College Mental Health: Resources & Self-Care Strategies

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College is an exciting time for students, but also one that often poses challenges. Not only are you in a new environment and perhaps away from home for the first time, but also, the college age range has the highest prevalence of mental illnesses among any age group.

These may include anxiety, depression, ADHD, learning disabilities, and alcohol and marijuana use.

Mental illness is nothing to be ashamed of, and is generally not something that a person can simply “snap out” of. A mental illness can affect all aspects of a person’s life, including school and grades, relationships, social life, work, and everyday functioning. If you feel that you are struggling with your mental health, it is important to reach out to get the help you need and to take your mental health seriously.

Learn about anxiety and depression in college, self-care strategies, and how to find a therapist below.


Mental Health in College

Prevalence of mental illness among college students

The college student age range has the highest prevalence of mental illness among all age groups.

Studies by the American Psychological Association (APA), the American College Health Association (ACHA), and the Association for University and College Counseling Center Directors (AUCCCD) also suggest that mental illness is more common among college students now than ever before.

According to a 2013 survey by the AUCCCD:

Mental health challenges that college students experience

Mental health issues among college students span more than just anxiety and depressive disorders. College students struggle with:

Additionally, it is common for students dealing with the stress of college life or a mental illness to turn to alcohol or other substances to cope. The use of drugs and alcohol can exacerbate symptoms of mental illnesses, interfere with school work and daily life, and develop into an addiction.

Prevalence of addictions among college students


Depression in College

What is depression?

Depression is characterized by persistent sadness or depressed mood and a lack of enjoyment in normal activities. During college, busy schedules, higher workloads, being away from home, living with new people, and dealing with financial pressures can contribute to feelings of loneliness and stress, which can lead to mild to major depression among students.

Prevalence of depression among college students

Depression is one of the most common mental health issues among college students. The 2013 National College Health Assessment by the American College Health Association (ACHA) surveyed 125,000 students across 150 schools, and found that about one third of US college students (33% of women and 27% of men) had experienced such severe depression in the last year that it had been challenging to function.

Signs of clinical depression among college students

Students experiencing a depressive episode commonly feel sad, empty, hopeless, fatigued, or irritated. They may be frequently tearful or frustrated and angry, even about small issues. They may find themselves uninterested in activities they once enjoyed, such as clubs, sports, volunteering, and spending time with friends. People with depression may feel tired most of the day, even if they have not engaged in strenuous activity or have had adequate sleep.

Changes in appetite, weight, and sleeping patterns can also accompany depression. People experiencing depression may gain or lose weight, feel more or less hungry than usual, and may sleep more or experience insomnia. Changes in body movements can also occur, such as moving more slowly or feeling restless. Depression can also make it difficult to think or concentrate; it may feel nearly impossible to complete assignments or pay attention in class or work. Finally, thoughts of death or suicidal ideation may occur.

Difference between normal feelings of sadness and clinical depression

It is common and normal to experience some of the symptoms of depression during a difficult time; for example, grief can resemble symptoms of depression. However, if these symptoms last for longer than two weeks or progressively worsen, it is important to take them seriously and reach out for help. Depression is usually recurrent, meaning that once one depressive episode occurs, future episodes are more likely. It is a frequent misconception that one can snap out of depression; However, there are many effective treatments for depression.

What is dysthymia?

College students may also experience longer term depression. This is called persistent depressive disorder or dysthymia. Dysthymia is characterized by symptoms of depression that persist more days than not for at least 2 years. Similarly to clinical depression, helpful treatments exist for dysthymia.

Factors contributing to college depression

While there are many potential causes of depression in college, some of the challenges unique to university life can act as triggers. These include but are not limited to the following. Because depression and anxiety often occur together, some of the same factors that affect college depression may also contribute to college anxiety.

How to deal with depression in college

It is never too early to start confronting feelings of depression. If you are experiencing depression in college, there are many resources for on- and off-campus professional and peer support, as well as self-care strategies. Sharing what you’re experiencing with a trusted friend, family member, dean, or professor can be a great first step. If feelings of depression and sadness persist, are hurting your grades and academics, r are causing you to experience scary thoughts, seek professional help. Being able to recognize the need and reach out for professional help is a strength: look for your university’s on-campus counseling services or find off-campus therapists for longer-term care.


Anxiety in College

What is anxiety?

Anxiety disorders involve persistent anxiety, worry, or fear that interfere with daily functioning. There are different types of anxiety disorders such as generalized anxiety disorder, social anxiety, and panic disorder. Anxiety disorders can often occur in high-stress college environments, and it is important to recognize when your anxiety levels are interfering with your happiness and daily functioning and receive professional support.

