Many people experience significant mental health challenges in college, Carleton programming is designed to help students avoid unhealthy coping habits and ensure that they feel a sense of connections, belonging, and self-efficacy.
Sarah came to Carleton from a close-knit family in a small rural town, leaving behind the circle of friends she’d known since kindergarten. Almost immediately after starting her first year, she found herself overwhelmed by the sheer number of new names and faces. Sarah began waking in the middle of the night, heart pounding. In class she felt nauseous and dizzy. She was convinced that the other students could tell, and would become so self-conscious she could hardly concentrate on the lecture.
Vincent grew up in a large and diverse city. He came from a family of activists and had participated in social justice efforts throughout his high school years. Biracial, Vincent knew that he’d be in the minority at Carleton but he was not prepared to feel so disconnected from his community. Over the course of his first semester, Vincent grew increasingly isolated and at times even felt hopeless.
Sarah and Vincent are composite characters, their names changed for privacy purposes and their stories based on the dozens of young people I’ve seen as a professional psychotherapist. And because the college years are a period of change and growth—a crucial but uniquely challenging transition between adolescence and adulthood—their experiences are common.
Beyond the stressors of academic life, leaving the nest means leaving behind familiar routines and relationships. Structure and support are foundational for mental health: we flourish when we know what’s expected of us day to day, and when we have friends and family to lean on. College can mean rebuilding these foundations from scratch, all the while navigating the heady questions that accompany early adulthood: Who am I? What matters to me? What do I want to do with my life?
As a result, many individuals experience an uptick in mental health concerns during this life stage, and Carleton students are no exception. In a 2019 survey conducted by the Consortium on Financing Higher Education, one in three Carleton respondents indicated that they often feel overwhelmed, while roughly one in five reported feeling sad very often.
“The most common presenting concerns for students seeking counseling are anxiety and depression, followed by relationship challenges and adjustment issues, which often present as stress, worry, and low mood,” says Marit Lysne, director of Student Health and Counseling (SHAC) at Carleton.
Sarah’s situation, for example, is a case study for how difficulty adjusting to a new environment can spiral into bigger concerns. As her social anxiety mounted and it became harder and harder to concentrate in class, she struggled to keep up with the coursework, which made lectures even more stressful. Before long she was experiencing panic attacks almost every morning.
Meanwhile, certain segments of the student population, like Vincent, often contend with even more distinct stressors.
“Students of color face all the same pressures, academic demands, and developmental challenges as their white peers,” Lysne explains. “But for BIPOC students on a predominantly white campus, I hear many of them say that they additionally struggle with a lack of belonging, cultural conflicts, acts of bias and institutional racism, and the wounds that accompany racialized trauma.”
Seeing pictures of friends at Black Lives Matter protests in the city at the end of spring term only compounded Vincent’s sense of isolation. His depression grew so that some days he struggled just to get out of bed.
When it comes to serious and persistent mental illnesses such as bipolar disorder, schizophrenia, and major depressive disorder, the early adulthood years are a risk factor in their own right, as the onset of these conditions typically occur around the late teens or early 20s. That means students may experience their first major episode while they’re in college. Setting aside the enormous functional and emotional impairments these disorders incur, a misdiagnosis—or missed diagnosis—can lead to years of ineffective treatment and, in some cases, a downward spiral into substance abuse or even suicide.
And while a majority of students won’t experience a major mental health crisis, that shouldn’t minimize the impact of the more common mental health concerns and vulnerabilities inherent to this life stage. The transition from adolescence to adulthood has always been paved with change and challenges, and each generation experiences the rite of passage through a specific sociocultural lens. For today’s students, that means contending with political divisiveness, increased demands for racial equity, and, most recently, the fallout of a global pandemic.
These trials are taking a toll. The National Opinion Research Center, a nonprofit organization at the University of Chicago, has been assessing Americans’ mental health at various stages throughout the pandemic. Their findings consistently demonstrate that younger adults (ages 18 to 34) have been more likely than their older counterparts to experience emotional and somatic symptoms indicative of depression and anxiety.
“For many students, having to leave campus meant returning to challenging or unsupportive home environments. Students had to adjust to distance learning while grappling with isolation, fear, and overwhelming emotions—all while they were disconnected from their campus support systems, including the counseling center,” Lysne says. “As the pandemic has stretched on, the prolonged social disconnection and loneliness due to pandemic restrictions and lockdowns has added significant stress, in addition to the difficulties caused by health concerns for self and family, financial struggles, family conflicts, and academic challenges.”
Last spring, for instance, Sarah was somewhat relieved to return home to study virtually during the pandemic. When her mom lost her job, though, Sarah’s anxiety ramped up and she began falling behind in school again. At first, Vincent was also happy to be home. But the murder of George Floyd in May brought back familiar feelings of sadness and hopelessness.
