On a Sunday night at the end of last semester, Delaney Arias was overcome with an overwhelming sense of dread. Her head pounded and her chest tightened. When she closed her eyes to sleep, she could barely breathe. Then that sense of dread seeped into her thoughts and she knew, then, that she was in trouble.

“Why did I come back?” she thought.

“What if I have an attack?”

“What if I fail?”

So she opened up a bottle and popped two pills — 2 milligrams of the anti-anxiety medication Ativan. The effects were almost immediate. The dread that overcame her disappeared and she could think clearly again.

“I can do this,” she thought as she peacefully fell asleep. “I came back for a reason.”

These moments are rare for Arias now, the moments when the anxiety, depression and panic become so debilitating that a voice inside her head — she calls it “the bad voice” — tells her she’s stupid and worthless.

It’s only after visiting several mental health services on campus, taking a year-and-a-half mental health leave of absence from Syracuse University and staying in an inpatient treatment facility for 15 days that Arias has the tools to deal with the anxiety, depression and panic.

She has the medication. She has a self-care regimen that includes watching “The Office” and painting her nails. She has the unwavering support of her boyfriend. She has the capacity to see the dread for what it really is: an irrational symptom of mental illness, a bad voice in her head.

***

Arias is one of many students around the country taking mental health leaves of absence from their universities. Increasingly though, students at institutions such as Duke University and Yale University have been finding it difficult to take a mental leave of absence and then get readmitted into school afterward.

“The policies that I see as problematic are overly intrusive and put challenges on students that are not in place for students that take other (non-mental health) leaves of absence,” said Karen Bower, a Washington, D.C.-based lawyer who works with mental health issues on college campuses.

Duke and Brown universities, for example, require that mental health leaves of absence last two consecutive semesters, according to the policies listed on their websites.

“It can be a lengthy period of time that might be more than what the student actually needs,” Bower said.

Reasons for the two-semester requirement may vary, said Victor Schwartz, medical director of the Jed Foundation, a nonprofit that works to promote mental health on college campuses. Some schools might have rigid course sequences, which would make it difficult for students to return after one semester and take classes usually offered another semester, he said.

Schools might also institute a two-semester policy to discourage frivolous leaves of absence, Schwartz said.

At the same time, some universities put a cap on the amount of time students can be on leave. Vanderbilt University, George Washington University, the University of Rochester and Boston University — all SU peer institutions — do not allow students to be on mental health leave for more than one year, according to the policies listed on their websites.

Some of the most restrictive leave policies, Bower said, require students to meet certain conditions, such as getting a job or taking classes, if they want to return to school. Southern Methodist University, for example, requires students wishing to return to campus after a mental health leave of absence to take a class at a community college, get a job or do volunteer work if they want to be readmitted back into school, according to SMU’s website.

The reasoning behind this, Schwartz said, is to ensure that students are in a place to handle the stresses of school when they come back.

At SU, there is no minimum or maximum time requirement for mental leave. Under SU’s policy, a stipulation for readmission is that students enter treatment with a licensed mental health provider, according to the Counseling Center’s website. Students also have to apply for readmission at their home college.

Under the policies at other schools, Arias may not have been able to return to campus after a year-and-a-half mental health leave of absence.

*** 

When Arias came to SU as a freshman in 2012, she was excited to start school as a newspaper and online journalism major in the S.I. Newhouse School of Public Communications. She was happy, even, because she started dating Julio Vidals, a freshman who, like her, was from New York City.

But soon she began to have anxious thoughts, and even little things, such as getting out of bed and completing assignments, became triggers for panic and anxiety attacks. So Arias stayed in her dorm, sleeping during the day and crying, or trying to figure out how to breathe during the night. Both were normal occurrences during her first few semesters on campus.

The more anxious Arias got, the more depressed she became, until her logic became warped and she worked herself into a vicious cycle of thinking about failing and not going to class.

By the end of her first semester, she was put on academic probation.

Vidals, her boyfriend, was with Arias during her first attacks. He would always hold her during her attacks and tell her they would get through it together.

