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How To Be Mentally Healthy Despite Being a Young Adult-- PHAA commencement address, Western PA Ceremony, June 24, 2010
Dr. Joseph Strayhorn, 8/23/2010

Dr. Joseph Strayhorn, a wonderful homeschooling father from the greater Pittsburgh region, was our Western PA PHAA Graduation Ceremony commencement speaker. Unfortunately, the sound system at the lovely Carnegie Music Hall in Homestead PA was not working effectively that evening, and I know that many of you attending missed Joe's wise words-- and we also felt his important message would be helpful to a broader audience, especially in this season of homeschool grads heading off to college or the work world. Joe is a psychiatrist who is very interested in mental health research and especially focused on discovering ways to help young people learn about gaining sound psychological skills. He has also developed an innovative daily phone tutoring program to help at risk children gain both academic skills and new tools to tackle life's challenges in positive ways. His daughter Jillian graduated through PHAA from homeschooling this year, and will begin her freshman year at Cornell University, and his daughter Emily will continue on with high school homeschooling in the family's new home in Ithaca NY. I've had the honor of serving as their homeschooling evaluator during their many years in Pennsylvania, and wish them all the best in their new home.-- Susan Richman, PA Homeschoolers Editor

            Congratulations to you graduates, and congratulations to your parent-teachers. I’m greatly honored to be able to address you on this happy occasion. 

            Many of you are headed now to college; all of you are headed to young adulthood. The stage of life you’re entering can be a thrilling and very happy time. But like all other stages of life, it has its threats to mental health. This address is entitled how to be mentally healthy despite being a young adult.

According to a recent (American College Health Association) survey, 43% of college students reported that at some time in the academic year they had felt so depressed that it was difficult to function. 10% had seriously considered suicide! About 2%, one out of fifty, had actually attempted suicide! Suicide is the second most frequent cause of death among college students, second only to accidents.

According to another survey by the National Institute on Alcohol Abuse and Alcoholism, 31% of college students met criteria for alcohol abuse. Moreover, there were about 1.3 million yearly alcohol-related injuries or assaults among college students, out of a denominator of about 17 million college students. Alcohol related accidental deaths are even more prevalent among college students than are suicides. 

For  those young adults who do not go to college, the suicide rates are even higher than for those attending college. The chance that serious mental health issues will affect one of your peers, if they don’t affect you yourself, is very high.

For most young adults, there are four challenges to mental health that I have time to talk about. These are: disrupted sleep rhythms, an alcohol promoting culture, difficult work environments; and the disruption of social support systems. Let’s discuss these one by one. In the interests of time, I’m only going to be mentioning the conclusions, and not the research that backs them up, because we don’t want me putting on an all night workshop. 

With respect to sleep: it’s important to know that sleep is, like dancing, about rhythm; it’s about doing something not just in enough quantity, but at regular intervals.

Sleep quantity is very important: the ideal quantity for young adults is probably closer to 9 hours than to 8. Mental performance, learning, memory, mood, and physical coordination are all hindered by sleep deficits. If one wanted to do something magical to improve the mental health of young adults, high on the priority list would be to give them two or even three more hours of sleep a night than they typically average.

Sleep rhythms are what let us go to sleep when it’s time to, and wake up feeling refreshed when it’s time. But how do we know when it’s time? There is a timekeeper in our brains, the suprachiasmatic nucleus, that’s part of the hypothalamus. The important message is: These clocks get set to a certain rhythm, and they can’t instantly be reset. Many smart young adults never realize this fact. They get used to going to sleep at 2 am and sleeping till 11 am. Then there comes a test or job interview scheduled for 8 am and they try to go to sleep at 1030 pm. When they find themselves lying in bed tossing and turning till 2 am, they think they have insomnia. What they have is a perfectly well functioning sleep rhythm, that unfortunately is set too late.

            If you want to reset your clock, how do you do it? There are four major clock-setters: bright light, eating, exercise, and of course being out of bed. If you do all of these things early in the morning, your clock tends to get set earlier. If you do them late at night, your clock gets set later. If you are repeatedly trying to move your internal clock first one way and then another, you tend to feel lousy, and you’re more likely to get depressed. We know this from studies of people who do shift work. If anyone has a genetic tendency toward bipolar disorder or migraines, it is even more important to maintain a regular bedtime and waking time.  Because the circadian rhythms of young adults tend to drift later and later, using those four clock-setters in the morning is usually necessary just to keep the circadian rhythm where it is.

