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Yesterday I was on a call with a client and in the course of our check-in she brought up an often discussed topic in our sphere. “If only she(her teacher) could see the amount of effort I am putting into this. If I was missing a limb, I would get more compassion.”

 We were working through the 11th hour of finals, after she came back from a medical leave of absence from school. This college student has been crushing it in terms of effort, steadily building stamina since February. On the outside, you can’t see the level of work and time put into catching up to finish 3 incompletes for the semester. Like a duck in water, no one seeks those feet furiously paddling beneath her. At times it felt like she was swimming upstream - efforts didn’t always generate the expected level of progress and success she had planned each day. What I have witnessed is an incredible tenacity and determination to score well and recover from a medical leave of absence, despite the odds.

 Working with a student who is also being treated for depression or anxiety requires an additional layer of vigilance and support. Mental health is mission critical. At times, students struggling with mental health may need to put coaching on the shelf while they recover from recurrences of debilitating depression or anxiety. Others may need more flexibility in the coaching relationship as they manage medical care in tandem with coaching. Above all, they often benefit from seeking therapy to provide treatment and support for these issues. What is more than evident is the feeling of invisibility when my clients with ADHD talk about the misperceptions that accompany academic effort when output doesn't match expected outcomes. Such is often the case when it comes to a learning disability or mental health diagnosis.

 Mental health training is not something that has traditionally been a huge focus for higher education, but it is a growing concern. In 2013, the American Psychological Association referenced the Association for University and College Counseling Center Directors survey reporting that 95% of colleges and universities surveyed reported a growing concern over the mental health of students enrolled, finding that the majority of students seeking counseling suffered from depression(36.4%) or anxiety(41.6%). In 2018 The Journal of Abnormal Psychology published results from a World Health Organization survey indicating that one in 3 college freshmen worldwide reported symptoms consistent with at least one mental health disorder present in the DSM-IV. While counselors are noticing the trends, professors and teachers are often ill-equipped or unable to notice the signs of distress.

 Academic struggles can easily be impacted by mental health challenges. Quite often, a downturn in academic success is perceived as a lack of effort or focus that can easily be course corrected by the student. In the case of ADHD, LD, anxiety, and/or depression - there may be far more happening underneath the hood than meets the eye. Chris Dendy’s ADHD Iceburg is a prime example of what might be happening that is invisible to the rest of the student’s world. What's more, this trend is non-discriminatory. Some of the brightest students can be impacted by these challenges.

 This conversation with my client was a humble reminder of the internal dialogue that is common with anyone struggling with a disability or diagnosis that bears no obvious or outward signs. They are, indeed, invisible to that average eye. Fitting that this conversation occurred in May, which is Mental Health Awareness Month.

 I can’t change the professor’s implied perception that my client procrastinates like a pro. I can’t take away the pain my client experienced in receiving that feedback. What we can do together is unpack the values it challenges and the choices going forward. My client ultimately chose to table the perceptions of her professor, but she is also brave. She plans to sit down with her professor to offer feedback, to talk about the intricacies and challenges she has overcome, the support given that she has greatly appreciated and valued, and to address the struggle that comes with “invisible” disabilities. Her hope? That the next student might be met with more compassion. But first, she has work to do.

 When you see someone struggling, losing steam, or missing an expected milestone, I hope that you might  step back and reframe your observations with compassion. While everyone struggles with things from time to time, mental illness is often chronic, debilitating, or incredibly impactful for an otherwise capable human. Compassion and a willingness to be curious and open to a new understanding is one of the greatest avenues to change and support. Help #breakthestigma for everyone.