Prevalence of anxiety among college students

Anxiety disorders are the most common mental health issue among college students with 57% of women and 40% of men having experienced overwhelming anxiety in 2010.

Common types of anxiety in college students

Difference between healthy stress and unhealthy anxiety in college

While it is a natural part of daily life to feel stressed from time to time, persistent and excessive anxiety can impair students’ daily functioning and happiness. With low levels of stress students are able to overcome difficult emotions and feel better in a short amount of time. Likewise, some stress before an upcoming exam or interview can actually help students perform better. Unhealthy anxiety is pervasive, persistent, and excessive. It affects the individual more days than not, and for most of the day. This may be the time to seek professional guidance.

Contributing factors to anxiety in college

Academic, career, personal, family, and financial stressors can contribute to anxiety in college. Because anxiety and depression often occur together, some of the same factors that affect college anxiety may also affect contribute to college depression.

How to deal with anxiety in college

One of the first steps to addressing anxiety in college is learning what causes your anxiety. When you understand the triggers of your anxious feelings, you’ll be able to better manage it with interventions specific to you. For example, for social anxiety, you may try gradual exposure, in which you have a friend progressively help you meet and interact with new people. You can also seek therapists with training specific to the type of anxiety you are experiencing.

Everyday strategies such as breathing exercises, mindfulness skills, yoga, meditation, and exercise, can help with any type of anxiety. Keep in mind that many of the resources and techniques that can help someone dealing with depression can also help someone battling anxiety. Find what works for you. If one technique doesn’t work for you, that’s okay. It’s a matter of finding a way to care for your mental health that is personally effective.


Self-care Strategies in College

Keeping up a healthy sleep level, diet, and exercise routine are things that college students often let slip, even if it may seem intuitive to address these factors when stress levels rise. To help prevent yourself from becoming overly stressed in the first place, make sure your schedule is reasonable; it can be easy to overload yourself with responsibilities to classes, a job, clubs, sports, or friends. Finally, breathing exercises and mindfulness skills can be used throughout the day to maintain a positive and peaceful state of mind.

What are useful self-care strategies in college?

Sometimes the most effective ways to manage your stress in college are the simplest: keeping up a healthy sleep level, diet, and exercise routine can help significantly, though they may be the easiest to forget when you’re busiest or when your stress levels rise.

Self-care during exams, midterms, and finals

The Yerkes-Dodson Law dictates how performance is affected by high emotional states, also called arousal. The law states that, generally, how well you do at a task increases with increased arousal to a certain level, at which point it begins to decrease. The Yerkes-Dodson law states that you reach your peak performance at about a middle-of-the-road level of arousal. You can use this concept to think about exam stress. For example, rather than falling into “all-or-nothing” thinking, find the middle ground of just enough anxiety to perform well, but not too much that it becomes debilitating. To keep your anxiety levels in check, get enough sleep, food, and quality time with friends. And make sure to reward yourself for the effort that you put in to keep your motivation high!

Self-care for freshmen

College is an exciting and new time in your life; however, it's also perfectly normal and common to feel hesitant. Transitioning to college means entering a new stage of life, and this can provoke a lot of anxiety for many freshmen students. Know your resources as a freshmen, invest in relationships, and develop a self-care routine early on. Know that almost everyone experiences some level of adjustment struggle, so you're not alone!

How to overcome the sophomore slump

Many people experience the infamous “sophomore slump." College suddenly feels like a drag as you're no longer celebrated as the newcomers on campus like freshmen, but you also don't get to take advantage of the research and internship opportunities of juniors and seniors. A 2012 report that 6% of students at state colleges take leave in their second year, while another survey found that a quarter of sophomores didn't feel energized by their classes or feeling at home on campuses. To find your place of belonging and reenergize your experience as a sophomore, invest in quality friendships, break out of your routine by exploring areas off-campus, and make sure to balance academic intensity with sleep, food, and basic self-care. Recognize that sophomore year can be a valuable and enriching year if you ease into the new stage of college and carve your own path.

Junior year is marked with a whole slew of challenges that can impact your mental health, but it’s also a great time to have new experiences and take on enriching opportunities. Learn to navigate the intensity of junior year with compassion for yourself and actionable items. For example, try communal cooking or meal prepping with your roommates to ease the transition to to off-campus living. Learn to handle rejection from summer internship and job applications, and draw support from your resources, including friends, counseling centers, career centers, faculty, and family.

