Now that the holidays are over, we know many parents with a college student in the family have had the first chance to spend a significant amount of time with their young adult child since they left on their college adventure in the fall: in some cases, the holidays went off without a hitch, but in others, this time together revealed something unexpected: the presence of severe, disruptive anxiety symptoms or a clinical anxiety disorder.
If this happened with your college-age child over the holidays, it may be hard to accept. Your hopes for their fall semester likely revolved around things like increasing independence, expanding intellectual horizons, making new friends, finding new hobbies or passions, and – ideally – finding an interest that might turn into a fulfilling and sustaining career.
Developing a clinical mental health disorder such as anxiety was probably not on your list of hopes for your college student.
Here’s something every parent in this situation needs to understand:
Your college student doesn’t want anxiety: they want to learn, grow, and thrive while they’re off at school, not feel paralyzed by the symptoms of anxiety.
If you have a college student with anxiety, you may wonder what the problem is. After all, college is a carefree time filled with potential, possibility, and hope for the future.
Right?
What’s there to worry about?
We can assure you that college students have real things to worry about. For some, those worries can escalate and become symptoms of anxiety associated with an anxiety disorder, as we mention above. This happens far more frequently than most people realize.
The University of Michigan releases an annual report called “The Healthy Minds Study” that identifies trends in mental health and wellbeing among college students across the United States. We’ll share data and information from the 2023 Health Minds Study throughout this article. We’ll start with the main things that college students worry about.
What Are College Students Anxious About?
The Healthy Minds study identified three areas that cause college students the most worry, anxiety, or concern. In addition, they identified a fourth area that includes lifestyle factors that can increase or exacerbate anxiety, rather than things that cause anxiety.
Area One: Academics
College students worry about:
- Grades
- Job
- Meeting family expectations
- Specific situations, such as social activities or taking tests
Area Two: Finances
Many college students report significant anxiety related to:
- Tuition
- Loans
- Personal responsibility
Keep in mind that if you’ve ever talked about how expensive college is or kvetched with friends about the financial burden of college, it’s likely your child heard that. They may have internalized that anxiety about money, which can contribute to the symptoms of anxiety.
Area Three: Transition to Adulthood
In the introduction to this article, we listed several common hopes that parents have for their children during the early years of college and/or adulthood. For some college students, these hopes take the form of anxiety, rather than inspiration. College students may develop anxiety around the following aspects of adulthood:
- Independence
- Financial fears
- Social fears
- Meeting family expectations
- Meeting personal expectations
It’s a conundrum. There’s rarely growth without challenge and uncertainty, but the challenges and uncertainties of college can overwhelm some students, cause difficult emotions they’re not prepared or equipped to manage or process, and lead to the development of a clinical mental health disorder such as anxiety.
Area Four: Lifestyle
When college students arrive on campus for their first semester, the healthy habits they had in place during high school – often facilitated by parents – can fall by the wayside. While it’s important to put some adolescent habits away and leave them in the past, it’s equally important to keep the good habits that promote wellbeing, such as:
- Eating three healthy meals a day
- Getting plenty of sleep
- Getting plenty of exercise
- Engaging in social/extracurricular
Another thing for parents to understand is that as college students get closer to adulthood, they often experience a disconnect between how they expected adult life to be and how life as an adult works. For instance, many high school students don’t realize – until they’re in college and thinking about the job market – that when they’re adults, they’ll have new things on their plate that are completely different than the things they’ve had to handle before.
They may face questions of survival they’ve never had to answer or consider. And unless they’re fortunate enough to have no short- or long-term personal financial responsibilities, they need to come up with a workable plan to cover:
- Rent
- Utilities
- Transportation
- Food
- Clothes
- Insurance
- Student loans
- Entertainment
- Savings
For a college student who’s thought about these things, the full reality of becoming an adult can be too much to process. And in some cases, it can exacerbate existing anxiety or lead to the development of a clinical anxiety disorder.
Your College Student: How Can You Tell if They Have Anxiety?
The National Alliance on Mental Illness (NAMI) identifies two categories of symptoms associated with anxiety: emotional and physical. Watch for any of the following symptoms in your college student:
- Extreme fear of common situations
- Restlessness
- Irritability
- Assuming the worst – about everything
- Always on edge
- Elevated pulse
- Hyperventilating
- Constant fatigue
- Excess sweating
- Nausea/stomach problems
For some people, the symptoms we list above can cause severe disruption in almost all areas of life. When severe anxiety goes untreated, consequences may include:
- Problems with family relationships
- Problems making and keeping friends
- Difficulty maintaining romantic relationships
- Work problems
- Decline in academic performance
- Difficulty finding and keeping a job
- Misuse of alcohol and/or drugs
- Increased risk of suicidality and/or non-suicidal self-injury
That’s why treatment is essential – and that’s why it’s important to take action if you think your college student has an anxiety disorder that meets clinical criteria.
How You Can Help Your College Student: Tips for Managing Anxiety
The most important thing for you and your college student to understand is that anxiety is treatable. The most effective approach for treating anxiety is a combination of psychotherapy, medication, lifestyle changes, and social support.
Psychotherapeutic modalities may include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), exposure and response prevention therapy (ERPT), and others. Medication may include anti-anxiety medication, a.k.a. anxiolytics, or antidepressants. Lifestyle changes include healthy eating, sleep hygiene, daily exercise/activity, and peer support groups or programs.
If your college student came home for the holidays and you learned they experience severe, disruptive anxiety, it’s essential to arrange a full psychiatric evaluation administered by an experienced, qualified, mental health professional as soon as possible.
