Starting college requires a shift in priorities, and coping with mental health issues during this time can be a challenge. When it comes to managing day-to-day life while attending college online, students need to practice self-care. This means adopting healthy habits, avoiding stress-inducing activities, and communicating with others about how they are feeling.
Anxiety has become a serious challenge for people of all ages and backgrounds, and college students are no exception. This guide will help you examine your concerns, determine where you can get a mental health screening, and how to access additional resources.
Times of transition demand that individuals learn how to balance self-care with new priorities. This can sometimes lead to an imbalance, resulting in a number of dysfunctional, harmful behaviors. Just as students with physical disabilities should seek out accommodations to help them achieve academic success, those with mental illness should seek out mental health resources.
Whether you or a loved one is a student is seeking support, the following information and resources curated by Maryville University Online may help provide some insight and relief:
Coping With Stress and Anxiety
Everyone experiences stress — the mental or emotional tension you feel when experiencing changes or when working through challenging situations in life. This stress, combined with unhealthy coping mechanisms, such as a reliance alcohol or drugs, can lead to mental health issues like depression. This can be worsened by pre-existing mental health conditions, such as post-traumatic stress disorder (PTSD). Managing stress is of particular importance for college students, as unchecked mental health issues can impact academic performance, and unhealthy coping mechanisms can become habit without appropriate, early intervention.
Unless the individual seeks out mental health resources to find a better balance, they can become overwhelmed. Depending on your specific stress-related issue, there are different approaches you can take to find a balance:
Anxiety and Panic Disorders
Low to moderate levels of anxiety and stress are common, but if they interfere with your ability to carry on with daily life, you may have an anxiety or panic disorder. If you experience severe levels of stress in college, irrational fear, trouble concentrating, or panic attacks, you should seek help.
In order to get screened for generalized anxiety disorder, social anxiety disorder, or a panic disorder, check out the ADAA link and other resources below.
Post-Traumatic Stress Disorder (PTSD)
PTSD is an anxiety disorder that an individual can develop after having a traumatic experience. Some events that commonly lead to PTSD are violent crimes, natural disasters, major surgeries, physical or sexual abuse, or life-threatening encounters while performing military duties. Symptoms include reliving these upsetting memories, avoiding anything that reminds oneself of trauma, and a high level of anxiety.
The disorder can be particularly debilitating for young adults looking to succeed in college, as it can lead them to make impulsive or damaging choices — such as dropping out of school in frustration or using drugs to cope. Like the stress disorders above, you can use the resources below to learn more about how to treat PTSD.
Self-Care and Therapy Options
There are a number of self-care and therapy options. Students must get enough sleep, eat a healthy diet, get regular exercise, and avoid overloading their schedules with classes, work and extracurricular activities. Self-care during your years of enrollment can also involve finding space in your life to breathe — taking time to meditate and avoiding the use of alcohol and other drugs to cope.
If you would like to communicate your feelings with others, there are a number of support groups — both in-person and online — that people with stress disorders can use to decompress and learn from others. Explore the organizations below for more information on support groups.
A therapist can also help you work through anxiety-related issues. When seeking the help of a licensed therapist, consult your primary care physician or your insurance provider for recommendations.
Additional Stress and Anxiety Resources:
- Anxiety and Depression Association: Anxiety Screening Tools
- American Psychological Association: How Stress Affects Your Health
- National Institute of Mental Health: Post-Traumatic Stress Disorder
- WebMD: What Are Support Groups for Anxiety?
- Anxiety.org: 4 Steps to Finding the Right Therapist for You and Your Anxiety
Understanding Depression, Suicidal Ideation, and Self-Injury
Depression in college is perhaps the most common mental health issue among students. It affects 20 percent of all college students. Schoolwork itself is rarely the root cause; psychiatric professionals attribute depression among students to common stressors during adolescence or early adulthood.
