Between the networking, the interviewing, the negotiating, and the onboarding, moving on or up can feel like a job of its own.

When Anna moved to South Bend, Indiana, to attend Notre Dame University as an engineering student in 2012, the 18-year-old freshman was assigned to Farley Hall, an all-female dormitory where residents are unofficially known as “Farley’s angels.” Like all the residences at the Catholic college, it housed a chapel where students could attend Sunday services.

“Certain dorms were known for having, like, hot chocolate after mass, or pasta, or pizza,” she says. “We were known for bread sticks.”

Dressed in loose layers and a hoodie, Anna (her name has been changed to protect her identity) has met me at a public library in a leafy, upscale New York suburb, near her home. She’s prepared to speak candidly, but says she has mixed feelings about discussing the reason she left not only Farley—which, in keeping with Notre Dame tradition, would have been her home for four years—but also the college she had been so thrilled to enter.

Five years earlier, she was still an ambitious overachiever, a fresh graduate of a high school for teens gifted in math and science. In her first year at college, she tells me, she was raped by a fellow student at an off-campus party. She attempted to continue studying toward her degree, but by the subsequent fall, she was deep in the throes of an eating disorder that threatened to become deadly. In time, she began self-harming (cutting) and was put on suicide watch.

Now, part of her wants people to know exactly how much lasting damage sexual assault can inflict, and how feebly schools tend to work to prevent violence or to support victims in the years following an assault. At the same time, she says candidly, her depression has been so all-consuming that she is not sure anything matters, or that her story is “so bad.”

She’s aware that it’s unusual to be that blunt about her state of mind, but she also doesn’t believe she can recover without being direct and open about her experience—and she wants to recover. She just doesn’t have the energy to be ambitious like the activists she’s become aware of. “I literally just do the bare minimum to survive, and I can’t wait to go to bed,” she says.

Anna has found some sense of solidarity in the #MeToo movement, which has brought woefully belated attention to the scourge of sexual assault and harassment in every kind of workplace, from Hollywood film sets and storied publishing houses to hotels, factories, and farms. At last, the media is examining what hidden aggression and sexual crimes have done to women’s careers and financial livelihood, recognizing that brilliant women have been sidelined, or even forced to walk away from their calling, to stay safe or because sexual violence has left them traumatized. But, as Anna notes, everything about #MeToo is “the workplace, the workplace, the workplace.”

“What about the kids before they go into the workplace?” she asks. “Their minds are polluted already.”

Indeed, few news reports have reached back to connect #MeToo to the same brand of violence in college and other educational settings, the places where young people begin to pursue a professional calling in earnest.

Although the numbers have been disputed, several national and international surveys, including one published in 2015 by the Association of American Universities, have found that approximately 1 in 5 women are sexually assaulted during their college experience. If nearly 10 million women in the United States attended a two- or four-year college in 2017, as estimated, that means about 2 million of them have experienced or will be the target of a form of sexual violence as they work toward a degree.

“What are we doing in this country?”asks Kerry Kennedy, president of the Robert F. Kennedy Human Rights advocacy organization and daughter of the late US senator.

“I have three daughters,” Kennedy said in May at the Milken Global Conference in Los Angeles. “If [someone] said to me, ‘If you send your daughter into that room over there, there’s a one in five chance she’s going to be sexually assaulted,’ would you do that?’ No,” she said, adding, “That’s going to college.”

It’s still unknown how many women typically drop out of school, delay their education, or redirect their life away from a particular career because of sexual violence, but women’s groups that work with survivors know anecdotally that Anna’s story is common. “There’s so much talk about, ‘If an offender gets expelled, it will ruin their life,’” says Diane Rosenfeld, a lawyer and director of the Gender Violence Program at Harvard Law School. But what about the victim? Not protecting that person can equate to what she calls “constructive expulsion.”

