Thursday, March 09, 2017


Earlier this week, I had a chat with a student who's missed more than half the class sessions this term because they're suffering from anxiety and depression.

I don't know what to say.  Shakespeare doesn't help here.  Don't kill a king.  Marry someone who's wit and personal qualities match yours if you can.  Don't ignore your day job if someone else is going to come in and cause problems for your dukedom.

It's not that I want to be unsympathetic, but I'm at a total loss.

I don't have much experience with real depression, but from the far sidelines experience I've had, it's horrible.

The thing is, if someone is too anxious or depressed to come sit in a classroom where little is demanded of them (a little small group discussion, maybe sharing ideas, but it's not like we're doing brain surgery and someone's going to die if we mess up), then really, my class is the least of their worries.  How can you hold down a job?  How do you deal with relationships?  (Bad things happen in relationships: loved ones get sick and need care and love, for example.  That can be hard under the best of circumstances.)

What I want to say, but don't, because I know it's not helpful is "just get up and drag yourself through the day like most of us do."

I don't say that, and I know it wouldn't help.  But seriously, I think for an awful lot of people in the world, getting up and dragging themselves through the day is how they get by a lot of the time.

And I think it's probably always been that way.  There was probably some Homo erectus out there who really didn't want to get out of the nest they'd made the night before, but then got hungry enough to either get up and go forage or decide to just lie there and get eaten by something else.  And until they couldn't any more, they got up and went to forage.  And even if they went out to forage, something else might have eaten them.

Those of us who are lucky, mostly get up and are happy to do what we're paid to do, at least mostly.  (I would be happier not to have to grade or fill out assessment paperwork, but there you go!)

I tried to help this student, gave them an option to help them catch up, dug out handouts for them, and so on.  I wish I felt even slightly confident that I could be helpful.

What's the most helpful thing for students with anxiety/depression (for an academic instructor) to do?

Edited to Add: I should have mentioned the counseling services stuff before.  The counseling services and the student were already working together, along with the Dean of Students office coordinating.

Thanks, all!


  1. Anonymous12:53 PM

    I would refer them to mental health services. A student dealing with depression or anxiety that severe needs help that we, the instructors, are not qualified to provide.

    1. Good point. I probably should have mentioned that the student is already in touch with several resources here on campus that are more qualified to help with the bigger issue than I am. But still, when they're in my office, what do I do to help?

    2. At least in my experience, students often show up in my office at the urging of academic/psychological counselors. The advice to talk to professors is good; the time charts with which some show up, showing how they're going to catch up with a semester's worth of work in a week or two, are, shall we say, somewhat less than realistic, even for someone who is functioning at their best. And of course it's dispiriting to draw up such a plan, especially with the help/encouragement of a counselor, and then fail to carry it out. So our counseling services, while I know, also from experience, that they do a pretty good job of dealing with students in crisis, may have a way to go in figuring out how to help students deal realistically with the semester-long consequences of falling severely behind.

  2. As you might know, my kid suffers from anxiety and depression. If the student is getting help, there's not a lot the teacher can add. What you've done -- offering handouts and make up work -- is more than enough.

    If the student actually can't make it to class, they need to think about dropping this semester and trying again when their meds and therapy are working. This is a disease. It's like a student who has any other debilitating disease. If the disease is keeping them from doing the work, they may well need to take a semester off.

    I've had students with depression/anxiety, I should add. I offer sympathy, and I let them know my kid suffers from it, and I offer to work with them. But in the end, they have to be able to do the work.

    It's tough.

    1. I teach at a community college and I'm finding this to be more and more common among my students. I had two students speak to me about similar issues this week, and I have a couple of other students that I think are having similar issues right now.

      The other thing I do, especially for those who are already receiving treatment, is I ask them if they are registered with our Disabled Students Programs and Services office. I'm not sure exactly how our DSPS office supports these students, but I know that diagnosed mental health issues qualify them for services.

