Mental Health in College Students

Transitioning from high school to college is a big deal. College means more freedom, new opportunities, and the beginning of true autonomy and independence.

Classes will be tougher than they were in high school, and your parents may not be around to keep you focused and disciplined. You might find yourself in a new living situation with people you’ve never met before. Many students may need to work part-time in order to help fund their schooling and living expenses.

There is absolutely no shame in feeling overwhelmed by these new responsibilities and pressures. In fact, it would be a little strange not to feel daunted by experiencing life as an adult for the first time – even if it all seems challenging in a good way. Change is hard, and all change (good and bad) can present challenges to your mental health. 

Mental health issues are on the rise in college students, especially in the past year or two, with the onset of the coronavirus pandemic, political unrest, and increasing awareness and discourse of systemic racism and inequality. (1)

Fifty percent of students in the Fall of 2020 screened positive for depression and/or anxiety, and 83% of students said that their mental health had a negative impact on their academic studies. (1)

The Stigma of Mental Health Issues

One positive thing that has resulted from the pandemic and the ensuing social isolation is that people are speaking more openly and honestly about their mental health struggles. We have a long way to go, but conversations are being had that were essentially taboo just a few short years ago. We are starting to realize that “It’s okay to not be okay”.

If you’re struggling, reach out for help sooner rather than later. Even if your anxieties and worries are completely normal for your current situation in life, you don’t need to suffer any more than necessary. Talk to someone before your anxiety becomes debilitating; before your depression spirals into suicidal thoughts; before your issues around food become a full-blown eating disorder. 

Mental Health is a Spectrum

It’s important to realize that your mental health doesn’t have to spiral out of control before you reach out for help. Just because you’re not feeling suicidal doesn’t mean you shouldn’t take your depression seriously. Just because you’re not drinking vodka for breakfast doesn’t mean it isn’t time to address your increasing desire to drink. 

This is why it’s so hopeful and uplifting to see these conversations happening more candidly and openly. Imagine all of the tragedies that can be avoided when we address our mental health issues before they overcome us. 

It’s normal to feel anxiety before an exam, or feel a little depressed and homesick if you’ve traveled far from home to attend college. It’s also normal to experiment with alcohol or drugs while living in the dorms, or being away from constant parental supervision for the first time.

So how do you know when it’s time to reach out for help?

A good rule of thumb is, if it’s hindering your ability to participate in the things that matter most to you, such as school, it’s probably time to reach out for help. If your relationships are starting to suffer, you may need help. If your physical health is declining, you may need help. If you’re losing interest in things that used to be of utmost importance to you, it’s definitely time to get some help.

Five Common Mental Health Issues for College Students

Depression

Depression is characterized by feelings of sadness and a loss of interest in activities that used to be enjoyable. It can lead to physical problems as well and may decrease your ability to function at school, work, home, or to participate in social activities. 

Symptoms of Depression

• Sadness or depressed mood
• loss of interest in activities you once enjoyed
• Change in appetite/weight gain or loss
• Loss of energy/extreme fatigue
• Feelings of worthlessness or guilt
• Difficulty concentrating or making decisions
• Thoughts of suicide or death (3)

In order to receive an official diagnosis for depression, your symptoms must last for two weeks, and cause a change in your previous level of functioning. 

There is a difference between Major Depressive Disorder (MDD) and feeling depressed about a recent break-up, or failing an exam. And there is no reason to feel shame about either scenario. The important thing is to address your depression, whether it’s situational or chronic so that you don’t have to suffer any longer than necessary, or start to lose sight of the things that matter to you.

Treatment for Depression

Depression is not something you can talk yourself out of. It is different from sadness or weariness, and it won’t necessarily pass with time.

Fortunately, depression responds really well to treatment, and the sooner you seek out treatment the sooner you can start to feel better. 

Once physical or medical causes for depression have been ruled out treatment can begin. Treatment can be one or a combination of several things:

• Therapy can include cognitive behavioral therapy, family-focused therapy, or interpersonal therapy.
• Medication can be useful in some cases and can consist of antidepressants, mood stabilizers, or antipsychotic medications.
• Brain stimulation therapies can be useful when medication and therapy don’t seem to be effective.
• Light Therapy has been shown to be useful in regulating the hormone melatonin.
• Alternative Approaches such as acupuncture, meditation, faith, and nutrition can be useful as part of a comprehensive treatment plan.

