Mental Health for College Students

College Mental Health Statistics

Common Mental Health Issues Affecting College Students

Anxiety

Anxiety is the most common mental health issue for college students. The American College Health Association found that 27% of college students have been diagnosed with some type of anxiety. Common diagnoses include Generalized Anxiety Disorder, Social Anxiety, and Panic Disorder, all of which can surface during early adulthood.

Other common anxiety disorders include panic disorder (characterized by panic attacks), phobias, social anxiety disorder, agoraphobia, and separation anxiety disorder.

How to Manage Anxiety in College: Treatment and Coping Mechanisms

Whether you're experiencing anxiety due to a specific situation or suffer from an anxiety disorder, the first thing you should do is seek treatment from a licensed counselor. Talk therapy is one of the best resources available to learn how to manage anxiety.

Many therapists use Cognitive Behavioral Therapy (CBT), a type of therapy that focuses on replacing harmful thought patterns with different ways of thinking, behaving, and reacting to things that make us anxious. You might get homework to help you work on developing new coping skills to manage anxiety in CBT therapy.

Exposure therapy can also help those with anxiety disorders overcome their fears and get back to everyday activities without being overwhelmed by worry or panic.

Doctors and psychiatrists also may prescribe medications to help alleviate symptoms of anxiety. Common medications include anti-anxiety medications such as benzodiazepines, selective seretonin reuptake inhibitors (SSRIs) and other antidepressants, and beta-blockers.

Therapy is critical for people who suffer from any mental health issues because you can learn to understand yourself better and learn to reduce and manage symptoms. However, it can be hard to access mental health services, especially if they are not offered at your school or you don't have health insurance.

Scientific research shows that meditation, regular exercise, and other stress management techniques can alleviate anxiety symptoms and help contribute to a healthy mind. These strategies will be an important piece of recovery alongside therapy. You'll likely need to make lifestyle changes and practice coping strategies. Eventually, you can train yourself to have a better response to stressors and learn to manage your anxiety.

Depression

Depression is the second most common mental health condition for college students. According to the American College Health Association, 22% of students report being diagnosed with depression.

While most students do seek treatment, 25% who have depression have not worked with a mental health professional in the last year. Left untreated, depression can not only have serious effects on your overall health and quality of life, it can also be dangerous. There were 9,188 suicides of Americans aged 18 to 29 in 2020, according to CDC data, making it the third leading cause of death for that age group.

People can experience situational depression in response to a hard time in their life, or they can suffer from clinical depression that is not based on circumstances. Both types of depression are difficult to get through, but they are treatable.

How Depression Affects College Students

College students who suffer from depression often have a harder time doing everyday activities, going to work, and maintaining relationships. It's also a common reason why students struggle in school — 22% report depression had a negative impact on their grades in the last year.

How to Deal with Depression in College: Treatment and Coping Mechanisms

Without treatment, major depressive episodes can turn into chronic depression. Luckily, depression is treatable through a combination of therapy, counseling, medication, and healthy lifestyle choices. There are many natural remedies thought to help balance mood as well, although students should talk with their doctor before starting new supplements or medications. With proper treatment, students who suffer from depression can learn to manage and reduce symptoms and help prevent another episode from happening.

The most common treatments for depression are talk therapy and antidepressants, and a combination of both has proven to be most effective. Psychotherapy, or talk therapy, can be highly effective in helping people understand their depression and learn to manage their symptoms.

Cognitive Behavioral Therapy (CBT) is a common method for treating depression and is considered to be highly effective. Other types of therapy for depression include interpersonal therapy (IPT), where you work on problems in personal relationships, and psychodynamic therapy, which focuses on resolving issues related to past experiences.

Antidepressants are also a common method of managing depression, but they can take two to four weeks to begin having an effect. Selective serotonin reuptake inhibitors (SSRIs) are often the first choice for antidepressants. Other common antidepressants include serotonin and norepinephrine reuptake inhibitors (SNRIs) and norepinephrine-dopamine reuptake inhibitors (NDRIs).

