Pretending to be Fine: Mental Health and Forcible Institutionalization

mccoshEditor’s note—The author of this piece has been granted anonymity due to her belief that she is revealing information that she would rather not reveal to CPS. She is a junior and can be reached at

“If it’s not migraines,” she said in April, looking up from her hasty sketch of circles and arrows, “Then you’ll have to leave for a while. We’ll have to send you to a hospital for psychosis, and you’ll have to stay there and take some time off…”

Ten minutes later I was frantically running outside of the class my psychologist had made me late for. I sent a hardly decipherable message to a friend, riddled with bursts of “THEY’RE THREATENING TO MAKE ME LEAVE!” and eventual defeat: “Maybe they’re right. I don’t belong here.” A man watching my spectacle in the hallway started laughing and I immediately stopped and sighed. I snuck into the lecture and lied to the friend next to me. “Oh, I just lost track of time!”

I lied to my other friends too. I smiled and drank a lot of coffee to keep my energy up. To my dismay, though, the severity of my coffee abuse on free coffee day at the Wa revealed that I was even more unstable than usual. I feared them discovering the truth because of the incidents of the previous year, so I spent my time hiding and even refused to sleep in my room for a while. Meanwhile my migraines (or alleged psychosis) worsened to a horrifying state. I Googled what psychiatric hospitals were like. I’d hoped being placed in a room and forced to follow a strict, monitored schedule was not as bad as movies portrayed. Optimism can be a fatal flaw, though.

I went to a neurologist shortly thereafter, and he immediately identified my episodes as the result of complex migraines. Some medication should cure that within two weeks. And if it didn’t? Well, I’d have to put on a cute dress, lots of makeup, and a warm smile to meet my psychologist and weave the lies I should’ve woven in the first place.

If a “normal” person walked into McCosh with intense headaches, temporary paralysis, major shifts in visual brightness and saturation, and a feeling of being “out of it”, not one doctor’s first reaction would be, “If this continues you’ll have to leave Princeton and go to a psychiatric hospital!” But for me it was different. CPS (Counseling and Psychological Services) would likely deem me a danger to myself and therefore insist that I take time off from my studies.

One of the first things I did after arriving to campus in 2013 was to call CPS. “I think I have type II bipolar disorder,” I squeaked to the receptionist, my voice hesitant to pronounce the words “bipolar disorder”. I’d never spoken them aloud before, but I figured I had to finally face this nightmare. Perhaps they could help me. This wasn’t high school anymore; a whisper about insomnia wouldn’t assemble a team of teachers secretly following and reporting on me. Right?

A few visits to CPS throughout freshman fall both affirmed my self-diagnosis and offered a prognosis. “You’re unlike anyone I’ve ever met before,” my psychologist announced, “You’re very self-aware and in control. This gives you an excellent prognosis. You should do fine here, improve a lot, and live well—as long as you never reach psychosis, of course.”

What I didn’t realize, however, was that I was being watched despite this praise, especially after I admitted to CPS that I was depressed. I learned this during fall midterms when I broke down crying the night before my math exam. I soon had the RCA-on-call knocking on my door, and when I refused to answer because I was too depressed to talk, two public safety officers were soon threatening to enter. Terrified, I quickly wiped away the tears, smoothed out my dress, and answered the door with feigned composure.

“We got a call that you’re suicidal.”

“Huh?” I answered. They soon scoured my room, looking for even the smallest sign of a suicide attempt. They questioned me relentlessly, but I talked happily through all of it. “Someone heard you say something about wanting to kill yourself. What did you say?” “What? I didn’t say anything like that. I cried because I’m not ready for my math exam tomorrow. But I’d never say anything like that.” “But someone heard you.” “I have no idea what they heard to make them think that.”

That was a lie. I knew exactly what I’d said: I’d sobbed that I needed to get away from my room immediately because my depression was worsening rapidly. But right as I was about to leave my room, the RCA got to me, and I was trapped into fearful silence. There was no way I could properly explain this to the officers; I knew a pair of scissors would’ve been enough to validate the concern, so there was no way I’d admit to depression.

“What are these medications for?” one officer asked as they examined each of my toiletries. “Bipolar II disorder.” “Ah,” he said, as if that explained everything.

At the end of the interrogation, they called the office and reported that I was perfectly pleasant and there were no signs that I was suicidal. They had me call a couple doctors at CPS and tell them I was fine. Reports were filled. They kept me for hours, and by the time they left it was very late and my plan for desperate cramming was ruined. I woke up for my 9 AM exam more disheartened than I’d been when I cried. After my exam, I had to report to my college deans, check in with CPS again, and go through an evaluation. And my psychologist and psychiatrist grilled me at my next appointments, of course.

Paranoia gnawed on me. One person heard me cry, and suddenly everyone was hovering over me with accusations. I was presumed guilty, and when proven innocent, I had to undo the mess they’d created—and in an animated, overly-innocent manner as if I were perfectly happy and perfectly okay with what had happened.

During spring finals, I spent eight hours studying and returned to my room skipping. I’d been depressed for a while, but I’d gotten myself to study—and a lot! However, this joy shattered the moment I reached my room. On the door were two notes: one from a friend and one from public safety. The former expressed concern because I wasn’t in my room and admitted to having called public safety, and the latter said to call them immediately.

I opened the door to my room and found it’d been raided. Everything was scattered and moved around. What did P-Safe think I was hiding in the stack of papers on my desk? I knew very well what the officers had been looking for: evidence of suicidal behavior. I picked up my phone and dialed the number on the note.

