An Open Letter to Parents From a College Psychiatrist

I have been a college psychiatrist for the past ten years; seven years at Harvard, a large co-educational urban university, and three years at Smith College, a small women’s liberal arts college in a rural setting. The cultures at these two institutions are very different, but the feelings students have shared with me are quite similar. As winter break is upon us, I’ve been reflecting on how I might use the many stories I have been privileged to hear to help reduce some of the pain and risk some students feel every time a school break approaches. I hope that sharing students’ feelings here may help families work toward healthier and happier relationships in the coming year.

“I can’t let my parents down.”

Many students put intense pressure on themselves to live up to their parents’ expectations and fulfill their parents’ dreams. When a student’s vision of the future involves going against their parents’ wishes, the student can feel trapped and hopeless about their future.

Many students have told me that they couldn’t possibly consider changing their major or career path, transferring to a school they’d like better, or taking a leave of absence, because it would anger or devastate their parents. These students push themselves to stay the course despite great emotional pain, reducing their chance of success, and sometimes even endangering their lives (think Dead Poets Society--a phenomenal Robin Williams classic.)

As a parent, of course you want your child to be happy. It’s just that your beliefs about what would make them happy may be very different from theirs. Many parents have sacrificed greatly to make college a reality for their child, and it is not always easy to remember to put your child’s sense of well-being above their academic success. Most students experience a tremendous amount of academic stress—from themselves, their professors, and their peers. Ask how they’re handling it, being careful not to add to it. Ask open-ended questions that invite conversation and express interest in them as a whole person—how do they like their school? What are they thinking of majoring in? Are they making friends? Are they doing anything for fun? Engaging with your son or daughter about how they are doing overall and not just about how they are doing academically is key to their mental health and overall success.

“I’m a disappointment to my parents.”

The college years are a time of exploration and discovery. Many students try on new hairstyles, identities, political ideologies, or relationships in the process of learning who they are. Students who feel judged and rejected by their families for being different are more likely to struggle with low self-esteem, relationship problems, and isolation. Loneliness and self-loathing place students at higher risk for social anxiety, depression, and suicide.

Is your child coming home with a new piercing, tattoo or hair color? Are they trying to find a way to come out to you as gay, bisexual, or transgender? Are their political or religious views moving away from yours? You don’t have to approve of everything your child is doing, and you can let them know how you feel, but don’t stop there. Express curiosity—ask your child more about why they are going in a new direction and how it makes them feel. Try to keep seeing around and beyond the things you don’t like to the things you have always loved about them and things you still have in common. Find topics you can safely talk about and consider giving them the gift of agreeing to take certain sensitive topics off the table. Too many of my students feel that the changes they are going through are destroying their relationships with their parents, when what they really want is for their parents to see them and continue to love them for who they are on the inside, even if they can’t understand or support everything they do.

“My parents don’t think mental health is a thing.”

Many mental illnesses first rear their ugly heads in late adolescence and early adulthood. Depression, bipolar disorder, and schizophrenia often surface during the college years. For students, this can pose a triple threat: emotional instability, declining academic function, and social stigma. I can’t tell you how many times students refuse care or drop out of treatment because they believe their parents would view them as weak or feel ashamed of them for seeing a counselor or taking medication for depression or anxiety. Some students pay for medication out of their own pocket rather than use their parents’ insurance, or even stop taking medication before going home for break for fear their parents will discover that they are taking medication. Some students would rather risk failing out of college than take a medical leave of absence for fear of their parents’ reaction.

Whatever your beliefs may be around issues of mental health, the last thing you want is for your child to be suffering. It can be confusing to see your child struggling to function, behaving oddly, or disconnecting. It can be scary to see scars from cutting, evidence of substance abuse, or hear your child talk about death. I honestly believe most parents want to help their children under these circumstances but simply don’t know how. The first thing you must do is acknowledge the problem. Let your child know you see them and that you are concerned. Simply talking about the problem can bring great relief and hope. The second most important thing you must do is to consult with others. Secrecy and isolation will only make the problem worse. Seek advice from your primary care physician, family members who may have faced similar issues, or a trusted pastor, and contact your college counseling center. While it is ideal to reach out with your child’s permission, and we do need students’ permission to share information about their care with you (unless your child is in immediate danger), permission is not required to discuss our services, give general advice, or hear about your child’s situation.

“My parents don’t get it.”

Students who are the first in their family to go to college or the first to attend college in the United States face a widening cultural gulf between themselves and their families, who have difficulty understanding the college experience and may feel conflicted about their child’s accomplishments. These same students often have difficulty fitting in on campus as well, and therefore may not feel at home in either world.

Psychopharmacology Essential Reads

Long-Term Use of Benzodiazepines and Dementia Risk

Does Antipsychotic Medication Work?

It can be very helpful to simply acknowledge the gap, share your feelings about it with your son or daughter, and ask them if they notice it, too. Without an open conversation, there can be misunderstandings and incorrect assumptions on both sides. Parents and students can learn from each other by discussing the differences between the types of stress involved in having a job versus being a full-time student. Some parents who have not gone to college may believe that college is less stressful than having a job, and discredit their child’s feelings. Validating their feelings will go a long way in maintaining a healthy relationship.

“My parents still treat me like a kid.”

Shifting gears from the freedom and independence of campus life back into a home environment can be uncomfortable. Some students wish they could stay on campus over break so that they won’t have to comply with parental rules at home or be expected to tell their parents where they’re going and what they’re doing.

Have a conversation with your child about wishes and expectations on both sides. How much time would you like them to spend socializing with family or helping with household duties? How much time does your child hope to spend by themselves, with friends, or with a girlfriend or boyfriend? What time do you want them to be home at night? What is each of you most looking forward to and most worried about? It’s your home, so you can set limits, but consider offering your child some time alone as a gift, understanding that emerging adults need their privacy. Think back to when you were 19—what did you need from your family? Treat them like the adult they are trying to become—respect and negotiate with each other about how you can both get your basic needs met.

“My parent would fall apart without me.”

Students who carry the weight of their parents’ problems often feel guilty, anxious or depressed and have difficulty identifying and dealing with their own issues. Ask yourself if you rely too much on your son or daughter for emotional support. This is a common issue for single parents, parents in unhealthy marriages, and parents with significant health problems. It is very important to find support outside of your relationship with your child so that they won’t feel responsible for your emotional well-being. This could take the form of a support group, therapist, friends, church or community organization.

Even if you think you have a good relationship with your child now, your relationship will necessarily change during their college years as they develop ideas and practices of their own. The good news is that approval of their choices is not required to maintain a healthy relationship. What is required is a willingness to try to see them for the person they actually are or are trying to become, which may not be the person you had envisioned. Try to view your son or daughter’s college years as a time of growth and discovery for yourself as well. Even if you’ve made some mistakes as a parent (and who hasn’t?)—it’s never too late to try to make things better.