It’s also a clear violation of Title IX, a civil rights law that prohibits blocking someone’s access to education, and ability to benefit from that education, based on gender. (The law applies to any educational program receiving Federal financial assistance, but makes exceptions for historically single-sex schools.)

Now that we’re mourning what could have been important contributions to the world if not for the assailants lurking in the workplace and snuffing out their victims’ potential, we need to give as much thought to the would-be doctors, teachers, biologists, or politicians who have had their aspirations crushed or stalled before they’ve had a chance to apply for their first internship.

***

Anna, now 24, tells me she can hardly remember what it felt like to be as driven as she was at her nerdy high school or in that first semester at Notre Dame, when she set herself up with a volunteer job as a lab assistant, on top of her full course load. She imagined one day working in medicine, possibly designing medical devices such as prosthetic limbs, or going to medical school and becoming a doctor.

She was assaulted in early 2013, just before spring classes began. Out with friends on a Saturday night, trying to dull the pain of a recent breakup, she and other women from Farley Hall found their way to an off-campus party at a house shared by athletes on one of the school’s teams. Everyone was drinking, including Anna. As the night progressed, she found herself dancing alone with a tall, attractive upperclassman in the basement. She agreed to walk upstairs with him, past the crowd on the main floor of the house to an upper bedroom. She remembers some of his friends from the sports team cheering them on, whistling as they passed.

He led Anna into an empty bedroom where they began to mess around. “We were hooking up, and my shirt was off, but I still had my bra on,” she says. “His shirt was off, and he had his pants on. We were on the bed and he started to pull down my skirt, and I let it go a little, but then when he wanted more than that, I realized I wasn’t that into it.”

She began to feel anxious that she’d miss a taxi ride home with the friends she’d arrived with. At Notre Dame, “parietals,” or regulations governing opposite-sex guests in dorms, ban co-mingling before 9 am and after midnight on weekdays, and after 2 am on Fridays and Saturdays. Local taxis only tend to run long enough to ferry students around before that curfew, then they vanish. Sensing it had to be close to 1:45 am, Anna got up to leave, believing she was sending the message that she wasn’t interested in sex. As she looked for her shoes, she tells me, he picked her up and threw her onto the bed. “I thought it was in a playful way,” she recalls.

She allowed it to continue. Once more, however, she felt anxious about the time. She remembers only a few words exchanged and hearing friends calling for her. “No, seriously, those are my friends,” she told him.

“Shh, it’s going to be okay,” she recalls him saying.

“I was like, alright, I’m just going to push you off and I really have to go,” she says. She tried to force him to move aside. “That’s when he got up and locked the door, and turned off the lights,” Anna says, “And that’s when I realized that he was like …”

She leaves the sentence unfinished.

This time when she tried to stand up, he pushed her back hard, causing her head to slam into the headboard. (She says she found bruises under her hair the next day.) He took off her skirt and held down her wrists, pinning her to the bed, and raped her. “I just laid there,” she says. “I didn’t know what to do.”

She doesn’t remember how she got back to the school, only that she did, and that while her friends went on a late-night taco and pizza run to the campus food court, which was open until 3 am on weekends, she showered and wept. It wasn’t clear to her what she’d been subjected to. Had she been raped? She had danced with him and followed him upstairs. She had allowed herself to be led into a bedroom. She’d been tipsy.

It would be months before Anna would recognize that she was a victim of sexual assault, but she didn’t speak about it for years. When she flew home for spring break in 2013, just a few months after the incident, her parents were alarmed to see that she had become dangerously thin. At school, she had begun restricting calories and working out for multiple hours a day, eventually dropping to 120 lbs, when something between 150 and 160 lbs would have been healthy on her nearly six-foot-tall frame. This was the beginning of an eating disorder for which she is still being treated.

In a letter her parents would send to the president of Notre Dame a few years later, they wrote that during that spring, Anna’s heart was already showing signs of stress. (Starving the body of nutrients damages organs in a “slow drip,” Anna’s mother tells me. “She knows that, but when you’re at your lowest point, it’s hard to care, even if you want to.”)

