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  • Kristen Stuppy, MD

What You Need To Know Before Starting College

Updated: Jun 22, 2022

Moving out and starting your college career is exciting, scary, fantastic and intimidating all rolled into one. This is true for all teens, but especially those with learning differences or mental health issues. Many who have never had those issues can suddenly develop them during college. Leaving the comforts and safety net of home to be on your own and starting college can be very challenging. But not insurmountable.


The Risks


Based on surveys from the JED Foundation, it’s unlikely that you’ll make it through college without at least knowing one student who has a mental health disorder, has attempted suicide, abuses drugs or has experienced an unwanted sexual contact.


Scary statistics.


It’s not college that’s the problem. The risk is the age of developing independence. Believe it or not, these statistics are higher for young adults not enrolled in college.


Talk about these statistics with your parents, therapist, and/or physician. Plan what you’ll do if you or someone you know starts to struggle. Thankfully, colleges offer a lot of support for their students.


It’s a great idea to keep the suicide hotline in your phone to use in case of emergency. Whether you or a friend needs it, you don’t want to be out of a service area and unable to search for it. Put it in your contacts now.

Suicide Prevention Lifeline: 1-800-273-8255
You can now use 988 to call the Suicide Prevention Lifeline

Know your personal and family history – and share it.


Ask your parents about any family history of mental health, psychological problems, and learning differences. Many mental health issues tend to emerge in young adults, so if there is a family history, you will want to be aware of it.


Beware: your parents might not really know the history. Historically we have hidden these. People felt mental health problems weren’t real. Learning differences were simply not recognized. Or they were a sign of weakness. A source of embarrassment.


We now know that these are real issues. Sometimes life events lead to mental health problems. Often there is a genetic component to mental health and learning challenges. Sometimes there seems to be no rhyme nor reason to mental health issues, they just happen.


What we do know is that they’re real.


And they’re treatable.


They are not the fault of the person. Mental health issues are health issues and can and should be handled medically.


Learning differences do not make people stupid. They do make it harder to learn in a traditional classroom, but people with them can benefit from accommodations.


What if no one talks about it?


Sometimes we don’t know that a person struggled with a mental health issue, but we know they drank a lot of alcohol or became addicted to drugs.


Because mental health is not always properly treated, many people suffering will self medicate with drugs or alcohol. Being addicted to these is a strong indicator of some mental health issue.


Many very smart people do poorly in school. If people in your family seem to not achieve what they should based on their intelligence because they failed at school, think about learning challenges they might have faced.


Personal history matters too.


If you have a personal history of ADHD, anxiety, depression, bipolar disorder, autism, or anything else, make sure you inform the university’s health center.


Your parents might be hesitant to provide this information because they worry that it will look “bad” — but colleges use this to help, not hinder you. It’s important that they are aware so they can help make sure you’re safe while you’re away from home and your parents can’t see you regularly.


Plan ahead.


If you have a history of anxiety or depression, touch base with the student mental health center to learn how to schedule with them when needed.


It is just too overwhelming to figure it out when you’re struggling, so do it when you get to campus – or sooner!


Continuing medicines.


If you are on medications for anxiety, depression, ADHD, or any other chronic issue, talk to your current prescriber to see how you can continue the medicine at school.


If you go to a school close to home, it might be possible to continue to schedule regular appointments with the same prescriber. Be sure to schedule in advance so you can coordinate appointments with your schedule.


If you go further away, you will have to really think about what will work best. If you are able to plan times to come home regularly, be sure to schedule appointments well in advance so you don’t miss the opportunity to go to your doctor.


If you aren’t coming home often or if your condition isn’t well managed and you need more frequent visits with your physician or therapist, finding a local provider is probably the best choice. This can often be done at the student health center, but may require a provider off campus.


You can also see if your therapist or physician can do telehealth visits. This can be difficult across state lines, but technology can help maintain the relationship you’ve built over the years!


Learning Differences


To be in compliance with Section 504 and the Americans with Disabilities Act (ADA), colleges must provide students with reasonable accommodations. These accommodations are not meant to make college easier, they are meant to level the playing field so that a student’s disability doesn’t impact their ability to learn and be successful.


  1. extended time on exams

  2. being provided with written notes in class

  3. separate testing locations

  4. audiobooks

  5. recorded lectures

How many kids have learning differences?


According to the National Center for Education Statistics, 11% of undergraduate students self-reported having a learning disability. Enrollment statistics show that 20.4 million students attended an American college or university in the fall of 2017. This means more than 200,000 students entering college have some type of learning disability.

200 THOUSAND students have some type of learning difference.

Accommodations can help with college success!

You’re not alone!


Studies show that only 17% of college students with learning differences take advantage of learning assistance resources at their school. This of course leads to academic struggles and a much higher dropout rate than for students without learning differences.


What can you do if you have a learning difference?


When researching prospective schools, students with learning differences should pay attention to how they offer support.


  • What do they offer in assistive technology?

  • Do they allow the use of a scribe or note taker?

  • What seating options are available?

  • Do they allow students to go to a separate classroom for taking examinations with less distraction? 

  • Could you be eligible to receive extra time for exams?


Some schools even offer oral exams if the student responds better to this type of testing.

You won’t know what’s available if you don’t ask!

Ask for help when you need it!

And you won’t get the help you need if you don’t apply for it.


These accommodations can be accessed through most college’s disability service offices for students with documented disabilities. Check out your prospective school’s website to see what they offer.


Fresh start!


There’s often a temptation to view starting college as a fresh start, which it is. But that doesn’t erase the past.


Some students want to quit their current treatment plans before starting college. This can really backfire.


Any big change, such as starting a new school (or job), moving, or living with new people, is stressful. With the start of college you have many of these big changes happening all at once.


It’s a really bad time to stop medicines or therapy.


Please continue with your current treatments until you’ve settled into things at school.


Once you’ve gotten used to the new routine, if you still think you’re ready to stop your treatment plan, talk to your providers. You can work with your physician or therapist to come up with a plan to stop treatments if you all agree that it is safe to do so.


If your doctor or therapist doesn’t think it’s a good idea: listen to them. They have seen this before. Use their experience to help you. Please.


Know your resources


Ask for help when needed!

Most colleges offer mental health counseling at their health center. Don’t be afraid to use it. Learn what’s available and how to access it before you need it. Before you even move onto campus.


It’s too hard when you’re struggling to do the research.


As mentioned above, learning difference accommodations can be accessed through most college’s disability service offices for students with documented disabilities.


Start accepting responsibility before college


As you approach the end of your high school career, talk to your parents about how you can develop healthcare independence. You’ll need to learn how to make your own appointments, take your medicine (and get refills on time), and so much more!


It can take at least year of practice before starting college, so work with your parents and physician on a plan.


Recognizing is hard…


Many college students only go for help when someone else tells them to. If your friends and classmates recognize you struggling and tell you to get help — get help.


Really.


If you recognize that you’re struggling before anyone says something, even better! Get help.

I know that calling to make the appointment is hard. The first step always is. Once you make the appointment, it all gets easier.


It’s Life!


College is such an exciting time. You’ll learn a lot about your academic studies, sure. But you’ll learn even more about yourself and other people.


Learn to live happily and healthily.


That includes taking care of yourself!

What to know before starting college.
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