Learning when to practice self-management versus seeking professional help is key to protecting your well-being. The Centers for Disease Control and Prevention (CDC) recommends completing a self-management education program in order to learn strategies to manage the symptoms of depression. These include developing a suicide safety plan, learning to recognize the signs of a relapse, and journaling, among other techniques.
If your depression seriously impacts your ability to perform daily tasks or complete academic work, lasts for longer than two weeks, or is causing you to contemplate hurting yourself, you need to contact a professional. Depression can lead to dangerous thoughts of self-harm, including suicidal ideation and patterns of self-injury. If you or a loved one have had thoughts about suicide or engaging in self-harm, you should contact the National Suicide Prevention Lifeline at 1-800-273-8255.
Recognizing the Symptoms of Depression
Depression in college is more than a mere case of the “blues” or momentary sadness. It’s a persistent mood disorder that affects how you think, feel, and behave. Depression can make you feel that life isn’t worth living anymore, preventing you from completing day-to-day activities.
Symptoms include: anxiety, a lack of focus, sadness, sleep disorders, social isolation, or repeated thoughts. Genetics, biochemistry, personality, and environmental factors can influence your likelihood of developing depression.
Students can screen for depression by consulting with a physician, or answering questions in the depression screening linked below to determine if they need to seek help.
Coping With Suicidal Thoughts
There is an important distinction between “feeling down” and suicidal ideation. If you begin experiencing suicidal thoughts — especially if those thoughts involve specific plans for ending your life — you must practice coping strategies and reach out for help.
To cope with suicidal thoughts, give yourself time to think things over before making any drastic decisions. Don’t use any substances that might cloud your judgement, and remove any tools you might use to injure yourself — such as blades, firearms, or drugs — from your vicinity.
Remember that your emotions are temporary; what you’re feeling during those moments doesn’t reflect how you’re going to feel at all times. Question the reasons you’re having such thoughts. Every problem has a solution, and the answer should never be to harm yourself.
If you need support in coping with suicidal thoughts, take advantage of the resources below.
Self-injury, while often a sign that an individual is having suicidal thoughts, is not always done with the explicit purpose of ending one’s life. There is a sense of control that self-injury provides, it puts you in charge of determining when and how you experience pain. Self-harm also releases endorphins, neurotransmitters that act similarly to morphine. Self-injury is an addictive and extremely destructive behavior.
Self-harming behavior typically starts in an individual’s teenage years. If you know someone in this age range who is having this issue, consult mental health resources for teenagers.
How can you avoid this cycle of harm?Dealing with the root source of your anxiety is a surer way of finding peace than self-harm. If a traumatic memory is the cause of your desire to self-injure, you may be suffering from post-traumatic stress disorder.
When dealing with self-injury, it helps to confide in a friend or family member about your thoughts. Instead of focusing on the specific physical acts you want to perform, focus on the thoughts and feelings that drive you to that desire. Through communication, you can work through these thoughts without resorting to self-harm. If you don’t feel comfortable confiding in anyone in your life, reach out to the Suicide Prevention Lifeline listed below.
Additional Depression and Self-Harm Prevention Resources:
- American Psychiatric Association: What Is Depression?
- Anxiety and Depression Association of America: Screening for Depression
- HelpGuide.org: Are You Feeling Suicidal?
- Suicide Prevention Lifeline
- Suicide Prevention Resource Center: State Resources
- National Alliance on Mental Illness: Self-Harm
Alcohol and Substance Abuse
Alcohol and substance abuse is a major cause of concern, and college-aged students are particularly susceptible to it, regardless of whether they attend school on campus or online. According to CollegeStats.org, about 1,825 college students aged 18-24 die every year due to alcohol-related injuries, more than 150,000 students develop alcohol-related health issues, and more than 97,000 students are sexually assaulted as a result of alcohol abuse.
Unfortunately, this behavior can have a serious impact on students’ personal lives and academic careers. Excessive drinking or drug use can also limit your ability to complete coursework, as the cycle of craving and being inebriated can make it nearly impossible to truly focus. Most institutions also have drug-free policies, meaning that you could face an educational intervention, suspension, or even expulsion for violating them.
