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Story against policy

Story against policy

Navigating U of T’s bureaucracy as a bipolar student with PTSD

Content warning: descriptions of sexual violence and suicide.

On January 29, 2017, I was admitted to a psychiatric hospital for a bipolar mixed episode gone wrong.

On June 12, 2017, I was readmitted for a suicide attempt.

On June 27, 2018, the University of Toronto’s Governing Council approved the mandated leave of absence policy, cementing tools administrators had to remove students in crisis from their studies. Had the policy or similar policies been used a year ago, it would have upended my life. This policy will upend the lives of numerous students who also struggle with their mental health.

During my last year of high school in Switzerland, I was being treated for depression. I discontinued treatment and therapy when I came to U of T in the fall of 2014. I figured a new country and new phase in my life would allow for a fresh start, and to some extent, this was true.

But mental illness doesn’t stay behind in the country you leave. I suppressed this truth and revelled in the novelty of university life.

I suppressed this truth until I returned to Switzerland over my first winter break.

It happened on the morning of New Year’s Eve. I went for an early-morning run in my hometown. The crisp winter air filled my lungs and the familiar scenery filled me with bittersweet nostalgia. I was running along a beaten path lined with trees. A man jumped out from behind one of the trees and, as the stereotype goes, he sexually assaulted me. I remember running across the road. I remember screaming “no” on the sidewalk. Cars passed. Some drivers slowed down to see a display of hysteria before driving away. One person’s trauma is another person’s spectacle.

When I left Geneva a few days later, home didn’t feel like home anymore. Over the next month, I ignored my parents’ advice to contact U of T’s sexual assault counsellors. I didn’t want to revert to my high school self, a depressed person sitting in a therapist’s office. Meanwhile, I had regular Skype calls with the police in Geneva as part of the year-long process to prosecute my assailant. I thought that I could balance the re-traumatizing bureaucracy behind the investigation with schoolwork. I thought that I could handle it — until I couldn’t.

My nightmares turned into night terrors. When I wasn’t in class, I stayed in bed, too afraid to leave my dorm room. I drank alone. I gained 20 pounds. I fell back into depression, a familiar sadness that came with an unfamiliar trauma. I finally made an appointment with the sexual assault counsellor at Counselling and Psychological Services (CAPS).

When I arrived, a receptionist at CAPS handed me a pen and a clipboard with a questionnaire. I filled it out in the waiting room, accidentally chewing the pen. When I was halfway through reducing my depression to a numerical value, the assault counsellor called me into her office.

“What brings you in today?” she asked. That’s how therapy starts. I had been in this situation before.

“I was assaulted,” I replied, clinging to the comforting ambiguity. I didn’t want to say ‘sexually assaulted.’ I didn’t want to say what happened.

The counsellor wanted me to say what happened. I racked my English literature brain for an escape route via euphemisms or circumlocution. “I was running and there was a man behind a tree and it just happened.”

The grammatically indefinite ‘it’ buffered me from the shock of retelling a violent story. But the counsellor pried for more.“

Did he put his penis against your body? I just want a better picture of what happened.”

I wanted to say ‘no.’ No to the question. No to re-traumatizing retelling. No to graphic details for the sake of graphic details. Instead, I said “yes.” One person’s trauma is another person’s picture.

After four appointments, the assault counsellor decided that I needed to see a psychiatrist instead. The re-triggering sessions were all for nothing.

After a few months on a waitlist, I got an appointment with a psychiatrist, who prescribed antidepressants and asked me questions about why I wanted to die. She seemed bored by my case during our 15-minute appointments. It’s difficult to explain suicidal ideation in a tight timeframe.

I stopped seeing her after two months.

When I returned to Geneva the summer after first year to see my family and attend the prosecution of my assailant, my body got sick. I underwent a series of tests, including blood work, an MRI scan, an ultrasound, a bone density scan, and a smell test (which I failed).