Addressing senior year quarter-life crises

Quarter-life crises may hit you a few years after graduation, or start in senior year when you start applying to full-time positions. A quarter-life crisis makes you feel doubtful about life due to stress around life transitions, including careers, dating, and relationships. A big part of the transition into adulthood involves finding your place in the world, and this can be a big stressor for many people. If you're feeling lost in your career decisions, consider taking advantage of volunteer and internship level positions. You can read career descriptions but will learn so much more about the industry and the day to day life of the field if you actually try working in the role. If you're facing dating challenges, take breaks, and get back into the game rather than lose hope. It's easy to feel discouraged after going on several dates and either not meeting people you really click with or even being "ghosted," but remember that it only takes one person who is the right fit. Finally, if you are struggling with serious relationships, whether romantic relationships or friendships, try engaging in self-reflective practices such as mindfulness, journaling, therapy, and self-development workshops. Therapy can also help you process your relationship patterns, as well as to simply vent and process thoughts and feelings.

Self-care for college athletes

If you are a college athlete, the emphasis on the body and pressure to perform can manifest in harmful ways. You’re navigating a new environment, need to find your place on a new team, and may struggle to balance new academic and athletic expectations. It’s a lot to take on, not to mention physically exhausting! To compete at the highest level while maintaining nutritional and emotional wellness, schedule meals, develop outlets to release stress, and encourage positive dialogue within your team. And if you can, take additional self care measures designed for college student-athletes.


How to Help a Friend in Need

Seeing a friend in deep pain can cause us to feel lost and helpless. Know that often what your friend needs most is to be free to safely express themselves in their vulnerability. Below are a few steps you can take to help a friend in need. Most importantly, remember that you are not a trained professional, nor are you expected to be! Use the suggestions below to help direct your friend to safe resources.

How to be a safe, supportive friend

  1. Take the time to listen. Notice your own feelings around what the person is telling you, try to care for your own feelings, and keep them separate from your friend’s feelings. This will help you to listen to your friend.
  2. Show them you've heard them. Reflect back to your friend what you've heard; for example, "I'm hearing you say that you feel unsafe right now."
  3. Use a validating statement. You might say, "that sounds really scary" or "that sounds really painful" to validate their experiences and show they are acceptable. Avoid phrases such as, "don't be silly, you're amazing," as they devalue the experience that your friend is sharing with you. Be careful not to go into your own story. You can share an example from your life to normalize their experience, but keep it brief.

Useful things that you can say

"I care about you and your safety and I want to make sure that you have the kind of help that you need and want."
"It sounds like you need more help than I can give and I want to make sure that you have it because you have the right to it."
"What I'm hearing you say is that you need help feeling and/or staying safe. Will you let me help you find assistance with this?"

How you can direct your friend

"I have a plan" = Call 911 or your university’s emergency medical system and report a mental health emergency. They will send a trained paramedic. Ideally you do this with your friend if they are willing. If they are unwilling, find a quiet place and send the paramedic to the location of the person. If you don't know their exact location, call anyway.

"I have no plan and I don't want to kill myself, I just feel like it sometimes" = Engage the person in a conversation of what they need right now to be safe as well in the next couple of days. This might mean, "Why don't you sleep over and tomorrow we can look for a therapist or go to urgent care?" or "I think it would be best for you to get some immediate help" (call 911 or your university’s emergency medical system).

Always trust your gut, and know what you can handle. Reach out to immediate help if needed.

How to help a friend during the holidays

One time of the year when you may notice your friend particularly struggling is the holiday season, such as Thanksgiving, Christmas, and the winter holidays. While the holiday season is often portrayed as the most wonderful time of the year, life circumstances such as a recent loss, financial insecurity, change in family structure, and mental health challenges can cause this time to be difficult to get through. Look for specific signs that may cause someone to struggle and ways you can help a friend during the holidays, such as acknowledging the stress of their situation or inviting them to join your holiday celebration.


On-campus Resources

Crisis support for college students

If you are experiencing suicidal thoughts, severe panic, dangerous impulses, extreme disorientation, delusions, or hallucinations, reach out for help right away. Many colleges have a mental health emergency helpline or a counselor on call, which you can find on your school’s website. There are also national helplines that operate 24/7 and can provide you with emotional support and further resources. These helplines are free and confidential.

See a list of other national and local immediate help resources >>

On campus mental health resources for college students

An increasing number of college students are seeking emotional support and mental healthcare at their campus counseling centers. This is a great start to learning more about your mental health and ways to deal with college depression, anxiety, stress, family issues, or any other mental or emotional challenge. Most counseling services provide short-term therapy and can provide you with referrals to off-campus therapists if you are seeking longer term care. Counseling centers may be able to identify outside resources who specialize in a certain topic or accept your insurance.

On-campus peer resources  

Peer resources including resident assistants (RAs), and campus groups such as Active Minds and NAMI chapters are there to help you. They are friendly and happy to talk or help with whatever you may need. It may be daunting to reach out to people or groups you don’t know, but keep in mind that you have nothing to lose by asking. Remember that you can also reach out to your roommates, friends, or family members for support. There are people who care about you and would be more than willing to be by your side; you just have to ask.


