Falling Silent: Harvard’s Quiet Mental Health Pandemic

Coming to college, coping with eating concerns and body image issues was harder than it was in high school, but spending a long period at home after having already been at college for nearly two years was even more difficult.

For most of high school and my first year at Harvard, I had convinced myself that I was fully recovered from the eating disorder I had initially been diagnosed with as an eight-year-old. I believed mental illness was a relic of my pre-adolescence. Through hard work and support, I had escaped its grasps. However, this enticing narrative, this perfectionist’s view of recovery, has only prevented me from being honest with myself about my own emotions and behaviors, ensnaring me in a silence that COVID-19 has exacerbated.

Eating disorders are extremely arduous— and common under normal circumstances. A remote lifestyle will only increase their ubiquity.

In recent months, there has been a swath of research published about the detrimental “second pandemic,” that the COVID-19 virus is carrying with it: a pandemic of mental health challenges. A survey by the Centers for Disease Control and Prevention revealed that more than 40 percent of U.S. adults reported struggling with mental health or substance use in June 2020, with symptoms disproportionately impacting young adults.

Typically, 10 to 20 percent of college women and 4 to 10 percent of college men are expected to develop an eating disorder. The risk of developing symptoms doubles for transgender students, compared to their cisgender female peers. Given the relationship between stress and eating disorders, on top of the unique conditions generated by new pandemic lifestyles, it's hard to imagine a scenario in which eating disorder rates wouldn’t be on the rise.

During these turbulent times, there’s an ever more pressing need to foster greater awareness about eating concerns and related issues. I’m not alone — and you’re not either. When we talk candidly about what we’re going through, we can disentangle ourselves from our shared silence, becoming mutually empowered to access the supports we deserve.

“Eating disorders often arise as a person's best attempt to cope with painful, difficult feelings: anxiety, relationship difficulties, loneliness, sadness. During the pandemic we've all experienced more of these difficulties, so students who've coped through eating or not eating in the past may have noticed an increase in disordered eating behaviors during this time of disruption and isolation,” Dr. Barbara Lewis, Chief of Harvard’s Counseling and Mental Health Services wrote in an email.

“Seeing ourselves on camera constantly as we use video platforms for daily life can also cause dissatisfaction with appearance/body image,” she added.

Never being able to escape one’s own image, alongside a heightened awareness of one’s own comportments, can be distressing for those of us already particularly conscious of how (much) we occupy space and how we look to others. Indeed, some doctors have observed that often the longer their patients spend looking at themselves on Zoom the more distorted their self-image becomes — affecting their ability to focus.

Kathryn S. “Kat” Boit ’22, a former Student Mental Health Liaison (now known as Active Minds at Harvard), seeks some semblance of privacy by speaking to me from her closet. Against a background of button-up shirts, she assures me that everything she is saying can undoubtedly be heard by her roommates. While she’s taking the semester off for mental health reasons, she counts herself as lucky to be living with friends who are aware and supportive of her borderline personality disorder and post-traumatic stress disorder diagnoses.

One of the biggest obstacles students face to seeking help during this virtual semester, Boit said, is a lack of the privacy needed to comfortably have conversations with a therapist, away from one’s family or roommates.

Another is a discontinuity in care. As of June, Boit’s Massachusetts-based psychiatrist was no longer able to see her: Kat recently moved to New York, and her psychiatrist doesn’t have a license to treat or prescribe there. One month ago, about to run out of medication, Boit had to email her psychiatrist and drive to a pharmacy in Massachusetts to pick up her prescription.

To combat some of these challenges, Margaret Schrier, Chief Clinical Dietician at Harvard University Health Services, highlighted the plethora of varied resources available to students, including Monday-Friday online appointments, forthcoming nutrition workshops, access to the Multi-Service Eating Disorders Association’s support groups, and Instagram pages, such as @covid19eatingsupport. CAMHS also sees students with eating concerns through triage assessments, individual therapy, workshops, and by working as collaborative treatment teams both inside and outside of HUHS.

There are inevitable limitations to delivering mental health care amid COVID-19. However, the University is clearly committed to connecting us with the support we need.

There’s a lot we can do collectively to fix the culture of competition and silence that fosters unhealthy eating in our community as well. Upon arriving at Harvard, Chloé L.M. Georgeaux-Healy ’22 experienced shock at how divisive and competitive food and exercise can be here, calling it a “really uncomfortable, dicey topic.” And yet it has often felt to her like there is not a single woman in her life who has not experienced issues with eating or body image.

Fortunately, we have the power to change these patterns and break silences that have become ritualized. “There is a silence, but the silence doesn't exist because there are not words to fill it. It just exists because there's fear and trepidation of what it means to be vulnerable with others. And I don't want to discount that. I think that is very real,” Marlena E. Skrabak ’22, a Crimson Design editor, said.

Skrabak and Georgeaux-Healy co-direct Harvard Eating Concerns Hotline and Outreach.

Boit’s message is even more straightforward: “Reach out to your friends. It makes such a difference to people to just shoot them a text and say, ‘Hey, what are you doing on Saturday? Let's call.’” It’s small moments and conversations with others who are struggling that make Boit realize, if we were all just more open about our mental health, maybe we wouldn’t feel so alone.

True to Boit’s wisdom, every Monday, no matter how busy, my best friend from home and I have a 15-minute call to check in regarding how we’re both feeling about the week ahead. Taking a break from work, I walk around my Cambridge neighborhood. This brief moment of connection and reciprocal care revitalizes me, reminding me that I’m surrounded by support.

The eating disorder recovery process is about improving relationships — relationships to food and to your body. And we all know relationships require constant work.

I have tough days. We all do. Take it moment by moment. Let’s lift each other up and out of the silence.

Aysha L.J. Emmerson ’22, a Crimson Editorial editor, is a special concentrator in Resilience Studies in Kirkland House. Her column appears on alternate Mondays.