College students are prone to anxiety for a number of reasons. The combination of academic pressure, moving away from home, new social situations, and financial stressors can create the perfect storm for anxiety to surface during the college years. Anxiety is felt by most people at some point in their life, and it is a normal reaction to external stressors or perceived danger.
Having fears or being worried about an outcome of a situation does not equate to a diagnosis of an anxiety disorder. However, if these symptoms are lasting for six months or more and getting in the way of how you normally function, there is a possibility that professional help is needed.
Thankfully, anxiety is quite treatable. Potential treatments for anxiety include therapy, medication, and lifestyle changes, all of which can be implemented with the help of the university.
Most Common Symptoms of Anxiety
Anxiety has become a word that people discuss openly in everyday life. It is not uncommon to hear someone admit that they are feeling anxious or worried. The question is, how do you know when you have crossed over from a healthy level of anxiety to an extreme that would be considered a disorder? Taking an honest look at how anxiety and stress are impacting your life would be a good first step towards knowing what level of support you could benefit from.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a diagnosis of Anxiety or Generalized Anxiety Disorder (GAD) can be made if:
- A person experiences excessive anxiety or worry, occurring more days than not for at least six months, regarding a number of events or activities (school performance, social situations etc.)
- The individual finds it difficult to control the worry
- The anxiety and worry are associated with three or more of the following symptoms, with at least some of the symptoms being present more days than not over the past six months:
- Restlessness, or being keyed up or on edge
- Being easily fatigued
- Difficulty concentrating or mind going blank
- Irritability
- Muscle tension
- Sleep disturbance (trouble falling asleep, staying asleep, restlessness, or unsatisfied sleep)
- The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
- The disturbance is not a result of substance use or another medical condition
- The disturbance is not better explained by another medical disorder1
What Makes College Students Especially Vulnerable to Anxiety?
College is an exciting time for many young adults as they begin to navigate life away from home and start a new chapter in their lives. This transformative period also brings new obstacles to overcome and challenges to face. Living away from home for the first time, managing difficult course work and schedules, increased social pressures, independent self care routines, the pressure to succeed on your own, and financial responsibilities are all stressors that make college students more vulnerable to anxiety.
If a student is having a difficult time adjusting to one or more aspects of college life, they may find themself feeling down and experiencing anxious thoughts. These thoughts usually include negative self talk, self doubt, worry, cycles of obsessing about various outcomes, and many other self-critical thoughts. As these thoughts continue to escalate, there is a possibility that the student will start to become more anxious and possibly isolate themself to avoid being exposed.
Even if the student knows that their peers are dealing with many of the same stressors, a personal experience with anxiety can cause them to feel isolated and alone due to the severity of the symptoms, especially if it is the first time. It is always a good idea to speak to someone if anxiety is impacting you.
Anxiety vs. Normal Stress Responses
Stress is a part of life and everyone struggles with worries and anxiety at times. However, when the reactions to the stress begin to overtake normal functioning, that is when the crossover into anxiety disorder can occur. Some examples of normal stress responses are realistic fears of danger to yourself or loved ones, feeling nervous before a big test or presentation, worrying about paying bills, stress related to securing a job after graduation, and feeling self conscious in an uncomfortable or new social situation.
Some examples of elevated anxiety responses include constant worry that causes significant stress, irrational fears or avoidance of situations that pose little to no threat of harm, avoidance of social situations altogether, panic attacks that come on suddenly without reason, and/or the subsequent fear of having another panic attack.
Specific Types of Anxiety Common Among College Students
The presentation of symptoms in college students can differ greatly as everyone is impacted by anxiety related to their own unique experiences. There are various types of anxiety which are common, yet not diagnosed as separate disorders.
The following are some specific types of anxiety and the corresponding symptoms that identify each category:
Anticipatory Anxiety
Anticipatory anxiety is characterized by increased anxiety and panic about events that are expected to happen in the future. Examples of these triggers could be large events such as a final presentation, an upcoming interview for an internship opportunity, or going on a date. Everyday experiences such as talking with a professor, participating in a small group project, or parking your car on campus could also bring out anticipatory anxiety.
This type of anxiety is not a condition that is diagnosed on its own but rather a symptom of other conditions such as Generalized Anxiety Disorder or Panic Disorder. Many times the anticipation of these triggering events causes increased anxiety because of the heightened fear of having a panic attack.
Separation Anxiety
Young adults who are leaving home for the first time are prone to feeling the impact of separation anxiety. Even with the excitement of going to college, feeling homesick or longing to be with family and friends is very common. Many students who are experiencing separation anxiety will call home or visit whenever possible. They may feel lonely or isolated when they are at school and miss their familiar connections.
Separation anxiety can stunt the social growth and development of community in college students. When students are not open to engaging in activities on campus with their peers, they become more isolated and therefore feel an even greater impact of the separation.