Anna agreed to see a counselor on campus to appease her parents, but says the therapist attributed her mental state to the stress of her transition to college, without ever asking whether Anna had been assaulted or abused. Notre Dame had been investigated by the US Department of Education the year before for its handling of sexual assault accusations against two men on its storied football team. One of the women who accused a football player of rape, 19-year-old Lizzy Seeberg, a freshman at St. Mary’s University, took her own life. The prevalence of rape on college campuses was hardly a secret, although it would be another year before a national activist network of student survivors made the issue frontpage news.

Anna says she didn’t volunteer the possible reason for her sudden decline. “I was still functioning. I thought if it was that big of a deal, I wouldn’t have been able to hold it together,” she says. “I cared more about my school, and I knew it’d be taxing emotionally to talk about it.”

No one wants to make themselves more upset when they don’t have to, she reasons.

Still, Anna longed to be too skinny, to strip herself of all womanly features. “I wanted to look like death so that people would just not be attracted to me—like, no butt, no boobs, losing hair,” she says. “I thought that was the surefire way to not get raped again, because who the hell would want to hook up with someone like that?”

She was suffering from nightmares, flashbacks, and paranoia. In the fall of 2013, her sophomore year, she left Notre Dame for good.

The number of victims who drop out is unknowable

There is no national database that tracks campus rape rates nationally, let alone one that documents how many students abandon or delay college studies because of a sexual assault. When retention rates are examined, schools typically probe issues of race, socioeconomic status, personality types, family dynamics, and the culture on campus, but not sexual harassment or violence. So, officially, there’s been no solid connection made between sexual aggression—whether committed by a student, a stranger, or a professor or advisor, for that matter—and school withdrawals.

It’s no mystery why a victim might leave, however. In various studies, researchers have found that sexual violence triggers post traumatic stress disorder (PTSD) in 30% to 50% of female survivors . And the physiological symptoms of PTSD—flashbacks, sleeplessness, panic attacks—can make it difficult if not impossible to physically attend class, study, or be productive.

Victims also often feel an urgent desire to put distance between themselves and their assailant, who is an acquaintance in nearly 70% of campus assaults, according to a Washington Post-Kaiser Family Foundation survey from 2015. “We know from talking with survivors that a change of scenery sometimes becomes necessary,” says Kristen Houser, spokesperson for the National Sexual Violence Resource Center (NSVRC), “or they become unable to cope with the structure of the academic year.”

Pinpointing the often multi-layered reasons students have abandoned college would be a complicated study to undertake, Houser admits. If a student has not reported an incident and is not participating in a disciplinary process, for instance, the school would have no good way of knowing what caused the disruption. And, unfortunately, data suggest that 89% of campus rapes go unreported.

Even in the case of a reported assault, a student might leave school not only because of the incident, but because of the secondary trauma brought on by a mishandled hearing or police investigation. Not seeing family and not having a strong support group can worsen the crisis. “Sometimes the assault can tear apart your peer group,” Houser says. When women attempt to come forward with an accusation, they’re often subjected to threats and intimidation from people who had once been friends.

All of those pressures can have a dramatic impact on the grades of a student who chooses to stay on campus, says Carol Jordan, who directs the Office for Policy Studies on Violence Against Women at the University of Kentucky, and runs a scholarship program for women who have been victimized, whether by a stranger or by a partner.

In a study published in 2014, Jordan and two of her peers sought quantifiable data to illuminate a rape’s effect on a student’s academic trajectory. They surveyed 750 women, first as incoming freshman and again after each of the students’ first two semesters. The women were asked about their history with sexual violence prior to college. For Jordan, the most surprising findings were connected to girls’ high school experience: More than 40% of the first-year university students said they’d either been raped or sexually assaulted during their teen years before college. Their trials early in their college careers were also alarming. Some 24% said they had endured “sexual victimization” in their first semester of college. And almost 20% said they had been sexually assaulted by the end of the second semester.

