The Top 10 Mental Health Challenges Facing College Students Today

By: BCD Staff
March 2017

The National Alliance on Mental Illness (NAMI) reports that one in five college students experience a mental health condition, with 75% of all mental health conditions surfacing by the age of 24. These staggering statistics show how important it is to increase awareness about mental health on college campuses because most people that struggle with a mental health condition will experience symptoms before they graduate from college. Young adults, many who will be away from home and their primary support systems for the first time, need to know how to identify signs and symptoms in themselves and their peers and how to access resources.

Here you will find information on the top 10 mental health challenges facing college students today. Additionally, we have included resources providing more information if you, or someone you know, is experiencing a mental health challenge.

To begin with we want to make sure everyone takes into consideration these important points.

  • For people experiencing a mental health challenge, stigma is often the biggest barrier to getting support. Reaching out for support is often the hardest step on the path towards recovery. People often feel embarrassed or ashamed of their symptoms and are afraid to ask for help. In the same way you wouldn't feel ashamed for seeking medical care for a physical health condition (think ear infection, broken leg, stomach pain) there is no reason to feel embarrassed for seeking help for a mental health condition. Health is health. Everyone is entitled to good health care.
  • Mental health conditions are treatable. Help is available. Finding a good therapist, doctor, or support group can make all the difference. You do not need to do this alone. There are trained professionals available to help. With the appropriate support you can and will feel better!
  • Like any health issue, left undiagnosed and untreated, mental health conditions can worsen. Symptoms can become increasingly intense, making it hard to cope with the daily routine of life. Students may find themselves becoming increasingly isolated, failing or dropping out of college, or in the worst case, attempting or committing suicide.
  • The stress that students experience in college can trigger a relapse in symptoms for a mental health condition that a student may have felt was under control. If you experience a relapse in symptoms it doesn't mean that you have failed, it simply means that it is a good time to reevaluate your current treatment. Maybe it is time to assess your current self-care (sleep, nutrition, workload), reconnect with a therapist, or reevaluate your medication with a doctor.
  • We have not provided information on specific mental health diagnoses, and we encourage you not to try to diagnose yourself, a friend, or family member. A diagnosis should only be given by a trained mental health professional (such as a therapist, psychologist, or psychiatrist) or medical professional (such as a primary care nurse practitioner or doctor). Many symptoms are similar across diagnoses and can be hard to differentiate without professional support. We provide the information here in an effort to increase awareness and understanding. Many people, upon receiving a diagnosis for the first time, express a great deal of relief in learning that their symptoms are common, they are not alone, and that their condition is treatable.
  • Many students will find that they are coping with one or more mental health challenges at a time. This is normal. For example, many people who are struggling with addiction may also be depressed. Or, in some cases, having an untreated mental health condition can put you at higher risk for other mental health challenges. For example, people experiencing PTSD are at greater risk for other mental health conditions such as anxiety and depression, substance use, and eating disorders.
  • Feelings are normal. Everyone will go through times where they feel stressed, sad, or anxious. These feelings become problematic when they are in excess of what is normal or developmentally appropriate, last for extended periods of time, are accompanied by physical symptoms, or start to interfere with daily functioning.

 

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Addiction

As we discuss addiction here we will generally be referring to substance use and addiction as problematic drug and alcohol use. Substance-related and addictive disorders cover 10 different classes of drugs as defined in the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition DSM-5. Drug and alcohol use is generally identified as addiction when a person has started to consume alcohol or drugs in increasing quantities, regardless of the negative personal impact, while at the same time unsuccessfully trying to reduce use. More and more, addiction is coming to be understood as the serious medical issue that it is. The American Society of Addiction Medicine explains that the disease of addiction is progressive and that without treatment individuals can experience "disability or premature death". Drug and alcohol use on college campuses across the country is a serious public health issue. Substance use can impact all areas of a college student's life including: physical health; mental health; sexual health; school performance; relationships; and ability to work. The National Institute on Alcohol Abuse and Alcoholism put out a report on college drinking, stating that 1 in 4 college students reported academic problems as a result of their drinking and that as many as 20% of college students have the symptoms of an alcohol use disorder. Students with an alcohol use disorder are frequently experiencing other mental health challenges as well.

Common symptoms include: using more drugs or alcohol than intended; trying unsuccessfully to reduce drug or alcohol use; spending increasing amounts of time accessing drugs or alcohol; strong cravings for drugs or alcohol; failure to meet commitments at home, school, or work; continued use of drugs or alcohol regardless of perpetual social and relational problems; avoiding important family, social, school, work commitments or activities; use of drugs or alcohol in physically dangerous situations; continued drug or alcohol use in the face of physical or psychological problems made worse by substances; tolerance and/or withdrawal symptoms.

Common treatments include: psychotherapy; group therapy; peer support (such as Alcoholics Anonymous); psychoeducation; residential treatment; and abstaining from all substance use.

