Talking Mental Health In College – Q&A with Richard Kadison, MD from Harvard University

Maria Pascucci, president of Campus Calm, had the opportunity to speak with Richard Kadison, MD, about why high schools and colleges are seeing an increase in the number of stressed students struggling with mental health issues. Kadison is the chief of the Mental Health Service at Harvard University Health Services and the author of College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It. Kadison has specialized in campus mental health and student mental health treatment throughout her career.

Calm Campus: Why are college campuses seeing an increase in the number of students with mental health issues?

Kadison: There are many reasons why we are seeing an increase in the number of students with mental health issues. We are seeing more students who are diagnosed with serious problems in high school and are functioning well enough to go on to college. That is a group. I think there is the millennial group of students with what are described as helicopter parents who hover over them and basically make decisions for them. You know the old metaphor about teaching people to fish instead of making them fish. I think there is a lot of fish sharing in high school. Children are also being moved from one activity to another, building their university resume and without much free time and without feeling passionate about things.

Calm Campus: How important are lack of sleep, eating well, and exercise for students who are stressed?

Kadison: Lack of sleep, I think, is a big problem. College students sleep an average of 6 1/2 hours each night and definitely experience symptoms of sleep deprivation, which damages their immune systems, impairs their academic functioning, and makes them more susceptible to depression and bipolar disorder.

Exercise is another big problem. There is good evidence for milder forms of depression, four days of 30 minutes of cardiovascular exercise works as well as antidepressant medication. Many students are busy, stop exercising and eating healthy, become more depressed, have a harder time doing their work, then start to get stressed and have a harder time sleeping. They enter this vicious circle.

Calm Campus: What role does perfectionism play in the lives of stressed students? How does the Harvard Counseling Center deal with academic perfectionism among students?

Kadison: That’s certainly a big problem here and I’d say most elite schools. I talked to the directors of the other ivies. There are two main impulses. I would say that one is trying to create some balance in the lives of students. They need to take care of themselves. Working all the time is not the best way to live. Have conversations with them about excellence versus perfection and working hard and trying to focus. But no test, no course, no situation is going to make or break your life. Lives take twists and turns that none of us expect.

Number one: you need to learn to be resilient. Number two: Learn some stress management techniques and skills because what you have in high school and college isn’t going to change once you get out in the real world.

Calm Campus: Who do you see more: boys or girls who stand out? Is it true that women seek help more than young people? Why or why not?

Kadison: In terms of more women seeking attention, I think it’s probably because women are more in tune with their emotions. There is less stigma. I don’t think the numbers are any different, it’s just that men aren’t always smart enough to come talk to someone about it.

Calm Campus: How do you work to help students find meaningful ways to base their identities beyond grades and awards?

Kadison: That is exactly the challenge. They are people who discover who they are: we all have flaws, we all make mistakes, and we all do things we wish we hadn’t. The key is to really get to know yourself, figure out how to accept yourself and do the best you can. Getting students to focus on the outside, back in balance, to get them involved in their community. There is mounting evidence that the more students are doing something to help their community, like working with high school kids or volunteering somewhere, those students have much more fulfilling experiences in college than students who are completely focused on themselves. It’s creating an environment where that’s really encouraged and rewarded.

Calm Campus: Do you think our current academic culture allows children to learn to make mistakes and fail safely?

Kadison: Well, I think part of the process is really educating the whole community. It’s not just the students. We try to do outreach and provide consultation to faculty, staff, and residential staff. However, the reality is that if the culture in the lab is that the professor is in the lab until 3 am and expects everyone else to be there until 3 am, that is not a healthy message to students.

I think mental health advocacy groups are a good idea because students listen to other students more than other professional adults. Having advocacy groups so students can hear that getting depressed in college is nothing to be ashamed of and is very treatable if you come in and talk to someone about it.

Calm Campus: Is an Ivy League education always the best way to achieve success?

Kadison: I believe that students can get a great education at any school. There are students who come here to Harvard and don’t get a good education because it doesn’t suit them. Being around other brilliant people who are totally focused on their studies doesn’t help them learn to create any kind of balance in their lives. That leads to disappointment.

Calm Campus: Many students see straight A’s and other academic achievements as stepping stones to a good college, to a good grad school, then to a good job, and ultimately to a happy life. Does our society place too much emphasis on this one path to happiness and prosperity?

Kadison: As for the students who see grades as stepping stones, I think that’s true. There is some reality there and it is also a problem. I think to some extent this depends on the college admissions people, that leading a balanced life and being involved in your community is just as important as being successful academically. Doing other things that you are passionate about.