Those women who had been attacked or raped in high school tended to arrive on campus with lower GPA scores than those who had not been victimized, and they earned lower grades in their first year. The same pattern was seen in women who experienced rape or assault in their first year of college.

The study also found a correlation between the severity of the sexual attack and women’s grades. Rapes were related to lower GPAs than other forms of assault. Of course, correlation is not causation; however, Jordan believes the data speaks to a need for more comprehensive studies.

“You can’t make the leap from saying that a rape in high school or college necessarily negatively affects someone’s career prospects,” says Jordan, “but you can extrapolate. When someone has lower grades in high school, they may be at a disadvantage once they get into college… And if a student is getting lower grades, not performing well, and experiencing other trauma, it’s an assumption that they’ll be more likely to drop out of college as well.”

She writes in her paper that a woman who has survived a sexual attack may experience cognitive impairment, “such that she is less able to concentrate, organize a set of facts, or remember details in the course of her studies.” Depression and anxiety might consume all of her energy, leaving little time for academic work or socializing. All of this “may translate into problems in terms of careers and achievements that other people are set up to make by virtue of not having had that experience,” Jordan argues.

To truly grasp the scope of this issue, says Catalina Velasquez, a spokesperson for the advocacy group End Rape on Campus, we have to also consider all forms of educational settings, including technical schools, beauty schools, and community colleges. There is as much sexual violence in these places as at four-year institutions, she says.

Up against the system

At the various, highly ranked treatment centers Anna attended following her withdrawal from Notre Dame, she was routinely subjected to bodychecks because she had begun cutting herself. The checks were intolerable, she says, and the programs were rarely helpful. “I did the motions and went through it and went home, and everything would just go to shit,” she says, “and it was because I didn’t talk about the trauma.”

In 2015, she finally confided in a psychologist in New Jersey, who, she says, was the first person who seemed to believe in her. At home, she slept through the night for the first time since the rape. “It was amazing,” she says. Next, she summoned the courage to tell her family.

“It was late, everyone had gone to bed,” her mother recalls. “I was at my desk and she came down and she sat on the floor and said, ‘I have to tell you something.’ And of course I knew.” Before Notre Dame, Anna had not been any more body-obsessed than the average teenager, her mother says. “I knew something had to have happened like that—something really, really horrendous.”

Shortly thereafter, Anna had the same conversation with her father, who was equally supportive of her, and, like his wife, reassured Anna that she had done nothing wrong. “It was the first time I saw my dad cry,” Anna recalls.

With the support of her parents, Anna attempted to re-enroll at Notre Dame. She says she was told she wasn’t ready to return from medical leave after she answered a mental health questionnaire. And in order to be readmitted, she’d need to go through the full application process again, which felt overwhelming. (At Notre Dame, students who take a voluntary health withdrawal, whether for medical or mental health reasons, must complete a re-admission application and be cleared with either the University Counseling Center or University Health Services, the school confirms.)

“We did contact the school,” says Anna’s father, a finance executive at a bank in midtown Manhattan. “I’ll give the school credit that they responded and they had a very senior person dealing with us. But he didn’t show us any willingness to compromise.”

“My wife is thinking the school’s going to go out of the way to give her some kind of diploma,” he adds. “I’m thinking, come on, it’s a business.”

Asked about Notre Dame’s policies regarding victims of sexual assaults on campus, a university spokesperson referred Quartz to the school’s Title IX policies, which stipulate that the university will protect a complainant’s identity and make information available about existing resources for mental health support, legal assistance, or financial aid. It will also inform students about the process for changing their “academic, living, transportation, and working situations, if so requested by the complainant and if such accommodations are reasonably available.” These requests are to be considered whether or not a crime is reported to police on campus or in the community.

Notre Dame’s president, the reverend John Jenkins, did write to Anna’s parents in the spring of 2016, in a letter Anna’s father shares with me. Jenkins says that the description of their daughter’s illnesses was “wrenching.”

