Dear James,

I know you never expected your first year of college to go this way. You started off in love with the rush of new friends and possibilities, and you were happier than ever. Within a month, you became inexplicably and severely depressed, though you didn’t have the language to quite make sense of it; these emotions were new to you. You were confused as to why you were now numb to the things that used to make you feel so alive. Others around you could tell you weren’t okay, but they did not have the tools to help you.

On your second visit to the hospital for attempted suicide, a month after the first, you were put on an involuntary hold in the psych ward, where you were diagnosed with depression and anxiety. Your school forced you to withdraw, its assessment corroborated by the wellbeing and counseling centers you’d been required to work with. Because of the method of your attempts, you were told that to have a chance at readmission, you should go through a nine-month intensive outpatient program for substance abuse. Your parents enrolled you right away.

You’re ashamed each time you introduce yourself with “Hi. My name is James, I’m 18, and I’m an alcoholic.” You do this most days of the week at your group therapy sessions and Alcoholics Anonymous meetings. You feel with every fiber of your being that you should be in treatment for your mood disorder — certainly not here, which you misconstrue as penance for reckless vulnerability in times when you should have said nothing.

But your decisions did not lead you to this point. You are in treatment because you are hurting, because of things about yourself you cannot control, even if this feels like the wrong kind of treatment. And yet you feel such anger toward your friends for calling campus emergency medical services, even though they literally saved your life, twice.

You feel anger toward your school for deciding you needed time away to heal. You kept trying to make compromises — anything but being forced into treatment away from your support network of friends and back to a family with whom you silently agreed to pretend nothing was wrong. You feel your life may have been irreparably derailed. I promise these feelings of hurt will not last. These accusations of betrayal will turn into gratitude.

But for now, because you’re so frustrated at losing what you had, you’ve resolved to seize it back. You want to return to your university, even if just to prove everyone wrong. And so, you’ve leaned into treatment. You’re even taking it as an opportunity to learn from the innumerable stories of hardship your peers endured, and the resilience and wisdom they cultivated. Although you’re physically distant from the friends you made, you regularly call to catch up with many of them. Their belief in you carries you forward.

Once readmitted, you’ll encounter others with similar stories and decide to become a mental health advocate through organizations and committees on campus. You will write legislation outlining students’ needs surrounding mental health resources. You will gain mental health literacy and an ability to be honest with yourself and others about your needs, practice self-care, and share with others what you’ve learned. You will renege your contempt for the wellbeing center, appreciating all the good it does and establishing a working relationship with the director. You will join both an educational group and a taskforce on substance abuse and take the brave step to share insights from your time in treatment. You also will struggle, make poor choices, and you will hurt people. Please do the hard work and take responsibility in the moment rather than in retrospect.

After years on medication, you’ll be weaned off it your senior year. But only months later, you’ll experience your first hypomanic episode, feeling untouchable yet perpetually on edge, and your impulsivity and unfiltered speech will hurt people. Your mood will do a one-eighty and fall through the floor, often leaving you on the verge of tears for no reason.

You’ll choose to return to the counseling center for the first time since you were mandated in your first semester, receive medication for bipolar disorder, and construct a wellness toolkit with your therapist. You’ll have your first panic attacks at 22, but you’ll experience them while among friends more affirming and understanding than you could’ve imagined. I owe all of my strength to where my past selves have been. Your adamant pursuit of betterment and fostering of healthy, mutually uplifting relationships will leave you beyond capable. Your hardheadedness is often your greatest strength.

With hope and love,

You at 22