Other methods of treatment and symptom management can also dramatically improve your quality of life coupled with therapy and/or medication. Studies show that exercise, spending time outdoors, meditation, and diet can all have positive impacts on mood. There are also herbal supplements available that can help with depression, but you should always check with your doctor before starting a supplement.

Overall, the most important thing you can do is seek help from a mental health practitioner. They will listen to your concerns and help you find the best methods of treatment for you.

Addiction and Substance Abuse

Drug and alcohol use are very common in college. The ACHA found that 63% of students reported drinking within the past month, and 23% reported using marijuana. While other substances are less frequently used, students are still at a high risk for substance abuse. 

Substance abuse occurs when someone uses a drug for recreational purposes or reasons other than its intended use. This can include prescription drugs, marijuana, and street drugs. Drinking is considered abuse when it has negative consequences or impacts someone's life. Both drug and alcohol abuse can cause serious health problems, lead to hospitalization and death, and are linked to other mental health issues such as depression and anxiety.

It can be hard to adjust to college and fit in, and college parties are a common way of meeting people and making friends, especially at schools that have fraternities and sororities. Students often feel a social pressure to drink or use drugs, or turn to substances to help them cope with stress. One of the biggest problems with the popular use of both drugs and alcohol in college is that it can lead to a higher risk of traumatic events such as sexual assault, violence, or car accidents from drinking and driving.

Substance Abuse Management and Coping Mechanisms

Treating substance use disorder or addiction is a difficult process. Addiction is a lifelong disease that can require long-term treatment and management. The U.S. National Library of Medicine outlines stages of drug use that can lead to addiction – experimental use, regular use, problem use, and addiction – and notes that young people often move through these stages faster.

If you are concerned about your drug or alcohol use, it's best to seek treatment as soon as you can to help prevent becoming more heavily dependent. It's also important to seek professional help to make sure you can quit safely. Withdrawal symptoms from some substances can be dangerous or even deadly.

Treatment methods for substance use disorder include detoxification, counseling, medication, treating other mental health issues like depression and anxiety, and long-term care or follow-up. Behavioral therapy is the most common treatment for drug and alcohol abuse and is especially critical for people with co-occurring mental illnesses. In some cases, inpatient treatment such as drug or alcohol rehabilitation may be necessary. 

There are also alternatives to in-patient rehabilitation. You can go to a facility to safely detox, or use outpatient services where you receive treatment weekly or a few times per week rather than staying in a facility. Students should contact their school's counseling center to work with a counselor, set up a treatment plan, or get connected with other services.

Quitting drugs or alcohol can be extremely difficult. These coping mechanisms and strategies can help you succeed:

Eating Disorders

Eating disorders involve a complex relationship between eating behaviors, thoughts, and emotions, and can have serious negative effects on mental and physical health. Eating disorders are serious psychiatric conditions that usually develop in teenage years and young adulthood.

About 5% of college students report being diagnosed with an eating disorder, and 4% say eating disorders interfered with school, according to the ACHA.

Although there are many different kinds of eating disorders, the three most widely recognized and common ones are anorexia nervosa, bulimia nervosa, and binge-eating disorder. Other disordered eating conditions include Pica, or the consumption of items that are not food, and Avoidant Restrictive Food Intake Disorder (ARFID), where people lose interest in eating food at all or cut out food based on texture, appearance, color, or smell.

Eating disorders can develop in response to extreme stress or trauma, and sometimes the stress of starting college can coincide with other mental health issues and result in the development of disordered eating. 

Many people use food and exercise as a source of control when they feel as if they don't have control over other aspects of their life. According to the Child Mind Institute, the stress school on top of navigating a new social landscape can trigger an eating disorder, especially for people who are already concerned about their body image or who are highly anxious.

What Are the Signs and Symptoms of an Eating Disorder?