“I pray for healing and peace for all of you,” he states, before citing Anna’s lack of timely reporting, which, “however understandable,” made it impossible for the school to take any action. He also offered to have the head of student affairs reach out to Anna for a conversation, if her family thought it would be helpful.

Her parents responded, saying they believed the school, where a crucifix hangs in each classroom, had a moral obligation to do more.

“When it is convenient and helpful for marketing the brand, fundraising, or recruiting, moral platitudes such as ‘Do the right thing’ or ‘Come to experience the invisible hand of God’ are often invoked,” they wrote. “Notwithstanding Title IX, the system in place in no way encourages victims to report rape or provides the necessary support system. For these reasons and other factors, the plight of rape victims on campus continues to be an epidemic problem.”

A classic “he said, she said,” says the local special victims unit

In the fall of 2016, Anna contacted the police in South Bend, Indiana, where Notre Dame is located, to officially report her rape. According to a log of events maintained by Anna and her family, she was told by a young female detective in the special victims unit that the case was weak, a classic he said/she said, because Anna had no witness and no rape kit. Based on questions she answered about the night of the party, she was also told she had not been “drunk enough” to be considered too incapacitated to give consent.

Without Anna’s agreement, she says, the detective then tracked down the accused to ask him about the Saturday night, three years prior, in question. Anna says the detective called her back to say the alleged assailant claimed he didn’t know anyone by her name. “Even though I knew that that was a very probable outcome, that broke me,” Anna says. “I remember I was with the dog and we were playing in the backyard outside. It was a really nice day, and I was just hugging the dog and crying.”

(The detective who handled Anna’s case did not respond to Quartz’s request for comment, and a spokesperson for the South Bend police denied our request for access to the case file.)

Eventually the case was sent to a prosecuting attorney, who stated in an email to the family that the matter deserved “his undivided attention,” and then went radio silent. He answered no further phone calls or email messages, including those from a former FBI agent Anna’s parents had hired to provide guidance in the case.

What could colleges do differently?

In a 2015 documentary about college rapes, The Hunting Ground, Caroline Heldman, a professor of politics at Occidental College, describes campus as “a small place, where everything is structured.” That’s what makes it especially difficult to continue living one’s life following a brutal assault. “Your living space is structured. Your eating space is structured,” she says, “so you’re going to run into your rapist.”

Title IX regulations oblige colleges to assist victims by providing “appropriate interim measures” that will allow someone to feel safe on campus following a claim of assault. So does the Clery Act, which dictates that any school receiving federal funding must report crime rates on campus, and demands that schools make “reasonable” accommodations for the victim of a sexual crime. In both cases, the language fortunately leaves open a wide range of scenarios that victims may seek to have addressed, but also makes it possible for schools to reject specific requests as “unreasonable.”

Certainly there are some requests that are legitimately not feasible. Asking to do all of your classes online at a school that’s not equipped for that might justifiably be called unreasonable, says Carly Mee, an attorney at SurvJustice, a small organization that provides legal help for students reporting assault and rape on campus. But, says Mee, it should be considered fair to ask for the opportunity to retake a class, or to have a bad grade wiped from a transcript.

For a school, there’s little cost involved in extending this kind of assistance; for the student, meanwhile, a lack of cooperation can be devastating. “This can affect the victim’s earnings potential. It ends up changing their income levels, changing their course of action that they had been planning for years,” Mee says.

In some cases, the students she counsels will succeed in achieving certain goals. One of her clients, Sabrina, who didn’t want her last name used in this story, happens to be at Notre Dame as a junior studying business. She says she was sexually assaulted during her sophomore year. When she brought her story to the school, she was taken seriously and the male student who attacked her was eventually expelled. The process took several months, however, as the school held a hearing and the accused appealed the outcome, during which time they both had to be on campus, attending the business school.