            Especially for adolescents and young adults, it appears to be much easier to set the clock later than earlier. Staying up late and sleeping in on two week end nights may set the clock forward enough that attempting to get up early and go to bed early on the other 5 nights may not be successful.

            If you want to pursue the early to bed, early to rise strategy in college, it’s good to be prepared for withstanding strong social pressure to the contrary. Perhaps you can use as a mantra a revised version of Ralph Waldo Emerson’s line from his essay Self Reliance, “To be a young adult with healthy sleep rhythms is to be a nonconformist.”  I hope that as homeschoolers, nonconformity may come a bit more easily: we are used to being a bit different.

            Before we leave the topic of sleep, exercise is a major aid to sleep, and exercise in itself seems to be an antidepressant. In fact one major study at Duke University randomly assigned middle aged depressed men to regular aerobic exercise versus Zoloft, an antidepressant drug. In the short run the two were about equal; on long term follow-up, exercise won.

            The second major challenge is booze. In most young adult social circles, the word “party” is more or less synonymous with “alcohol intoxication.” Most colleges provide enormous social pressure not just toward alcohol consumption, but toward alcohol abuse.

But, as Hamlet said, it’s a custom more honored in the breach than the observance. When I consulted at Allegheny General Hospital, it seemed that hardly a day went by without some young adult being admitted because of some fairly horrible alcohol-related accident.  Seeing smashed faces and the results of damaged brains there made an impression on me that statistics can not sufficiently make. But when you look at statistics, you find  fractions in the general neighborhood of ½ coming up a lot: a third to a half or more of murders, fatal gun accidents, drownings, and fatal motor vehicle accidents, approximately, involve alcohol. 

What fraction of depressive episodes are attributable to alcohol? It’s hard to say. When one uses alcohol a lot, the times in between drinking episodes are spent in various stages of the withdrawal state. The withdrawal state can feel pretty lousy, and can be confused with depression arising from other causes. 

Of course, the most reliable preventive for alcohol problems is simply not to drink at all. For males, the chance of becoming an alcoholic once one becomes a social drinker is approximately one in six or seven, not very far away from your chances if you should play Russian Roulette. For females the chances are about half that. But for alcoholism, most people feel, the chances that other people will become alcoholic are this and that; the chances that I would ever become alcoholic are zero.

A third protective factor for mental health is meaningful work, and being reinforced or rewarded for the work you do. College students of course do a great deal of work, but on the average they get more negative feedback on the quality of that work than they have ever received in their lives. Work that got A’s in high school routinely comes back with C’s in college. Many students have been socialized to feel that a C represents a very humiliating failure. Furthermore, the work done in college is mostly of the sort that immediately and directly benefits no one, although of course the eventual benefits can be great.  Sometimes tests and papers are even shredded so as to permit reuse of assignments the following year. (This practice is a shocking contrast to the PA homeschooling situation, where it’s just possible that when we parents are 90 years old, we just might be spending our days with a bookshelf full of portfolios next to our rocking chairs, looking over them saying things like “Oh look dear, here’s where our Smedley first learned about the law of cosines!”)

The problem of non-meaningful work is not limited to college. Young adults entering the work force often find out that what they’d like to do and what people are willing to pay for are different. Bosses who provide criticism but no reinforcement are unfortunately common.

Three pieces of advice regarding work are helpful: the first is encapsulated in the adage, don’t bite off more than you can chew. You want to set reasonable goals, and take on an amount of work that is in keeping with accurate self-knowledge. It is obviously much better to be highly successful at four courses than to be unsuccessful at five; the trick is to think of this before getting in over your head. The second piece of wisdom is to become expert at time management: to take those reasonable goals and figure out how best to allocate  time to them, getting into regular daily routines of work. Time management means consciously deciding what to do when. College students are notorious for putting off work until the eleventh hour, and then pulling all-nighters to finish the work on time. This isn’t good for mental health or for exam performance. Psychologists have known, at least since my undergraduate days in the late 60’s, that spaced practice is better than massed practice. In other words, if you rehearse what you need to know in a course a little bit every day, you can consolidate it into long-term memory much more efficiently than if you cram the learning into the same number of hours all massed together. If you take advantage of this principle, you’ll both maximize the efficiency of memory and avoid lots of stress.