Though Sarah and Vincent struggle in different ways, their experiences are not unusual. And like many of their peers, they both turned to not-so-healthy habits to cope.
A coping mechanism is any strategy used to manage difficult emotions. We initiate some coping mechanisms consciously (think purposefully journaling before bed to cope with daily stress) and others more automatically. For example, we may absentmindedly chew our fingernails when we’re worrying about an upcoming project or “space out” when we’re reminded of a distressing event.
Coping mechanisms can be adaptive or problematic. Most lie somewhere in the middle of a spectrum ranging from healthy, like exercise, to mildly harmful, like skin picking, to extremely risky behaviors such as abusing drugs or cutting.
When we repeatedly turn to a certain form of coping in response to difficult situations or emotions, we are essentially training our brain to associate the two (as the saying goes, neurons that fire together wire together). In other words, the more one pairs a particular stimulus, such as feelings of sadness, with a particular response, such as binge eating, the harder it is to break the habit.
Everyone uses coping mechanisms. Which ones, when, and why depends largely on the individual, but several coping mechanisms are especially common among college students:
- Substance use: College has long been associated with drug and alcohol use, and experimentation can easily give way to dependence. When substance use becomes the go-to form of relief from life’s stressors, an individual develops tolerance for that substance and needs increasingly greater amounts to achieve the same result.
- Video games: In moderation, gaming is not problematic. Modern video games are so immersive, however, that two hours can easily become ten, and prolonged use can lead to a dependency not unlike substance use disorders (in fact, the American Psychological Association is considering adding video game addiction to the next edition of the Diagnostic and Statistical Manual of Mental Health Disorders).
- Sleep: Too much of a good thing can become a bad thing. Repeatedly hitting the snooze button not only interferes with academic and social functioning, it can also initiate or exacerbate depression. For Vincent, the more he slept, the harder it was to feel motivated for anything, even activities he typically enjoyed, which only left him feeling more depressed.
- Food: Like sleep, eating can turn from a healthy coping mechanism to a dangerous one. While the root causes of disordered eating are complex, in essence both bingeing and restricting serve as coping mechanisms. The former often functions as a form of numbing out, while the latter offers a way to feel a sense of control. Sarah, for example, frequently binged on cookies in her dorm room after class to relieve the day’s anxiety. The next day she felt ashamed and sick to her stomach.
- Taking on too much: Just as adults sometimes use work to avoid dealing with personal issues, college students may overcommit to a heavy course load and extracurriculars. Our culture tends to glorify busyness, when in fact hyperproductivity can easily become unhealthy–especially if we beat ourselves up when we can’t keep pace with the treadmill.
- Cutting and other forms of self-injury: It may seem strange to think of hurting oneself as a form of coping. Yet for individuals in the throes of depression, pain does exactly that. Cutting and other forms of self-harm provide an immediate rush of relief from overwhelming emotions, and the act can become addictive.
In the summer between their freshman and sophomore years, both Sarah and Vincent realized they needed help when school started again in the fall. Fortunately, it wasn’t hard to find. Carleton offers a wide range of services aimed at bolstering students’ mental and emotional well-being, with SHAC serving as the primary resource for mental health support.
“In a typical year, at least 25 percent of Carleton students seek counseling at SHAC, and that represents all demographics of students across class year, gender, race and ethnicity, sexual orientation, socioeconomic status, and many other identities,” says Lysne, noting that services are free of charge and confidential, and that counselors are prepared to assist with the full gamut of concerns. “Although we certainly treat students who have a diagnosed mental illness, it is not necessary to have a diagnosis to seek support. Counselors also help students address issues of culture, gender, sexuality, disability, and other aspects of identity within the context of psychotherapy with emerging adults.
“Everyone can use some help at times. No emotional burden is too big or too small to ask for help in carrying it,” Lysne says.
Besides individual counseling, SHAC also offers psychiatric services, support groups, and nutritional therapy. These adjunctive services highlight the need to address mental health in a holistic manner, which sometimes means looking beyond SHAC’s walls. Lysne notes that when students come in for a consultation, their counselor may identify additional resources at Carleton or in the broader community that might be beneficial, honoring the notion that it takes a village to support a student.
Janet Muth is the director of Carleton’s Office of Health Promotion, which employs a public health framework that emphasizes community-level actions. Muth maintains that students flourish when they leverage additional resources in conjunction with counseling.
“Several other offices provide important services that support overall well-being,” she says. “For example, the Academic Support Center does tons of work with students that can alleviate major stressors, while the Career Center helps students feel positive about their transition away from Carleton.”
