As the summer ends and the crisp fall air approaches, the season of back to school is upon us. While this time of year can excite some, for others, the beginning of school is coupled with feelings of anxiety and stress. For those individuals considering going away from home for school for the first time or leaving home once again to return to college, this time can be fraught with decisions around lack of parental involvement which can lead to struggles with schedule, sleep, study, exercise and food.
I recently spoke with a client regarding a “quick admission” to residential treatment so she could return to college for her junior year. During the course of the conversation, this lovely, articulate and bright twenty-year-old told me every summer for the previous three years she had been in treatment. When we explored those treatment stays, she reported she consistently discharged to “get to school on time”. We discussed what it would mean for her to commit to being present in treatment for the recommended length of stay, rather than entering treatment for a specified period of time to engage in minimal weight restoration, receive a quick tune-up and brainstorm potential pitfalls for her return.
This conversation is one many professionals have during this time of year. When is it time for our clients to remain in a higher level of care and when is it time to return to their college campus? College students are left to cope with high-pressure academic environments, navigating complex social nuances and trying to engage in self-care; even in the best of circumstances this is challenging. Add an eating disorder to the mix and an individual is left to manage feeding themselves, self-monitoring exercise and managing substances which can significantly increase engagement of eating disorder symptoms, anxiety and depressive symptomatology.
The National Eating Disorder Association (NEDA) conducted a Collegiate Survey Project in which they reported:
The increased pressure and stress of school and leaving home may lead to mental health problems among college students and a greater need for campus services. This is also a period of development in which disordered eating is likely to arise, resurface or worsen for many young men and women. Full-blown eating disorders typically begin between 18 and 21 years of age (Hudson, 2007). Although some students will experiment with dieting and escape unscathed, 35 percent of “normal” dieters progress to pathological dieting. Of those, 20 – 25 percent progress to partial or full-syndrome eating disorders (Shisslak & Crago, 1995).
With every client, parent and provider I speak with, I encourage them to dig deep in consideration around the return to school. The idea of taking a semester off may be a painful one; however, the ultimate benefits may far outweigh the potential challenges.
I believe it is more beneficial for an individual to engage in treatment fully and completely, rather than potentially need to reenter in the future.
For questions or more information on supporting your client or loved one in the transition from treatment to school, please email us directly.