College Mental Health: Resources & Self-Care Strategies

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.

  • 22% of people aged 18-25 have a mental illness (in comparison to 21% among adults aged 26-49 years and 14.5% among adults aged 50 and older, according to the National Institute for Mental Health)

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:

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

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:

  • Learning disabilities
  • ADHD
  • Schizophrenia
  • Bipolar disorder
  • Eating disorders
  • OCD
  • Self-harm and self-injury
  • Suicidal thoughts

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

  • 20% of college students meet the criteria for an alcohol use disorder, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 2015
  • 7% abuse unprescribed stimulants, such as Adderall, as of 2005
  • 4% use marijuana on a daily basis
  • 4% use cocaine recreationally
  • 0.1% use cocaine on a daily basis

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.

  • Homesickness – Whether you attend college in a different country, a few states over, or nearby, living away from home can be difficult. You may miss your family and friends, the familiarity of home, and your old routines.
  • Social challenges – Starting fresh at college with few or no friends to begin with can be intimidating, especially if you had the same group of friends throughout middle and high schools. It’s common to feel like you’ve forgotten how to make friends or like you don’t fit in on campus.
  • Academic stressors – College academics can feel like a whole new level compared to the workload of high school. Some classes may only have a couple of large exams that make up your entire grade; others may have heavy reading assignments or weekly essays. And when midterms and finals roll around, stress levels can be higher than ever.
  • Imposter syndrome and self esteem – The rigor of college academics can be a big shock, especially if you were a high-achieving student in high school and everyone around you suddenly seems like a rockstar, or you receive a C for the first time. Imposter syndrome is the experience of doubting your accomplishments and feeling like a fraud, along with feelings of inadequacy and self-doubt. Being surrounded by peers and intelligent people at college can make it difficult not to compare yourself to your impressions of others.
  • Trouble adapting to college life – College comes with a whole host of changes that can be stressful. You may not get along with your roommate or you may have trouble finding the right classes for you. It may a struggle to find your place on campus and feel comfortable in the new environment.
  • Relationships – College may be a time when you are learning the dynamics of a relationship for the first time, experiencing your first breakup, or dating long distance. You may struggle with loneliness during a long distance relationship or struggle with self-worth after a breakup.

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

  • Generalized anxiety – Students affected by generalized anxiety may experience excessive and often uncontrollable amounts of worry related to everyday events such as academics, part-time jobs, college loans, and family issues. Some symptoms that may accompany generalized anxiety include restlessness, fatigue, difficulty concentrating, and irritability.
  • Social anxiety – Social anxiety involves intense anxiety or fear about social situations in which one could be judged by others. Students affected by social anxiety may experience persistent fear of being scrutinized by other students during a conversation, at a party, or while running errands. They may avoid social situations that cause them fear or anxiety, or endure the situation with intense discomfort and anxiety.
  • Anticipatory anxiety – Anticipatory anxiety refers to anxiety about events or activities to come. This could be about an exam, a date, a meeting, or any stress-provoking future event.
  • Panic disorders and panic attacks – Panic attacks are intense, abrupt episodes of fear with physical and cognitive symptoms, including chest pain, shortness of breath, sweating, shaking, pounding of the heart, and nausea. Many individuals fear they are having a heart attack when they experience a panic attack. Panic disorder entails the recurrent experience of such panic attacks. The individual fears having more panic attacks and often tries to take steps to avoid situations that may lead to them.
  • Separation anxiety – Students experiencing separation anxiety may feel excessive fear or worry about being separated from home or important people in their lives as they head to college. This may be an experience they have in freshman year, but can recur with each semester or each time they leave home.
  • Test anxiety – Students may experience strong fear and anxiety when preparing for an exam, midterm, final or project. They may also experience test anxiety when taking the exam, or even simply thinking about it.

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.

  • Grades and exams – Grades and exams are one of the most common stressors for college students. The pressure to earn good grades can be overwhelming, especially when you are juggling clubs, a part-time job or internship, and a social life.
  • Being away from home – Learning how to live independently at college can be a challenge. You may feel lost without the guidance of loved ones or you may feel uneasy or isolated without their comforting presence.
  • Social anxiety – College is a place full of entirely new people all looking to make friends and find belonging. Approaching new people and introducing yourself can be nerve-wracking. If you feel like everyone else already has a close group, making new friends can be intimidating and anxiety-provoking.
  • Choosing majors, graduate schools, and careers – College opens many doors, but the amount of choices and possibilities for majors, graduate schools, and careers can also feel overwhelming. It can feel like you need to decide your future in one moment, and it’s very common to feel immense pressure to make “the right choice.”
  • Career stress – College may be the first time that you go to an interview, whether for a job, an internship, or another position. It's common to stress about interviews, resumés, and career paths; however, it’s also important to recognize when these turn into persistent anxiety that affects your daily functioning.
  • Imposter syndrome – Upon entering college, you may feel like everyone is smart, everyone has a plan, and everyone knows what they’re doing. This type of thinking can easily lead to imposter syndrome. When an individual is experiencing imposter syndrome, they doubt themselves and their abilities, they feel like a fraud, and they have a fear of being “found out.,” which may lead to anxiety.
  • Money, loans, and part time jobs – College tuition is on the rise and with it increases students’ stress levels. Students may have to take on part-time jobs or loans to cover the cost of their education. A job on top of course work can be overwhelming and just the thought of students loans can be frightening.
  • Living with roommates and in dorms – If you are used to having your own room, adjusting to living with one or more roommates can be difficult. You might find that you having different living habits, such as when you go to bed or how clean you keep your space. You may feel pressured to be best friends with your roommate, though you are just not compatible in that way. Whatever the issue, living with and around new people can be a source of anxiety and stress.
  • Perfectionist attitude – It’s often said that we are our own worst critics. Perfectionists strive for faultlessness and their best never seems good enough. They beat themselves up for mistakes and have unachievable personal standards. In college, perfectionist tendencies may present as getting very upset over a B or criticizing yourself over not getting a certain internship.
    Learn more about perfectionism, self-standards, and how to address unhealthy thinking >>
  • Anxiety around relationships – College is a time when many students begin to explore romantic and sexual relationships, whether they are long term committed relationships or short term hook ups. These new experiences may lead to anxiety around self-image, commitment, sexuality, social media and online dating, balancing relationships and other responsibilities, figuring out what you want in a relationship or sexual experience, and finding a compatible partner. Likewise, many students struggle with feelings of isolation when they see peers engaging in new relationships and they are left behind. Relationship challenges are one of the most common reasons college students seek therapy, and persistent concern about how to find a relationship or maintain one can contribute to anxiety.