Test Anxiety
Many college students experience test anxiety at some point during their studies. Some common characteristics of test anxiety include physical symptoms such as sweaty palms, dry mouth, and racing heart. Some mental manifestations of test anxiety are obsessing about the outcome of an exam, perfectionism, disruption to sleep, inability to concentrate on studies, and fears of failure. Many of these thoughts and symptoms can result in a heightened sense of panic or excessive fear, even when the individual is adequately prepared for the exam.
There are some ways to manage test anxiety before it gets out of hand. Recognize that some anxiety can be helpful because it enables you to perform at your best. Remind yourself of times in the past when you felt anxiety prior to a test and still had a positive outcome. Make sure to take care of yourself physically and practice self care. Get an adequate amount of sleep, eat well balanced meals, and exercise to help release some stress.
Social Anxiety
Social Anxiety or social phobia is an intense fear or anxiety of social situations. Some examples of these scenarios include distress regarding social events, fear of being judged by others, performance anxiety, and fear of being rejected.
Due to the intense fear of these social situations, it is common for people with this type of anxiety to avoid social situations altogether, even when they know that isolation is not a healthy choice. There are also physical symptoms associated with social anxiety such as sweating, heart palpitations, nausea, rapid heart rate, and panic attacks.2
During the college years, there are added pressures to engage in social situations related to educational coursework and outside of academia. Peer pressure is heightened during this time and presents added pressures related to experimenting with drugs, alcohol, sexual situations, and academic dishonesty.
Signs of Anxiety in College Students
Anxiety in college students is more than just feelings of nervousness or worry. The symptoms that can present during this time tend to be debilitating, and without the right interventions can have a long lasting impact on the student, even beyond the college years.
Some signs to watch out for include:
- Nervousness and/or unease
- Inability to maintain focus
- Uncontrollable worry
- Sleep disturbances or Insomnia
- Missing classes or assignments
- Isolation from family, friends, and classmates
- Changes in eating habits
- Cycles of negative thoughts
When & How to Get Help with Anxiety
Anxiety and the worries that come along with it may not go away on their own. According to the Mayo Clinic, there is a point where it is important to seek medical attention.3 You should contact your doctor if the symptoms of anxiety are interfering with your relationships or other parts of your life. It is also important to seek help if your fear, worry, or anxiety is upsetting to you, is difficult to control, or if you think that your symptoms may be linked to another underlying health condition.
It is always important to seek professional help if you have thoughts of self harm or suicide. Like many mental health conditions, the earlier that you begin to treat anxiety, the easier it will be to learn the coping mechanisms and find the best treatment options for your situation. Allowing the symptoms to progress over time, may cause more emotional and physical discomfort and disturbances to your life.3
A thorough evaluation for anxiety usually includes a physical examination, mental health evaluations, and psychological questionnaires. The physical component of the evaluation may include blood and/or urine tests to rule out underlying health conditions which could be contributing to the symptoms you are experiencing. The mental evaluation will consist of assessments to assist in diagnosing an anxiety disorder and the type of treatment needed.
In many instances, untreated anxiety can lead to heightened stress and possibly even anxiety attacks. These episodes can be very frightening for the individual and sometimes can even be mistaken for a heart attack due to the intensity.
Anxiety attacks are characterised by a few or many of the following symptoms:
- Sweating
- Trembling
- Shortness of breath
- A choking sensation
- Chest pain
- Nausea
- Dizziness
- Fear that you are losing your mind/going crazy
- Fear of dying
- Hot or cold spells
- Numbness or tingling
- Heart palpitations or racing heart
- Not feeling like yourself
The good news is that anxiety is a very treatable disorder. There are evidence based therapies and medication options that have proven to be successful for many individuals. Behavioral therapies such as Cognitive Behavioral Therapy and Exposure Therapy are examples of treatments that providers often use for the treatment of anxiety disorders.
Cognitive Behavioral therapy addresses cognitive distortions and negative thinking patterns that make anxiety worse. Exposure Therapy encourages you to confront your fears in a safe environment through gradual exposure. Finding the right course of treatment will give you the ability to overcome the struggles that you face due to anxiety.
What Resources at My University Can Help?
College campuses are equipped with many resources to assist with your mental health needs. Becoming familiar with the services that are available at your school is especially important. The types of support services found on college campuses are typically similar, however what they are called and the exact services provided may vary.
Here are some examples of what you can expect:
- Campus Counseling Center: Therapy services, community referrals, online assessments, group programing, and mental health educational and outreach services.
- Health and Wellness Center: Ambulatory care, primary care services, health education and wellness programs.
- Student Support Groups: Usually run by a mental health professional. On many campuses, support groups are available both in person and online.
- Campus Police: Responsible for safety, security, and upholding the laws. Police are trained to respond to mental health crises when they arise.