With Mee’s help, Sabrina says, she knew what accommodations to ask for to make life more bearable during that period. “I said I didn’t want him to be allowed in the dining hall that was closest to my dorm. I said I didn’t want him in the places I studied or did extracurricular activities,” she explains. In total, she asked that he be banned from that nearby dining hall, two floors of the library, parts of the student center, and the gym during certain periods of time. She also asked that he not be admitted into the business school when she had class.

“Notre Dame was actually pretty accommodating,” she says. The accused student wasn’t allowed in the dining hall. He wasn’t prohibited from entering the library, but he was not allowed to go to the second floor. A section of the student center, and the parking lot, became off-limits to him. He had already been ordered not to enter her dorm and not to contact her or her friends.

At one point in the week, their classes met in the same room right after each other, so he was arriving just as she was walking out. The school came up with a scheme: “I had to go in this one door and he had to go in another,” says Sabrina. “I was told I had to leave that class immediately and take a certain path so that we wouldn’t run into each other.”

Even with these protections, she was terrified, “constantly scanning” her surroundings, fearing that he’d retaliate, given an opportunity. She isn’t sure she would have stayed at the school had his hearing turned out differently.

“You’re the second person I’ve told this to”

Mee is currently SurvJustice’s single attorney, which speaks to part of the dilemma facing administrations that may want to do the right thing by students. Victims have to reach an advocate—and on most campuses there are only so many people with the expertise and knowledge to adequately respond when a rape victim who comes forward.

That first reaction, especially, has to be a positive experience for the victim, because if not, it might be her (or his) last attempt to find help, or the last in a while, says Sarah Bolton, president of The College of Wooster, in Ohio.

When Bolton was the dean of Williams College in Massachusetts, from 1995 to 2016, she noticed an unsettling pattern. Seniors she spoke to would confess, “What you need to know is that when I was a first year student, I was assaulted, and this is how it affected my path,” she says. She was often just the second person that the student had confided in—the first usually having been a friend, or perhaps a trusted professor.

This was troubling, not only because of the incidents themselves, but because her learning about them years later meant there were others at the school “who were affected by this in different ways, and whose campus experience had been limited by it,” Bolton says. It was becoming obvious that the first person someone spoke to at Williams commonly didn’t know what to say or do.

In 2010, Bolton and her staff began to rethink their strategy. Over the next few years, led by Meg Bossong, director of Sexual Assault Prevention and Response at Williams, they systematically trained all employees in student affairs, and later faculty, so that a critical mass of people on campus would know what rights a victim had and whom to speak to get what was needed to feel secure on campus again, and begin healing.

The process included expanding training for front-line professionals—such as school nurses, residential advisors, and counselors—so that they’d also know when to proactively approach students who may be in distress. The school had found, for instance, that librarians were often witness to signs of struggle or trauma late at night, so they were trained in a seminar tailored just for them, on the special challenges of late-night crisis management. As the knowledge base built up across the wide range of people, Bolton and her Title IX office saw a change: More victims were more likely to be brought into a system that served them.

Reclaiming an education “that was long stolen”

Another model schools might consider adopting is Jordan’s Women Empowerment Scholarship Program at the University of Kentucky. It was created in 2014, specifically for victims of sexual violence and partner abuse, and takes what Jordan calls a wraparound approach to supporting a survivor in school. In addition to funding, students have three people to keep them steady as they venture into the sometimes intimidating classroom: an academic advisor; a victim’s advocate, who could be a therapist or a representative from a local women’s group; and Jordan herself, who acts a mentor to those involved in the program. A handful of these types of scholarships exist across the country, but Kentucky’s is the only one Jordan knows of that takes this triple-pronged approach.

One student Jordan is mentoring now, Michelle Kuiper, was a freshman student when she was raped in Louisville, Kentucky, in 1994, and almost immediately dropped out of college. Her assailant was a stranger, who turned out to be a stalker. She had been sitting outside her house one night having some milk and cookies when, she says, “I felt like I was falling off the porch, but I wasn’t falling. Someone had taken me from behind and pulled me off.”