For more information on addiction:

Substance Abuse and Mental Health Services Administration

National Institute on Drug Abuse

National Institute on Alcohol Abuse and Alcoholism

College Drinking Changing the Culture

Adjustment Disorder

Going away to college can be a challenging time in any young adult's life. Adjusting to a new town, new school, making new friends, living in a new environment and being away from home and family for the first time requires adjusting to numerous circumstances at the same time. Many college students handle this well and while it may be hard at times they are able to cope and move through all the changes successfully. However, because college is a time of so many changes many students find that at some point they struggle to adjust. A significant stressor such as a bad break up, a new housing situation, change of major, new job, or illness could cause significant distress and impairment in functioning that would fit the criteria for an adjustment disorder. The DSM-5 reports that up to 20% of individuals receiving mental health treatment (in an outpatient setting) have a diagnosis of adjustment disorder.

Common symptoms include: difficulty functioning in school, work, or social relationships; depressed mood; anxiety; disturbance of conduct (disruptive or inappropriate behavior/actions); isolation or withdrawal; and physical complaints (headaches, stomachs etc.).

Common treatments include: psychotherapy, group therapy or peer support group.

For more information on adjustment disorders:

Psychology Today – Adjustment Disorder .

Mayo Clinic – Adjustment Disorders .

Anxiety

The DSM-5 describes anxiety as "anticipation of future threat." Everyone feels anxious sometimes but anxiety starts to become a problem when it is in excess to what might be expected, and when it starts to negatively impact someone's ability manage their daily responsibilities and relationships. Anxiety disorders are quite common and almost 30% of adults are impacted by anxiety, to the point that it becomes disruptive and could be classified as a disorder, at some point in their lives. Anxiety can manifest itself in many forms from generalized anxiety to panic attacks to social anxiety. The American Psychological Association found that "Anxiety is the top presenting concern among college students (41.6 percent), followed by depression (36.4 percent) and relationship problems (35.8 percent)." The New York Times reports that over half of students who seek support at campus health clinics report being concerned about their anxiety.

Common symptoms include: feeling restless or on edge; easily fatigued; difficulty concentrating or mind going blank; irritability; muscle tension; and difficulty sleeping.

Common treatments include: psychotherapy; medication; and mindfulness exercises such as meditation and yoga.

For more information on anxiety:

American Psychiatric Association – Anxiety Disorders

National Institute of Mental Health – Anxiety Disorders

Attention-Deficit/Hyperactivity Disorder (ADHD)

Most college students will know by the time they get to college if they struggle with ADHD. About 5% of children and about 2.5% of adults experience symptoms of ADHD. Most college students will have already received an official diagnosis and treatment and will have learned to successfully manage their symptoms. However, entering college presents new challenges to making sure that accommodations are met to support the student in the classroom. This may be the first time a student is advocating for themselves with teachers or doctors if their parents fulfilled that role while they were in high school. Students who are experiencing symptoms related to inattention and hyperactivity in multiple settings in a way that is interfering with their ability to be successful in school, work, and/or with peers may be struggling with ADHD.

Common symptoms include:

Inattention such as: difficulty with giving close attention; difficulty holding attention: difficulty listening; difficulty following through on tasks; difficulty organizing; difficulty maintaining attention for extended period; tendency to lose things; and easily distracted.

Hyperactivity such as: fidgeting; difficulty sitting still; feeling restless; difficulty with talking excessively or blurting things out; and trouble with waiting turn or interrupting.

Common treatments include: Cognitive-behavioral therapy; social skills training; medication; and academic support.

For more information on ADHD:

Attention Deficit Disorder Association – College Accommodations

Centers for Disease Control and Prevention – Attention-Deficit/Hyperactivity Disorder (ADHD)

Bipolar

Bipolar Disorder is one of the more complicated mental health challenges to understand and diagnose. It is also one of the diagnoses listed here that tends to have a lot of stigma attached to it. Unfortunately, "bipolar" is a term that people often throw around in a derogatory way to describe someone who is seen as moody. Individuals struggling with bipolar disorder should know that their symptoms are treatable and they do not have to suffer in silence. The DSM-5 states that "The lifetime risk of suicide in individuals with bipolar disorder is estimated to be at least 15 times that of the general population. In fact, bipolar disorder may account for one-quarter of all completed suicides." Clearly, we want individuals coping with bipolar disorder to get immediate and effective treatment to reduce and manage symptoms. College students may notice symptoms for the first time in their late teens or early 20s. The National Alliance on Mental Illness reports that the average age of onset for bipolar disorder is 25 years old. There are many nuances to bipolar disorder that a trained mental health or medical professional can help sort out for the appropriate diagnosis.

