Graduating from college with schizophrenia

This is a composite story, drawn from common experiences shared in the schizophrenia community. It does not depict a real individual.

I graduated from a state university in upstate New York at age 25, three years later than I had planned. My first psychotic break happened the second week of my sophomore year. I took two leaves of absence. I changed my major from biology to history. I dropped down to part-time for almost a year. The diploma I have on my wall is the same diploma my classmates received at 22, but the path I took to get to it was, to put it mildly, not the standard one.

I want to write about it because, the year after my diagnosis, I went looking for stories like this one and could not find many. I want to tell anyone who is right now sitting in a dorm room wondering whether their academic life is over: it isn't. It might look different. It is not over.

The break

The second week of my sophomore year, I started believing my organic chemistry TA was somehow communicating with me through the lecture slides. The belief had a kind of feverish weight to it. I stopped sleeping. I stopped eating in the dining hall because I had become convinced that one of my hall-mates was watching me. By the end of week three I had not slept in four days, was barely speaking, and was refusing to leave my dorm room. My RA called the university counselling centre. The counselling centre called my parents. My parents drove eight hours overnight.

I was hospitalised the next morning. I was in for ten days. I was discharged on risperidone with a referral to an early-intervention program in my home city. I formally withdrew from the semester from a hospital bed.

The first leave

The first leave of absence lasted a full year. I lived with my parents. I went to outpatient treatment three days a week. I started CBTp. I worked twelve hours a week at a bookstore. For the first six months I could not concentrate well enough to read more than a magazine article without the thread slipping. I did not look at my old textbooks. The thought of returning to school made me physically anxious.

What pulled me back in, slowly, was reading for pleasure. By month eight I was reading novels again. By month ten I had started reading nonfiction history, which had been a side interest of mine since high school. The historian Eric Foner's writing about the Reconstruction era was the first thing I read after my hospitalisation that fully held my attention. By month eleven I had decided I wanted to go back, but as a history major rather than a biology major. Lab work and the time pressure of pre-med were no longer right for me.

Returning, the first time

I went back at the start of the next fall semester. I had registered with the university's office of disability services over the summer. The accommodations I requested were:

• A reduced course load (three classes instead of four).
• Extended deadlines on papers (typically a 48-hour extension on request).
• A quiet exam room.
• Excused absences for psychiatric appointments.
• Permission to record lectures.

The office approved all of them. None required my professors to know my diagnosis — only that I had a registered disability. Some semesters I told my professors anyway. Some I didn't. I made the call on a class-by-class basis based on the professor and my mood.

The first semester back was harder than I had expected. The campus was loud. The dining hall was stressful. I had moved off campus into a single apartment which helped enormously. I joined no clubs. I went home most weekends. I got Bs and a B+. It was the most academically successful semester of my life.

The second leave

The next spring I tried to push too hard. I added a fourth class. I joined a history society. I tried to act like the version of myself I had been freshman year. By March my sleep was off and I was hearing things again. My psychiatrist and I caught the relapse early. I did not need to be hospitalised. I did need to take another leave — this time just for the rest of the spring semester.

I learned then that I could not bargain with the illness. The accommodations existed for a reason. The reduced course load existed for a reason. Trying to be normal on a normal schedule was not strength. It was a way of guaranteeing another setback.

The slower path that worked

From that point on I took three classes per fall semester, three per spring, and one per summer. I no longer compared my pace to anyone else's. I treated my degree as a multi-year project that had its own timing.

I built a sustainable routine. Therapy on Tuesdays. Psychiatrist once a month. A standing dinner with one friend on Thursday nights. Sunday afternoons for groceries and meal prep. I went to bed at the same time every night. I learned that the structure was the medicine. The medication was the medicine too, but the structure was what let the medication work.

What helped me academically

The disability services office

I cannot overstate how much these offices can do, on most US campuses, for students with mental illnesses. They are quiet, confidential, and they do not show up on your transcript. If you are a student with schizophrenia and you are not registered, register. The accommodations are only available if you ask.

Professors who knew

The professors I told privately, in the first week of class, were almost without exception kind and helpful. The ones I never told were sometimes confused by my deadline extensions but never punitive. The single worst experience I had was with one professor who had not been told and felt blindsided when I missed an exam during a hard week. After that I told everyone in advance.

One friend

I had one friend on campus who knew everything. She would text me on Monday mornings and ask if I'd slept. She would walk to class with me on bad days. She did not treat me as fragile. She did not treat me as normal. She treated me as a friend who happened to have a chronic condition. I would not have finished without her.

Walking across the stage

The day I graduated I had been in remission for almost two years. I had a job lined up at a small museum, doing collections work. My parents were in the audience. So was my friend. So was a classmate from the early-intervention program who had finished his own degree the year before and had driven six hours to be there.

I do not feel that I overcame schizophrenia to graduate. I feel that I built a life that included both schizophrenia and a degree. The graduation was one good day in a long stretch of days that I had to design carefully. That is what graduating with schizophrenia looks like for me, and for many of the people I have met since.

If you are a student right now, in the middle of this: take the leaves you need. Use the accommodations that exist. Move at the pace your nervous system can carry. The diploma is the same diploma at 25 as it is at 22. The life you are building underneath it is the part that matters.

This article is for educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a qualified mental health professional. If you or someone you know is in crisis, call or text 988 in the US, or your local emergency number.