I have taught mentally ill college students, given advice to mentally ill college students, and been one myself. Based on those experiences, here is a guide to not tanking your exam / your class / your degree while you’re having a meltdown. This is probably most applicable to college students at universities in the United States, but there’s generally applicable stuff in here too.

None of this is easy to do when things get rough, but many of these suggestions are minor time commitments that can make a huge difference.

1. Decide on your major goal

If you are clear on what you want, it will be easier to decide what to do while things are going south. If your major goal is to get a good education, get a good job, or go to graduate school, your top priority should be using relevant resources (including those related to mental illness). If your major goal is to avoid treating your mental illness (or using accommodations, extensions etc), evaluate what you are willing to sacrifice (grades, time, extracurricular activities, your job, future salary, etc) and plan what you will sacrifice when.

See the bottom of this entry for my opinionated take on this.

2. Know your available resources

If your school has a students with disabilities service, a counseling center, or a health services, and you are not already using them, look them up and find out what they offer.

3. Know your course policies

Take time out of your day to go over your syllabuses with a fine-tooth comb. You need to know your teachers’ policies about emergencies, grade appeals, accommodations, and extensions/make-ups. Plan to make use of these where they can help you.

4. Stay in touch

Many teachers will make arrangements for minor life emergencies if (and only if) you contact them before the assignment due date / the exam date. One of the worst things you can do in a course or a job is to simply stop showing up. You do not have to give them all the details. Some things you might consider asking for extensions/accommodations for include: medical emergency; inability to concentrate due to medication side effects; recently diagnosed and have started accommodations process; etc.

If you have a major emergency – for example, being hospitalized for a week without forewarning – teachers are generally more lenient.

If you go to talk to a teacher about an extension/accommodation/etc and they’re an jerk about it, it doesn’t mean you did something wrong. Some teachers are just jerks. See section on escalation below.

5. Plan ahead

Sometimes talking to your teacher is sufficient. Sometimes they’ll want a doctor’s note, so make sure to get one. Sometimes they’ll want documentation from the disabilities office (especially for ADD, since jerks who do not have ADD sometimes try to abuse the system).

With accommodations, teachers often have a policy of “the first X weeks of the semester” or “X days prior to the exam”. The actual policy may be more lenient – for example at my university we’re required to give accommodations up to the exam itself. But it is very difficult to accommodate people on the spot if they need resources (like an extra classroom) that are not easily available.

6. Know your school policies

Like drop/withdrawal deadlines and tuition refunds for different dates of drop/withdrawal, and any policies for medical leave. Put those deadlines in your calendar. Nobody wants to drop or withdraw from a course or a semester, but should it come down to it, failing grades on your transcript look way worse than a withdrawal. A failing grade communicates “I screwed up and didn’t handle it in time” (even, unfortunately, if that’s not the case); a withdrawal says “things got really bad and I’ll need to give you a good excuse as to why, but I recognized what was going on and handled it as well as I could”. Don’t be too proud to take a needed break to get your shit together.

7. Track your grades

If you don’t know how much trouble you’re in, you won’t know what steps you need to take next. If the grade calculations are confusing, go to office hours and ask for help. If you can’t make office hours, contact your teacher to see if you can set up an appointment.

8. Escalate if necessary – and do so politely

For example, if you ask a graduate student teacher for an extension for medical reasons, and you don’t have a doctor’s note, and he/she turns you down, you can go to the professor supervising him/her. The professor may back them up; he/she is not necessarily obligated to reverse a decision. Keep in mind that the professor and graduate students are usually in communication over issues that come up, and will tend to support each other, so being polite to all involved will help your case.

If a teacher gives you grief over accommodations, document it and go to whoever manages accommodations at your school.

If a teacher is being an jerk to you in general, and your school has an ombudsman, they may be able to help you, or at least give you advice.

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My advice for people unsure of whether they should seek treatment/accommodations/extensions/etc:

1. Employers want someone who performs well, not someone who sacrifices good performance in order to not treat medical problems

You are preparing for a job or an advanced degree. A good grade says that you are capable of handling any problems that might make you a poorer employee/grad student; a bad grade says that you did not (or were not able to) handle your problems. A withdrawal looks a lot better than an F.

Employers and schools want to hire someone who values performance over pride. They are not interested in whether you pulled off D’s because you “valued overcoming your ADD through willpower”; they are interested in hiring people who will do what they need to perform well. (And it’s often a bad idea to tell them about any mental illnesses you have, anyway.)

2. You are an investment and you are expected to make use of available resources in order to pay the investment off

You get help every time a teacher chooses a textbook for you or gives a lecture, and every time an administrator does anything that makes your life easier. You or someone is giving the school money on your behalf, but that money *is not enough* to pay for all the services you receive.

So who’s paying for the rest of it? The government (sometimes), grant funders (at research universities), and alumni donations (at all schools). Why? Because you’re an investment. They’re investing in you because they think you will give them a good return, by learning as much as you can and then going and doing good stuff with it after you graduate.

Counseling and health services, and disability services, if your school has them, are getting funded this way too. They’re part of the investment and part of what you pay for, both with money and with your blood, sweat, and tears. You’re not accepting free help. You’re using available resources intended for you to use when they will be helpful.

If you’re refusing or putting off going to counseling services or health services or the students with disabilities office, or refusing to ask for / accept extensions or other accommodations, you’re not doing anyone any favors by making yourself a poorer investment for all the people who pay for your available resources, and you’re not doing anyone any favors by giving yourself a poorer education.