Muth also cites the Office of Intercultural and International Life, the Gender and Sexuality Center, and the TRIO program, which help participants navigate cultural, financial, personal, academic, and other challenges. “These programs help students feel a sense of connection, belonging, and self-efficacy that absolutely contribute to mental health,” she says.
Of course, parents and faculty and staff members also play a crucial role in promoting students’ well-being. “Attending to student mental health is the job of everyone on campus, not just the counseling center,” says Lysne.
Katie Berg ’03, director of Parent and Family Giving, supports the Parents Advisory Council’s health and safety communications task force and notes that Carleton created an online hub specifically geared toward supporting students’ mental health after hearing from faculty members who felt unsure how to do so. The site, which is geared toward families and staff and faculty members, offers tips on how to talk to a student who might be struggling. It also includes links to emergency services, information about campus resources such as SHAC and the Office of Health Promotion, and a list of books, videos, and expert websites related to college students and mental health.
Vincent found the Young, Gifted, @Risk, and Resilient resource especially valuable. Developed by the Steve Fund and the University of Michigan, the website is described as “a video toolkit to support the well-being of students of color.” Meanwhile, Sarah’s parents used the recommended book The Stressed Years of Their Lives: Helping Your Kid Survive and Thrive During Their College Years by B. Janet Hibbs and Anthony Rostain to better understand what she was going through and express their concern nonjudgmentally.
“Ultimately we want students to learn how to access resources and advocate for themselves,” says Berg, “but parents will always be an important ally in recognizing problems.”
Muth echoes this sentiment in regard to faculty and staff members.
“In general, professors and staff members should not be afraid to ask students how they are doing, and really listen to the answer,” she says. “Most of us without clinical training feel like it is not our role to talk to students about their mental health, but the vast majority of students who struggle would benefit from having someone to talk to, whether or not they would also benefit from professional help.”
Muth’s advice is a reminder that the path to wellness is just as multifaceted as the students themselves. “Students benefit from being treated as individuals,” she says. “There really isn’t a one-size-fits-all approach to mental well-being.”
Author Alexandra Smith is a licensed professional clinical counselor.
Mental Health Watch: What to look for and how to help
You may know a student who seems to be struggling. It’s important to know what to look for and how to express concern.
Discerning when a coping mechanism crosses the threshold from adaptive to problematic can be difficult. First, consider frequency, duration, and context. Is the student engaging in an occasional ice cream binge—or eating to excess nearly every day for months at a time? Is it only after finals week, or has the habit become routine?
Next, look for any impairments in functioning. Is the student struggling academically? Socially? Physically? Consider an individual who sleeps in so frequently that he or she is repeatedly missing class, avoiding social activities, and not maintaining basic hygiene.
Difficulty stopping or cutting back the behavior represents another red flag. Clinicians use this criterion when diagnosing addiction, as it suggests the individual no longer has a sense of control. Especially concerning is when an individual recognizes a behavior as dangerous yet still struggles to stop.
Subtler signs of a problem include persistent fatigue, lack of motivation, significant changes in sleep or appetite, difficulty concentrating, or irritability. All are signs of depression. Also watch for social isolation, which can both ignite and exacerbate depression: inadequate social support can lead to feeling sad or lonely, which may trigger negative self-talk that leads to further isolation (Why would anyone want to spend time with a loser like me?). It’s a devastating cycle.
Speaking of depression, remember that it, too, exists along a spectrum. A few “blue” days are normal. Weeks at a time in which one doesn’t get out of bed or keep up with the basic functions of life signify a more serious problem. Again, intensity, duration, and impact are key.
Because most severe mental illnesses emerge in early adulthood, it’s especially important to intervene if you notice a student who has bizarre, grandiose, or delusional beliefs (I’m being followed by the CIA) or who is seeing or hearing things that aren’t really there. Watch for sudden, extreme swings into either an elevated mood, during which the individual appears alarmingly revved up (speaking and moving faster; sleeping less), or a severely depressed mood.
Always take thoughts of suicide seriously but avoid jumping into panic mode. Gather information in a matter-of-fact manner, asking how long the person has been thinking about suicide, how frequently they’re having thoughts, and whether they have a concrete plan (a big red flag) or access to a weapon (also a red flag). If a student indicates that he or she is actively considering suicide, seek immediate professional support or consider short-term hospitalization.
For less urgent concerns, a kind, nonjudgmental ear can do wonders. Just listening to and validating another’s emotional experience—and, when appropriate, gently expressing concern about unhealthy coping mechanisms—may be enough to turn the tide. If the symptoms or behaviors described here continue, however, additional support may be necessary.