Every fall, many college freshmen experience something they probably didn’t anticipate when they went off to college: depression. The excitement and anticipation of this big event soon shifts to the day-to-day reality of life away…
Every fall, many college freshmen experience something they probably didn’t anticipate when they went off to college: depression. The excitement and anticipation of this big event soon shifts to the day-to-day reality of life away from home, friends and the predictability of high school. For an increasing number of college freshman, that has led to serious mental health consequences.
The Center for Collegiate Mental Health at Penn State University reported that between 2009 and 2015, the number of students visiting counseling centers increased by, on average, about 30 percent, while enrollment grew by less than 6 percent. In another report, released in 2017 and based on a survey of more than 63,000 students from more than 90 different schools, the American College Health Association discovered that almost 40 percent of college students reported being so depressed the previous year that they found it difficult function, and 61 percent of the students said they “felt overwhelming anxiety.”
The problem is, in fact, global in scope. A 2018 study in the Journal of Abnormal Psychology looked at data from the World Health Organization’s World Mental Health International College Student Initiative, a survey of almost 14,000 students from 19 colleges in eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain and the U.S.). Students answered questionnaires about common mental disorders, including major depression, generalized anxiety disorder and panic disorder. The researchers found that 35 percent of the respondents reported symptoms consistent with at least one mental health disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders. Major depressive disorder was the most common, followed by generalized anxiety disorder.
“The finding that one-third of students from multiple countries screened positive for at least one of six mental health disorders represents a key global mental health issue,” lead author Randy P. Auerbach, a professor of medical psychology in the department of psychiatry at Columbia University, said in a statement.
Why Are Freshmen at Risk for Depression?
College presents a host of risk factors for depression, says David Miklowitz, professor of psychiatry at the UCLA Semel Institute. They are away from home for the first time. They are increasingly dependent on emotional support from a peer group, which they may have trouble developing in college. They may have left or lost a boyfriend or girlfriend. Their diets change, and they may rely on high-fat, high-carb comfort foods to cope with depression or anxiety. Sleep cycles are disrupted. The stress of more rigorous academic requirements may become overwhelming.
In addition, alcohol, marijuana and other drugs, including stimulants like Adderall and Ritalin that students think help them study, are easily accessed. “Many students who were not substance abusers before college start drinking and smoking regularly,” Miklowitz says. “Substance use becomes a way of coping with emotional upheaval, while also contributing to worsening mood states or anxiety.”
For many students, college may simply worsen a preexisting vulnerability for depression or anxiety, rather than causing it. “We don’t know if these students would have developed the same disorders if they had stayed at home instead of going to college,” Miklowitz says.
The situation is made worse by the fact that previous research suggests that only 15 to 20 percent of students will seek services at their respective counseling center. Although colleges are becoming increasingly aware of depression, anxiety and substance abuse, they are often poorly equipped to deal with it. “University systems are currently working at capacity and counseling centers tend to be cyclical, with students ramping up service use toward the middle of the semester, which often creates a bottleneck,” Auerbach says.
Miklowitz concurs with this assessment of the issue. “The major problem is not only quality of care at the college level, which is variable, it’s also that college health facilities are overwhelmed with students needing help, and they don’t have enough staff,” he explains. A typical student may only get four to six therapy sessions and then is sent on their way, he says. “This may be adequate for a student undergoing a life transition but isn’t nearly enough for someone with a lifelong psychiatric disorder or one who has serious suicidal thinking.”
Auerbach says that internet-based clinical tools offering techniques in cognitive behavioral therapy or mindfulness-based stress reduction may help students who are not willing or able to get on-campus services. Some college mental health services also provide peer counseling services.
Students should be encouraged to practice lifestyle habits that have been proven to help maintain mental health:
— Keep a regular sleep/wake schedule. Strive for the same bedtimes and wake times each day. “Even if that means going to bed at 2 a.m. and getting up at 10 a.m., try to get at least eight hours a night, including weekends, and avoid sleep bingeing on the weekends,” Miklowitz says.
— Eat a balanced diet and exercise regularly. When you work out, try to do it with other people rather than alone.
— Rely on social supports as much as possible. This can often include family, new or old friends or a therapist. “Developing friends on a sports team can contribute to resiliency, both for the exercise and the social supports,” Miklowitz says.
If the student has had psychiatric problems before, families need to be aware of what the early warning signs of a recurrence look and sound like in their child. “For example, starting to ruminate or make self-defeating statements like ‘I can’t handle this.’ Ask him or her what’s wrong, offer to talk it out with them, or if you know that the student has a close relationship with a brother or an extended relative, get that person involved,” Miklowitz says.
Despairing parents can take comfort in knowing that many of these disorders will disappear within a few weeks on their own. “Not every person who develops a mood or anxiety disorder in college will have a recurrence of major depressive disorder or anxiety,” Miklowitz says. “Sometimes an event like breaking up with a girlfriend or boyfriend or doing poorly in a class can precipitate anxiety or depression in a student, but it will pass.”