Mental Health Issues in College Students

Know These Mental Health Warning Signs

by Dr. Christina Z. Atti, PsyD—Licensed Clinical Psychologist

College students are gearing up for yet another school year but now with a whole lot more uncertainty than students past. Terms with the words “crisis” and “epidemic” are being used by top experts to describe the mental health challenges American college students are facing. A 2018 and 2019 student survey conducted by the American College Health Association (ACHA) indicated that approximately 60% of students felt “overwhelming” anxiety, and 40% felt severe depressive symptoms that interfered with daily functioning.

Mood disturbances are just some of the mental health problems that are affecting college students. Other issues such as eating disorders, substance abuse, and suicide are also prevalent. According to the National Institute of Mental Health (NIMH), suicide is now the second-leading cause of death among college students. NIMH also reports that up to 25% of all college students struggle with an eating disorder, and eating disorders have the highest death rate of any mental illness. The National Library of Medicine’s (NIM) National Institutes of Health reports 37% of college students have used an illicit drug (e.g., benzodiazepines, cannabinoids, opioids, stimulants) and abused alcohol on a regular basis.

The information and statistics above are startling, to say the least, and highlights how we MUST make mental health a priority above all else. The following contains information to help students identify potential mental health issues and some resources to locate valuable resources. Download PDF of the Resources from Dr. Chrstina.

Anxiety

Anxiety is something most people experience from time to time. Anxiety may often be mistaken for simple everyday stress or minimized by chalking it up to ‘worrying too much’. When anxiety starts to interfere with daily life, this is when it crosses the line from stress to anxiety. Some warning signs of anxiety are:

Irritability
Persistent and chronic stress
Trouble concentrating and/or mind goes blank
Panic attacks
Dizziness and/or sweating
Shortness of breath (trouble catching breath or shallow breathing)
Muscle pain and/or tension
GI issues (upset stomach, diarrhea)
Restlessness and/or fidgety (appear wound up)
Headaches
Racing thoughts and/or obsessiveness (unable to shut the mind off)
Sleep issues (unable to fall asleep and/or stay asleep)
Withdrawing from friends, family or peers

Short-lived and infrequent periods of anxious feelings or behavior do not automatically indicate clinical anxiety. However, if anxiety seems to last longer than usual, or if symptoms start to manifest in obsessive behavior or an overwhelming sense of fear, then it’s time to seek help. Download PDF of the Resources

Depression

Depression is classified as a mood disorder that involves persistent feelings of sadness, hopelessness, and loss of interest in activities that were previously enjoyable. People experiencing depression may experience mood swings, sleep problems, changes in appetite, and physical ailments that have no apparent cause. Depression looks different in everybody and typically has symptoms that affect three areas: physical, emotional, and thinking. Some warning signs are:

Constant feelings of sadness (depressed most of the day, nearly every day)
Lack of pleasure and/or interest in activities that were once enjoyed
Changes in sleep (sleeping less or more than usual)
Changes in appetite (eating more or less than usual, weight loss or gain)
Fatigue and/or loss of energy
Isolating from friends and/or family
Feeling hopeless (“things are never going to change or get better”)
Feeling powerless (“there’s nothing I can do”)
Inability to think or concentrate and/or indecisive (can’t read or complete tasks)
Feeling worthless (“I’m no good”)
Inappropriate feelings of guilt
Thoughts of death and dying (without a specific plan)
Attempts of suicide and/or a specific plan for committing suicide

Exhibiting some of the above symptoms does not mean that you are depressed. However, if these symptoms are present with some regularity, you should seek some assistance and support in order to err on the side of caution. If you think you or someone you care about may be suffering from depression, seeking the help of a mental health professional is the best thing you can do. Download PDF of the Resources

Eating Disorders

Eating Disorders include a variety of conditions that are marked by irregularities in eating habits in addition to being preoccupied with one’s body image or shape. Some types of eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. As a whole, these disorders involve food deprivation, bingeing on food, purging after a binge, the use of diuretics, and/or over-exercising. There are some typical warning signs of eating disorders and they are as follows:

Anorexia Nervosa: involves an unhealthy fixation on thinness, where one severely restricts their intake of food oftentimes resulting in being severely underweight which then can result in extremely severe medical complications.

Fear of weight gain (even when severely underweight)
Restricting calories (oftentimes skipping meals or avoiding eating in front of others)
Lower body weight than what is considered “healthy”
Unable to see one’s body or shape in rational terms
Extreme weight loss
Fatigue
Dizziness and/or fainting
Dry or yellowish skin (jaundice)
Appearance of fine hair across the body (called Lanugo)
Changes in hair (becomes brittle or thin) or hair loss
Constantly feeling cold
Refusal to eat certain foods (carbs, fats, sugars)
Taking diet pills or medication that suppresses hunger (Ex: Ritalin or Adderall)
Frequent negative comments about appearance and/or body
Excessive exercise (even when injured or sick)
Withdrawing from social activities or friendships
Developing food rituals (eating foods in certain orders, not having food touch each other, chewing food a certain number of times)

Bulimia Nervosa: involves frequent and recurrent episodes of eating large amounts of food followed by compensatory behaviors such as purging, fasting, or over-exercising.