Addiction is similar to other mental health issues in this guide because it is the result of an inability to balance self-care with other concerns. Most medical organizations define addiction as a disease because it, like any other disease, is caused by biological, behavioral, and environmental factors. It will also usually worsen if left untreated.
Fortunately, there are resources for those looking for help coping with addiction:
Finding Help for Addiction
Simply stopping the use of addictive substances isn’t the only step to ending addiction. The key to coping is to replace old, harmful habits with new, constructive ones. Instead of lying about your reasons for using, be honest with yourself about the nature of your addiction. Instead of ruminating about things that are stressing you out, learn to relax and clear your mind.
Of course, improving your perspective is only one component of resolving issues with addiction. If you need help discussing your problems with addiction, seek out a support group in your community or explore online support groups at PsychCentral.
Finally, in emergency situations where you feel like you are at risk for using, you can utilize a helpline. SAMHSA’s National Helpline, included in the list below, can be used to get referrals to local treatment facilities, support groups, and community-based organizations for additional assistance.
Recognizing and Resisting Peer Pressure
Students drink for a number of reasons. Individuals often develop addictions due to societal pressures and the stresses of major life changes. In college, binge drinking can help individuals feel that they can fit into a crowd. Falling in with a group of friends that enable addiction and other destructive behaviors can cause individuals to lose interest in academics, limiting their chances of success.
Resisting peer pressure starts with simply saying “no” and offering your reasons for refusing. Explain that it hurts your academic performance. If you participate in sports, discuss how it impacts your athletic ability. You can also take your own drinks to social gatherings; people will be less likely to offer you a drink if you already have one. If you know binge drinking will occur at a social gathering, don’t go if you believe you will be tempted. Resisting peer pressure can be challenging, but if you prepare yourself, you can work to overcome it.
Additional Substance Abuse and Addiction Resources:
- National Institute on Drug Abuse: Trends & Statistics
- The National Council on Alcoholism and Drug Dependence: Understanding Addiction
- Substance Abuse and Mental Health Services Administration (SAMHSA): National Helpline
- National Institute on Drug Abuse: Drug and Alcohol Use in College-Age Adults in 2016
- College Drinking Prevention: Alcohol and You – An Interactive Body
Eating disorders are another coping mechanism that individuals may use to deal with stress, though they, like other disorders in this guide, can lead to a dysfunctional lifestyle. Unfortunately, it can be difficult to admit or even recognize that you have an eating disorder as a new college student; often, eating disorders are normalized. For example, consider how the concept of the “freshman 15” normalizes binge eating disorder, or of how unrealistic beauty standards in the media may support anorexia and bulimia.
Eating disorders typically manifest themselves in individuals between the ages of 18-21, so new college students are especially at risk. In fact, according to a survey conducted by the National Eating Disorders Association, 32 percent of females and 25 percent of males in college suffer from an eating disorder. These eating disorders have a serious impact on young adults, including potentially life-threatening side effects. Here are some of the most common eating disorders and resources for coping with them:
People with an unrealistic, distorted body image may develop an intense fear of gaining weight. Subsequently, they can develop anorexia nervosa: an eating disorder characterized by weight loss as a result of a severely restricted diet. Restrictions may include specific types of food, specific nutrients (such as carbs), or skipping certain meals of the day. Anorexia nervosa has the highest mortality rate of any mental illness.
This disorder leads to malnutrition and symptoms like:
- Weight loss
- Extreme fatigue and dizziness
- Digestive issues like constipation and vomiting
- Irregular or absent menstruation
People suffering from anorexia can begin to cope by first addressing that they have a problem. By acknowledging the severity of the issue, sufferers can grow to understand that their self-image is unrealistic. Support groups and professional counseling can also help sufferers cope with their disorder — check out the resources below for more information.
People with a negative, distorted body image may also begin inducing vomiting to avoid gaining weight. When a person falls into a cycle of binging on food and purging afterwards, they may have a condition called bulimia nervosa.