Common symptoms include:

Manic Episode symptoms can include: elevated mood; increased energy; inflated self-esteem; decreased need for sleep; more talkative than usual; racing thoughts; distracted; increase in specific goal-directed activity; and involvement in high risk activities

Depressive Episode symptoms can include: depressed mood; decreased interest in activities; weight loss; disrupted sleep; noticeable restless or slowed behavior; loss of energy; feeling worthless or guilty; difficulty concentrating; and thoughts of death including feeling suicidal

Common treatments include: medication; psychotherapy; psychoeducation.

For more information on Bipolar disorder:

National Alliance on Mental Illness – Bipolar Disorder

National Institute of Mental Health – Bipolar Disorder

Depression

Depression is common in the general population and very common for college students in particular. The National Institute of Mental Health identifies depression as a serious mental health challenge and reports that 30% of college students reported having a difficult time functioning due to feeling depressed. Depression commonly occurs with other medical and mental health conditions. In college, students may find themselves struggling in a variety of ways such as experiencing higher levels of stress and anxiety then they are used to, or struggling to adjust to a new environment. These challenges can exacerbate symptoms of depression. In the most serious situations, depression can lead to thoughts of self harm or suicide. The Centers for Disease Control and Prevention reports that for "youth between the ages of 10 and 24, suicide is the third leading cause of death." This statistic shows just how important it is to treat the symptoms of depression before they escalate. There are different types and levels of severity for depression, and with the help of a mental health provider college students can sort out what exactly they are experiencing and the best course of treatment.

Common symptoms include: depressed mood; decreased interest in activities; change in weight; difficulty sleeping; noticeable restless or slowed behavior; fatigue; feelings of worthlessness or guilt; difficulty concentrating; thoughts of death that may include feeling suicidal.

Common treatments include: Psychotherapy; and medication.

For more information on depression:

National Institute of Mental Health – Depression and College Students

National Alliance on Mental Illness – Depression

Eating Disorders

The National Eating Disorders Association (NEDA) reports that eating disorders generally start between the ages of 18-21. Eating disorders are a mental health challenge that significantly impacts traditional college age students. According to the Walden Center for Education and Research as many as 20% of college students are impacted by an eating disorder. Anorexia and Bulimia are two of the most common eating disorders. Since eating disorders have the highest mortality rate of any mental illness, the earlier an eating disorder is recognized and treated the better the long term outcome. Due to the high level of college students who are impacted by eating disorders, NEDA created an anonymous online screening tool specifically for college students to help college students determine if they are experiencing an eating disorder.

Common symptoms include:

For Anorexia: restricting calories needed to maintain the minimal weight for age and height; fear of gaining weight or becoming fat, while underweight; behavior that interferes with gaining weight, while underweight; disturbed experience of personal body weight or shape; sense of self is significantly influenced by body weight or shape; and inability to recognize the seriousness of low body weight.

For Bulimia: recurrent episodes of binge eating; eating more in a window of time than what most people would eat in same period of time; a feeling of a lack of control during an episode of eating; recurring and inappropriate behavior to prevent weight gain (vomiting, use of laxatives or other medications not as directed, fasting, or excessive exercise); and sense of self is significantly influenced by body weight or shape.

Common treatments include: psychotherapy; family therapy; collaboration with a medical team; and residential treatment.

For More information on eating disorders:

Multi-Services Eating Disorders Association (MEDA)

The National Eating Disorders Association (NEDA)

Panic Attacks and Panic Disorder

Panic attacks often come on quickly and without warning and cause people to feel as though they are going to go crazy or are about to die. Students who have experienced a panic attack often report that the panic attack was so frightening and they find themselves so fearful of having another panic attack that they go out of their way to avoid any activity or event that might lead to another panic attack. If students start to negatively change their behavior to avoid a panic attack (such as not going to class, avoiding certain parts of campus etc.) this can lead to a panic disorder.

Panic attacks are often experienced with other anxiety disorders as well as other mental health challenges such as depression, PTSD, and addiction. In some circumstances, when untreated, panic disorders can feel so unmanageable that they can even lead to suicide. It is recommended that anyone experiencing symptoms of a panic attack consult with a physician to rule out and confirm that the symptoms are not related to a medical condition. While panic attacks and panic disorders are very serious and terrifying, they are also very treatable. As the American Psychological Association reports, panic disorders often develop during adolescence or early adulthood and "while the exact causes are unclear, there does seem to be a connection with major life transitions that are potentially stressful." As the transition from high school and living with family to college and living independently can be challenging, students are encouraged to reach out for support if experiencing symptoms related to a panic disorder.

Common symptoms (which typically come on quickly) include: accelerated heart rate; sweating; shaking; shortness of breath; feelings of choking; chest pain or discomfort; nausea or abdominal pain; feeling dizzy or lightheaded; feeling hot or cold; feelings of numbness or tingling; feelings of unreality; fear of losing control; and fear of dying.