Distorted and/or poor body image
Broken blood vessels in the eyes (from vomiting)
Calluses or aggravated skin on the knuckles or fingers (from inducing vomiting)
Continual fluctuation in weight
Enflamed esophagus
Constant use of bathroom after meals
Teeth that are noticeably stained
Using mints or perfume after the use of the bathroom (to hide the smell of vomit)
The disappearance of abnormally large amounts of food
Eating when others aren’t round
Hoarding and/or stealing food
An aversion to spontaneous meals or snacks

Binge Eating Disorder: characterized by constant cravings of food that occur any time during the day and result in binge eating.

Ingesting food rapidly
Continuing to eat even when full
Lacking control over what and how much is eaten
Eating in secret or at unusual times (ex: hiding food in the closet to eat in the middle of the night)
Eating alone out of feelings of embarrassment
Weight fluctuations
Feelings of stress or anxiety that are only alleviated by binge eating
Cyclical feelings of guilt
Withdrawing from friends or family
Never feeling satiated or satisfied, despite how much is eaten

Eating disorders are complicated. If you suspect that you or someone you care about is struggling there are a myriad of resources and health professionals available. Download PDF of the Resources

Substance Abuse/Addiction

College is often a time of experimentation of alcohol and recreational drugs for many young adults, and this can lead them to engage in risky behavior. Binge drinking, prescription drug abuse, and recreational drug use are all common problems on college campuses. Addiction describes a pattern of physical and/or psychological dependence on one or more substances, including strong cravings and indulgence in substance abuse despite known risks and harms. Although not every student who participles in alcohol and/or drug use will develop an addiction, some will and the effects of withdrawal or prolonged use can be dangerous, if not deadly. Different types of substances will produce different types of effects however, some general warning signs of a problem are as follows:

Built tolerance of alcohol and/or drug use (needing more of the substance to get the same effects)
Being physically ill or “off” when not using the substance (ex: nauseous, shaking, difficulty breathing, sweating, pale)
Worsening physical appearance (ex: unkept, bad hygiene)
Weight loss or gain
Changes in personality (ex: fearful, anxious, aggressive or paranoid for no apparent reason)
Slurring of speech, bloodshot eyes, and/or impaired coordination
A sudden need for money and/or having a financial crisis
Increase in troubling behaviors (ex: getting into fights, being arrested)
Sudden change in friends, activities and/or hobbies
Withdrawing from friends, school, work and/or family
Using a substance to relieve stress, “feel better”, or avoid/suppress dealing with an issue

It can be complicated to establish when someone is actually dealing with an addiction problem; denial is often a very difficult barrier. If you are a college student who is struggling or knows someone who is struggling with binge drinking, prescription drug use, or the use of illicit drugs, you don’t have to face this alone. Download PDF of the Resources

Suicide

Suicidal ideation, or suicidal thoughts, is thinking about, considering, or planning suicide. The range of suicidal ideation varies from fleeting thoughts to extensive thoughts, to detailed planning of ending one’s life. Remember, if you suspect on any level that someone might be in danger, immediately call 911. It is not uncommon for students to feel frustration and doubt, but sometimes those emotions can begin to spiral, bringing students to a place where they are seriously considering ending their lives. Just like anything else, signs of suicidal ideation may look different from person to person but the following are indicators that a person may be in immediate danger and may need help:

Talking about wanting to die or kill oneself
Looking for a way to kill oneself (ex: buying a gun, hoarding a large number of pills)
Expressing feeling hopeless or not having a purpose in life (“what’s the point?”)
Sharing about feeling trapped or being in unbearable pain (“I can’t handle this”)
Talking about being a burden to others
Increasing alcohol and/or drug use
Engaging in reckless behavior (ex: driving too quickly, spending a lot of money)
Sleeping too little or too much
Withdrawing and/or isolating from family, friends, peers, or co-workers
Losing interest in activities they enjoyed before
Displaying mood swings (such as from rage to depression)
Appearing anxious or agitated
Giving away possessions they once cherished
Inexplicably visiting people to tell them goodbye

If you see any of the above behaviors in yourself, contact 911, take yourself to the hospital, and/or contact your campus counseling center immediately. If you are concerned that a roommate, friend, or peer is suicidal, it is important to talk to them immediately about your concerns. Ask them directly, “Are you considering killing yourself?”; studies show that asking this question does NOT increase the likelihood of suicidal thoughts and can be the foundation for taking the next steps to get a person some help.

Download PDF of the Resources from Dr. Christina Atti.

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