Dealing with mental illness at MIT
Reflections and advice from an MIT graduate
Confession: I experimented on myself starting in my first year at MIT. I could cycle into, within, and out of mania. I came to believe that I could control the frequency and timing of cycling. During a typical manic episode, my mental capacity and ability to solve problems increased. This was measurable; I earned top undergraduate grades at MIT, produced substantial research in an MIT lab, gained admission to top graduate programs, and joined a high-quality laboratory at Harvard as a PhD candidate. I coordinated manic episodes with academic performance. Or so I thought. Coordination implies control; there was no control. As a student in rigorous programs at prestigious institutions, I feared losing my productivity and professional opportunities by addressing and “treating” my abnormal behavior.
Real discrimination is levied against people labeled as sufferers of abnormal behavior spectrum disorders: anxiety, depression, bipolarism, and schizophrenia. Molecular underpinnings — genetic and environmental — of these spectrum disorders are unknown. In broad terms, science and medical research still have not definitively proven if these spectrum disorders are a result of altered neuronal connectivity or altered neuronal activity and whether drivers of these neuronal changes are endogenous to neurons or derivatives from other biological processes (e.g. immune system, microbiota). Molecular diagnostics do not exist. Patients are binned into spectrum categories based only on presentation of behavioral symptoms. “Treatments” for these spectrum disorders are not known to target symptoms specifically. On a biochemical level, the target of pharmacological drugs and the resulting cellular or organismal outputs also remain a mystery.
No amount of wellness programs or passionate opinion articles will break the stigma against people who suffer from mental illness. When people say, “We need more advocacy in general,” I disagree. We need clear science and medical understandings of the molecular underpinnings for these abnormal behaviors, including both genetic and environmental etiologies. We need treatments that specifically suppress symptoms. We need scientists and medical professionals discussing research questions, directions, and context. We need transparent policies and cultural changes that support people getting critical care while protecting their privacy. We need college communities, such as MIT and Harvard, to provide an answer to, “Are individuals with mental illnesses viewed and treated as legal liabilities?” Most importantly, we need to reach people who are suffering, especially those who have become unreachable. As a student at MIT and Harvard, I was unreachable.
These realities fueled my fierce denial and normalization of my symptoms. My associated fears led to lack of empathy toward other students experiencing mental illness symptoms or seeking care. I don’t know exactly when it happened, but I blurred into accepting a destiny sequence: my suffering in exchange for my contribution of some novel value to society before earning my peace, death by suicide. For students who think about suicide, it does not always happen in one evening. It can happen for many evenings over months or years. It can happen in private such that no one knows. This is death by suffocation. When I started planning my end, I started small. I organized my workspace, putting all materials into formats easily accessible and interpretable by others. I pared down my possessions. Then, this escalated. I thought practically about how to minimize emotional pain and inconvenience to others.
MIT community and alumni, have you normalized an abnormal behavior? Do you understand the risk associated with this normalization? Have you accepted a destiny sequence as I had? I am crying out to you — please do not accept that, and please consider seeking critical care. I am not saying you should tell everyone about it. Definitely don’t do that. I am asking you to start addressing it now. It takes time and energy to find a management strategy. The summer is coming up, which is a perfect time to look into medical resources, establish connections with medical professionals, and adjust to prescribed treatments when you don’t have classes. Finding a management strategy alone or while in crisis does not work. If you are in crisis now, call or ask a friend to call a HIPAA (Health Insurance Portability and Accountability Act of 1996) protected resource for you. Not all resources marketed as “private” or “confidential” actually are in legal terms. Be careful. Literally ask, “Is this resource legally protected by HIPAA or by doctor-patient confidentiality?”