Don’t try to treat depression on your own. Seek out help. Your college or university likely has student resources available, which include medical and mental health sources. You don’t have to go through this alone, and you’re more likely to recover and thrive with the help of professional guidance.

Anxiety

Some anxiety is a natural part of life. An oncoming exam, problems with time management, annoying roommates, being stuck in traffic – all of these things can cause anxiety. Normally, anxiety will diminish once the exam is over, or traffic starts to flow again.

For people with anxiety disorders or chronic anxiety, however, these symptoms of anxiety can be constant and not necessarily caused by a specific event. And again, the symptoms can interfere with school, work, and your social life. 

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is characterized by excessive anxiety or worry for most days out of 6 months. Those worries can be about school, work, relationships, or just everyday life. Symptoms include:

• Feelings of restlessness or being on edge
• Feeling easily fatigued
• Muscle tension; tight shoulders, clenched jaw
• Difficulty concentrating; mind going blank
• Sleep troubles; insomnia, restless sleep, difficulty staying asleep (4)

If your anxiety is becoming unmanageable, talk to someone as soon as possible. Chronic anxiety can become debilitating, and it’s tough on your physical body as well as your mental health. Anxiety can be managed, if not completely eradicated, and you shouldn’t have to go around feeling perpetually anxious for any longer than necessary. 

Anxiety is extremely prevalent all over the world right now. The ongoing pandemic is a huge source of anxiety for a lot of people. Whether it be fear of catching the virus, recovering from the virus, losing a friend or loved one, a loss of income, not being able to travel or see family or friends – all of these are legitimate sources of anxiety. 

But it shouldn’t take over your life. Definitely seek out treatment if your anxiety is starting to become your “normal” state of being for any reason, whether or not it’s to do with the pandemic.

Treatment for Anxiety

• Therapy Cognitive Behavioral Therapy (CBT) focuses on learning new ways of thinking, behaving, and reacting to stimuli that produce anxiety. It can also be useful for social anxiety disorders since it can be used to learn and practice social skills.
• Medication can be used to manage the symptoms of anxiety but doesn’t help to get to the source of the anxiety. Medication can be prescribed by a doctor or psychiatrist. Anti-anxiety medications can be addictive, so be cautious when using the medication, and only take it as prescribed.
• Support Groups can be great for sharing not only your struggles with people who understand what you’re going through but your achievements as well. Any mental health struggle makes you feel alone, and a support group is a good reminder that you’re not alone, and other people do empathize with your daily challenges.
• Diet, Exercise, Mindfulness If you have an anxiety disorder, or you’ve recently been feeling crippled by anxiety, seek out help as soon as possible. If you’re struggling with anxiety as a result of a new lifestyle and responsibilities, keep in mind that diet, exercise, and mindfulness practice, such as yoga or meditation, can work wonders in managing anxiety.

Eating Disorders

Eating disorders can occur in any age group, but they are most prevalent between the ages of 18 and 21; college years. The median age for the onset of bulimia and anorexia is 18, and for binge-eating, it’s 21. 

Eating disorders are complex, arising from biological, psychological, and social factors. Eating disorders often develop as an attempt at retaining control. College life demands adult behavior from students who aren’t necessarily quite there yet; the sudden onset of adult responsibilities, peer pressures, social anxiety, less structure, and increased workload can all lead to the increasing need to find something to control. 

If you’ve struggled with depression, anxiety, or other mental health challenges in the past, you’re even more susceptible to developing an eating disorder at this time. In this “thin” obsessed culture, food restriction and over-exercise can seem like a perfectly reasonable way to react to the stress and pressures of college life. 