Off-campus Resources

What to look for in an off-campus therapist

Some factors to consider when looking for an off-campus therapist include the type of provider that you need, which insurances the therapist accepts, the therapist’s specialties, and, later, your general feel for the therapist based on a phone call, video, or intake session.

Different types of therapists are licensed to provide different services; these mostly fall into the buckets of medication prescription (psychiatrists and psychiatric nurse practitioners) and talk therapy (all other mental health professionals, such as psychologists, social workers, and counselors). If you are aware that you are struggling with a certain issue, you may want to look for a therapist that specializes in your needs, for example, those with specific training anxiety, disordered eating, or addictions. Finally, client-therapist fit is an important aspect of therapy; think about whether you feel you can connect with the therapist moving forward.

How to pay for off-campus therapy

One way to offset the cost of off-campus therapy is to find a therapist who is in-network with your health insurance. You usually pay for part of the cost of therapy (your copay, or copayment), while your insurance covers the rest. The copay can range in amount, but typically falls somewhere between $20 - $30 per session. However, your health insurance may also have a deductible, which is the amount you need to pay before your health insurance starts to cover part of your session costs. Check your health insurance website or call your insurance company for these details of your benefits. While it can feel like a hassle to check, having this information upfront can significantly streamline your search.

If you are attending a college outside your home state and you have your parents’ health insurance, you may also find that your health insurance doesn’t cover services outside your home state. If this is the case, you can call your insurance company to learn about out-of-network benefits or check your out-of-network benefits on your insurance company website.

You can also try asking your therapist about sliding scale fees. A sliding scale is a range of lowered fees that a therapist may offer based on the client’s financial need. For example, a therapist may list a sliding scale of $80-$150 per session. Some clients with financial needs, including undergraduate and graduate students, may pay $80 per session even though the therapist’s standard fee is $150.

Off-campus therapy vs counseling centers: Privacy

On-campus counseling centers protect your privacy and take your confidentiality seriously. Where off-campus therapy may provide more privacy is in running into someone you know in the waiting room or while coming and going from sessions. Because therapists in the community are based off-campus, there is less possibility of this happening. Some students may also prefer to keep their college life and therapy separate to have more distance.


How to find an off-campus therapist

Finding an off-campus therapist can be a great option if you are seeking longer-term care, want to keep college and therapy separate, or need a therapist who specializes in a particular topic like eating disorders or addictions.

If you are in New York City, the Greater Boston Area, or Rhode Island, you can use Zencare.co to check the most up-to-date therapist availabilities and insurances. All clinicians on Zencare are interviewed and vetted by our clinical team before joining our network, and you can view videos of each therapist to get a feel for them and find someone you feel you can connect with. For those who have phone anxiety, you can book a free initial call on the website for the therapist to call you, or message the therapist via email.

Otherwise, you can contact your primary care provider for a list of therapists or psychiatrists nearby that accept your insurance. Campus counseling centers usually can provide referrals. There are also various online resources that you can turn to, including online therapists, self-care apps, and websites for finding mental health professionals in the area.

You don’t have to do this alone. Friends and family can help you find the resource that is best for you, whether that be an off-campus therapist that you see every week, a campus support group, or an online community.


Find Therapists Near Your College

Find therapists on Zencare who support college students, below. Search by insurance, fees, and location; watch therapist introductory videos; and book free initial calls to find the right therapist for you!

New to therapy? Learn about how to find a therapist here.


Sources

Young adults aged 18-25 years had the highest prevalence of AMI (22.1%) compared to adults aged 26-49 years (21.1%) and aged 50 and older (14.5%)."

41.6% of college students reported symptoms of anxiety and 36.4% indicated symptoms of depression.

20% of college students meet the criteria for an alcohol use disorder.

7% of college students had abused unprescribed stimulants, such as Adderall.

38% of college students reported they had used marijuana in the past year

4%, or one in 25 undergraduate students, used marijuana or pot nearly daily; 4% had ever used cocaine and 0.1% had used cocaine on a daily basis.

About one-third of U.S. college students had difficulty functioning in the last 12 months due to depression, and almost half said they felt overwhelming anxiety in the last year, according to the 2013 National College Health Assessment, which examined data from 125,000 students from more than 150 colleges and universities.

57% of female and 40% of male college students experience overwhelming anxiety.

Recommended hours of sleep per day for adults 18-60 years old: 7 or more hours per night

The association estimates that between 10 and 20% of women and 4 to 10% of men in college suffer from an eating disorder, and rates are on the rise.