Anxiety in College Students: Signs, Symptoms & Treatments

What Makes College Students Especially Vulnerable to Anxiety?

Living away from home for the first time (and perhaps feeling homesick), 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 students more vulnerable to anxiety and burnout in college.

In addition, students and younger populations may feel additional anxiety due to climate change, political events or recent racial unrest. Uncertainty about the future can often lead to increased anxiety.

Even if the student knows that many of their peers are also dealing with school stress, 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.

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.

Signs of Anxiety in College Students

Anxiety in college students is more than just feelings of nervousness or worry. The symptoms of anxiety 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 of anxiety to watch out for include:²

• Nervousness 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

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 stress can turn into anxiety.

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 that are common, yet not diagnosed as separate disorders.

The following are some specific types of anxiety that can be common among college students:

• Anticipatory Anxiety: Anticipatory anxiety is characterized by increased anxiety and panic about events that are expected to happen in the future, such as an upcoming exam or meeting with a professor.
• Separation Anxiety: Separation anxiety can leave students feeling lonely or isolated, missing their familiar connections. It can stunt the social growth and development of community in 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: Test anxiety can have both physical and mental manifestations such as racing heart and inability to concentrate, often resulting in a heightened sense of panic or excessive fear, even when the individual is adequately prepared for the exam.
• Social Anxiety: Social anxiety is an intense fear or anxiety of social situations. 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.³

When to Seek Professional Help

Anxiety and the worries that come along with it may not go away on their own. You should contact your doctor if the symptoms of anxiety are interfering with your relationships, academics, or other parts of your life as a college student.

You should 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

In many instances, untreated anxiety can lead to heightened stress and possibly even panic attacks. These episodes can be very frightening for the individual and sometimes can even be mistaken for a heart attack due to the intensity.

How Anxiety Is Treated on College Campuses

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.

While it is highly treatable, only about one-third of the population seeks treatment for anxiety.⁴

Some specific ways that anxiety is treated are:

• Therapy: In therapy, 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. Some common therapy techniques include CBT for anxiety and exposure therapy.
• Medication: Anxiety 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: 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: Natural remedies for anxiety, like yoga, meditation, mindfulness practice, good nutrition, support groups, and spirituality can all aid in the treatment of anxiety.

How to Get Help for Anxiety in College

Campus counseling centers are a great first step, as they are available to provide assessments, treatments, and referrals for the college community’s mental health needs. Contact the counseling center to schedule an appointment for an evaluation to help determine 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.

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.

Resources for mental health support on a college campus typically include:

• Campus Counseling Center: Therapy services, community referrals, online assessments, group programming, 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.

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 1973.⁶ 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

Coping With Anxiety as a College Student

Some helpful strategies to ensure that you are addressing your anxiety and making sure not to worsen the symptoms might include:

• Eating well-balanced meals
• Exercising regularly
• Learning ways to better manage stress
• Getting a healthy amount of sleep
• Learning breathing exercises and grounding techniques
• Working with a therapist who uses evidence-based treatment for anxiety
• Connecting with other people who understand what you are going through
• Learning 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. If it’s test anxiety, find better ways to feel prepared.
• Don’t try to hold it in and keep your difficult feelings to yourself
• Avoid using substances like drugs and alcohol to cope with your anxiety symptoms

How Parents Can Help Their Anxious College Student

When your child is struggling, it is important to remember that they will need help overcoming their anxiety.

Here are some things that you can do to help your college-aged child without enabling them:

• Talk to your child 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