Positive Psychiatry in College Mental Health

What is positive psychiatry? I was introduced to this concept a few months ago on May 22, 2023, during a talk about “Novel Positive Psychiatry” by Dr. Samantha Boardman at the American Psychiatric Association Annual Meeting in San Francisco. This is an approach to psychiatry that may treat symptoms of mental disorders like depression and anxiety with therapy and/or medication but that also focuses on increasing a sense of well-being by enhancing a positive outlook, strengths, values, social connectedness, and healthy habits. At her talk and in her previously published paper, Dr. Boardman provides evidence that specific tools related to these areas decrease psychiatric symptoms as well as improve well-being.

This talk is especially relevant to my work with young adults in the college psychiatry clinic where I have been employed for nearly three decades. Through my training as well as my core beliefs, I have always incorporated aspects of positive psychiatry into my approach. While medications are often helpful, the tools of positive psychiatry give students lifelong skills to feel better. In visits that might focus on medication management and are under 30 minutes, psychiatrists can introduce a few of these tools to facilitate recovery and follow up at the next visit to see if the student found them helpful. For students that need more therapy, psychiatrists may expand the visit to an hour, but if that is not possible, they can refer them to a therapist.

Below are examples of how college psychiatrists can use positive psychiatry to help the young adults we work with live their best lives. Sometimes I have introduced these tools, and at other times students have started them on their own. Parents can use these tools as well to make suggestions when their children are struggling.

Positive Outlook

One of my patients described starting their day by sitting out on their porch in the morning drinking a cup of tea and enjoying the view of the woods in the distance. This practice reduced the anxiety they felt every morning that medication had not fully addressed. I supported the student taking this approach and encouraged them to continue. Other patients use meditation apps before bed to enhance relaxation and sleep. Meditative practices and reflection have been shown to improve a sense of well-being. Keeping a gratitude journal and writing about the good things in your life can also improve mood.

Strengths

Some patients get more depressed when they lose sight of their strengths. One of my patients was so down they had trouble leaving their apartment. They had tried a few different antidepressants at that point with no improvement. While trying to motivate them to have outside contact, I asked them about hobbies they enjoyed or were good at. They said they were excellent at cooking. We talked about their going to the supermarket to buy ingredients for a recipe, and they started to food shop and cook meals again. They were eating better and had more structure to their day. They invited a friend over for a meal. Their mood began to improve.

Values

What does your student value or find meaningful? I work with many students who have chosen a major and career path that they think society and/or their parents will approve of, but they have little interest in. One student was encouraged by their parents to major in engineering but realized they did not like this field. They had a job tutoring high-school students in math and determined they wanted to be a teacher. When they talked with their parents about changing their major to education, their parents supported the change upon seeing their level of unhappiness. This student experienced a great decrease in anxiety and depressive symptoms once they found their sense of purpose. They were eventually able to taper off their psychiatric medication.

Social Connections

Social support is critical to someone experiencing a mental health problem. For example, I worked with a patient who had severe obsessive-compulsive disorder (OCD). They experienced far fewer obsessions and compulsions on their medication. However, occasionally the symptoms would reappear in times of stress. It was hard to leave the house when obsessions or compulsions occurred, and they would cancel plans with friends. They worried that OCD would always rule their life and isolate them. They came to a decision: They would go out when the OCD symptoms were occurring, even telling friends what was going on but explaining how much they wanted to spend time with them. They realized that, even in the face of some symptoms, maintaining their social connections was a critical element to their well-being.

Healthy Habits

For college students, the two healthy habits I focus on are sleep and exercise, as they are both important for well-being and mood. I had one patient who was sleeping four to six hours per night because they had been asked to do too many projects in their Ph.D. program. I encouraged them to get adequate sleep by setting boundaries and ending participation in a few projects. They reduced their workload and, once they started sleeping more, their mood improved. We were able to cut back on the number of medications they were taking. Another student experienced a lessening of their depression and anxiety when they exercised three or four times a week.

By helping college students focus on a positive outlook, strengths, values, social connections, and healthy habits, we can greatly enhance their sense of well-being as well as reduce mental health symptoms that occur in depression and other mental health disorders. They can develop long-term skills that will improve their quality of life for years to come.

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©2023 Marcia Morris, all rights reserved. Details have been altered to protect patient privacy.