How to handle flameout in 2nd semester college sophomore?

[Lemaitre1]

OP, while I am not a psychiatrist I am an MD in General Practice and not keeping his appointments with his psychiatrist and non-compliance with medication is something that needs to be dealt with on an urgent basis. I am not going to diagnose your son over the internet but it seems there is the strong possibility that his academic problems could be related to mental health problems. If this is the case, it is my experience that keeping his appointments with his psychiatrist and strict compliance with his medication is the key factor in symptom control and leading a normal life.

[delfinium]

Responding to questions:

Was there an internship too?
There was supposed to be a summer internship, but he pulled out of it when he started the summer class.

About his EC, I don't want to say what it is for privacy reasons. I think he is in an appropriate major - in an area that genuinely interests him, and he is very capable in, when he bothers to do the work.

Could it be that this reach, prestigious uni is just too hard for him?
I've pondered this question myself, but he did have 3 successful semesters (with steadily rising GPA: ~3.35, 3.45, 3.55), and I don't think the 4th semester classes themselves weren't really any different/harder than the other semesters. The class he failed should have probably been one of the easiest ones he was enrolled in. Why did he fail? He was a no-show at 2 of the 4 exams. He got an A- when repeating the class this summer.

I do think that going to a selective University has been a blow to his ego though, and a shock that he couldn't just glide through with minimal effort like he was able to do in high school.

I suggested to him that he consider transfering to a less selective school, such as the local public flagship, but he is strongly opposed to it. (Frankly, I don't think that would make things better, since I think he is getting a lot more assistance from his current University in this situation than he would in a larger, public school.) I've also suggested taking a lighter and easier courseload, just doing the minimum needed to graduate and taking advantage of AP credits.

Non-compliance with the appointments with the psychiatrist and counselor is my biggest concern. It hasn't yet gotten to the point where he is non-compliant with prescribed medication, because he hasn't been prescribed any yet. From what S told me, the psychiatrist said that medication was an option to consider in the future, depending on how things went. But since S never went to another appointment, it was never prescribed. During high school, S was VERY non-compliant for other less serious medical related things - wearing his retainer, acne treatment, etc.

But how can parents influence non-compliance for a young adult who lives far away? I've asked S how we can know that he is following through with mental health appointments when he goes back to school. (He is briefly at home now, and will return to school soon.) He suggested that he will call us after he has his appointments to check-in with us. Which would be fine if he actually goes to appointments, but I'm somewhat skeptical that he will. I guess we will know if he stops going, but will be powerless to do anything about it.

Thanks to everyone for your feedback and encouragement.

[JonLaw]

The only thing that you can do for non-compliance is to stop paying for college. Other than that, you're pretty much out of luck.

At least in my case, my energy levels would drop through the semester as I got behind, which would only make things worse, so that's something you might want to look for.

I'm certain that there's a good way to handle this, I'm just not sure what it would be. Ultimately, he's got to take responsibility for himself, which includes making the appointments.

Lightening the course load is probably an excellent idea for the next semester.

Having experienced the joys of large state schools, I think I would have preferred being at a private school.

[lookingforward]

I'd compare your son with one of my girls, but the truth is, it's not easy for any of us.

In our case, we had to appeal to her own sense of worth and her own hopes (no, not easy, when they're down or we're annoyed.) Tell her this is temporary, that we believed she will get through it, one way or another, and praise her real, surviving strengths, etc.

So many kids suffer from criticism, failure and threats. Some only respond to them. If your son came up with the idea of calling after appts, that's something we'd react to positively. Great idea, glad you suggested it. Of course, they may not follow through. But for us, it would represent her participation in the discussion.

Sometimes, the sports analogy works- hey, kiddo, it's no different than the efforts you make to be on top of your game, keeping an eye on commitments and expectations, meeting up with a coach, if that's what he needs.

I wish you the best.

[delfinium]

I wanted to send a private message, and was told that I needed to have posted more to be allowed to do that. I guess the policy changed, since I sent and received them before. So, I'm making an update to increase my post count.

So far, so good for my son this semester. When he returned to school he started again seeing the on-campus psychiatrist, and was prescribed an anti-depressant (at a low dose). He says he is taking it, but hasn't felt any effect yet, but its only been a few weeks.

[delfinium]

^ Update continued.

He is taking a lighter courseload this semester - just 4 classes, 12 credit hours, and seems to be generally positive about the classes.

He has been good at calling us weekly to let us know what is going on.

[delfinium]

^ Update continued.

He is participating in his EC again. He claims that having the structure of it is helpful to him. He is enthusiastic about it, so that is good.

[delfinium]

^ Update continued.

So, at this point, we're just crossing our fingers, and hope that things continue to go smoothly. I'm much less stressed about it than I was before, and more hopeful that he'll get through the semester OK.

