program.

Talk to your shrink about your meds. Give it a couple weeks to get settled out, biochemically. Then talk to your shrink about talking to your mother. Good luck, man.
posted by fairytale of los angeles at 10:01 AM on November 2 [3 favorites]

I'm sorry that you have Asperger's and that you are depressed. We all have some disability, but it's not an excuse to stop living life.

Now, I'm gonna give it to you straight, the way I see it: You're 20 years old, you need to stop trying to get your mom to help you. You may not want to hear this but at this age you should be taking care of yourself (as in, supporting yourself and fixing your own problems) and not even living with your mom.

Second, your GPA is only determined by how hard you work. Yeah, you have a low GPA because you don't work hard enough. While you're busy with your hands in your pockets, some other student probably half as smart as you is out there working hard, getting the education you should be getting, getting the grades you should be getting, etc.

Yes, hard work sucks. College is boring. But, like the saying goes, "no pain, no gain" my friend. Work your ass off, and you will be surprised how much your life will change.
posted by Theloupgarou at 10:06 AM on November 2 [1 favorite]

There is something significant going on here, and it is well beyond the scope of the situation your parent has framed for you.

I strongly suggest you get a job and move out. There is something hinky about your mom and her investment in your lack of performance, any diagnosis you've received, and whatever treatment course is pursued.

Frankly, I would assume the medical professional, and not your mother, would help you decide on treatment options.

What's that? You say didn't realize that you are the final decider in all this? See! that's exactly what I mean. Either your therapist, your mother - or both - have misled you if they haven't made it clear that you are the last word on any treatment.

You are an adult and it is past time for you take responsibility for yourself. Doing so will give you confidence and lead you to a better result than "doing what you're told" or "making do with limited options."

FWIW -

A) Mom is threatening to "send you away"? Sounds like you might enjoy this book.

(do most of the 112 customer reviews seem familiar to you? read them, and if they do strike a chord, please be aware you can probably get this book for free from your library, or at a deep discount on sites like half.com)

B) Sometimes depression is situational. Otherwise, depression is usually exacerbated by bad situations. It is depressing to feel you do not have control over your life. Ditto to be around dysfunctional people or live in a dysfunctional household. If you decide any of this applies to your life, please understand that moving out will not fix everything instantly! You'll need help (therapy) to begin dismantling limiting beliefs and unlearning poor relationship patterns, but you can do this. Help is out there. For depressed people that following this course of action will benefit, the first step is getting themselves out of dysfunctional situations and obtaining some measure of control - even if that means putting school or other goals temporarily on hold.

(and upon preview - what fairytale of los angeles said!)
posted by jbenben at 10:15 AM on November 2 [3 favorites]

I also think you need to talk to the counseling staff at your college and/or see the health center. Your mother is not being your best advocate in this situation. Is there another family member that you feel comfortable speaking with about your mother?
posted by otherwordlyglow at 10:20 AM on November 2

Some random ideas for moving forward, I don’t know what you should do for communicating with your mother.

There are more resources available to you; don’t do this alone. It sounds like you still have depression, although IANYP, nor are any of us here on metafilter.

I really wish I remember the name of the various groups/resources, but I have no doubt they exist at your school, too (this is from my days of teaching at a small college/and a university).

First, does your school know about your diagnosis (I’m not sure if it is aspergers, depression, or there is comorbidity) – but if you are (if not, find out about the services and do the paperwork). Why? They can help you communicate with your professors and tell them that you are dealing with X and that you should be allowed to (whatever it is – have certain accommodations, be allowed a makeup--they will decide based on your particular issues, documentation, etc.). If you feel uncomfortable reaching out to your profs, they can take this first step for you. In addition, at least with some of my students that told me about their difficulties with whatever problem it was (ie, perhaps they were diagnosed with depression but couldn’t afford the medication), I would ask other faculty/the university about other resources in the community and send the student there – there are probably other people who will try to help you, but they can’t help you unless you tell them about this. Believe it or not, most college faculty members have seen these challenges before and every single semester.