  3. I refer them to counseling services if they're not using them and make them aware of medical drop policies that let them get back most of the semesters tuition if it looks like their grade is past redemption.

  4. Good advice from both Nicole & Maggie and Good Enough Woman!

    We're not allowed at our school to ask our students about their disability status, or to urge them to contact disability services; but if you can, that's definitely something you should do.

    And medical drops to recover at least part of the tuition can make students feel somewhat better about bailing.

    1. Hmmm. I should probably double check that I can, in fact, say, "Are you registered with DSPS?" I think I can. I've been doing so for nearly 20 years, but maybe not? Thanks for making me think about this, delagar. I'll check.

  5. Right there, in your office, you ask them to wait while you call counseling services, and then you walk them to the actual location of counseling services and help them get an appointment or, if possible, wait with them until someone professionally qualified can talk with them.

    1. We're no longer allowed to do either as academics. Apparently we were cluttering up the system or something? It's really, really frustrating! We have to tell the student to go see an advisor in a different building, and the advisor will then decide if they need to go to counselling services and get them on a wait list. SIGH

  6. Referral is definitely the way to go if the student *hasn't* been referred (or hasn't been in touch with hir doctor lately; a few times, in response to a student's desription of behavior/mood that sounds like textbook depression, I've said "you know, I'm no expert, but it sounds to me like you might have depression; have you talked to a doctor?" and had the student respond with something along the lines of "I know; I guess I shouldn't have stopped taking my meds; I'll talk to my doctor." So sometimes they know darn well what's going on, and are looking for outside/adult confirmation, which I'm happy to provide, within the bounds of my (lack of) expertise.

    More often, as I mentioned above, they've already talked to counseling services, and may even have drawn up a plan for catching up -- often one, sadly, that is unrealistic, especially under the circumstances. In those cases, I tend to express a willingness to take late work without penalty (because they're dealing with an illness -- one that has the additional insidious effect of making it hard to acknowledge what's going on, and take appropriate measures to cope -- and illness is a valid reason for work being late), while at the same time mentioning options like dropping, voluntary withdrawals, incompletes, and the like, and urging them to explore the possible financial and academic consequences of taking any of those options, alone or in combination, before they have to make a decision on short notice with insufficient information.

    My syllabus also mentions, in the context of lateness/absence/illness policies, that few student who fall more than a week behind in the work of the class ultimately pass, and that a student who finds hirself in that position for whatever reason may be better off dropping and concentrating on other classes. Of course it's easier for me to say that, because the required course I teach is taught every single semester/term, in multiple sections.

    I don't know if we have a medical drop policy. I'll have to check. I fear that the answer will be that we can't afford one given declining state funding.

    tl;dr: at least in my experience, counseling services are sometimes a bit too invested in a model in which the student recovers in the course of the semester, with little or no trace of the illness on hir academic record. This isn't always a realistic goal, and sometimes professors end up being the ones to deliver that news, as gently and compassionately as possible.

  7. I have a hard time dealing with students with mental health problems because I'm not a warm/fuzzy person. I do tell them about our counseling services -- usually they are already doing that. But I am the type of person who throws herself into work when things are bad, so I have a hard time when students say they are suffering and can't work. I have to really restrain my own instincts in that situation, because my instinct is to say, "This work will cure you," even though that is probably untrue for anyone but me.

  8. I actually have the same diagnosis, and clearly (looking back) had it from my mid-teens if not earlier. And I am a reasonably warm person - I'm the kind of female academic who has several students at year who aren't in any way "mine" drop in on office hours in a state about something, because they trust I'll be willing to listen and help if I can.

