Is My Child With Depression Ready to Go to College?

Sam was diagnosed with depression and anxiety during his sophomore year of high school. After some difficult times, he was admitted to a psychiatric inpatient service, then discharged to an intensive after-school therapy program. Over the next two years, his symptoms improved. He took medications and went to therapy. He eventually decided to go away to college, not too far from home. He hit some bumps the first semester, but stayed in touch with his family, me, and his therapist and he was able to stay at school and eventually graduate in four years.

Students like Elle can struggle to adapt to so much change at once.

Source: Ground Picture / Shutterstock

Elle was treated for depression and anxiety beginning in third grade. She took her medication and went to therapy, but still sometimes struggled with low mood and energy, getting to classes, and getting work done. In her senior year, after a period of stability, she, her parents, and the treatment team supported her going away to school. The first semester was challenging but she managed. Second semester she struggled from the start—staying in her room, unable to get to classes or get work done. She took a medical withdrawal and eventually finished her degree at a school closer to home.

Teenagers who are diagnosed with and treated for depression in high school (and before) are often bright kids who have a hard time in school due to their mood symptoms. Planning for college makes sense because they are capable intellectually—and at the same time, depression can significantly affect a young student’s ability to succeed in college. They may have been managing their symptoms while living at home with you, but are they ready to do this on their own? What kinds of conversations should you be having when planning for college with your child with depression?

How stable is your child's recovery?

The first consideration is the stability of your child's recovery from depression.

Honest discussions anchor any further planning around college readiness. Fundamental points to cover here are the severity and duration of their illness and the quality and duration of recovery/symptom relief. Was your child’s depression diagnosed recently (months to a year) or over a year ago? How severe were the symptoms? Were there suicidal thoughts or behaviors? Did your child need inpatient care at any time? How much relief has there been to their symptoms and how long have they been feeling better?

Source: 3rdtimeluckystudio/Shutterstock

Within this framework, safety-related symptoms are a top priority. Symptoms such as self-harm or suicidal thoughts/behaviors need to be carefully assessed by your care team before sending a child to college. Severe sleep disruptions, food restriction, and/or weight loss also need to be considered. Careful and ongoing monitoring of these symptoms—by you, your child, and the psychiatric care team—will be essential in answering the question of college readiness.

Does your child understand and accept treatment?

The second discussion point is how much insight your child has and how accepting they are of the treatment plan.

Is your child honest with you, their treaters, and themselves about what’s happening with them? Are they aware of their medications and are they consistent in taking them? Has the student actively participated in psychotherapy? It’s not uncommon for college freshmen to forget or stop needed medications, or to miss therapy appointments, so you can’t always prevent these from happening. But it’s important to assess your child’s commitment to the care plan before they need to manage their treatment on their own. You want to have a sense of their willingness to anticipate problems and generate possible solutions before they go.

Is your child willing to stay connected to you?

The third area of discussion is how willing your child is to stay connected with you during their college transition.

Part of going away to college is being away from your parents and not having them monitor your daily activity. It is both healthy and crucial for development to have an increase in independence as they move into young adulthood. But for many students with depression, regular check-ins with you can contribute to a needed sense of routine and support in a time of great change. Having routine times to connect and touch base can help you become aware of changes in your child’s patterns sooner rather than later. You need to get a sense of your child’s willingness to stay connected early in the college readiness discussion. Many kids will protest to keeping up with phone calls to some extent, but if they flatly refuse that type of communication, your planning discussions need to be made with that in mind.

Asking for help and communication skills

The fourth area of discussion relates to asking for help and communication skills.

Can your child use the resources availale to them?

Source: Monkey Business Images / Shutterstock

You want to consider how well your child can self-monitor. Are they aware when they are struggling? Do they have consistent communication skills for tasks such as reaching out to professors or their RA? Are they accepting help—will they work with disabilities services to get and mobilize accommodations and supports? Will they work with tutors and student services if they need help academically or administratively? Will they reach out to you and/or their care team if they are stuck?

Keeping the conversation going

You will think of many other questions, of course, keeping in mind the goal of prioritizing your child’s mental health over any one academic plan. If your child isn’t ready to go away to school, commuting to a local college can be an option for some. A gap year or a job might work for others. Maybe they need some time in more intensive therapies. Some kids will try college but need to come home and reset. The range of options is much wider than the standard view of high school to four years of college. Honest conversations and flexible thinking will be key to your child’s growth from high schooler to young adult, whatever that looks like.