[Shrinkrap]

Best wishes!

[Lemaitre1]

For some of the most commonly prescribed anti-depressants called Selecive Serotonin Reuptake Inhibiters (SSRIs) such as Prozac and Paxil it is not unusual to have to take them for several weeks before symptom control is achieved.

[Naturally]

OP, when I was in college I went through something similar to your son. I did well in high school without too much effort, then crashed and burned at the end of sophomore year, and pretended that everything was all right to my parents until it couldn't be hidden anymore. I don't know if this is the case with your son, but for me one of the things holding me back was SHAME. I would miss a class and imagine the professor being offended if I went the next day . . . so I'd skip it again. And now I'd skipped two classes, oh no, now it was even harder to go back so I skipped again . . .

An important thing to get kids to understand is that the professors have seen it all before. They have seen it ALL before. They aren't going to feel shocked when a kid skips a bunch of classes. If you miss one day, two days, five days in a row, GO TO CLASS the next time anyway and get back on track.

Another thing that was holding me back: PRIDE. In high school I was a kid with tame tastes--no drunken binges or such--and associated low grades with being a goof-off. My baseline assumption was, "If I try hard I will get an A, if I don't then I will get a B." Well, I was still a tame kid in college--I still didn't have any interest in drinking, etc--but the work was much harder. I might try hard and get a B. Or a C. This was upsetting and frustrating. But I didn't ask my professors or the writing center for help; I had a self-image that did not include "being the type of person who runs to someone else for help", so I just kept struggling on my own. Not a good move.

I also never told my parents when I was having trouble--whether it was big trouble or little trouble. I wanted to make them proud and had a vague notion that it would not be anything that they wanted to hear. (They were sort of "see no evil, hear no evil" types.) I recommend being as open, upfront, and non-judgemental as possible when dealing with your son.

Okay, on to the third setback I had. This was a biggie, and is sort of wrapped up in the aforementioned pride. I was something of a PERFECTIONIST. If I wrote a paper, I wanted to get nice comments from the teacher in the margins. If I took a test, I wanted to get an A. This led to a perverse logic where I found it less stressful to skip a paper altogether and get an "F" than to turn in a substandard paper and get a "C".

Parents: For years you've told your kids to do their best, try their hardest, and live up to their full potential. And that is good advice. But before they go to college, take them aside and tell them, "I want you to try hard, but when push comes to shove . . . Getting a 80%, a 60%, even a 30% is better than getting 0%." At least with those grades you have a chance of pulling your average up via your other work!

Frankly I would not worry about Top Whatever law schools at all at this point. After college, if he has high enough grades, he can try for them. If not, that just calls for some plan readjustment. "Man plans, God laughs", as they say.

Whether your son is dealing with the same issues I was, I don't know. But it is worth thinking about and talking to him about.

If he is, the best thing you can do is make it clear that you still love him and will always love him. It is NOT the time to start applying "tough love". "Tough love" would have utterly destroyed me. I was angry enough at myself and struggling under an enormous burden of guilt for not being "good enough".

I did, incidentally, end up flunking out. But years later I returned to college, a good college, and graduated magna cum laude. I just needed time. Remind yourself that even if your son does not complete college, that doesn't mean his life is over or Ruined Forever (TM). Deep breaths. This too shall pass.

[ordinarylives]

OP, it's also pretty common for the the first AD to be less effective than hoped, especially at low doses. There may need to be dosage increases, supplementation with other meds, or a change from one AD to another. And then the waiting begins again. It is a very tough road, but one many have taken. Make sure he sees a counselor in addition to the psychiatrist.

[peacefulmom]

delfinium-- thank you for your updates. i am so glad your son is doing better. good luck with the rest of the semester!

[OHMomof2]

Glad to hear it's working out. And Naturally...we had very similar experiences in college

[delfinium]

Checking in one more time. My son has finished his semester, and is back home for Christmas break. The semester went well - he ended up with a 3.6 GPA, which is even better than he had ever accomplished before, although this semester he took a lighter course load. He has also continued with his EC. He also seems to be in generally better spirits.

I wonder if it safe now to breathe easier and hope that the worst is past?

He has been taking advantage of the student health services on campus. He has seen a psychiatrist and a counselor, and he said that they were both helpful. He was prescribed anti-depressants, and had the dosage changed once, from an initial very low dose. The psychiatrist said that he should remain on the anti-depressant for a year, and then re-evaluate.

I think my son's selective private University has handled this difficult situation well, and his advisor was particularly helpful in advocating on his behalf with his professors about making up work missed during his bad semester. Getting put on academic probation and at risk to have to leave his University was a good push to force him to accept that he was having a problem with depression, and take steps to resolve it.

Thanks to everyone for your support earlier.