Bulimia can lead to symptoms including:
- The same symptoms as anorexia (above)
- Severe heartburn
- An inflamed, sore throat
- Poor dental hygiene, including excessive cavities
Bulimia, like anorexia, is rooted in issues with self-confidence and a distorted perception of one’s body. The journey to recovery begins with acknowledging that a problem exists and communicating with loved ones about the feelings that prompted it. Support groups and professional counselors can also help sufferers recover from this disorder.
Binge Eating Disorder
Binge eating, unlike the other eating disorders listed here, results in weight gain. While gaining a few pounds here and there (and perhaps indulging in a little too much fast food) is not uncommon, there is a clear difference between this behavior and binge eating disorder. This disorder is the result of chronic feelings of emptiness, and it can lead to feelings of embarrassment and guilt.
People who binge often try to counteract their eating disorder by excessive dieting, exercising, or purging. Binge eating includes the following symptoms:
- Weight gain
- A feeling of a lack of control over your eating behavior
- Depression or guilt stemming from your eating behavior
- Eating when you’re not hungry
- Eating in secret
By admitting that an issue exists and practicing frank communication about your feelings, you can start to heal. Support groups, as well as a professional consultation may help you recover from this disorder.
Additional Eating Disorder Resources:
- National Eating Disorders Association
- Child Mind Institution: Eating Disorders and College
- National Association of Anorexia Nervosa and Associated Disorders
- HelpGuide.org: Eating Disorder Treatment and Recovery
Sleep Health Related Disorders
“Sleep health” is a rarely defined term, but it is essential for academic (and real-world) success, as well as your physical well-being. Sleep health refers to the quality and quantity of sleep an individual gets — a person who sleeps at a consistent time, in an efficient manner, and for a sufficient number of hours, can be said to have good sleep health. The specifics can depend on your individual needs. Some people, for instance, require fewer hours of sleep each night than others.
As a college student, you must ask yourself: “Am I getting enough sleep?” Some factors that can impact a college student’s sleep health include getting accustomed to new class schedules, late-night study sessions, procrastinating completing assignments, and social events. For online students, time spent in front of a computer, and even the student’s work and study space (or lack thereof) can impact sleep quality or ability to fall asleep.
Do you feel too tired to concentrate? Do you regularly have trouble falling asleep in a reasonable amount of time, if at all? You may be suffering from a sleep disorder. Poor sleep health can cause serious problems in your day-to-day life. Take a look at the information below to learn if you need help improving your sleep health.
Adults from the age of 18-25 should get around 8 hours of sleep each night. As reported by NPR, the average amount of sleep college students get per night is just over 7 hours. While this deficit may seem trivial, it’s important to note that sleep deprivation is cumulative; over time, it can have extreme detrimental effects.
The effects of sleep deprivation include:
- Memory issues
- Trouble focusing
- Weakened immune system
- High blood pressure
- Weight gain
In addition to negatively affecting your mood and your ability to perform daily activities, sleep deprivation can lead to deeper, potentially chronic health issues, such as cardiovascular disease and diabetes. Obviously, given some of these effects, sleep deprivation can also inhibit your ability to meet your academic goals.
Habits for Improving Your Sleep Health
When establishing a good sleep schedule, you’ll want to go to bed and wake up at the same time on each day, regardless of your class schedule. This will help regulate your body’s “clock,” helping it to anticipate rest.
Before going to sleep, avoid any activities that can cause stress or anxiety. You’ll also want to avoid looking at bright lights (like from your phone, for instance) while in bed. Doing so can make it difficult to fall asleep in a timely fashion, so minimize phone time and keep the lights off.
If you struggle falling asleep, take an inventory of how you are feeling and try to determine what is keeping you awake. Are you uncomfortable in your bed? You may need to invest in a new bed or mattress topper. Are you too hot or cold? Experts state that temperatures between 60-67 degrees are ideal for sleep.