Have you been fully evaluated and diagnosed? You may want to make queries, again, with everyone that you know – faculty, the college, etc. Are there free or reduced cost resources in the community? I know that some towns have resources that they will even provide you with medication – you may have to wait half the day/or sign up for an appointment, but additional resources may help you. There is probably also support services, ranging from meetings to vocational programs – maybe there is something out there for you already. You may want to contact the National Alliance for the Mentally Ill (a local branch) - they may know of resources in your community.

Also, if you are using your college health resources – those are usually at a lower cost, and may even offer services such as counseling (I know you have a therapist – it may just help to have another voice to help you out and help you navigate).

My main concern for you right now (quitting school/starting a job, etc) – these things can and do help some people dramatically, but I have also seen times when they do not. It may help to get diagnosed and treated first, then take the next step or steps. Or it may even help to take 1 college class next semester, work part time – but stay attached to the university because you may have access to additional resources. Good luck.

I'm also going to nth fairytale's suggestion - you should probably take that step, first. See if they can modify your medication.
posted by Wolfster at 10:23 AM on November 2

I think a sabbatical might be a good idea. Under no reasonable circumstances does sabbatical = "not to try", any more than vacation = "refusing to work" or exercising = "obstinately not lying down".

My take:
You need to change where you are in your life, OP. You must not, must not be living as a dependent in a house with what sounds like a somewhat judgmental parent and a lot of pressure. Negative, judgmental pressure--and that's what you're describing--will not help a depressed person. You are afraid of letting people down so you lose the motivation (perhaps there is even a back-of-the-mind fear) to even try.

You have to find a job you are at least slightly interested in and become more independent. In my personal experience, nothing makes doing hard work easier than knowing I won't get crucified if I mess up. I"m the kind of person who loves doing things for people, but hates doing things for people when they harass me about it or demand it--and it sounds like your mom has preempted your self control by demanding performance from you. Motivation is internal, not external. Until you get out of that environment of minimum lack of control or benefit with maximum responsibility and culpability, there won't really be a positive "place" to go.

You are used to doing well, and so there is no longer anything rewarding associated with it. It is the default taken-for-granted state, but it takes a lot more effort in college than it used to--so you're working a lot harder just to stay in one place. Combine that with the negative atmosphere at home and you have a recipe for negativity. You've got to get out, stop feeling like a burden, a resource to be managed, and a disappointment. You are none of those things.

But please allow me to reiterate that this is nothing more than my personal and vicarious experiences talking, as We Are All Special Snowflakes with Unique Situations, and Your Mileage Will Almost Certainly Vary. I hope this might help.
posted by Phyltre at 10:36 AM on November 2

I would urge you to simply pour it on. I don’t want to simplify your problem because I know how debilitating depression can be at times, but the solution to your problem isn’t and never will be to take time off and do less. You are going to be so much better off by stepping up, being a grown up and fighting this illness with actions.

Make a plan for how you are going to spend your day and stick to it. Ace a test as an F YOU to depression. Don’t procrastinate at all. If you don’t feel like doing homework, then go for a run. Turn off your TV (no TV at all). The only way out of this spiral is to swim as hard as you can against the tide. When you wake up in the morning, make extra special care that you are in the right frame of mind to face the rest of the day. Make yourself breakfast, read a favorite quote, do whatever you have to do to get back up to baseline.

You can do this without retreating into a sabbatical. In fact it’s your easiest option.
posted by pwally at 10:38 AM on November 2

I'm commuting from home to community college. I live with my mom and sister right now.

So I don't understand how your taking a semester off from community college will cost her any more money than your living at home and going to community college will cost her.

Here's a thought: why don't you guys have a session or two with a family therapist to talk about this stuff? Because the reasons she's giving don't make sense logically, and a therapist will be able to tease out what's underneath that.