I was misdiagnosed with partial Kallmanns Syndrome, polycystic ovary syndrome, and hyposmia — an impaired sense of smell. I was accurately diagnosed with a pituitary microadenoma (which sounds scarier than it is) and osteoporosis (which, to a 19-year-old, sounds as scary as it is).

My body matched my mind: both were starting to break down.

I entered second year feeling older, and not in a good way. I made an appointment with a doctor at the Health & Wellness Centre to discuss management options for my osteoporosis. This doctor was kind and thorough. She also recognized that I was depressed. She prescribed medication I was comfortable with and put me on a waitlist to see a different psychiatrist at CAPS.

My doctor continued to see me regularly and offered me more help than I had received from either the sexual assault counsellor or the psychiatrist in first year. For the first time, I experienced good care at Health & Wellness.

I continued to receive good care with an excellent psychiatrist at CAPS. Although my medical care got better, I got worse. I experienced not only depression but also psychosomatic reactions to trauma, a response which manifested in tics and a stutter.

It started in January 2016, about a year after my assault. My head jerked insistently to the left, keeping me in a constant state of negation, and my shoulders shook like laughter. I felt like a modern-day hysteric. I could handle the physical pain of these motor tics. What I could not handle was my loss of language.

With the thick stutter clipping my words, I could no longer speak in class or be the engaged English student that I wanted to be. I dropped one of my classes because I couldn’t stand the looks I was getting from the other students. Fewer classes meant fewer people had to see my awkward twitching body.

Over a few months, my psychiatrist and doctor treated my psychosomatic symptoms.

Although I still twitch whenever I get stressed, startled, or over-caffeinated, my tics are no longer a 24-hour full-body workout. Aside from depression, panic attacks, night terrors, motor tics, osteoporosis, and a faulty sense of smell, I finished second year relatively scot-free.

In retrospect, second year was a breeze compared to the years that followed. Things took a turn when I started experiencing symptoms of bipolar disorder.

During the fall of third year, I felt good. Too good. I was energized in a way that I had never been before. Everything looked sharp, as though someone had increased the saturation and resolution of the world around me. I wrote thousands of words of terrible poetry, convinced that I had to publish a book immediately. My pressured speech and racing thoughts demanded an audience.

I would waltz around the Junior Common Room (JCR) to find someone to listen to my latest theories on behavioural homeostasis, the physical antimatter of our bodies, and Greek etymological connections to a specific musical chord progression. Friends would often stop me mid-speech to tell me they couldn’t follow. I was elated, electric. I could write an A-grade paper on modern poetry in a few hours and spend the rest of the night running around the city.

But this dream-like, sleepless state didn’t last. Eventually, I’d crash. After every high-energy episode, I’d spend weeks in bed, incapable of reading, writing, or thinking. These drastic mood and energy fluctuations would happen several times a month, stretching my brain like an overused elastic band.

My psychiatrist eventually identified these high-energy episodes as hypomania and diagnosed me with rapid cycling bipolar disorder type II. Afraid of losing the thrill of hypomania, I resisted the mood stabilizer and antipsychotic she suggested until my fluctuations landed me in the Centre for Addiction and Mental Health (CAMH).

I stayed in an in-patient unit during February 2017. Had U of T used the new mandatory leave policy that year, or the existing Code of Student Conduct, the administrators could have removed me from school. Throughout my hospitalization, a Student Crisis Response Coordinator helped me manage my course work. She sent me comforting emails, telling me, “We will do everything possible to make sure things stay on track.”

One of my professors also messaged me while I was in the hospital: “Kristen, just checking in — do you need books? Can you have visitors? Please let me know — I’d be happy to come see you and bring you what you need.” Professor S. not only accommodated me as a student but also cared about me as a person.

I used one of my hour-long hospital passes to visit this professor. I’m not saying that all professors should offer to bring their students books in psychiatric hospitals. But if all professors had this level of compassion toward struggling students, perhaps we wouldn’t struggle as much.