How Anxiety Is Treated on College Campuses
Anxiety is one of the top two mental health complications that college students experience. While this disorder is highly treatable, only about one third of the population seeks treatment for anxiety.4
Due to the high prevalence, most college campuses have specialized services in place which are also convenient to access and are usually low cost or free to students. Campus mental health counselors are well prepared to treat anxiety and they are also able to refer students to the health center for a medication evaluation if indicated.
Some specific ways that anxiety is treated are:
Therapy
If you are struggling with symptoms of anxiety, therapy or counseling can be very helpful. Through the therapeutic process you will explore the struggles that you are facing and develop a plan to help you learn to cope with your specific symptoms of anxiety in a healthy way.
Your therapist can teach you calming methods and provide a safe space to talk about anxiety. You will learn different methods to overcome the symptoms that you are experiencing and address negative thought patterns. Therapy provides tools that you can use to regain control over your life.
Medication
Medications are sometimes used to treat anxiety and prevent episodes of severe symptoms. A medical doctor or a psychiatrist can complete an evaluation and determine if medication will be used in your treatment plan.
Exercise
Regular exercise can help to lessen the symptoms of anxiety. In fact, Scientists have found that regular participation in aerobic exercise has been shown to decrease overall levels of tension, elevate and stabilize mood, improve sleep, and improve self-esteem. About five minutes of aerobic exercise can begin to stimulate anti-anxiety effects.5
Natural Remedies
Yoga, meditation, mindfulness practice, good nutrition, support groups, and spirituality can all aid in the treatment of anxiety.
How Do I Get This Treatment as a Student?
Campus counseling centers are available to provide assessments, treatments, and referrals for the college community’s mental health needs. Contacting the counseling center to schedule an appointment for an evaluation would be a good first step in determining a course of treatment. The mental health provider will be able to discuss your needs and work with you to develop a specific treatment plan to address the symptoms of anxiety and how it is impacting your life.
Do Universities Make Accommodations for Students with Anxiety?
Colleges are required to provide assistance and accommodations to students who are diagnosed with a mental health disorder according to Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973.
Students who are managing the symptoms of anxiety while working towards their degree are often relieved to find out that services are available for them. Some examples of these accommodations include, but are not limited to, additional testing time, audio recordings of lectures and books, and additional time to complete assignments.
In order to qualify for accommodations due to a mental health diagnosis, an application must be submitted through the school’s disability office. This process can begin once the student receives their acceptance letter or at any point during their educational experience.
Colleges have different documentation requirements, however most require a letter from a doctor or mental health professional who is qualified to make a diagnosis, assessments supporting the diagnosis, relevant treatment data, and records of functional limitations requiring accommodations.6
Do’s & Don’ts for Students with Anxiety
Anxiety is an illness that should be taken seriously. During the college years there is so much conversation surrounding worry and stress that it can take away from the seriousness of the suffering that people go through with symptoms of an anxiety disorder. Here are some helpful strategies to ensure that you are addressing your anxiety and making sure not to worsen the symptoms.
Do:
- Eat well balanced meals
- Exercise regularly
- Make sure to get a healthy amount of sleep
- Learn breathing exercises and grounding techniques
- Work with a therapist who uses evidence based treatment for anxiety
- Get connected with other people who understand what you are going through
- Learn about your anxiety—seek books, articles, blogs from experts in the field. Giving your symptoms a name and taking the time to understand your thoughts and reactions reduces the power that they have over you
Don’t:
- Try to hold it in and keep it to yourself
- Use alcohol or drugs to cope with anxiety
- Tell yourself to “get over it” or minimize the impact
- Ignore physical reactions to anxiety
How Parents Can Help Their Anxious College Student
When your college student is struggling with symptoms of anxiety, it can be really difficult to watch. Many times parents and guardians find themselves searching for ways to help their child cope in a healthy way. It is important to remember that the child will need validation and support in order to overcome their anxiety.
Here are some things that you can do to help your loved one without enabling them:
- Talk to your student about their anxiety
- Provide a safe space to listen to their concerns
- Help your student remember times when they were able to achieve their goals despite feeling anxious
- Connect your student with local mental health providers and resources.
College Student Anxiety: Statistics
Anxiety Disorders impact millions of adults in the United States each year. Most people who have an anxiety disorder will experience symptoms before the age of 21.3 This indicates that college students have already experienced symptoms of anxiety or will develop them during their college years.
Here are some more statistics about anxiety in the adult population:
- Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year.3
- Anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life experiences.3
- Among adults with an anxiety disorder, an estimated 22.8% had serious impairment, 33.7% had moderate impairment, and a majority of people experienced mild impairment 43.5%.7
- Females are more likely than males to have a diagnosis related to anxiety, according to a study conducted from 2001-2003 by the National Comorbidity Survey Replication (NCS-R).7