And you might need to go up on the Effexor XR. I had a couple of "tolerance plateaus" myself until I got up to 300 mg/day.
posted by Sidhedevil at 10:40 AM on November 2

Thoughts (IANAD):

1) Might be time to bump up the dosage. Talk to your doctor.
2) Your mom has significant issues of her own. There may be no way for you to get her to believe you or be helpful or anything else. However, maybe you can talk to your therapist about having a few joint sessions with her to talk about you.
3) That makes it all the more important to find a therapist that you can and do trust. If you don't feel you can be honest with your therapists or understood by them, perhaps you should shop around a little more. Many therapists have long lists of things they "specialize" in, so I'm sure you can find one that specializes in both Aspergers (for your mom, because she's obsessed, but also because it's relevant) and depression.
4) College is probably the best place in the world to get accommodations for health (including mental health) issues. In my experience, they'll often bend over backwards to help you if asked.
5) It seems to me that it would be enormously beneficial for you to have an "adult" (someone a bit older and wiser) who you trust completely and can give you advice. Clearly your mom is not cut out for this position. Perhaps a therapist could be, but maybe you can also turn to a friend's parent or a professor or clergy person or even just a friend who's got his head on straight.
6) You may just need to grow up a little yourself. Realize that your mom, although she's no doubt doing her best, cannot play the same role for you as she did when you are a kid. Find a way to become more self-sufficient, emotionally if not fiscally, so that you aren't quite as dependent on her. She may fight that, so be ready for it. You are turning into an adult, scary enough as it is.

If you'd like to MeMail me, feel free.
posted by callmejay at 11:06 AM on November 2

I think a sabbatical might be a good idea. Under no reasonable circumstances does sabbatical = "not to try"

When I think of a sabbatical, I think of a scholar taking a year off from teaching classes to write a book or a professional taking some time off to do charity work. In those situations, the person isn't trying to escape an unpleasant environment by doing something else. They're taking time off to pursue another goal for a limited amount of time.

So yes, a sabbatical does not mean "not to try".

But the OP is not looking to take time off to pursue a goal that cannot be accomplished while attending school. Instead, he is in a depressive episode and anxiety is preventing him from attending classes and speaking honestly with his therapist. These are real problems that need to be addressed before making major life changes.

The depressive mind does a good job of confusing cause and effect: "If depression makes it hard for me to succeed in school, dropping out of school will make the depression go away." While this may be true in the short term, in the long term it is important to learn ways to deal with depression if you don't want this cycle to repeat itself. Depression and anxiety are not magically cured by getting a job or joining the Navy.
posted by turaho at 12:52 PM on November 2

PS I'm sorry if I was too harsh on you OP, I hope you get better soon and that everything goes well.
posted by Theloupgarou at 1:04 PM on November 2

Depression can be relieved tremendously by determining for yourself your fate. If you've been stepped on all through your life, it's really important to break free of that - and it's often the people closest to you who try the hardest to keep you imprisoned. Choose what you want to do. If you don't want to be in college anymore, then get out. Not tomorrow, but today. Step back. Your universe will not crumble if you step back from the march of study for a while.

I think a lot of what gets called 'depression' and 'cured' with pills is really just people who have never listened to their hearts, who have never stood up for themselves. And if you never stand up - if you never prove what you're made of - you don't know yourself. And if you don't know yourself, you hate yourself.
posted by schmichael at 1:08 PM on November 2 [2 favorites]

So, first I want to say I sympathize with you a lot, dude. My situation is not as complicated as yours, but I'm in college right now and fighting my way through a pretty miserable semester and I came almost to the point of withdrawing from a class, considering going home, etc. a few weeks ago. I don't know that I can really address your other problems (other than echoing the advice above to not let your mom run your therapy and mental health stuff- you're an adult, and you can tell her you think she's wrong about this stuff. It's your brain and your life. Just because she's your mom doesn't make her more of an expert on you than you are), but as for the school stuff:

1) Talk to professors. I have a lot of trouble getting embarrassed about being behind in a class, which leads me to not go and talk to the professor, which makes me more behind and confused, and on it goes. I've realized recently that every single professor I have has probably dealt with students in my exact situation. They aren't going to judge me, or think I'm a terrible person, or whatever. Just talk to them! Doing that shows you care about the class at least enough not to give up on it. My advisor told me today that profs hate nothing more than a student who withdraws without ever talking to them. Professors, at least in theory, want you to learn. They want to help you salvage as much from the class as possible. If you go to them and show you're willing to try again and make some effort, if they're any good as a teacher they will try to work with you. Right now, as in stop reading and do this, make a list of things you haven't done, work out a priority order, email each of your professors, set up meetings, then bring that list and see what they have to say. Be candid, be honest, don't promise too much and don't ask for too much. Be grateful but don't beat yourself up. Maybe it's too late, but maybe it isn't. It's so, so worth a try, at the very least to make you feel like you're taking an active role in making your life better.

2) I realized as I was thinking about your problems that what tends to keep me engaged in a class is being at least somewhat interested in the material. Rereading your question, you never mention what you're studying. Do you like what you're studying? Maybe not the particular class, but the subject in general? Does it excite you at all? I don't get that sense from what you're written, and while that might just indicate that your troubles have led you to lose that interest, I wonder if you had it to begin with. Taking time off to work might be worthwhile just to help you figure out what you want from college.

Good luck! I really hope you work through this stuff and are happy.

Also, this might be presumptuous, but I have friends living at home and going to community college who find it really isolating. Memail me if you want to talk, complain about frustrating classes, whatever.
posted by MadamM at 1:36 PM on November 2

It sounds like the situation with your mom is pretty toxic. As in, living with her is probably making your depression worse, and she is so stressed out from other life things that she doesn't seem to have the patience to deal with a) any of your concerns and b) normal annoyances. It sounds like she's barely holding herself together, let alone having any clue what to do with you.

Welcome to that harshest truth of growing up: our parents are flawed and don't always know what is best for us. It sounds like you are close to this realization, but the fact that you are looking to her to fix things for you is just another way of not really letting this sink in. She might not have your best interest in mind by wanting to send you away. She might have her best interest in mind.

What you should do:

1) When you wake up in the morning and you don't want to do anything because you're depressed, throw one leg over the side of the bed. Got it? Give yourself kudos for that. Now get up. Don't sit back down. Feel proud that you made it this far. Take a shower, brush your teeth, get dressed. Once you're dressed, you might as well do what you need to do. Sometimes living isn't necessarily about motivation. It's about endurance. You can endure this.

2) Get thee to a school therapist ASAP. If that therapist sucks, get another one. Most universities have a wide selection of therapists available for students at little to no cost. Your mom doesn't even have to know that you're going to a new therapist.

3) Tell this new therapist everything: How you feel, what meds you're on, what other therapists have said about you, what you think about that. Work out what your priorities are and address them in order. If your first priority is to finish this semester without flunking out, talk to your therapist about ways you could do that. If your first priority is moving out of your house (if this is not a priority, it might be a good idea to start making it a priority for the sake of your mental health), then figure out with your therapist a plan to accomplish this.

4) You are not your sister. Your needs are different than your sister's needs. Sit with this idea and let it sink in.

5) Everyone experiences a similar burnout midway and to the end of the semester. As students, we always get excited at the beginning of the semester, and then the work gets overwhelming. By the time finals happen, it is like we have no idea how we're going to do it all.

The difference in finishing your work and not finishing your work is really not about motivation. It is about opening the book. Making a rule not to turn on the tv. Now that the book is open, you might as well read a couple paragraphs. Now that you've done that, you might as well read some more. Maybe get a snack.

Same thing with writing papers. You write a couple sentences. You get up. You sit down. You write a few more. It is about doing for the sake of doing. Not doing because you are so motivated and excited, yay! Learning is not always fun. Sometimes it is just work. Recognizing this can be freeing, freeing because you can create a structured routine that will help you accomplish tasks, one. small. increment. at a time.
posted by whimsicalnymph at 9:25 PM on November 5 [1 favorite]