High School and College Student Anxiety: Why the Epidemic?

The epidemic of anxiety in high schools and on college campuses is stunning. Over the past seven years, anxiety has become the No. 1 reason college students seek counseling.[1] I’m seeing it in my clinical practice, reading about it in news articles, and hearing about it from therapists when I give workshops around the country on anxiety treatment. Anxiety disorders affect 25 percent of teenagers, a percentage that has steadily risen over the past 30 years and is showing no sign of slowing down.[2] What's going on?

When I was writing Prescriptions Without Pills, which offers self-treatment options for relieving anxiety, I had little idea how prevalent anxiety disorders were becoming and even less awareness of the dramatically rising rates among high school and college students. The treatment "prescriptions" I suggest in the book seem all the more vital now. Students are best off relieving their anxiety with techniques that do not involve medications. Anti-anxiety medications can create physical dependency (sedating antidepressants) or addiction (benzodiazepines like Valium).

Prevention almost always beats treatment, so I have been on the lookout for ways to understand the factors that have been triggering the increases in anxiety among young people.

I am pleased therefore to have stumbled on an opportunity to interview 21-year-old author and mental health activist Jake Heilbrunn. Jake’s book Off The Beaten Trail, his newly released TEDx talk, and his speeches to student groups around the country have impressed me.

An interview with Jake Heilbrunn on the student anxiety epidemic

Many thanks to Jake for sharing his perspectives with us.

Dr. H: Jake, how did you become so dedicated to helping anxious teenagers?

JH: During my first semester of college, I battled crippling anxiety, an anxiety-induced skin condition, and depression. One of the few people who knew I was going through this was a career counselor. At the end of my first visit with this career counselor, who had asked me how I’d been feeling and what about, I broke down crying in her office. After bottling up my issues for months, I had found an adult who encouraged me to share what was on my mind. The relief I felt that day was enormous.

Dr. H: What do you think is a key reason young people are experiencing so much and such severe levels of anxiety?

JH: Based on my own experience plus talking with thousands of high school and college kids when I speak at schools across the country, I see the widespread use of social media as a major new anxiety trigger.

Millennials and Gen Zers like myself are growing up in a world with two lives, both equally as real: digital and analog (in person.) In our digital lives (a.k.a “social media”) we are constantly trying to maintain an image. We paint pictures of our lives with the photos and stories about ourselves that we post. And we compare the realities of our lives with the images others paint on social media of their lives, or at least of what they want us to think their lives are all about.

Dr. H: Why do you think social media be a bigger anxiety-generator for young people than for older adults?

JH: Quantity. Gen Zers spend, on average, four hours a day on social media.[3] Imagine spending ¼ of your waking-life subconsciously comparing yourself to the people you follow on Snapchat, Instagram, and Facebook.

More time on social media yields more emotional distress. Constant scrolling and social comparison bring about thoughts like, “I’m not good enough, happy enough, smart enough, good looking enough...etc.” A continual stream of these kinds of negative comparison thoughts all too frequently culminates in overwhelming feelings of worry—generating anxiety—and of being less-than, which generates depression.

In fact, research studies have shown a direct link between quantity of time spent on social media and levels of anxiety and depression.[4]

At the same time, the more anxious young people feel, the more tempted, and even addicted, they may become to constant searching on social media for information about their social status. The vicious cycle spins on.

Dr. H: Are there additional ways in which social media seems to invite anxiety?

JH: For sure. Students open the door to enter their dorm room, and instead of talking with their roommates what do they do? They check their Facebook page. They want to take a study break, and what do they do? The same. First thing when they wake up in the morning what do they do? Check their email and Facebook pages. All of this social media checking is time that in the past might have been spend hanging out with friends.

Chatting in person, unlike reading about friends on social media, builds social connections. Social connections build self-confidence. So in addition to creating anxious feelings, social media checking decreases the amount of oxytocin-induced good feelings generated by actual friend-to-friend contact.

In addition, there’s something about cell phones and computers that makes them addictive. That means that student’s are not just occasionally thinking about how they match up with others. Addicts keep checking and checking in hopes of a shot of good feelings. And they far too often experience anxious or depressed feelings because instead of getting that shot of an upper feeling, they see someone who looks better than them or someone who has said something hostile about them.

Of course, looking at others for clues about how others see you has long been a teenage way of clarifying self-image. Teenagers have always sought to understand who they are and how they rank with others by checking out what others think of them. The sad twist induced by social media is that students receive false images of great happiness induced by others’ image-enhancing posts. And when Likes for their posts replace the fun teens used to get from direct social interactions like talking, smiling and “hanging out” with their friends, life becomes both scarier and less fulfilling.

Dr. H: What else may be inducing so much student anxiety?

JH: Of course there are the usual suspects like girlfriend and boyfriend difficulties, stress from too much homework, and roommate conflicts.

What may have changed however is that helicopter parenting, with parents always hovering nearby to “help” rather than kids learning to problem-solve on their own, may leave college students less prepared for dealing with these stresses.

Dr. H: What about the reality that more young adults now go to college?

JH: That’s probably a factor as well. In high school kids and their parents stress about what college they will get into. In addition, for many students, college is the automatic next step after high school even though in their gut they know that they have only minimal interest in getting more education.

Then in once they get into college, students and their parents are spending huge amounts of money and may be taking on huge student loans. Yet so many kids at college have very little sense of what’s valuable in what they are buying. So college can generate huge financial pressure with little payback other than a fun social life—i.e., parties and drinking.

