At around twelve years old, I was diagnosed with a chronic neurologic condition that causes severe pain and cognitive symptoms. This seems like a negative, but truthfully, having a diagnosis is a huge relief and I’m grateful. It took a lot of persistence and family support to find a physician who truly listened to what I had to say. My disease is considered an invisible disability, and even now, nearly ten years later, it continues to have a serious impact on my daily life. Managing my physical health took so much effort that taking care of my mental health always got pushed aside. This meant that it took until the time I started college for my anxiety behaviors to be diagnosed as obsessive-compulsive disorder. Around this time, it became clear that I also had post-traumatic stress disorder, although I rarely spoke about it.
Sometimes it feels as though it is only acceptable to have one problem at a time. I can be physically ill today, or I can be mentally ill – I can’t be both. The problem is, I am. Our diagnoses don’t take days off. We can’t get stuck in the trap of constantly giving one condition higher priority, because your mind and your body depend on each other. It’s been ten years of trying to find a balance, but as I enter my last year of college, I feel as though I finally have at least some of it figured out.
Be Your Loudest Advocate
When you’re dealing with more than one diagnosis, coordinating with your treatment team is important. It can be tempting when you go to a new doctor to “accidentally” leave a mental health diagnosis off your medical history, or to “forget” to write down that you take antidepressants. Don’t do it. I know firsthand that there’s a lot of stigma attached to saying “I have a mental illness” and that it only gets harder to say when you’re a young person living with chronic pain. We’re afraid that our physical symptoms will be dismissed on account of our anxiety, or that a self-reported pain scale won’t be taken seriously because we have depression, and with depression can come body aches. The short answer is that a doctor who dismisses your concerns isn’t a doctor worth seeing. You know best how you feel, and you need to be your loudest advocate. Without a thorough medical history, you’re putting yourself at risk. Symptoms can overlap, medications can have a wide variety of side effects, combinations of prescriptions can have serious interactions, your mental health can exacerbate your physical health, and vice versa.
At face value, another college student getting poor sleep might not seem like a big deal. Unfortunately, post-traumatic stress disorder has had a serious impact on my ability to sleep and poor sleep is a guaranteed way to make my neurologic symptoms worse. It’s a vicious cycle: I don’t sleep because I’m anxious, I get physically ill because I didn’t sleep, I don’t sleep because I’m ill, then I just get more stressed out, and repeat. Therefore one of my priorities when working with physicians is always to keep my PTSD under control, so that it doesn’t interfere with my sleep. A proper night of sleep means that I’m less likely to start a day with neurologic issues and that I’m also better prepared to handle any triggers that might come up.
I cannot stress how important it is to stay on top of things, especially if you have a condition that can fluctuate in terms of severity. While it might be feasible (although not advisable) for my roommate to put off writing a paper until the night before it’s due, for me, that would be a recipe for disaster. My physical health can go from fine to needing a trip to the emergency department in a matter of hours. If I wait until the last minute to study or complete an assignment, there’s a risk that I will be too sick to accomplish it. On the occasions when this has happened, my anxiety skyrockets, which makes feeling better and getting anything done impossible.
The best way of keeping this from occurring is to try and schedule out when things need to be done. Try keeping a planner, journal, or to-do list. I tend to divide my tasks based on priority and color code to-do lists, which helps me budget my time appropriately. Breaking larger tasks into small tasks (ex. “Write a paper” becomes decide on a topic, look for sources, create an outline, write one paragraph, and so on) can be helpful on days when you’re feeling especially low energy but can’t fall behind on work. Even if the tasks need to be as small as “write one sentence,” that’s one more sentence than you had to start with. If you are struggling to accomplish things, it’s the time to reach out for help.
Use Your Resources
On my campus, I receive support from the university disabilities office so that I can make the most of my education. Some of my accommodations are designed to help manage my mental health, while others are in place for my disability. These accommodations are considered part of the Americans with Disabilities Act, and make sure that disabled students are on equal ground with their abled counterparts. If you know you’re struggling or have specific concerns about the accessibility of your education, talk it over with your treatment team and take their recommendations to your university’s disabilities office. Unsure what office covers disability resources at your school? Try contacting the university intercessor or equal opportunity compliance director, and they should be able to point you in the right direction.
Anaclare currently attends the University of Rochester and serves on the Active Minds Student Advisory Committee.