She was dragged under a neighbor’s porch, where she found herself encaged in lattice work. “He assaulted me in many different ways,” she says, and she felt pretty sure he was going to kill her.

Her education, she says, stopped at that moment. Kupier first worked with the college to change her ID and thus stay enrolled, but her attacker managed to reach her by phone, commenting on a recent haircut. Frightened, she left school and she married soon after, allowing her identity to be subsumed by that of her husband’s as she followed him around the country for his career. “I felt like, the more invisible I could be, just be Mark’s wife, it’d be safer,” she says. But she dreaded the moments at corporate parties when Mark’s accomplished friends turned to her to ask, “And what do you do?”

Kuiper held jobs as a nanny in several cities, and learned to manage despite her nightmares and anxiety attacks. Before the rape, she had planned to become a nurse. Giving up on that made her feel “like a failure,” she says. She wondered to herself, “Why couldn’t I just get over this?”

After Kuiper’s assailant, a serial rapist, was finally captured and imprisoned in 2011, partly with evidence from Kuiper’s rape kit, she became an advocate for victims’ rights, and pushed for law agencies to begin testing hundreds of thousands of rape kits stored across the country and left untested. That campaigning led her to the University of Kentucky campus, where she was eventually was introduced to the scholarship program run by Jordan.

Now in her late 40s, Kuiper is studying gender and women’s studies, with a minor in criminology, and will be a junior in the fall. She receives all the support offered by Jordan’s office except for the financial aid, as her tuition and living expenses are funded by a different scholarship. She feels she is reclaiming a piece of her “that was long stolen.”

For years she had never even considered going back to school, feeling the weight of shame and fear and not believing any path existed for her. Her rapist, she says, “doesn’t own that piece of me anymore,” she says.

“If someone would have given me that empowerment in the beginning,” she says, “I don’t think I would have waited this long to get an education.”

Surges of an old ambition

A couple of years ago, Anna began attending a college closer to home, where she could finish her degree while living with her parents. Her return to school—where she had switched into a behavioral neuroscience major—was interrupted at least three times because of depression and her tenacious eating disorder.

She also began walking dogs to earn spending money, which she says helped her to feel she “has a place in the world,” and was depended upon “even if it’s just dogs.” Her weight returned to a healthy range, but when we spoke in early spring, she confessed that she still found it hard to get dressed to go meet people; being at a normal weight makes her feel vulnerable.

“I can function and do school now, which is a huge amount of progress compared to how I used to be, but I’m still in [the depression],” she said.

The goal of finishing her degree had kept her going. “It’s the reason I’ve lived,” she explained, “but now that I’m closer to it, I’m like why? What’s the big deal? Now I don’t even know.”

When she dared to look ahead, maybe to a job or to graduate school, she worried about having to present herself as a professional, in the tailored clothes one might have to wear in an office. Even the prospect of interviewing for a part-time job at Starbucks or Jamba Juice terrified her. (Her therapist has worked on this with her, with role-playing exercises for practicing interviews.)

“Employment is something that’s quite daunting for her to address and deal with,” says her father. “She’s asked us about grad school, and and our view is that we want to be supportive, but you don’t continue your schooling just because you feel like you can’t be employed.”

Anna did eventually graduate from a local university. She also received a job offer, which she has had to table for now, because she recently checked into a new residential treatment center to address her eating disorder.

Before leaving, Anna told me that she was considering nursing school, partly because she believes in the profession, but also to avoid the one-to-one interviews and self-promotion involved in applying to other kinds of programs. “It’s upsetting that I can’t do a normal thing,” she said. “But I just don’t feel great about myself, so I don’t see why people should hire me in the first place… And I’m ashamed of my past.”

But now and then, there are occasional moments of peace, and surges of the ambition that had been one of her defining traits. Whenever that happens, she says, she feels like she has to act fast, before the feeling fades.