Dr. H: How can parents and educators help young people who are suffering from anxiety?

JH: Many millennials and Gen Zers feel inordinate pressure from parents and society to be successful in school. While it is true that young people in previous generations also felt this kind of pressure, the advent of social media seems to have significantly magnified it. When parents feel anxious about if their kids will get into the right college, or succeed in college and after, this pressure multiplies.

So to help their kids, one place for parents to start is to evaluate their own anxieties. If parents can take a leap of faith and just love their kids as they are, with or without measurable achievements, that more relaxed and loving attitude may go a long way to easing the passage into adulthood for their kids.

Parents also can be helpful by inviting their kids to say what is going on inside their heads. “What…” and “How …” are the best question-starter words as these open-ended starters invite full answers. “Do you…” or “Have you…”, by contrast, invite short yes or no answers. They also tend to invite defensive responses instead of thoughtful ones.

Parents then need to be willing to respond with interest, not with criticism, whatever the answers they hear. “Yes, that makes sense because…” Then, if they don’t get it, they can ask for more information. They can ask the next “What…” or “How…” question. The conversation will quickly end if a parent responds with any version of “You shouldn’t feel that way because…”

Dr. H: How did talking with a counselor help you to relieve your anxieties?

JH: Over a period of several months, I saw the career counselor five times. The counselor taught me anxiety coping skills, mainly by encouraging me to say aloud the negative thoughts. Putting into words the anxious feelings that had been consuming me enabled me to listen to my feelings so they could inform me about my concerns. The counselor then asked me what might be alternative ways of responding to these concerns. I began then to discover new solutions to the challenging situations I was facing.

Talking about my feelings and thoughts with a listener who took my concerns seriously and then encouraged me to seek solutions taught me to do the same. Talking about the feelings offers relief in and of itself. In addition, with feelings and thoughts out in the open, I could begin figuring out what might help.

These conversations changed the course of my life. They taught me that anxiety signals that there’s a problem I need to address and solve. They kick-started my journey that led to me being able to overcome my disabling anxiety.

Dr. H: What else did you learn from your college experience of anxiety and eventual relief?

JH: Parents and educators need to understand that when young people are experiencing anxiety and depression, we often feel ashamed. We think we are alone. We think nobody else is experiencing these feelings. And we have no clue what to do to make the anxious feelings go away.

With no one to talk with, we feel isolated, hopeless, stuck in feelings that embarrass us, and spinning with worries instead of launching into problem-solving. That’s when self-harming behaviors can begin to look appealing.

Now, looking back, I can see that in these fragile moments:

• We first need to be heard. Not to be told that it’s not really so bad, but rather to take our feelings seriously, as good data. That way we can begin to hear and understand ourselves.
• Then to be asked, or to ask ourselves, “So what might you want to do about this situation? What could you do differently that might help?” These questions lead us to begin to problem-solve.

Dr. H: What other culturally prevalent beliefs may contribute to anxiety?

JH: Many young people believe that they need to be “perfect” to be happy and successful. I held this belief, and it scared me a lot. I kept encountering other students who seemed to be more “perfect,” and I was terrified.

Our education system has a heavy focus on grades. Students may share the belief that good grades = success, and bad grades = failure. Buying into the belief that grades are the sole factor that determine success and happiness in life promotes anxiety. It's terrifying when we believe that we are a failure, and will continue to be a failure, if we don’t get A’s and gold stars.

This isn’t to say that students shouldn’t work hard, seek advice or tutoring, and strive to learn. The problem comes when students adopt a belief that “grades are everything.” This belief can lead to anxiety, cheating, depression and even drastic measures like suicide.

By switching our beliefs to a perspective that focuses on learning because of interest in the subject, we can decrease stress, and gain more education, from high school and college studies.

Gratitude, sports, writing in a journal, volunteering, exercise, and extracurricular hobbies also develop the broader perspectives that set up for both vocationally and socially successful living.

One further mistaken belief for me, however, was the most deadly. I believed that my parents and teachers were the ones who knew best about what was good for me. This belief resulted in inability to listen to my own gut, to my own thoughts and feelings. When I assumed that my parents wanted me to be in college, and I didn’t want to be there, I began to drown in an anxiety whirlpool. I was shutting down the quiet voices within myself in favor of doing things because of other people’s expectations, which proved to be a perfect route for ever-increasing anxiety and depression.

Dr. H: What information would you offer to a student who is struggling with anxiety?

JH: I’d teach them first that they are not alone in what they are experiencing. Anxiety is normal. Everyone feels it from time to time. It’s even a helpful feeling because it warns them when something needs their attention.

I’d teach them too that anxiety is temporary. It goes away as soon as they identify and create a plan of action to fix the problem that the anxiety is trying to get them to look at.

I would encourage them to find someone to talk with. Seeking help is a sign of strength, not weakness.

I’d tell them to listen to the thoughts that go with their anxiety. Then figure out a new plan of action for the situation that the anxiety is trying to get them to pay attention to.

And lastly, I would tell them that anxiety can be chronic, a sickening feeling that seems to come out of nowhere and lasts on and on. For most high school and college students however anxiety need not be a meaningless curse. Yes, it may feel absolutely horrible. That's for sure. At the same time, anxiety can highlight important concerns and point the way to solutions. Anxiety then transforms into a blessing that helps us to find peace and purpose.