Sending Depressed Teens To College

Dear Dr. G.,

My 18 year old daughter is going to be a freshman in college in less than 3 weeks. My husband and I are very worried. My daughter has struggled with anxiety and depression since middle school. In seventh grade she was cut off from her friend group. I tried to talk to her about it all the time but when I heard the stories about how her friends were treating her I just got so upset that I think I made things worse. Eventually, I got my daughter in to see a good therapist who has helped her quite a bit throughout the past several years. My daughter started antidepressant medication this year which also appears to have helped her. She has been working with a very good psychiatrist. My daughter's mood has been pretty good this past year but I am worried about how she will do in college. Her college is only about 2 hours away from our home. I didn't want my daughter to be too far from home in case she needs me. I am, nonetheless, very worried about the transition. What can I do to make things easier for my daughter? Please offer any advice.

A Grateful Mother

Dear Mother,

Thank you for writing to me. August is typically a very busy month for therapists as many children, teens, and college students are experiencing anxiety about returning to school, moving to a new school, and/or going to college. Parents also experience anxiety because they want their kids to be happy and safe and they tend to worry, right? The first order of business, of course, is to work with your teen's treatment team at home and set up a treatment team for your daughter while she is at school. She must have these services in place. You should also be aware that many colleges offer mental health services. Work with your daughter's treatment team on getting these services set up as soon as possible. Your daughter needs a safety net and a safe space in which to continue to discuss her issues.

Transitioning to college offers a new set of challenges to all students. These challenges may be particularly tricky for an already anxiety-prone child. The many pressures of college include being homesick, dealing with roommates, new schedules, managing money, dealing with new relationships, and time management. This is a very complicated set of challenges for young people to deal with.

In addition to making sure that your daughter has a good treatment team in place I have a number of other suggestions. First, encourage your daughter to value good self-care. She should pay attention to eating well, getting enough sleep, and incorporating exercise and relaxation time into her schedule. Individuals who are taking good care of themselves feel better about every other task that they have to accomplish. Second, speak to your daughter about setting up a schedule for herself. Everyone benefits from structure and schedules as long as they don't adhere too rigidly to them and sacrifice their well-being in the process. Third, talk to your daughter about having reasonable expectations for her first year of college. She is unlikely to get perfect grades and meet her best friends immediately. Figuring out who your good friends are and how to manage courses are both processes which take time and patience.

Finally, and this is extremely important, you must be very careful not to become overly anxious about your daughter's transition and then engage in excessive discussion of her worries with her. You certainly want to and should be available to your daughter. Your conversations with her, should not, however, be characterized what is referred to as co-rumination. This refers to engaging in problem and worry discussion only without any emphasis on solutions. I am not suggesting that you attempt to solve all of your daughter's problems for her. Instead, I am suggesting that you listen to her and then encourage her gently and gingerly to figure out how she can make college life a bit easier. In addition, pepper your conversations with her with positive moments and details. Your conversations with your daughter should not consist exclusively of gloom and doom topics.

If you notice that your daughter is slipping into a depression and is isolated and/or sad, agitated or irritable then you must encourage her to reach out to the professionals on her treatment team. If you are not sure how your child is faring then you may want to reach out to her treatment team and express your concerns. Also, please consider getting help for yourself if this life change (your daughter leaving home) is keeping you up at night and causing you an excessive amount of stress. Please reach out to me again and let me know how the transition goes.

Best,

Dr. G.