A survey released in January shines a startling light on a problem that many may be unaware of. The survey of more than 500 health care providers and 700 parents and guardians of high school students found that today’s teenagers are feeling more stress and anxiety, and their doctors are treating more teens with mood disorders, than in the past. But the survey found parents put little thought into the mental health issues they may face when going off to college or the services they may need once they get there.
The survey, Preparing for College: The Mental Health Gap, was conducted by WebMD/Medscape, in collaboration with JED, a nonprofit dedicated to protecting emotional health and preventing suicide among teens and young adults. A large majority of health care professionals, which included 202 pediatricians and 201 psychologists/psychiatrists, said they had seen more mental health issues among teens in the past five years:
- 86 percent said teens have more stress and anxiety.
- 81 percent treated more anxiety disorders.
- 70 percent treated more mood disorders, including depression and bipolar disorder.
Parents echoed these findings, with 45 percent saying their child has been diagnosed or treated for a mental health issue, learning disorder or substance abuse problem, and 51 percent reporting that their child has seen a therapist. But just 17 percent of all parents said they thought about access to on-campus mental health services when considering schools for their child. Among parents of teens with diagnosed mental health issues, only 28 percent said they had thought about mental health services when shopping for schools.
The survey is “an attempt to remind people of the importance of not just looking at ratings of colleges for cost,” says Dr. Victor Schwartz, chief medical officer of the Jed Foundation. “We know that the U.S. does not do great job of getting students to graduation. In fact, we lead the world. A significant part of that is cost, but we believe a lot of that is the result of psychosocial factors like stress. You need to consider the support services a college has, and consider the culture of the campus,” he says, when deciding where to send your teen for school.
Stress and an Undeveloped Brain
The problem of mental health among college students is a growing concern, says Dr. Steven C. Schlozman, assistant professor of psychiatry at Harvard Medical School and associate director of the Clay Center for Young Healthy Minds. “It’s on the minds of all of us who care for what we call the transitional age group, of 18 to 25 or 26,” he says.
Schlozman explains that there are several reasons for concern: “From an epidemiological perspective, this is the average age that most psychiatric symptoms declare themselves or get bad enough that people can’t ignore them anymore.” This big life transition places stressors on a not-yet-fully developed teenage brain that is “at its prime moment of being capable of deep thoughts and at same time acting impulsively on those deep thoughts. That is the strange place that 18-year-olds are in,” he says.
Leaving home and losing that protective cocoon places stress on kids, especially those who have had everything scheduled and monitored for them by helicopter parents and guardians. Going off to school is even harder on kids who already have mental health issues, of which there are now far more, Scholzman says. “Kids who would not have gone to college in past now go, because we have gotten better at acknowledging these symptoms, and they get into treatment before college. But when they go to college, the treatment often disappears because there hasn’t been a lot of thought about how to transition their care.”
Scholzman adds that the longstanding promise of college, where you go to get a better job, is not a given anymore. “Kids know that, and this economic reality brings uncertainty and stress.” They also know the financial burden college places on their parents and increasingly themselves. “Everyone talks about justifying the inflationary rate of tuition, and how they will ever recoup that,” he says. “I can’t imagine kids aren’t hearing that from parents, and that further adds to the pressure.” Social media, and the pressure to compare themselves to others, also plays a role, he adds.
Proper planning and adequate treatment can help prospective students with mental disorders succeed in college.
Take an Active Role
Colleges are struggling to meet the demand for mental health services, which has risen over the past several years, according to a 2017 report by the Center for Collegiate Mental Health. Parents need to consider such services and the culture of the campus in dealing with mental health. “If there is a history of mental health concerns, you need to be thoughtful how that care will continue in a college setting,” Schwartz says. Also think about how far from home the student may be comfortable traveling, whether he or she may be better suited to a large or small college, and whether the campus is in or near an urban setting, where more mental health care providers are located, as opposed to a rural campus that may not have a large hospital or medical center nearby. And ask the school directly what it offers in terms of mental health services, such as whether it has a counseling center, if services offered for free and if there local health care providers who work with the school when needed.
Scholzman recommends having an active discussion with your child before he or she goes to college. For kids already in treatment, include the child’s provider and the school, to prepare for and set up transition of care. For other kids, tell them that college is a big change, and that you want some kind of plan in place if he or she starts to feel stressed, anxious or depressed. “This happens a lot more than we think it happens,” he says, “and you can’t assume it will take care of itself.”
“We heard too many stories,” Schwartz says, “where kids were treated for anxiety or depression in high school and might have a had suicide attempt. People have this idea that college is a new lease, but there isn’t a well-thought plan for how care will be given and how a crisis, if it develops, will be managed. This is an important piece for your child’s success in college.”
You know you best.
Only you truly know the unique triumphs and travails of living in your own head. If you experience ongoing depression, anxiety or other symptoms, “Seeking professional help as early as possible, rather than waiting, can be critical,” says Dr. Robert Klitzman, a professor of psychiatry at Columbia University in New York City. However, you needn’t be diagnosed with a mental health condition to benefit from taking steps to improve your psychological well-being. Here are some ways you can get a mental edge. The payoff could include everything from a happier, healthier, longer life to better relationships.Get moving.