Common treatments include: psychotherapy and medication.

For more information on panic attacks:

The American Psychological Association

National Institute of Mental Health

Post-traumatic Stress Disorder (PTSD)

Many people experiencing PTSD feel that their life has been disrupted significantly since experiencing, witnessing, or hearing about a traumatic event. Sometimes people experience symptoms or notice being impacted right away and sometimes it can take years. Anyone who is exposed to a traumatic event is at risk of developing PTSD.

Sexual assault is an example of a traumatic event that usually leads to symptoms of PTSD. As studies have shown, one in every five women on college campus have been sexually assaulted in their lifetime, and many of these women are likely experiencing PTSD symptoms. Veterans are a population that frequently experience symptoms of PTSD as well, and many veterans begin or return to college following their service. The Mayo Clinic reports on risk factors that can contribute to a person being more likely to develop PTSD following a traumatic event such as: having experienced previous trauma; experiencing other mental health conditions such as anxiety or depression; substance abuse; and lack of a strong support system. College students should reach out for support if they have experienced a traumatic event, even if they have not yet developed symptoms of PTSD, because prompt support is indicative of better long term outcomes for mental health.

Common symptoms include (after experiencing, witnessing, or hearing about a traumatic event): Distressing memories that are recurrent, involuntary, and intrusive; distressing dreams; flashbacks; distressing feelings or physiological reactions when exposed to things that remind person of the traumatic event; avoiding or making an effort to avoid memories, thoughts, people, places, or things that remind the person of the traumatic event; difficulty remembering important parts of the traumatic event; irritability; reckless or self-destructive behavior; hypervigilance; easily startled; difficulty concentrating; difficulty with sleep.

Common treatments include: psychotherapy

For more information on PTSD:

US Department of Veterans Affairs – PTSD: National Center for PTSD

Anxiety and Depression Association of America

National Institute of Mental Health – PTSD

Sleep Disorders

A report put out by Harvard Medical School shares that "Only 11 percent of American college students sleep well, and 40 percent of students feel well rested only two days per week." When you think about how busy college students are with classes, studying (sometimes staying up all night to study), friends, late night parties, extracurricular activities, sports, and work it is not surprising that many of them struggle to either find the time to get the sleep they need or to relax enough to fall asleep and/or stay asleep through the night.

Medscape reports on a study that showed a link between sleep disorders and poor academic performance in college students, with students not at risk for a sleep disorder having a higher GPA. When making a diagnosis, mental health clinicians frequently assess sleep because sleep and mental health are so interconnected. It is often hard to know which comes first, the sleep disorder or the mental health challenge, because, for example, anxiety can make it hard to sleep and a lack of sleep can increase symptoms of anxiety.

The DSM-5 classifies a number of different sleep disorders revolving around the general complaint of poor quality of sleep, as well as the timing and amount of sleep. Common sleep disorders experienced by college students include insomnia, restless leg disorder, and obstructive sleep apnea. In order to not suffer the consequences of sleep deprivation and to get the most out of college, students are encouraged to consult a mental health or medical professional for support in managing sleep effectively.

Common symptoms include: Dissatisfaction with sleep quantity or quality; difficulty falling asleep; difficulty staying asleep, waking up frequently; difficulty falling back asleep if wake up in night; waking up earlier than you would like; disturbed breathing at night including snoring; feeling sleepy during the day.

Common treatments include: Psychotherapy; medication; exercise.

For more information on sleep disorders:

National Center for Biotechnology Information

Anxiety and Depression Association of America -Sleep Disorders

 

We hope you have found this information to be helpful. Remember, lots of college students experience a mental health challenge at some point. It is normal, nothing to be ashamed of, and treatable. Help is available. Please reach out and get the support you need!

Find a mental health therapist near you:

Most college campuses have a counseling center specifically designed for and dedicated to students. Often treatment is available at little to no out of pocket cost. We encourage you to reach out to your campus counseling center. However, if for any reason you don't feel comfortable doing so, you can find a mental health therapist in private practice by going to
Psychology Today and using their find a therapist tool . If you type in your zip code you will be linked to therapists near you along with their information, the specialties they provide treatment for, cost of treatment, and type of insurance accepted. If reaching out to a therapist feels overwhelming or you feel you need more immediate support we encourage you to seek crisis support through one of the following resources.

Crisis support:

National Suicide Prevention Lifeline: 1-800-273-TALK
The National Suicide Prevention Lifeline offers free and confidential crisis support for suicide prevention 24/7.

National Helpline: 1-800-662-HELP. The National Helpline offered by the Substance Abuse and Mental Health Services Administration (SAMHSA) is available 24/7. This confidential and free helpline offers information (in English and Spanish) for individuals and families seeking information on treatment options for mental health and substance use disorders.

Crisis Text Line -for eating disorders: text text "NEDA" to 741741.