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Key points
- The rates of anxiety and depression among college students are sobering.
- College counselors feel that being academically prepared is only part of the puzzle.
- Three practical strategies can help students manage stress.
As a former psychiatrist at Barnard College's counseling center, and as a therapist who works with students and families, I can share that these are challenging times for many college kids. The statistics about the escalating rates of anxiety and depression among our college students are sobering. A national study co-led by researchers from UCLA, the University of Michigan, and Boston University looked at 350,000 students attending 300 different college campuses. The researchers found a 135% increase in depression and a 110% increase in anxiety between 2013 and 2021. (While COVID added to the trend, it was not the main cause). College counseling centers, meanwhile, are flooded with requests for appointments and either have to offer limited interventions or quickly try to refer students out into the community.
A colleague who heads the counseling center of a highly competitive university told me that while their students are better equipped academically than ever before, they are often under-equipped for the social and emotional challenges that come with living on their own without the structure and support they used to have. Added to that is the often negative impact of social media and the competitive process of getting into and excelling in college. As one student told me, "I feel like I'm just going from one set of stressful deadlines to the next. It's like it never ends."
Despite these headwinds, there are things students can do to better prepare themselves for the journey ahead. Thanks to the neuroplasticity of the human brain, all of us can learn how to adapt, change, and pivot the way we think. Here are three steps, based on cognitive behavioral theory, that students can use to equip themselves emotionally in times of stress, during the college years and beyond.
These steps are also practical for parents and I personally find them to be a great way to get centered and think more clearly when stress comes knocking at my door—which, as we adults know, it always does.
Identify your top stressors during the week
A first step is to pinpoint the most stress-inducing events. I ask my patients to use a notes app or a journal to track when they feel the most anxious during the week. They rate their level of anxiety from 0 to 5 (five is the maximum intensity) and pay attention to the specific events or settings that rate as a 3 or higher. This has the effect of helping define exactly what triggers anxiety, instead of experiencing it as a free-floating emotional state that comes out of nowhere.
Example: Anxiety, 4 out of 5. Event—thinking about my upcoming history exam next week.
Describe your underlying thoughts
This second step further puts the brakes on the anxiety spiral. I ask patients to write down what it is about the event that causes distress and why. This helps people understand what specific sets of thoughts are linked to their anxiety. The scientific name for this step is affective (emotional) labeling. Studies have shown that labeling a particular emotional trigger may allow the brain to become less activated by that trigger. Labeling is also a form of exposure therapy: By squarely naming the thing we fear, it tends to become less intimidating and easier to handle.
Example: The history exam is worth 30% of my grade. I didn't do great on the first one and I worry I might end up with a poor grade in the class. I think of myself as a top student and it feels scary to not be able to handle it. I tend to value myself based on what I achieve.
Challenge and re-frame those automatic thoughts
Once people know the specific thoughts that drive the most anxiety, they can begin to question the thoughts more objectively. I ask patients to find any exaggerated thought patterns, known as cognitive distortions, that could lead to inaccurate assumptions. An example of this would be an "all or nothing" pattern, where it feels as if one bad outcome means all outcomes will therefore be bad. Another example is catastrophizing, where we follow an idea to its worst possible outcome. Knowing when a cognitive distortion is in play helps weaken its impact. I also ask patients to challenge their core thoughts by looking for evidence that does or does not support it. This has the effect of stopping an automatic assumption and reframing it in a more realistic, less anxiety-provoking way.
Example: I might get a lower grade overall but that doesn't mean I will necessarily fail the class. There is probably a 75% likelihood that I won't outright fail. Also, if I'm not always a top student, that shouldn't define my value as a person. I value people for who they are, not just for what they do. And I know my friends and family feel the same way. Maybe I can begin to see myself that way too.
Summary
Like any new skill, identifying our automatic anxious thoughts and reframing them with a more nuanced, balanced perspective takes practice and repetition. But with time, all of us can learn to become aware of the link between our thoughts and feelings, slow down assumptions that don't serve us well, and move ahead through college (and life) challenges with a greater sense of ease.
