Back to School With Bipolar? How College Can Unleash Mania

The rituals of college—making new friends, studying until dawn, excessive partying—can stress out any young adult. But students with bipolar disorder, or those at risk for the condition, are even more vulnerable in a college environment. Academic pressures, social concerns, and sleep disruptions can lead to bouts of depression as well as mania, the euphoric, revved-up state characteristic of bipolar disorder. Without the right treatment and support, bipolar college students face higher dropout rates, drug and alcohol abuse, and even suicide.

“The new structure and new stresses for [bipolar] students who leave home to go to school sometimes can trigger problems and relapses,” says Richard Kadison, MD, the chief of mental health services at Harvard University and the author of College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It. These stresses, he adds, can also trigger mania in students who have an underlying vulnerability to bipolar disorder. “Oftentimes, the first manic episode occurs in college,” Dr. Kadison says.

At its most severe, bipolar disorder is a dangerous condition that can lead to psychotic episodes and hospitalization. Milder forms of the disorder can cause problems as well, and can interfere with academic success. A 2006 study in the Journal of Affective Disorders compared a group of bipolar adults with a group of healthy adults who had similar IQs and social backgrounds. More than 60% of both groups entered college, but their achievements differed greatly: Nearly half of the control group received a college degree, compared to just 16% of the bipolar group.

Students with bipolar disorder can survive—and even thrive—in college, but doing so requires a plan. Taking the proper medications, arranging for the appropriate counseling and medical care on campus, avoiding drugs and alcohol, maintaining a steady sleep and study schedule, and finding sources of peer support are all crucial and can make the difference between achieving your goals and dropping out.

A breeding ground for bipolar symptoms
Jennifer Overfield, 23, was diagnosed with bipolar disorder during her senior year of high school in Rochester, N.Y., but it wasn’t until she left the support of her family and went away to college that the disease threatened her life.

During the first weeks of her freshman year, she felt isolated and alone. She quit the soccer team and stopped going to classes. She started to stockpile medications and alcohol. In October, she drove to a nearby apple orchard, downed the pills and alcohol, and passed out. She woke up in the hospital after spending three days in a coma. (A passerby had seen her taillights, found her unconscious, and rushed her to the hospital, where she was medevaced to a larger hospital.) Overfield says she remembers being angry to be alive.

“I kept telling my family and friends that I was OK, but I was planning my suicide,” says Overfield, who is now a healthy senior at the University of North Carolina, Wilmington. “I had so much support back home—and then, in this new place, I didn’t even know where the counseling center was.”

Numerous aspects of college life can trigger a manic or depressive episode. Sleep deprivation and the keeping of irregular hours—both common practices on college campuses—are known to trigger mania, while binge drinking and the use of substances such as marijuana can cause depression. Stress, whether it stems from the pressure to succeed academically or to fit in socially, can trigger mania as well. According to Russell Federman, PhD, the director of Counseling and Psychological Services at the University of Virginia student health center, the desire to fit in and conform to the college lifestyle can cause some bipolar students to abandon healthy behaviors—even their medications.