Symptoms of eating disorders can be emotional, behavioral, or physical. People who have an eating disorder may show some signs but not others. One of the most common myths about eating disorders is that if someone isn't visibly underweight, they do not suffer from a true disorder. According to the National Eating Disorders Association, most people with an eating disorder aren't underweight, and many people who have them actually gain weight. All types of eating disorders can have lifelong impacts on different aspects of physical and mental health.

Anorexia nervosa

Anorexia nervosa typically occurs when someone thinks they are overweight despite being underweight. It's characterized by weight loss and restricting food intake to control weight. Anorexia nervosa is the deadliest psychiatric disorder, claiming the lives of 10% of people who suffer from it. 

The nature of this mental health condition means self-diagnosis is extremely difficult. People who have anorexia nervosa usually have a distorted view of themselves and may struggle to recognize the effects of their condition. It's important to note that people who are not underweight can still have anorexia. Atypical anorexia affects people who are not underweight but meet other criteria for diagnosis.Other signs and symptoms include:

• Extremely restricted eating
• Focus on weight, food, calories, fat grams, and dieting
• Refusing to eat certain foods or entire food groups (e.g., no fat, no carbohydrates, etc.)
• Food rituals, which can include eating foods in certain orders, very small bites of food, or burning food to make it taste bad, and experiencing anxiety if the ritual isn't followed
• Avoiding mealtimes or situations involving food
• Excessive exercise routine with a focus on burning off calories consumed
• Intense fear of gaining weight
• Physical effects of anorexia include dramatic weight loss, being underweight, feeling cold, constipation, fatigue, stomach cramps, acid reflux, sleep problems, fainting or dizziness, anemia, slow heart rate, thinning hair, muscle weakness, and irregular periods or not getting a period at all

Bulimia nervosa

Bulimia is typically characterized by cycles of binging and purging. Binge eating means consuming significantly large amounts of food in a short period of time, coupled with feeling out of control over your eating during this time period. People who suffer from bulimia will engage in potentially harmful ways of preventing themselves from gaining weight. This often includes self-induced vomiting, fasting, or using laxatives. It can also involve other medications or excessive exercise. 

Many of the symptoms of anorexia apply to bulimia as well. Other signs and symptoms include stealing and hoarding food in strange places, excessively drinking water or other zero-calorie drinks, evidence of binge eating (empty wrappers and containers or large amounts of food disappearing at once), and evidence of purging (going to the bathroom after meals, signs of vomiting, and laxative or diuretic packaging). 

Unlike anorexia, most people who have bulimia are in a normal weight range or overweight. Physical impacts of bulimia can include weight gain or loss, stomach cramps, acid reflux, constipation, anemia, low thyroid or hormone levels, dizziness and fainting, sleep problems, cuts and calluses across the top of the finger joints from vomiting, dental problems, hair thinning, dry skin, and damage to the throat or esophagus.

Treatment Options and Support for Recover

It can be extremely difficult for people who suffer from eating disorders to recognize when it's time to ask for help. It can also be a difficult and scary process to work on recovery. Seeking treatment is the best thing you can do to help yourself recover from an eating disorder, and there are many different methods of treatment. 

Because eating disorders have such significant impacts on different parts of the body, it's also important to have a medical exam to determine if any other medical issues need to be addressed.

Support for recovery and treatment can include friends and family, a therapist or counselor, a treatment facility, a doctor, a nutritionist or dietitian, and support groups. The first step in getting treatment is reaching out to someone for help. Seeking counseling or behavioral health services from your school or from an off-campus clinic are both good options.

For many college students with eating disorders, outpatient services may be the best treatment option. You'll work with a team of health professionals such as a therapist and dietitian or nutritionist a few times a week to overcome the mental and physical aspects of your disorder.

For more serious cases, inpatient care may be necessary. These are residential facilities where you stay for a period of time and receive medical supervision in addition to structured therapeutic services.

Hospitalization is also an option for those who are in physical danger as a result of disordered eating. Some people may need to become medically stabilized and receive intensive treatment before going to an inpatient facility or using outpatient services.

Counseling services are key in recovering from an eating disorder because they help you rebuild a positive relationship with food while addressing other mental health issues that can lead to unhealthy eating habits.