He encouraged Arias to go to the Counseling Center at the end of the first semester of her freshman year. After going twice, the Counseling Center referred Arias to The Psychological Services Center, which is staffed by doctoral students in the psychology department on campus.

Frankie Prijatel | Staff Photographer

After weekly appointments at Psych Services, she had a diagnosis: clinical depression and general anxiety disorder.

She was prescribed anti-anxiety medication and antidepressants from the psychiatrist in Health Services. But the medication didn’t always work well with her body or mind.

Arias continued to skip classes and not complete assignments, while still attending weekly therapy sessions at Psych Services. The therapy helped, she said, but she sometimes thought about taking more medication than her prescribed dose, or cutting herself. But she never did.

“I thought I could always just take all my pills at once and be over it with it,” she said. “But then I was like, ‘What’s the point in dying?’”

Arias decided to take a mental health leave of absence at the end of her sophomore year. She went to the Office of Student Assistance and a counselor sat down with her and helped her fill out the paperwork. She said SU’s services were “great” about the process.

“I still felt this darkness,” Arias said. “And I thought, ‘I can’t do this every semester I’m here.’”

***

Nearly six months after Arias returned home, her mom checked her into an inpatient facility at the Columbia University Medical Center because her anxiety and depression were still present. The inpatient ward was called 9-Garden North, or 9GN for short, Arias said.

She stayed there for 15 days. Woke up. Took meds. Ate. Did activities. Ate. Did activities. Slept. Repeated.

Arias became known throughout the facility for painting people’s nails right before lunch. There would be lines of people, she said, waiting for her to paint their nails.

She was put on more medication: Cymbalta, Klonopin and Gabapentin. She was re-diagnosed: panic disorder and major depressive disorder.

At 19, Arias was the youngest person at 9GN. All of her friends were older. There was Lindsey, the bipolar former heroin addict who would sneak Arias muffins at lunchtime. There was John, an older man who was obsessed with saying “yowza” and “oh girl.” There was Nancy, an 80-year-old woman who kept a cat colony in the city.

Vidals, her boyfriend, visited Arias every day he could.

She was released when the therapists and psychiatrists at 9GN felt like Arias was not a danger to herself. When her mom wheeled her out the building — it’s hospital policy for patients to be in a wheelchair when they’re discharged — Arias started weeping.

“I did it,” she cried to her mom. “I did inpatient.”

It still took her about a year to be in a place where she could still come back to school. She found a regular therapist, and learned to break down her thoughts and target which ones triggered attacks. It’s a process she still uses today.

The readmission process back into SU was smooth for Arias. She went to the Counseling Center and received a list of therapists she could see in the area. She wrote an impassioned plea to the Newhouse Academic Standards Committee to explain why she would be a great student.

“My academics were affected by my mental illness but not by my will or passion for my major and journalism,” she wrote in the appeal letter. “I had to try my best to stick it out but built up the courage to get help for myself. I am now ready to return and truly put my best foot forward and complete my education.”

Newhouse accepted her back into school for the fall 2015 semester, after a year and a half on leave.

***

On a Friday night at the beginning of January, Arias and Vidals walked into a generic beauty supply store near the entrance of Destiny USA. Inside the store, Arias’ eyes got wide. She spotted some shelves with assorted nail polish, ordered by color and style.

Occasionally, she said, seeing nail polish will remind her of her time at 9GN, especially when she does people’s nails.

Arias has more than 20 vials of nail polish sitting in her South Campus apartment, also arranged by color and style. They’re an important part of her self-care routine when she gets anxious or stressed. At home, she has more than 200 bottles.

As Arias browsed the shelves with her pink-for-Valentine’s-Day nails, Vidals tapped her shoulder and pointed at single bottle of nail polish titled “Cute as a Button.” Vidals then pointed at her.

Arias smiled at him. He smiled back. They both laughed.

Arias is on her way to being happy for the first time in a while. She’s starting to go to weekly therapy again, and she’s starting to make friends and go outside her room.

“It feels like I’m seeing things completely differently than before I left,” Arias said. “There’s no longer this dread every time I wake up in the morning.”

Published on February 25, 2016 at 12:25 am

Contact Rachel: rsandler@syr.edu