            Here’s the third piece of advice about work: try to mix the evaluation-oriented work of papers and tests, with some sort of work that directly makes someone better off. Tutoring younger kids is an example of this second type. Most people appear to need to see that our efforts actually make an impact on someone else’s life. I think that lots of college students feel a sort of emptiness that goes away when they get the opportunity to actually help someone in a big way. 

The fourth protective factor for mental health is a good social support system: close, friendly ties with family and/or friends. Most college students are plucked away from their entire social support systems and surrounded by strangers. Roommates can be a source of support, but they are also very frequently sources of conflict and rejection. The geographical dispersion from friends that begins college also marks the end of college. As a result, relationships are temporary. Romantic unions are also often temporary, even though the rootlessness of college students makes them yearn for someone on whom they can depend. Plus, if you don’t go boozing and staying up late with other students, and if you don’t enjoy the camaraderie from the brinksmanship of  procrastinated work, you establish yourself as unusual.

            What to do? It’s helpful that with today’s technology it is easier than ever before to hang onto the support system you already have, despite where you are geographically.  It’s usually smart, not wimpy, to stay emotionally connected to family.

With respect to new friends, people who have their act together, who are joyous and pleasant and cheerful in their tones of voice, will almost always find friends eventually. The music of approval and enthusiasm in tones of voice is probably even more important than the lyrics. By that I mean: if someone says, that’s interesting, the lyrics are of approval, but the music isn’t. If the person says, that’s interesting, the music is of small to moderate approval. And if the person says, that’s interesting, the music is of large approval.

Friends also come to those who are good listeners for others – who can ask others about their lives, ask follow up questions, check out to make sure they understand, give positive feedback occasionally, and importantly, stop talking so as to give the other person a turn. People also tend to seek out people who welcome new relationships, but are not desperate for them and not overly dependent.

While we’re on the subject of pleasant and respectful communication, a very important person to speak respectfully to is yourself. Some people who would never think of calling other people idiots or stupid or worthless don’t have qualms about denigrating themselves with such terms. Talking respectfully to yourself is one of the most important antidepressant techniques.

            We’re still on social support. When I’ve been called regarding a suicide attempt, the chances are high that the main issue is the breakup of a romantic relationship. For the average young adult, the chance of being either the dumper or dumpee in a relationship at least once is high. Both of these have high emotional costs. And need I say that membership in the  the homeschooling community, or any other community, fails to confer immunity to problems with the ending of relationships.

The popular culture of today, as well as yesterday, is full of works that glorify not being able to live without someone’s love. Some that lodged in my brain are  (speaker sings) “I couldn’t live without your love,” and “Can’t live if living is without you,” and “It’s the end of the world, it ended when you said goodbye.” Parenthetically: If you remember when these came out, you’re invited to my next speech on how to be mentally healthy despite being an OLD adult. Even a few years earlier than my youth were Romeo and Juliet. And in what’s hot today, I understand that the Vampire and Werewolf Mental Health associations also are reporting the same issues.

What doesn’t sell many pop songs is that you can live happily without the love of any one person, even though you might strongly prefer to live with said love. You will get over it, particularly if you believe you can. Getting rejected by one person doesn’t change you from a kind, polite, productive, and honest human being, to a worthless one.

            So I’ve advised a bunch of things your grandmother might have already recommended: regular sleep rhythms, regular exercise, avoidance of booze, good work habits, doing work that helps someone, using respectful talk in your internal dialogues with yourself, cultivating good social support, not only among people your age, and not putting all your eggs in the basket of one person. If these things have seemed totally obvious to you, that’s great, and you probably have a wise grandmother. But to many of your peers, mark my words, these ideas will prove not to be obvious enough.  

Looking out for yourself in these ways is not selfish. In fact we have a duty to look out for ourselves. Along with all its beauty and wonder and happiness, this world is plagued with problems, and it needs you to help solve them. I worked some on an alternative speech entitled “What Have You Done Today to Reduce Cruelty?”  But this speech took priority, because to help make the world a better place, you first need to keep yourself in good working condition. 

            I’ve definitely left out more than I’ve said. But because I have, I’m now able to say to you two welcomed words, very uplifting words, the two most important words for any commencement speaker:    

            The End 


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