The Talk You Must Have Before Your Child Goes to College

Youth are vulnerable to mental health issues, and they need to know it.

Posted Jul 11, 2016

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When the Browns’* high-achieving daughter, Julia*, went off to college, the family expected more of the same academic and social success that had marked her high school years. But it wasn’t long before her parents noticed troubling signs: Julia’s calls and texts home began to decline, and when she did get in touch, her tone seemed different, more subdued. She sometimes confessed to sleeping most of the weekend, and her Facebook profile, normally filled with smiling selfies, went quiet. 

At last, in a late-night call to her parents, Julia admitted to feeling overwhelmed—even unable at times to leave her dorm. She had tried to snap herself out of it, she said, but she felt confused and desperate—at times, even suicidal. She came home that night.

“It was a tough time for us all,” Julia’s mother says, looking back. “And it makes me really sad to think she was going through this all alone, afraid to talk about it to anyone, not sure what was happening to her, when she could have been getting help.”

The Often-Overlooked Reality of Young Adulthood

Today, after finding an effective combination of therapy and medication for what was diagnosed as major depressive disorder, Julia is again doing well and is back at school, armed with new insights. But her story points out a disturbing truth: Mental health issues most commonly appear when a person is young. In fact, according to a National Institute of Mental Health (NIMH) study, half of all cases begin by age 14 and three-quarters by age 24. 

That means young adults often experience the first signs of an illness such as depression, anxiety, bipolar disorder, or schizophrenia while away at college. Add to this natural vulnerability the stress of leaving home and having to adjust to new social and academic expectations, and the risk becomes even greater. 

If a student isn’t prepared for this reality or aware of how to deal with mental health problems, their issues can become much worse than they need to. “I often think about how different things would have been if Julia had gotten help the minute she noticed something wasn’t right,” her mother says. “I wish I’d have known to tell her, ‘Hey, this is something everyone needs to be on the lookout for, but especially your age group. If you start having problems, don’t hide it. Get help.’”

A Growing Demand for Strapped Services 

Not only are mental health issues common among the young, they appear to be growing. A lot has been written about rising levels of anxiety and depression coupled with frightening rates of suicide in today’s college students. The 2014 National College Health Assessment found that at some time in the last 12 months:

  • 46.4 percent of college students felt hopeless.
  • 32.6 percent felt so depressed it was difficult to function.
  • 54 percent felt overwhelming anxiety.
  • 8.1 percent seriously considered suicide.

According to an American Foundation for Suicide Prevention-sponsored research study, 1 out of 6 college students report having made a suicide attempt at some point in the past. Colleges are attempting to respond with stepped-up mental health services, but because of demand, help isn’t always accessible when a student needs it.

That makes it even more crucial to talk openly with your child about the need to monitor their mental health just as they do their physical health. Indeed, the two aren’t really separate. The mind is part of the body, after all, and each greatly influences the other. 

The Message to Send to Your Child

"Mental health issues are common in your age group and can be serious, but they are highly treatable. Don’t ignore warning signs, which can include: 

  • Sadness or worry you can’t seem to shake;
  • Irritability or short-temperedness;
  • Changes in your sleeping or eating patterns;
  • A lack of interest in things you used to enjoy;
  • Extreme highs or lows that don’t seem to connect to what’s going on;
  • For females, mood changes around your period that now seem to last all month;
  • Confusion, excessive fearfulness, or paranoia.

"If you suspect a problem is developing, let others (including us, your parents) know what you’re dealing with, and seek help. If you’re put off by your campus mental health services, don’t try to convince yourself you don’t really need to see someone. Keep trying, or look for assistance off campus. 

"Also, resist the temptation to use alcohol or other drugs to cope with or numb what you’re feeling. This type of self-medication provides only temporary relief at best. And with continued use, more of the substance will be needed to get the same effect. In the long run, what’s far more likely is you’ll end up with another problem—addiction.

"Above all, don’t let any sense of embarrassment or fear keep you from acknowledging what you are going through. The sooner you deal with this, the better. In fact, the NIMH notes that failing to treat a mental disorder can make it more severe, tougher to overcome, and more likely that other mental health issues will develop.

"In addition to finding professional help, you can help yourself in a variety of ways. Some are basic: Eat healthy food, get enough sleep, take breaks from social media, and try to deal with stress through exercise and some form of relaxation—perhaps yoga or meditation. Yes, it’s tough to fit it all in and be a college student, but that degree you’re working so hard for will be meaningless if you’re too ill to use it.

"Finally, if problems arise, don’t assume you’re the only one feeling this way. You’re not. In fact, campus organizations such as Active Minds exist to spread just that message. See if your campus has a chapter. College is often billed as the highlight of your life, but the reality is that it will have highs and its lows. That nonstop party everyone else seems to be having? It’s an illusion. 

"The lessons learned at college will serve you for the rest of your life, and perhaps the most important one is this: True strength is not pretending that everything is OK when it’s not. It’s being able to say these three words when necessary: I need help."

* Names changed to protect privacy.

David Sack, M.D., is board certified in addiction medicine and addiction psychiatry. As CMO of Elements Behavioral Health, he oversees a number of substance abuse treatment programs for teens and young adults including The Right Step in Dallas and Promises young adult drug rehab in West Los Angeles.