Here are some signs and symptoms of 3 of the most prevalent eating disorders:

Anorexia Nervosa

• Low body weight/dramatic weight loss
• Feeling overweight (even when you’re clearly not)
• Denying feeling hungry
• Preoccupation with body weight and shape
• Obsession with food (calories, fat, carbs, etc.)
• Food rituals (tiny bites, chewing excessively, etc.)
• Excessive exercising
• Fatigue, weakness
• Dry, thinning hair
• Frequently cold
• Amenorrhea (ceasing menstruation in women)

Bulimia Nervosa

• Fluctuating body weight
• Frequent episodes of bingeing (consuming large amounts of food) followed by purging (self-induced vomiting, using diuretics, laxatives, or enemas)
• Hiding food to eat in private
• Feeling out of control during a binge episode
• Feeling guilt and shame about eating
• Preoccupied with body weight and shape
• Obsessive exercising
• Withdrawal from social life

Binge Eating

• Highly fluctuating body weight
• Frequent episodes of bingeing
• Feeling out of control during a binge session
• Hiding or hoarding food/ eating in private
• Feeling shame while eating
• Eating when not hungry
• Eating to the point of (and past) discomfort (7)

Treatment for Eating Disorders

The sooner you seek out treatment for an eating disorder, the better. Eating disorders can lead to medical complications, as well as increase the likelihood of substance abuse and suicide.

Talk therapy, nutritional counseling, medication (for anxiety or depression), or a combination of the 3 are most effective at treating eating disorders. Complete recovery is absolutely possible, especially if you seek out treatment as soon as possible. You are not alone, and there is hope. (8)

Addiction

Substance abuse is fairly common among college students and can lead to problems with academics, physical health, mental health, and social life. 

Some experimentation with alcohol and drugs is perfectly normal (if not perfectly healthy), during your young adult years, but how do you know when your “experimentation” with alcohol and other drugs is turning into a problem?

The truth is, you probably know somewhere deep inside yourself if you have a problem with substance abuse. Denial is a symptom of addiction, but if you’ve lost interest in things you once cared about, if your grades are slipping, if your relationships are suffering, or if you’re preoccupied with your drug of choice, it is likely time to reach out for help. 

Signs and Symptoms of Substance Abuse in College Students

• Skipping classes/ academic decline
• Poor personal appearance
• Avoiding friends or social situations
• Lying about alcohol or drug use
• Losing time to recovering from alcohol or drug misuse
• Needing alcohol or drugs in order to relax or have fun
• Mood changes; irritability, depression, anger
• Poor concentration or memory issues
• Continuing to drink or use drugs despite negative consequences (9)

Reaching out for help regarding substance abuse issues can be really difficult. Unfortunately, there’s a lot of shame and stigma surrounding addiction in our culture, and this can make it really hard to admit to anyone (including yourself) that you need some help.

Asking for help with substance abuse may be one of the toughest things you’ve had to do – but also one of the smartest. Addiction is a chronic and progressive disease; the longer you drink or use, the more dependent you become on your substance of choice. And the more dependent you become, the more the rest of your life will suffer. You still have your entire life to live, and the sooner you learn coping skills that don’t involve drugs or alcohol, the sooner you can start to really thrive and succeed, in your college years and beyond. 

Addiction is a disease. There is no shame in admitting to needing some help. You might be surprised to find how much better you’ll feel, just by admitting that you have a problem.

Treatment for Addiction

If you’ve been dependent on alcohol or other drugs for some time, you may need medical supervision in order to safely detox. Please reach out for medical help if you have suffered from withdrawals in the past, or feel extremely ill if you stop drinking or using. 

Once you are safely “clean” from your drug of choice, there are many options for maintaining your sobriety. Talk therapy can be effective for those who have underlying conditions that lead to the addiction in the first place, such as depression, anxiety, or underlying trauma. 

AA and NA are support groups that you may have heard of. The premise is that with the support of other people, and by lending your own support, sobriety is not only possible but a new lease on life. You don’t just learn how to stay away from drugs and alcohol, you also learn how to cope with day-to-day struggles with hope and gratitude.

There are likely meetings on your campus for recovering alcoholics and addicts. Finding a community of like-minded people who have been where you are and understand what you’re going through is often the absolute best way to attain and maintain sobriety. 

Suicide

Suicide is the third leading cause of death for 15-24-year-olds. More than 10% of college students recently reported seriously considering suicide in the past twelve months. (9)

One of the most important things to know about suicide is that depression, substance abuse, and other underlying mental health issues are the most common risk factors for suicide. Most people who attempt or achieve suicide have been struggling with their mental health for a while. 

This is one really good reason to make your mental health a priority at all times.

