In this article, the author, director of Watauga College and residential learning communities at Appalachian State University in Boone, North Carolina, shares her experience dealing with first year college students who are taking medication to manage depression, anxiety, or attention deficit and hyperactivity disorders. She stresses that this is a serious social problem in a nation that has become increasingly dependent on drugs to solve problems. She states that any first-year college student worthy of his or her pierced nose has an agenda that includes asserting independence, developing a sense of autonomy and self-authorship, and a powerful determination to stretch the limits of themselves and all of those around them. One of the best ways to do this is to reject what the parents and the pediatrician expect from them: taking their medications. Just as students will choose not to attend church or will consider changing majors from one their parents prefer to one they prefer, they can be expected to reduce their medication or stop medicating themselves altogether. As a result, the social and psychological skills needed to maneuver on the complicated playing fields of residence hall living, of classroom pressures, of new and exciting freedom are diminished, and many students end up in her office. Learning how to distinguish, with certainty, those students who are truly in need of medication to function appropriately and those who are seeking relief from the typical emotional distress of this incredibly challenging, transitional, soul-searching time in their lives is an ongoing challenge.