You might not want to sit down for this. “Physical exercise is very important in preventing or reducing mental health problems,” Klitzman says, which include depression. “When we exercise, our body releases endorphins – natural opiates that improve our mood and make us feel good. Exercise can also help cognitive functioning – how well we think.”Watch your weight.
Watch your weight.
Being sedentary, by contrast, can prove a double whammy, since we don’t get the mental jolt from exercise – and we’re more likely to pack on pounds. Putting on extra weight, research shows, can weigh down our mental health, too. Obesity and diabetes increase the risk for depression, says psychiatrist Dr. Mahendra Bhati, an assistant professor of clinical psychiatry in the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.Be careful what you consume.
Be careful what you consume.
Your diet – whether predominantly plant-based with healthy greens, nuts and other lean proteins (good), or laden with saturated fat, processed foods and sugars (not so good) – can impact mood and anxiety levels. So, too, can other things we put in our body to get by in the moment, from tobacco and alcohol to recreational drugs. Better to avoid the feel-good momentary fixes, Klitzman says, and spare yourself the crash later.Stay in the moment.
Stay in the moment.
We all sometimes seek to avoid uncomfortable situations, either by physically removing ourselves or checking out mentally. “That’s normal … it’s just that when you do that very chronically and habitually, it could develop into significant problems with anxiety and depression,” says psychologist Brandon Gaudiano, an associate professor of psychiatry and human behavior at Brown University in Providence, Rhode Island. Experts recommend practicing mindfulness instead to help deal with difficult circumstances and emotions. “It’s paying attention to the present moment and what your experience is,” says Gaudiano, noting that approaches vary. “Bringing awareness, acceptance, self-compassion, curiosity and just noticing non-judgmentally those internal experiences as they’re arising.”Meditate about the ones you love.
Meditate about the ones you love.
Want to get even more from that wonderful vacation or visit with family? Focus your mind on it. In researching different forms of meditation, Barbara Fredrickson, a professor of psychology and neuroscience at University of North Carolina–Chapel Hill, has found that so-called kindness meditation or loving-kindness meditation can improve a person’s emotional well-being and reduce symptoms of depression; she adds that other researchers have found it eases anxiety. “It’s a very simple meditation based on … sending well-wishes to yourself or others,” Fredrickson says, describing it as somewhat similar to mindfulness meditation.Keep a journal.
Keep a journal.
Just as mindfulness can help a person recognize and cope with difficult thoughts and emotions in the moment, experts say it’s important to have outlets to process complex experiences. Journaling, or expressive writing, allows a person to put negative thoughts, feelings, aspirations and anything else that might be going through their mind to paper – and, Gaudiano says, to get some mental distance from those experiences. “It has been [shown to be] very helpful in some of the research I’ve done as well for [addressing] anxiety and depression,” he says.Stay socially connected.
Stay socially connected.
Social support plays a vital role in helping optimize our overall mental well-being, Klitzman says. He recommends “surrounding ourselves with supportive people – loving friends and family – and avoiding, if we can, ‘difficult’ people who may bring us down.” By contrast, a lack of social connectivity can put us at risk for health problems that affect body and mind and contribute to premature death. “Lack of socialization is … the leading cause of geriatric depression,” Bhati says.Prioritize – and schedule – positivity.
Prioritize – and schedule – positivity.
Pay bills, do work, spin wheels. Check, check, check. Lunch with a friend? Not on the list. “Basically when people make their 'to-do' list, they are often thinking of achievement, as opposed to scheduling something in their day that they know is a boost to their positive emotions and their mood,” Fredrickson says. But her own research finds those who prioritize positivity, such as allotting time to visit loved ones or engage in a beloved hobby, tend to be mentally healthier.Assess your stress.
Assess your stress.
Avoiding high levels of stress and finding ways to cope can make a big difference. “Many times, we can actively avoid difficult, stressful situations,” Klitzman says, When we can’t, “framing our experiences positively, and trying not to worry (especially about things you can’t change) can also be beneficial – focusing on the positive, not stewing about the bad things that may occur.” Under such circumstances, he adds: “Mindfulness – relaxation or meditation – can also help.”Sleep on it.
Sleep on it.
Whether you’re wrestling with serious mental anguish or just smelling the roses, it’s important to get ample rest and practice proper sleep hygiene – room-darkening blinds in the bedroom, TV out. “Poor sleep wreaks havoc on the brain and circadian rhythms, [and it can] alter brain function and gene expression,” Bhati says. In short, whether you’re predisposed to mental health issues or not, skimping on shut-eye can awaken psychological problems that make it even harder to function during the day.Find purpose.
Just as making time to visit with friends can change the complexion of a day, mental health experts say doing something meaningful and finding purpose can ground a person in psychologically beneficial ways. “Engaging in activities that give us meaning in our lives can further aid us,” says Klitzman, in terms of improving mental health. That might include volunteering to help others, engaging in hobbies as well as doing other things we enjoy, he adds. Bhati echoes that doing things with a sense of purpose or meaning is a proven way to improve mental health.Read More