Common types of therapy used to help people who have eating disorders include Cognitive Behavioral Therapy (CBT), which helps people replace harmful behaviors and thought patterns with new ways of thinking and responding; Medical Nutrition Therapy (MNT), which involves meal planning and dietary education; Dialectical Behavioral Therapy (DBT), which focuses on developing new coping mechanisms in response to stress and painful emotions; and Acceptance and Commitment Therapy (ACT), which helps people better understand their mental illness and develop a healthier relationship with their emotional experience.

Support Services and Resources for Recovery

Finding Mental Health Support for College Students

College students struggling with their mental health have many resources available to them, and there is no shame in asking for help. According to the National Alliance for Mental Illness, 20% of American adults experience mental illness, and less than half of them receive treatment in a given year. The stigma surrounding mental health causes many people not to seek help because they are ashamed, embarrassed, afraid, or think they can handle things on their own.

It can be hard to tell if what you're going through is just part of normal life or if it's indicative of a bigger problem. Either way, there are resources available to help you. Counseling and other services can help get you through a tough time and give you lifelong skills to help you navigate difficult times in the future.

Mental Health Resources for College Students

Most campuses offer mental health services either through a counseling center or the health clinic. If there are no services on campus, your clinic can refer you somewhere nearby. Many of these services are low-cost or free, making it a good option for students who don't have health insurance.

If you do have insurance, call your health insurance provider to find out what services are covered, how much your copay will be, and how to find counseling covered by your insurance.

Students who use campus mental health services may struggle to continue counseling during breaks when they are away from school. Luckily, the growth of telehealth services during COVID-19 has made it easier to access virtual care. Check with your counselor to see if they offer telehealth services or therapy sessions by phone.

If not, you may benefit from connecting with a text therapy service or apps like BetterHelp or Talkspace while on break. Verywell Mind offers a list of text therapy services to compare costs and other considerations.

Free and Low-Cost Mental Health Services for College Students

If you can't afford to go to therapy, there are some lower-cost or free options available. Consider joining a support group or other student organization, such as NAMI on Campus clubs or Active Minds chapters. There may also be a women's or men's group, students of color support groups, an LGBTQ support group, or other clubs on campus where you'll find people who share your experience. Text therapy may also be a more affordable alternative for those without health insurance.

Students with diagnosed mental health problems may also qualify for accommodations through the Disability Services Office, including extended times for taking tests and turning in assignments, reducing course loads, and tutoring or mentoring services. If you're struggling to keep up in school due to anxiety, depression, or another issue, a leave of absence may be an option for you. The National Alliance on Mental Illness provides detailed information on how to ask for these accommodations.

Mental Health Resources for Online Students

One benefit of being an online student is that it can make it easier to manage mental health issues from home. Many online schools provide virtual counseling services to support students, which means your care won't be interrupted during a school break.

Enrolling in asynchronous online classes also means you can get your work done when you have the ability to do so, rather than being held to a class schedule. This can make it easier to manage your studies and other responsibilities on top of any mental health problems.

However, some people may struggle without face-to-face interaction or a set class schedule, which could actually make mental health issues worse. If you feel that keeping to a set schedule would benefit you, synchronous online classes could help you stay on track.

How to Find Mental Health Services as an Online Student

For online students, seeking out services through your school's online counseling center is the first step. Find out what virtual services are available. Some schools offer free or low-cost options, but there may be a limit on how many appointments each student is offered. If this is the case, work with your counselor to find out what else is available.

Open Path Collective is a great resource for low-cost counseling. The site charges a $59 lifetime membership fee and connects you with therapists who offer virtual and in-person counseling for $30 to $60 per session. BetterHelp is another virtual therapy option that costs $60 to $80 per week.

Online students who struggle with mental health also may benefit from finding counseling services in their area. For some people, the online setting can be isolating, which can contribute to or worsen symptoms. Seeking counseling in your area can help boost your mood if you need a face-to-face connection.