Facts About Suicide

• Most suicidal people don’t wish to die, but can’t see any other alternative to their problems.
• Most suicidal people do give some warning about their intentions, but they go unnoticed, or people don’t know how to react or intervene.
• Talking about suicide does not create suicidal feelings.
• Just because someone has openly expressed their feelings about feeling suicidal, does not mean they are no longer suicidal.
• Suicide attempts are usually signs of extreme distress, not cries for attention.

Risk Factors for Suicide

• Depression, substance abuse, other mental health disorders
• Stressful life events in tandem with depression or other mental health issues
• A prior attempt at suicide
• Family history of mental disorder, substance abuse, or suicide
• A history of violence or abuse
• Access to firearms or other lethal means (such as medication)

Suicide is preventable. If you suspect that someone you care for is feeling suicidal, talk to them. If you’re not comfortable doing so, contact a friend, loved one, or a professional on your campus.

If you are feeling suicidal, know that you are not alone. Reach out to anyone you feel comfortable with and talk to them. There are likely counselors available on your campus who can help you. 

National Suicide Prevention Lifeline (24 hours, 7 days a week, English, Spanish)

1 (800) 273-8255

Being Proactive about your Mental Health

You eat food for energy, you exercise for strength, you sleep for rest. Your mental health should be just as much of a priority as your physical health, perhaps even more so. If you don’t feel good in your mind, how can you effectively take care of your body?

There are proactive things you can do to take care of your mental health before your mental health is in crisis. The more you care for yourself when you’re feeling well, the better equipped you’ll be to handle it when you start to struggle. And lets’ face it, life is full of challenges and struggles. There will be a time when you’ll be very grateful for the attention you’ve given to your mental health. 

Talking about your feelings is not a sign of weakness. Even talking about your happy feelings is good for your mental health! And when you feel comfortable talking to people when you’re doing well, it’s easier to reach out when you’re struggling.

Exercise is so good for you! And not just physically. Regular exercise will help you concentrate, sleep, and feel more confident and energized.

Eating and drinking sensibly are imperative. Food is fuel not just for your body, but for your brain. What you eat absolutely has an effect on your brain functioning and therefore your mental health. And if you’re going to drink, drink responsibly. Eat a good meal before indulging. Drink lots of water, designate a driver, and drink in a safe location.

Take a break if you need one. Take a walk in nature, go to a movie, read a book that has nothing to do with school. It’s ok to recharge once in a while; in fact, it’s necessary.

Your mental health is one of the most important things you have to take care of. The sooner you start practicing, the better you’ll be equipped to handle mental health challenges. And you deserve to feel like the healthiest version of you at all times, good and bad.

Sources

1.  Boston University. (2021, February 17). Depression, Anxiety, Loneliness Are Peaking in College Students | The Brink. https://www.bu.edu/articles/2021/depression-anxiety-loneliness-are-peaking-in-college-students/

2.  Igoe, K. J. (2021, July 28). 16 Simone Biles Quotes to Forever Be Inspired By. Marie Claire. https://www.marieclaire.com/culture/a37146629/simone-biles-quotes/

3.  What Is Depression? (2021). Web Starter Kit. https://www.psychiatry.org/patients-families/depression/what-is-depression

4.  NIMH » Anxiety Disorders. (2021). National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders

5.  Michel, A. (2021, April 20). Eating Disorders in College Students. The Emily Program. https://www.emilyprogram.com/blog/eating-disorders-in-college-students/

6.  Jacobson, R. (2021, May 18). College Students and Eating Disorders. Child Mind Institute. https://childmind.org/article/eating-disorders-and-college/

7.  Prevention | Eating Disorder Foundation.org. (2021). The Eating Disorder Foundation. https://eatingdisorderfoundation.org/learn-more/about-eating-disorders/prevention/

8.  NIMH » Eating Disorders: About More Than Food. (2021). National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/eating-disorders

9.  Substance Abuse In College Students: Statistics & Addiction Treatment. (2021, August 4). American Addiction Centers. https://americanaddictioncenters.org/rehab-guide/college

10.  Welcome to Governors State University in Chicago Southland. (2021). Governor’s State University in Chicago’s Southland. https://www.govst.edu/suicide-prevention/