I returned to school the week after I was discharged. If the current mandatory leave policy had been applied to me, this return would have been impossible. Students on enforced leave “must apply in writing” 30 days before the next school term. Along with asking an already vulnerable person to perform the emotional labour of self-advocacy, the policy expects people to schedule their crises.

If a student does not meet the 30-day timeframe, the university may “terminate the student’s registration.” I could not have written that application in the hospital. Would U of T have ended my undergraduate degree?

A month after I left the hospital, my psychiatrist went on maternity leave and CAPS transferred my care to someone different. When I asked my new psychiatrist if I could have therapy for my post-traumatic stress disorder, she refused. She said she wanted only to focus on treating my bipolarity, primarily with medication, because I “wasn’t ready” for trauma-informed counselling.

I acquiesced and dealt with the flashbacks and nightmares alone, ashamed that I had asked for help in the first place.

I rapid-cycled my way through the rest of third year. Since I missed my course deadlines, I petitioned for extensions during the summer. While my professors agreed to the deadlines I requested, the petition officers did not: “It is not reasonable to expect special considerations for substantial amounts of outstanding coursework after the courses have ended.” This email sank me.

The three Fs on my transcript replaced my 4.0. Failure, failure, failure.

I closed the email.

That night, I punished myself and, with a bipolar penchant for extremes, I took things too far. When I realized that what I was doing could end my life, I scribbled an apology and the names of some important people in my life (names that included Professor S). Most people would judge my reaction as melodramatic, and they wouldn’t be wrong.

But most people don’t have an illness that heightens emotions and fuels destructive impulsivity.

My mind is one of extremes: I experience happiness only as elation, sadness only as despair. When I woke up the next morning, my body was fine, but it also wasn’t. I rationalized that since I was still here, I had to seek medical help.

I went to CAPS for an emergency walk-in appointment with my psychiatrist. She called Campus Police. Campus Police called the emergency medical technicians after one officer asked to see the damage. I wanted to say no, but I didn’t really have a choice. The medical model, which the mandatory leave mirrors, seldom offers Mad people choices; instead, it intimidates. I was in a room full of police officers, a psychiatrist, and a mental health nurse.

Paramedics eventually joined the party. The police officers and paramedics escorted me out of CAPS. I felt like a criminal walking through the Koffler Centre. Inside the ambulance, a paramedic took my vitals and attempted small talk.

“So, what do you study?”

“English.”

“Cool, what kind of English?”

“Modern poetry.”

“Cool, and how’s modern poetry?”

“It’s fine.”

“Well, you know, we all have bad days. You just have to stay positive.”

A Campus Police officer stayed with me in the waiting room. She showed me pictures of her dog on her iPhone. I didn’t feel like talking about her dog. I didn’t feel like talking.

A security guard joined the police officer to observe me. A doctor examined me before making her final assessment: “You know this could have killed you, right?”

I shrugged off her finger-wagging. She then established whether I posed a physical threat to myself and/or other people.

The slash is a convenient punctuation mark.

Incidentally, the threshold for intervention for a mandated leave also conflates “harm to self or others.” Since it’s easier to justify a mandated leave of absence for students at risk to others than it is to mandate a leave for students at risk to themselves, the policy combines the two scenarios. I would have met this threshold.

If a denied petition was enough to push me over the edge, what would a mandatory leave do to students like me? After treatment and observation in Mount Sinai Hospital, practitioners sent me to CAMH, where I stayed the night. I returned to school and my work-study position the next day.

I appealed my denied petition, finished my coursework, finished my summer class, and finished third year — three very different Fs.

Toward the end of the summer, I returned to Switzerland, and, unfortunately, another trauma occurred. It happened on the night of August 22, 2017. I was raped in an alleyway behind the bus stop where I used to wait as a kid. My parents took me to a hospital, where I stayed overnight.