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.

  • Keep your responsibilities to a manageable level: One of the best ways to manage your stress level in college is to make sure you don’t overload yourself with responsibilities to classes, a job, clubs, sports, or friends. It may feel like your peers are taking more classes than you, are involved in more clubs, or are more social. Everyone can handle different amounts of activities. Do what is best for you, even if it takes some time to figure that out.
  • Get sufficient sleep: You’ve probably heard it time and time again, but: make sure you get sufficient amounts of sleep. It is recommended that college students get at least a solid seven hours of sleep per night. While on some nights it may seem impossible to get a full seven hours (for example, if you have a big exam the next day), getting enough sleep will ultimately help you feel and perform better.
  • Eat a balanced diet: Learn how to eat well on a college student budget, including grocery shopping, meal prepping, and eating enough to sustain academics, work, and activities. A nutritious diet is essential for your body to function, as stress can take an even greater toll when you are malnourished or not eating healthily.
  • Be mindful of your comfort foods: When you are stressed, your digestive system is likely under a great deal of stress, too. It’s tempting to have pizza, burgers, and cookies from the dining hall everyday, but foods like these that are high in salt, fat, and sugar can upset your system even more. When you seek your comfort foods, consider closing your laptop or textbook and really savor the food you’re eating. Taking the time to enjoy the food, rather than eating while working or stuffing it down, can help you feel more satiated. If you are concerned about binge eating, know that this is very common, especially in a high stress environment like college and around this age range; according to the National Institute of Mental Health (NIMH), the average age of onset for binge eating disorder is 25 years old. Consider reaching out to a dietitian or counselor to discuss ways you can better address stress, as well as any changes you may be able to make to your current particular situation.
  • Take note of when you're under-eating: By the same token, under-eating in response to stress can lead to fatigue and nutrient deficiencies, ultimately straining the body even more. Intense or ongoing stress can lead to restricting behaviors and eating disorders, too; the National Eating Disorders Association (NEDA) estimates that between 10-20% of female college students and 4-10% of male college students suffer from an eating disorder, and rates are on the rise. Maintaining a balanced diet during times of stress can be difficult, and if you’re struggling with food intake, know that you’re not alone. Speaking with a dietitian or counselor can be a great first step to rebuilding a healthy relationship with food.
  • Moderate your caffeine intake: Many college students practically run on caffeine, whether in the form of coffee, energy drinks, or soda. Unfortunately, too much caffeine hypes up your system in a way that will make you feel even more strained. Caffeine increases the body’s levels of cortisol, the “stress hormone.” Cortisol has a central role in the body’s stress response. A moderate amount of caffeine may boost your mood, but too much throughout the day will stimulate your body just to let you crash later.
  • Make time to exercise! Exercise is linked to stress reduction, and good news: most colleges have gyms on campus that students can attend for free! Physical activity releases endorphins, the feel-good neurotransmitters of the brain. You could join a club sport team, practice yoga, use treadmills or ellipticals at the gym, or lift weights. You can even make up your own exercise routine to do right in your room, including stretching or body weight moves such as mountain climbers and leg lifts.
  • Try meditating and breathing exercises: Meditation and breathing exercises are great ways to deal with stress and anxiety. While it can be hard to practice on a regular basis amidst the busyness of daily life, there are many simple mindfulness exercises to manage anxiety that can be practiced anywhere, anytime. Try finding 5min in the morning, between classes, or even before you begin studying at the library. You can also download guided walking meditations to listen to on your way to or between classes. Don’t feel ashamed or guilty if you don’t practice daily – you can simply see it as a tool to use whenever you remember it.
  • Incorporate small acts of self-care: Try to sneak in self-care in small places: set aside the 10 minutes between classes for a meditation in a quiet spot, grab a coffee and really pay attention to the taste and warmth, stretch your muscles, and walk mindfully between classes, paying attention to the colors all around you. These small acts of self-care definitely add up.

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 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.

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


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%)."

  • National Institute for Mental Illness. Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-9.

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

  • The Association for University and College Counseling Center Directors Annual Survey, Reporting period: September 1, 2011 through August 31, 2012

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

  • National Institute on Alcohol Abuse and Alcoholism (NIAAA), 2015

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

  • McCabe SE1, Knight JR, Teter CJ, Wechsler H., Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey, 2005

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

  • American College Health Association-National College Health Assessment fall 2016

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.

  • American College Health Association, 2017 survey

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.

  • Novotney, A. (2014, September). Students under pressure. Retrieved August 18, 2018, from

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

  • Neuman, B. (2015, August 31). 57% of Female and 40% of Male College Students Experience Overwhelming Anxiety. Retrieved August 18, 2018, from

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

  • How Much Sleep Do I Need? (2017, March 02). Retrieved August 18, 2018, from

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.

  • Jacobson, R. (2017, August 30). Eating Disorders in College Students. Retrieved August 18, 2018, from