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College students with bipolar disorder can face added pressures, obstacles

By Margot Pera
On August 27, 2013

Some of the names have been changed.
At first, Mary Niles kept up with her school work but then started missing class for weeks at a time.
"There would be some weeks I would not leave my room," Niles recalls. "My roommates would bring me food and check to make sure I was still breathing, but they were just as powerless over my condition as I was."
Mary Niles was 17 when she was diagnosed with bipolar disorder during her freshman year of college at University of Texas at Arlington.
According to the National Institute of Mental Health, of the 5.8 million people diagnosed with bipolar disorder, at least half are diagnosed before age 25.  For young people with the illness, succeeding in college can be more challenging than for those without the illness.
Bipolar disorder is a brain disorder that affects a person's energy, mood, activity levels and ability to carry out daily tasks. There are several types of the disorder that affect people in different ways.
"I wasn't convinced of the diagnosis, and the side effects of the medicine made me uncomfortable, so I stopped taking it," Niles said.  "I rationalized if my grades were good, I couldn't possibly be mentally ill."
A common danger among people diagnosed with bipolar disorder is a refusal to take medication or period of absence from medication.
"A lot of bipolar people are artistically or musically inclined," Cathy Pollard, a counselor at Lakeside Behavioral Health Systems, said.  "They feel that being prescribed a substance that controls their mood limits their creativity. The patients also do not like something else being in control of them."
Niles was on a scholarship for music. She maintained her grade point average for three semesters but was hospitalized four times during her college career.
"I had a very personal relationship with Mairiko and took a liking to her instantly," said Jena Grant, a retired music theory professor.  "When I learned of her struggle with the illness, I tried everything I could to accommodate her in terms of assignments and what not. She told me I was one of the few teachers that understood her illness."
According to Pollard, stress is a big contributing factor in terms of "pushing a patient toward a psychotic or depressive episode."
After she dropped out of college, Niles checked into a long-term psychiatric hospital.
She stayed for four months, and after she was discharged, she continued to see the psychologists for medication adjustments.
Niles moved to Memphis shortly after completing her outpatient program and moved in with boyfriend, Stan Banks.
"The psychologist I saw was very unhelpful and seemed more concerned about passing time than helping me," Niles said. "That was when I decided that I am better off without meds."
Pollard thinks that some of patients' distaste for medication may be the side effects like sleeplessness, weight gain, increased anxiety or increased depression.
Some patients also enjoy the high of their mania and are willing to risk the depressive or psychotic episode that accompanies it.
Banks had a little knowledge about bipolar disorder from reading articles he found online and attending family workshops but did not really understand the severity of the illness until he witnessed a psychotic episode.
"She walked into my room and told me aliens had artificially inseminated her, and she was carrying their child," Banks said. "I laughed, because I thought she was just joking, but then she started screaming and crying and begged me to watch the house for people trying to cut her baby out.'"
Pollard has seen patients act out in harmful ways during a manic state, such as going on lavish shopping sprees and acting out sexually.
"I came home from work one day, and the whole kitchen counter was covered in knick-knacks from the Dollar Store," said Banks. "Grace had spent $300 at the Dollar Store alone and was outraged when I questioned her about it."
Niles said one of the most harmful characteristics of being in a manic state is this "unshakable feeling that you are right, and everyone else is trying to harm you."
Virginia Ryells, an art student at a private college in Memphis, struggles with an eating disorder as well as bipolar disorder.
"I was diagnosed with bipolar at 18 and have been struggling on and off with bulimia for about three years," Ryells said. "The obsession with being thin makes me want to go off my meds, so I can become manic and not eat for days on end."
Ryells said that when she was first diagnosed as bipolar, she would check into treatment almost weekly for even minor conflicts.
"I would literally be in class at and talk myself into checking into the psych ward, because the teacher was stressing me out with all of her questions," Ryells said. "I would call my parents and have them come with me. This would happen two or three times a month."