Calling a resource is not the end. It does not mean that you will have to change your life plans or accept your symptoms as an impairment. For me, calling a resource led to a functional management strategy for my mental illness. I no longer have to worry about killing myself. For a long time that was always the plan: I was destined to die by suicide, hopefully after making a novel contribution to society. To be clear, I did not actively plan suicide for years; rather, I actively became comfortable with the idea of suicide. Now, I do not think that way. Now, I know that people battling behavioral spectrum disorders have value to society and deserve to live without discrimination. We are the different thinkers. We are able to see alternatives and have the energy to pursue them. Yes, there are negatives to our spectrum disorders that need management strategies. We need science and medicine to provide drugs that treat these negative symptoms. But no, we do not need science or medicine to “cure” us of the positive value that our disorders provide us. Society needs us. I have internalized this. I feel like I belong. You also belong. I don’t think less of myself, and you should not either.
To the MIT administration, I have five calls to action. I hope you can thoughtfully consider these calls over this summer term and implement changes prior to the next academic year.
(1) Redesign resource websites (e.g. S^3, MindHandHeart, Office of the Chancellor website, MIT Medical) to be more user-friendly and deliver information clearly regarding privacy, scientific facts about mental illness and existing policies for students seeking care with mention of how financial standing and degree progression is handled. Announce and make this information available at freshman orientation. Consider designing a cartoon roadmap of mental health resources and scientific facts about mental illness; place this cartoon roadmap in bathroom stalls across campus.
(2) Take down all information that reduces student likelihood to seek care. Additionally, consider adding videos other than depression on MIT MindHandHeart. By showcasing only one disorder, students may think that if they have a health issue other than depression, resources at MIT might not recognize it or offer support. If you film new videos, watch them approximately 100 times and ask, “Will this video showcase the diverse severity of issues MIT students face from imposter syndrome to serious medical issues? Are all types of students encouraged to seek critical medical care?”
(3) Take down all the survey questions and percentage answers on Office of the Chancellor’s website; only ~35 percent of MIT community responded. Are these statistics being abused to market MIT as a healthy place or platform much needed policy and cultural changes? At the very minimum, both positive and negative framing of questions should be displayed with equal frequency. For example, display, “X percent of students agreed with Y, and 100-X percent of students did not agree with Y.” Note only ~35 percent of community responded. This technical point aside, there is a larger issue. Does the Office of the Chancellor have a conflict of interest with marketing the MIT brand and caring for the MIT community? Do the statistics, that may or may not be representative of the community, make students more likely to seek help when they need it or more likely to keep quiet — feel further isolated by the MIT community and not respond to surveys?
(4) Request the Committee on Medical Leave and Hospitalizations to release a data table to supplement their recently released report. Such a data table should have columns with existing MIT policies prior to their committee, recommendations to replace or change the policies, future steps to implementing changes with associated timelines, and comments on the efficacy of the policies — in terms of how likely students will receive appropriate care.
(5) Create a medical leave fund that would cover the tuition for students who need to leave mid-semester to seek medical care. Additionally, allow grade replacement for these students when they retake the classes at a later time.
And so what happened to me? I spent time at McLean psychiatric hospital in Belmont, Massachusetts during graduate school. My advisor protected my academic progression and did not discriminate against me at any stage. A few years later, I remain on the drug that I was prescribed during that hospitalization. The student health services at Harvard and staff at McLean Hospital saved my life. This was not the first medication that I tried or the first time I talked to a psychiatrist or counselor. I had spent five months seeking care through student health services and was a guinea pig for different medications, but somehow this particular medication was only available upon hospitalization. An extended manic episode led to my hospitalization. “Led” is not so accurate; that implies a logical decision made by myself or at least some logical choice. I did reach out to someone who then explained the severity to a HIPAA-protected avenue.
So is that the end? Did I just need that particular medication, and now I can be normal and tell everyone about surviving this thing called mental illness? No. The truth is that I am still experimenting on myself. I change the dosage, and at times, when I need the mania, I alter or skip dosages. To be clear, the medication is not specific for mania symptoms; no mechanism of action is known, and generally it suppresses everything about myself, which at times is absolutely necessary. This is not a treatment. The word treatment implies full recovery. This is managing mental illness. I regularly seek medical care. I am 100 percent okay, should hospitalization become part of my care again.
Mental illness affects people across the world and is not specific to MIT or Harvard. I hope that both institutions can be leaders for the rest of the world and address this issue with grace and activism.
Editor's Note: The author was granted anonymity due to the extensive personal details shared in the article.