One factor that affects the sleep habits of many college students is their caffeine intake. One peer-reviewed study found that on average, college students drink approximately 160 mg of caffeine a day. If you have a habit of drinking excessive coffee or energy drinks, however, you can easily exceed 500 mg in day. Avoid drinking too much caffeine before heading to bed in order to improve your sleep health.
If you need help falling asleep, consider looking into sleep aids. If you live in a loud neighborhood or near roads with heavy traffic, for example, ear plugs may dramatically improve your sleep — just be sure your alarm is loud enough to wake you up before class!
Additional aids like melatonin, magnesium, and valerian root have been shown to help some people fall asleep, but your personal experience may vary. Furthermore, some of these aids may have unwanted side effects. Consider consulting your physician before taking any medications or supplements to assist with sleep.
Recognizing Sleep Disorders
Sleep disorders are recurring patterns of behavior that lead to sleep deprivation. Some of the most common sleep disorders are:
- Insomnia: A disorder that makes it difficult for sufferers to fall or stay asleep. This can lead to a severe lack of rest. Insomnia can be short term or chronic. Students often experience short-term insomnia when adjusting to a new school or class schedule.
- Sleep apnea: If a person experiences interruptions in breathing during sleep, they may be suffering from sleep apnea. This usually occurs when the tissue of the back of the throat collapses during rest, leaving the sufferer gasping for air. While anyone can experience it, people who are overweight are more likely to have sleep apnea.
- Restless leg syndrome: As a result of a disorder with a part of the nervous system, restless leg syndrome can cause sleep deprivation. Those with this syndrome experience a strong urge to move their legs. Obviously, this can complicate the act of falling asleep.
If you believe you may have a sleep disorder, try taking a sleep disorders screening survey. If this indicates that you could have a disorder, discuss your concerns with your primary physician.
Additional Sleep Resources:
- Sleep Problems in University Students – an Intervention
- Sleep Education: Sleep Disorder Categories
- National Sleep Foundation: Sleeping Tips and Tricks
- Mayo Clinic: Insomnia Treatments
- Caffeine Safe Limits: Calculate Your Safe Daily Dose
Mental Health Stigma and Bullying
Students of all ages often feel an intense social pressure to fit in with their peers. While this can lead to destructive, addictive behaviors, it can also manifest as stigma against mental health issues. People who “out” themselves as having a mental health issue can face social isolation, mockery, and worse from their peers. Even online students can be shunned in academic forums and during collaborative assignments. Bullying can make attending college with a mental illness intolerable, and the prospect of being honest and open about mental health issues in a hostile environment, unfortunately, can be a huge barrier to seeking treatment.
Mental health issues are and should be regarded as a widespread public concern. When a peer admits they have a mental health issue, take the time to help them access quality information about their disorder and help them work through coping strategies if needed. Understand that working through a mental illness can be a long journey, sometimes lasting a person’s entire life. Through empathy and understanding, you can be a powerful ally to friends and family with mental health concerns.
The Relationship Between Mental Illness and Dropouts
Mental health stigma can be prevent those who have it from achieving academic success. According to surveys reported on by the National Alliance on Mental Illness, 47 percent of students with schizophrenia drop out of college, and 70 percent of students with bipolar disorder are more likely to drop out of college than those with no diagnosed mental illness.
In order to limit your or your loved one’s likelihood of dropping out, keep in mind that those affected by mental illness must learn to accept their condition and follow the medical advice of their physician, as well as take advantage of coping strategies. You should also maintain contact with the school about the diagnosis, and let them know when time off will be needed to manage the condition.
Responding to Mental Health Discrimination and Bullying
In order to accept and be open about mental illness, you need to respond to inappropriate and insensitive comments about mental health. The American Psychiatric Association suggests:
- Being open about your own mental health issues, as long as you are comfortable doing so. Demonstrate that your illness does not define you.
- Being mindful about your own word choice when it comes to mental illness. Don’t use demeaning, hurtful terms like “crazy,” “psycho,” or “insane” to describe an illness. These words reinforce mental health stigma.