Ryells' mother, Jill, knew very little about mental illness prior to her daughter's diagnosis.
"I just thought the constant in and out to the psych ward was normal in the beginning, so I went along with it," Jill said. "After attending a few workshops and family sessions, I realized Virginia had started to believe that she had no control of her illness and was sort of manipulating us with it."
Ryells said that looking back, she was using her illness as an escape, a way to abdicate personal responsibilities.
"I do not think I was consciously choosing not to deal with my problems, but I honestly thought that treatment would be the magic cure.  It was nice to have a place where I couldn't binge and purge," Ryells said, "It was almost like a sanctuary where I could give myself permission not to engage in eating disorder behaviors."
When Ryells was put on the mood-stabilizing drug Lamictal, she gained about 70 pounds in three months.  Her binging and purging began to spiral out of control.
"I was horrified by my inability to stop eating," Ryells said.
Ryells checked into the Transformation Center, an eating disorder program in Memphis. She felt he staff was very affective at adjusting her medicine.
After her discharge from treatment, Ryells began attending outpatient therapy regularly, changed her diet routine and attending free support groups for people with bipolar disorder.
"My binging would spike my blood sugar up and down, exacerbating the mood swings," Ryells said. "I finally gave up sugar and noticed my moods were manageable, but that does not mean I can abandon my treatment completely."
Jacqueline Geralds, a veterinarian assistant, was diagnosed with bipolar disorder at a time when a scant amount of information about the illness was known.
"My mother died in '75, my sophomore year of college, and I just completely went nuts," Geralds said. "I was attending Mount Vernon College  in Washington, D.C,, at the time (now George Washington University) and started wandering the streets thinking Dustin Hoffman was looking for me."
Geralds said she saw a poster of Hoffman feeding a dog through a bookstore window and thought he was telling her to break the window. Geralds threw a rock into the store window, shattering the glass.
"I do not remember the details, but I was told later by family members who spoke to police that quite a few people were looking at me like I was a crazy person," Geralds said.
Police apprehended Geralds and took her to a hospital where she was  immediately sent to a psychiatric hospital in New Jersey.
"My grandmother and brother came to see me.  I was so convinced Hoffman was coming to rescue me. I was appalled they did not believe me," Geralds said. "As I sat there and told them of his plans for me, my brother began sobbing. I could not understand why."
Following her release from the hospital, Geralds was sent back home to Memphis where she lived with her father and earned a degree in art at the University of Memphis.
"I was on Lithium for a while, but stopped taking it because I felt like a robot," Geralds said.  "I did not have any psychotic episodes like back in D.C. for a decade.  A psychiatrist  I used to see told me it was all of the exercise I did kept the symptoms at bay."  
She was exercising six to seven hours a day training for triathlons, instructing aerobics occasionally and coaching tennis.
Geralds' last major psychotic breakdown occurred in the summer of 1998. She locked her children out of their home and made them sleep outside on the porch. She would sit in her car for hours. Eventually, the children's father found out and took custody away from her.
"I thought God was telling me to do these things.  I have never been religious in my life, I hear these 'God delusions' are a common part of psychotic breakdowns," Geralds said. "I ended up wandering the streets of Memphis and being pistol whipped and raped."
Geralds was put in Memphis Mental Health Institution and later sent to Genesis House, a halfway house founded by Catholic charities.  She has not had another psychotic episode since that summer. She attributes most of that to an adjustment in her medication.
"People with this disease are not going to take something that makes them feel lethargic and depressed. Mania just feels too great in contrast," Geralds said. "I am so grateful to have discovered this medication, Abilify. My mood swings are still there, but I am not so out of touch."
Geralds, like most other people with bipolar disorder, must stay on her medication or will risk lapsing into psychosis.
Mary Niles expressed optimism toward those with bipolar.
"We are normal people, capable of great things," Niles said. "We just have a little trouble staying on track sometimes."

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