You can do this whether they return to school after the holidays or decide to stay home. A mental health professional can arrive at a diagnosis and refer your child for professional treatment. When you take that route, the path is clear: you, your college student, and a mental health professional decide on a treatment plan – and then your child follows it, with whatever level of support they want and need from you.
Once you have a treatment plan in place, you can help your college student by taking the following steps.
Three Tips for Helping Your College Student Manage Anxiety
1. Demystify:
- You and your child can learn everything there is to know about anxiety, starting with helpful organizations like the Anxiety and Depression Association of America (AADA). Understanding the science behind anxiety and anxiety treatment can help you gain perspective and offer context for the diagnosis. When you learn the facts about anxiety, you learn that millions of people manage their symptoms every day – and live full and productive lives.
2. Avoid Isolation:
- People with anxiety often have a powerful urge to keep to themselves, stay alone, and reduce social contact. This is counterproductive. People need people – and so does your college student with anxiety. Work with them to identify and plan safe and healthy activities that include other people. Start small, and work to build a healthy and strong social network. Putting the time in now can help set up a support system for the rest of college and beyond.
3. Non-School Activities:
- We all need balance in life – and that includes college students. It’s true: when they’re in college, it needs to be the number one priority. At the same time, in order to perform at their best and meet their potential, your college student needs healthy and productive ways to relax and blow of steam, when needed. You and your child can work together to identify non-academic activities to help create the balance that promotes overall wellbeing. Sports, music, arts, anime, yoga, and mindfulness all count – as well as any other hobby or interest that helps you college student reset, recharge, and return full of energy.
That’s how you can help your college student with anxiety. It’s also important to understand that neither you nor your child are alone. To help drive that point home, we’ll review the latest data on the prevalence of anxiety among college students in 2024.
Anxiety Among College Students
The National Institutes of Mental Health (NIMH) estimate the following lifetime prevalence of anxiety among adults 18+:
- Mild/moderate anxiety: 30%-35%
- Severe anxiety: 20% -25%
Here’s the latest data on mental health among college students, published in the University of Michigan Healthy Minds Study (2024):
- Any mental health diagnosis, lifetime: 50%
- Anxiety diagnosis: 39%
- Depression diagnosis: 33%
- Bipolar diagnosis: 4%
- Obsessive-compulsive disorder: 4%
- Trauma disorder: 12%
- Eating disorder: 5%
- Personality disorder: 2%
- Substance use disorder: 2%
- Psychosis: 1%
- Anxiety:
- Any anxiety: 34%
- Moderate anxiety: 18%
- Severe anxiety: 16%
- Depressive symptoms:
- Any depressive symptoms: 38%
- Moderate depressive symptoms: 19%
- Severe depressive symptoms: 19%
- Suicidality:
- Suicidal ideation: 13%
- Made a suicide plan: 6%
- Attempted suicide in past year: 2%
- Non-suicidal self-injury: 26%
And here’s the breakdown by major/field of study:
Severe Anxiety Among College Students By Academic Program
- Art: 19.7%
- Humanities: 18.3%
- Social Work: 17.8%
- Social Sciences: 17.3%
- Nursing: 16.1%
- Public Health: 15.3%
- Medicine: 12.4%
- Natural Science or Mathematics: 16%
- Business: 12.7%
- Engineering: 11.8%
- Law: 13.6%
In 2024, evidence revealed the highest rates of severe anxiety – by major – appeared in students majoring in Art, Humanities, Social Sciences, and Nursing. If your college student majors in any of those fields, we encourage you to watch for the signs and symptoms of anxiety we list above.
Is Professional Treatment for Anxiety Common Among College Students?
Yes, but not as common as we’d like it to be. Here’s the data on treatment from the U of M Health Minds Study:
Engaged/Participated in Professional Counseling
- All students, 2024: 36%
- With anxiety and/or depression: 46%
- All students, lifetime: 54%
- With anxiety or depression: 66%
You now understand what we mean. A significant number of college students engage in professional treatment, but the treatment gap is simply too high: in 2024, over half the college students with anxiety did not get the treatment they needed.
But why?
Here’s what they said:
Barriers to Professional Support
- Time: 24%
- Money: 22%
- Prefer to handle independently or with support of family/friends: 19%
- Unsure how to find help: 14%
- Problems finding available appointments: 9%
- Counselors don’t understand my issues: 8%
- Plan to go, but haven’t yet: 5%
- Privacy concerns: 4%
As a parent, you can help your college student overcome these barriers to anxiety treatment. In addition, you can encourage them to engage in the following types of informal support for anxiety:
Sources of Informal Support for College Students With Anxiety
- Friend (who is not a roommate): 39%
- Family member: 39%
- Significant other: 31%
- Roommate: 12%
- Religious counselor or other religious contact: 5%
- Support group: 3%
- Faculty member/professor: 4%
- Staff member:2%
- Other non-clinical source:1%
While those sources of support are informal, they’re also critical. Having a wide and diverse support system can make all the difference. A person with five places/people to go to for support has a better chance of managing anxiety than a person with one or two. However, every little bit helps – and any type of support leads to better outcomes than none at all.
Finding Help for College Students With Anxiety
First, call us here at Bay Area Clinical Consultants: we can help.
Second, use the therapist and treatment locators provided by the American Academy of Child and Adolescent Psychiatry (AACAP), the National Institute of Mental Health (NIMH), and the National Alliance on Mental Illness.
When a college student needs treatment for anxiety, they may be too nervous or afraid to admit it out loud or ask for help. However, evidence shows that the earlier a person – of any age – who needs treatment gets the evidence-based treatment they need, outcomes improve for everyone: the student, their parents, and the whole family.