They didn’t believe me when I said that been studying for eight hours. They found my whole story suspicious and kept picking at details as if they were inconsistencies. Why was it anyone’s business what I’d done that day, where I’d done it, or how long I’d done it, if it didn’t harm anyone? Why was it different for me? Why did leaving my room to study lead to a thorough investigation of my room and a heavy implicit accusation of having intended to hurt myself?

Again, they eventually conceded, and I had to call and meet with everyone all over again. However, this time made things even more interesting by telling me my parents had been called. Their little girl, who refused to step on spiders because it made her too sad to think they’d have to die, was dangerous.

I learned to watch my every step after that. I’d almost gotten through sophomore year without an incident, until the migraines hit.

I told my psychiatrist what my psychologist had said, and he was bewildered. “You have migraines, not psychosis! They won’t kick you out.”

I looked sadly at my feet, “But that’s what my psychologist said.” “I won’t let them,” he responded at that point I hardly cared anymore; it seemed no matter what I did, I was always seen as a danger that had to be chased down. I’d resigned myself to the fact that I was powerless. I had no control over my fate.

On the thirteenth day of the medication, the migraines disappeared. My psychiatrist and psychologist were thrilled. I, however, was not. Finally being free of the painful, delusional headaches, I fully realized how trapped I was.

My psychiatrist said the University couldn’t make me leave because it was migraines – but what if it hadn’t been? Or what if that specific medication hadn’t worked? Or what if it had taken longer than two weeks to work? Or what if the migraines came back? Would they automatically dismiss “migraines” as a misdiagnosis and go back to the circles and arrows labeled Trauma and Psychosis?

These are questions I must consider now that I’m starting my junior year re-diagnosed with migraines and very depressed—a repercussion from the incident last spring that has yet to dissipate. I had only offhandedly mentioned having headaches one day, and that escalated into the migraine/psychosis disaster. What will I offhandedly say next that will get me put into a room against my will, isolating me from everyone I love and messing up my future? What inevitable episode of depression will be the next to get the authorities chasing me down with interviews, tests, and room invasions? What if one day I don’t want to act cute or happen to have a butter knife on my desk or just want to sit by Carnegie Lake by myself? Why is any of that wrong? Why must I act and explain myself? I feel sad, paranoid, and isolated because of something beyond my control; how does that give anyone the right to make me even more powerless?

Fear of CPS ordering my involuntary commitment to a psychiatric hospital forces me into silence. Silence that follows me everywhere, silence that keeps me hostage, silence that demands that I lie to my friends and doctors over and over again. Lies that keep a distance between me and those I care about, lies that eat away at me, lies that force me to flee when I can’t say them with a smile anymore. Night after sleepless night I awake in terror from the same nightmares: friends, strangers, public safety, and police officers chasing me through hallways until I eventually fall to floor in helpless tears, admitting defeat. If you want to take me away, fine, I can’t take this act anymore. I awake in fear that I’ve let this happen.

Such paranoia, fear, and separation would take a heavy toll on anyone. Moreover, having those whom you’re supposed to go to for help hold the power to uproot your life and throw you into a new environment with limited rights without your consent dissuades students from seeking psychological help—the very thing the system tries to encourage.

This is, of course, not a Princeton-specific phenomenon. All fifty states have laws concerning emergency hospitalization, inpatient civil commitment, which requires being held in a hospital until a psychiatrist orders release, and outpatient civil commitment, which requires continual treatment at a hospital without being kept overnight. Although each state’s criteria are different, the fact remains that any mentally ill individuals who are considered “at risk” of self-harm by a healthcare professional must be evaluated by a psychiatrist and can be forced to see a judge, who can order either strict adherence to a treatment schedule or indefinite institution in a psychiatric facility. Whatever the outcome, the individuals have no say in it. They no longer have control over their own lives and are at the mercy of a judge who is supposed to “know better”. And while such seizure of rights can be justified for criminals, we are not criminals. I live amongst the other students without the slightest threat to them. On the contrary, if you asked someone to describe me, the most common adjectives listed would be “warm”, “caring”, “silly”, and “sweet”. This remains true whether you ask someone aware or unaware of my illness. And even if I weren’t a warm personso what? We do not force hospitalization for arrogance or fickleness or disorganization or grumpiness or aloofness. That would be absurd.

I go to classes, struggle through math problems late into the night with my problem set groups, write essays discussing the merits of moral philosophies, dance and sing in the rain with my friends, get heavily involved in community service, have fun at events at my eating club, and care deeply about those around me. I am no threat to society, and I refuse to be treated as such. And this refusal has the unfortunate consequence of requiring a set of lies and omissions that both severely worsen my illness and preclude the extent of treatment that could improve my life. Because of regulations intended to “help”, I must be a quiet, good little girl to retain the right to personal autonomy. And perhaps I will reach a point where my depression would benefit from such intense treatment as is found in psychiatric hospitals.Only I can make that decision. Until this point, I need to remain at Princeton.

Forcible hospitalization of adults who are no threat to others is unique to mental illness. Those with cancer cannot be required to undergo chemotherapy, and those with broken limbs cannot be ordered to have surgery. But why can I not decide whether I want to have my freedom taken away and be placed in an environment that quite frankly sounds like my personal hell? By refusing to realize that, despite my depression, I am an intelligent, loving, and capable adult who can determine what is in my best medical interest, those in authority further torture those with tortured minds.

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