- Standing up for friends, family, or yourself when someone says something insensitive about a mental health condition. Explain how common mental illness is, and remind them that mental illness is not a choice.
- Supporting education and understanding about mental health. Share mental health resources with people who demonstrate a misunderstanding of mental health conditions.
Additional Bullying and Mental Health Awareness Resources:
- National Alliance on Mental Illness: How You Can Stop Mental Illness Stigma
- Psychology Today: Combating Stigma Associated with Mental Illness
- Psychiatric Time: Cyberbullying and College Students – What Can Be Done?
Other Common Mental Health Challenges and Resources
There are other common mental health issues impacting college students that are not covered in prior sections in this guide. For those looking for resources related to other conditions they might be dealing with, this section offers further resources related to ADHD, bipolar disorder, and psychotic disorders:
Attention-deficit/hyperactivity disorder is a condition that affects millions of college students, and it can complicate schoolwork. While high school individualized education programs (IEPs) ensured that you had access to whatever accomodations you needed, you’ll need to be proactive after transitioning to your first year of college.
Succeeding in college with ADHD requires being open about your condition. If you need accommodations, get in touch with your school’s disabilities office with documentation about your needs. This will improve your chances of academic success.
While ADHD can lead to procrastination, poor organization, or poor time management, you can succeed by practicing good self-care, taking advantage of support systems, and setting personal goals and priorities. Work closely with your physician and take medication for ADHD as prescribed.
The term “bipolar” is often used as a pejorative, but bipolar disorder is a real mental illness that affects many college students. Because symptoms appear between the ages of 15 and 24, many college students are unaware of their condition until it has caused a considerable amount of anxiety — sometimes leading students to dropout before getting a diagnosis.
Symptoms of bipolar disorder include:
- Cycles of depressed and elevated moods, with each stage lasting anywhere from a few days to a few months (this varies greatly from person to person)
- Constant feelings of anxiety, apprehension, guilt, and apathy
- A lack of concentration
- Weight gain or loss, often in tandem with mood cycles
If you suspect you may have bipolar disorder, discuss your concerns with your doctor. Bipolar disorder can be notoriously difficult to diagnose, though those experiencing clear manic and depressive episodes usually receive a quick diagnosis. The sooner you determine the cause of your mental health concerns, the sooner you can begin to address it through medication and coping strategies.
There are a number of psychotic disorders that haven’t been covered in this guide thus far. While there are a wide range of these illnesses, here are some of the most common that affect college students:
- Schizophrenia: People with this condition have changes in behavior and experience delusions/hallucinations that persist for longer than six months. Students who suffer from schizophrenia and are left untreated often experience social isolation and a loss of interest in academics or extracurricular activities.
- Brief psychotic disorder: Those undergoing a great period of stress — such as losing a loved one — may have a psychotic break, consisting of delusions, violent outbursts, and depression. If you experience a short and sudden episode of psychotic behavior, you may have brief psychotic disorder.
- Delusional disorder: People who hold false, persistent beliefs about the real world that last for at least one month may be experiencing delusional disorder.
- Substance-induced psychotic disorder: If, during the use of or after ceasing the use of alcohol or drugs, you experience delusions/hallucinations, you may be experiencing substance-induced psychotic disorder. Read more about alcohol and substance abuse above, earlier in this resource guide.
Suffering from a psychotic disorder can be an alarming, stressful experience, but you can successfully navigate college by openly communicating your experiences with friends, family, your physician, and your school. Doing so will enable you to get a diagnosis, seek proper treatment, and take steps to care for yourself.
Additional Mental Health and Wellness Resources:
- College Students: Mental Health Problems and Treatment Considerations
- Children and Adults with Attention-Deficit/Hyperactivity Disorder: Succeeding in College With ADHD
- Attention Deficit Disorder Association: Support Groups for Adults
- HelpGuide.org: Bipolar Disorder Signs and Symptoms
- WebMD: What Is a Psychotic Disorder?