Depression and anxiety are prevalent problems in colleges across the country. “There is no question that all of the national surveys we have at our fingertips show a distinct rise in the number of mental health problems,” said Jerald Kay, M.D., Professor and Chair of the Department of Psychiatry at the Wright State University School of Medicine. Indeed, in the past 15 years, depression has doubled and suicide tripled, he said. According to a survey from the Anxiety Disorders Association of America (ADAA), universities and colleges also have seen an increase in students seeking services for anxiety disorders.

The average age of onset for many mental health conditions is the typical college age range of 18 to 24 years old, said Courtney Knowles, executive director of The JED Foundation, a charitable organization that aims to reduce suicide and improve mental health for college students. In fact, according to the National Institute of Mental Health, 75 percent of all individuals with an anxiety disorder will experience symptoms before age 22, as cited in the ADAA Report.

Other students, who might not have clinical anxiety or depression, still suffer. According to the 2006 American College Health Association Survey, 45 percent of women and 36 percent of men felt so depressed that it was difficult to function.

Contributing Factors

During college, “students deal with a unique amount of stressors,” said Knowles. Specifically, college calls for a significant transition, where “students experience many firsts, including new lifestyle, friends, roommates, exposure to new cultures and alternate ways of thinking,” said Hilary Silver, M.S.W., a licensed clinical social worker and mental health expert for Campus Calm.

When students can’t manage these firsts, they’re more likely to struggle. “If students do not feel adequate or prepared to cope with the new environment of a college campus, they could easily become susceptible to depression and anxiety,” said Harrison Davis, Ph.D., Assistant Professor of Counseling and Coordinator of the Community Counseling master’s program at North Georgia College & State University.

Feelings of inadequacy can stem from academic stressors. In college, competition is much more significant, said Dr. Kay. So, there is the palpable pressure to do well, whether the demands come from parents or the student, said Silver.

Adjusting to college also influences identity — a phenomenon Silver has termed Identity Disorientation. “When students head off to college, the familiar people are no longer there to reinforce the identity these students have created for themselves.” This can make students “disoriented and feel a loss of their sense of self,” contributing to symptoms of depression and anxiety. A shaky identity and lack of confidence can lead college students “to make poor choices about drinking and drugs,” said Silver. In fact, according to the National Center on Addiction and Substance Abuse (CASA) report, Wasting the Best and the Brightest: Substance Abuse at America’s Colleges and Universities, 45 percent of college students binge drink and nearly 21 percent abuse prescription or illegal drugs.

For some students, college isn’t the first time they encounter depression and anxiety. Because of advancements in psychotherapy and medication, “we’re seeing students matriculate into college who have had a previous psychological disorder,” said Dr. Kay.

And though these students “can handle college in an effective fashion,” he said, it puts a great strain on counseling centers to accommodate the larger numbers. When evaluating universities, parents and students should make sure schools have the necessary mental health resources. It’s important they approach investigating these services just as diligently as they do looking for a school that has a great biology program if that’s what their child wants to study, said Knowles. Explore what each counseling center offers; review the school’s leave of absence policy; and work with the counseling center on the appropriate accommodations, he said.

Why Students Don’t Seek Services

For students, stigma remains the most significant barrier to seeking treatment. “Our research shows a high self-perceived stigma,” said Knowles. Specifically, according to a 2006 study, students cited embarrassment as the number one reason someone wouldn’t seek help. Only 23 percent would be comfortable with a friend knowing they were getting help for emotional issues.

Students also might not seek help because of concerns over confidentiality and finances and the fear that accepting they’re struggling will mean they can’t lead a productive life. Such concerns cause students to keep their emotional troubles to themselves, reinforcing the stigma and making life far more difficult than it need be.

Finding Help

For students struggling with anxiety and depression, the best place to start is the on-campus counseling center. Unfortunately, some centers do have waiting lists. While waiting for services — or if your school doesn’t have a counseling center — get a referral for a therapist in the community or speak with an approachable professor, career counselor or resident assistant. Also, you can call the National Suicide Prevention Hotline (800) 273-TALK, which isn’t just a crisis line; students can get advice and have someone to talk to.

According to Silver, to avoid Identity Disorientation, before leaving home, ask yourself “who you are on the inside, not just the label you’ve taken back at home, such as captain of the cheerleading squad or the straight A student.” Consider the following:

  • What makes me happy, sad, frustrated, etc.?
  • What are my values and beliefs?
  • What accomplishments and traits am I proud of?
  • Can I stick up for myself and ensure my emotional and physical safety in a way that is socially acceptable and appropriate?

To combat depression and anxiety, work on coping skills and know your personal limits, said Dr. Davis. Monitor your stressors, expectations and sudden changes in motivation and energy, he said. Lifestyle is directly related to emotional health, so it’s vital to get enough sleep, eat well and avoid caffeine and excessive drinking.

Although the Internet shouldn’t replace an evaluation with a therapist or treatment, reputable Web sites can serve as good sources of information. In addition to Psych Central, consult these sites:

  • Healthy Minds, provided by the American Psychiatric Association, has information on mental health, including prevention, symptoms and treatment and tips for students and parents.
  • ULifeline offers a screening tool, developed by the Duke University Medical Center, and contact information for university counseling centers.
  • Half of Us features inspirational interviews with artists and athletes along with information on mental health. You can also access the screening tool here.
  • The JED Foundation provides resources and research on mental health and suicide prevention for parents, students and colleges.
  • Campus Calm gives high school and college students the tools to combat stress.