A nurse drew my blood and brought me to an adjustable bed. I pulled the papery white blanket over my body. There would be more tests, examinations, preventative injections, and pills to take when I woke up. Given my psychiatric hospitalizations that year, it was strange to be in a hospital for purely physical reasons.

Back in Toronto a few weeks later, I felt sick from the antibiotics and post-exposure prophylaxis pills I was taking in addition to psychotropic medication. I knew how trauma worked after my first assault; school would be hard, so I booked an appointment with my accessibility counsellor to discuss accommodations.

“Something traumatic happened,” I told her, hoping that was enough of a story to have my academic needs met. I clung to the indefiniteness of “something,” but my counsellor asked for more.

“Was it sexual trauma?” I wanted to say ‘no.’ No to invasive questions. No to prurient curiosity veiled as concern. No to counselling that so desperately lacks trauma-informed approaches. Again, I said “yes.” One person’s trauma is another person’s intrigue.

It was only after this second assault that my former psychiatrist agreed to transfer my care to a psychiatrist who specializes in trauma. For the first time, I experienced an appropriate approach to treating trauma. In my first appointment, the new psychiatrist said, “You can tell me as much or as little as you like. We don’t even have to talk about it.”

Different counsellors at U of T led me to believe that trauma therapy required traumatic retelling. This psychiatrist showed me an exit route without my having to search for one. He gave me the option to say ‘no,’ a ‘no’ I knew he’d respect. My care got better, but I got worse.

Toward the end of fall term in 2017, trauma took its toll and sparked a bipolar mixed episode. This episode included racing thoughts, heightened irritability, pressured speech, erratic energy, and about two hours of sleep a night over two weeks.

I hallucinated while trying to write a seminar presentation and paper on Virginia Woolf and Jacques Derrida (two writers who can make anyone’s head spin). I heard voices saying, “There’s something you need to show, there’s something you know.” I started seeing things that weren’t there.

Words transformed. The Thomas Fisher Rare Book Library turned into Rape Fisher. I saw a mangled skeleton on College Street. After a rare nap, I woke up to a man in a mask. I saw devils on the day of my presentation. An hour before class, I ran around the JCR talking about Derrida and “what it all means” to anyone who would listen. My apologies to all these people.

Those who support the mandated leave policy would argue that I should have taken a leave of absence. But while students in these situations often need more time, more time does not mean mandated time away from one’s school community.

Last winter term, I took a creative writing course with Professor S. She let me write about my rape in a personal essay. Writing this essay restored my ability to write. It took me five months, but I eventually finished that Woolf paper. Had I been placed on leave, I would have lost the support I got from my professor.

On June 27, 2018, I joined a group of students in protest while Governing Council held a meeting to pass the mandated leave policy. We chanted and gave speeches outside Simcoe Hall. The noise we made reached Hart House, and our message reached the news.

While we made ourselves heard, the governors did not listen. At the end of the meeting, our voices were raw, and the policy passed. It rained that day.

I worry about students who could lose their jobs, their residency, their international student visas. I worry about marginalized students, particularly those who are Black, Indigenous, or People of Colour, who will face the additional stress and discrimination of a mandatory leave. I worry about Disabled and Mad/Mentally Ill students. I worry about students dealing with difficult life experiences.

When the proposal first came to light, many of my friends and I were afraid to be on campus, afraid to be seen in CAPS and Accessibility Services. This policy will dissuade students from seeking help. This policy will divest Mad and Mentally Ill students of the dignity and agency they deserve. This policy will put people’s lives at risk.

The day after the mandatory leave policy passed, Professor S. emailed me: “Keep fighting — we studied human rights together, and your right to participate at your university is one.” Students will keep fighting against the policy. We will hold the policy administrators accountable for their discrimination until we’re guaranteed barrier-free access to education.

We will keep telling our stories. This was mine.