    But I still find it hard to deal with this sort of student, the one who is properly diagnosed and receiving treatment, but apparently not able to either get their act together and catch up OR make the decision to take a break, but wanting some magical third option to come into existence. There are several reasons:
    One, I'm something of a sponge and catch their distress, so I want them to GO AWAY as they are hurting me in some ways.
    Two, like Fie, I've always dealt with my issues - especially before they were diagnosed, when I was a student myself - by working. Anything with books or paper is safer and easier for me than the world in general - it's an escape, a focus. A very bad sign is when I struggle to read or write, and then I know I need to take a break/get more support. So I'm kind of torn between a gut-level assumption that they are seriously ill and shouldn't be trying, and confused by the fact that by their own report they're able to do other things which are much harder than working to me (socialise, keep my house tidy and my clothing in order and do my hair, travel around, be out in public, exercise), because I don't understand it at all and so don't know what to say.
    Three, magical thinking - I struggle to understand students who want ME to fix stuff I can't fix - they KNOW leaves and extensions on work have to be agreed by a support person, not an academic (to keep things fair, sigh), and I can't magically make it so they can catch up without that however much they tell me their stories.
    And then many of them get inappropriate academic advice from their services - as CC notes - and that's also challenging and irritating. Especially when the support service tells them that I can help them with things which I can't (e.g. administrative tasks which have been removed from academic purview, or line editing their work - we have a writing centre...).

    Fie said "I have to really restrain my own instincts in that situation, because my instinct is to say, "This work will cure you," even though that is probably untrue for anyone but me." Work doesn't CURE me, but it helps me wait out the mental storms and anchors me when they buffet. The thing _I_ want to say is more along the lines of sh*t or get off the pot - be properly sick, take sick leave, use the systems that exist for that, OR show the sense to bring me questions I can answer, rather than wishes I can't fulfil, and control your own fate by prioritising studying - or not, if that's your choice or the way your illness affects your life, but then take the consequences of that choice, don't expect me to magic them away.

  9. Grrr. I hate it when Google eats my comment!

    So I started leaving a comment and it got overly long so I posted the more personal aspects on my blog and can now be more concise: just sympathize and assume the student is doing the best s/he can. I try to always be realistic with students about what they can make up, but I'm always willing to give incompletes to those students who have any kind of extended illness or problem (partly that's because we're on the quarter system and it's crazyfast anyway). It's really hard to learn when there's all that noise in your head and no energy or motivation or itch to do anything.

    I also understand wanting to tell them to snap out of it (not that anyone said exactly that) or to piss or get off the pot. I've definitely felt that way -- in fact, I lost a dear friend because of my inability to deal with her depression -- and my inability to say that I was struggling to deal with her depression (because of my own depressive tendencies). But I also see it from the other side and so empathize, especially right now.

  10. EE is entirely right. The only thing you can do is to assume they are doing the best they can.

    I was in a mard (still am) and my comment is a bit too wishful thinking!

    I do think that sympathy does not have to be large or obvious - simple acceptance - "I'm sorry to hear that; what can I do to support you with your studies/in my class?" - can be the most useful thing to hear (and can also head off some of the over-sharing some students feel they need to indulge in to get help). I know some colleagues think they're being helpful when they try and encourage a student to return to class, but also that that can come across as not taking the (very real) illness seriously. Like unhappy families all depressions have their own mean little quirks, and are shaped by the brains they've colonised.

    I do try to offer supportive suggestions if the student is being vague but showing no signs of leaving, such as "why not come, sit by the door, and if you need to leave I'll know why and not mark you down for it", but that's probably not ideal.

    In general, my approach to students with issues is increasingly to be sympathetic without being coddling, and to make the message "I believe you, I'm sorry to hear that, but let's focus on what's going to happen next". Because I personally can't cope with too many details and too much indulging-in-poor-me, I'm not actually that good at sympathy-without-advice-giving, and I want to let them know I heard them but actually focus on what I and they can DO with things-as-they-are.

  11. Also, I think many of my students who go through this know that they aren't likely to complete the course/term, but they want to remain hopeful as long as they can, limping along with the thought that things might suddenly get better and they'll be back on track. So I try to be patient an sympathize (after directing them to the proper resources) even though it can be a drain on my time because I spend time accommodating the situation, and it then it all comes to nothing. But, ah well.

    And we, too, have a "medical withdrawal" in case they need to drop after the last official day to drop without an F.