Anxiety and the College Student

Anxiety comes with the territory in college, and a little is a good thing. After all, it’s what helps spur you to finish that paper, to pay attention to your health and safety, and to show up for class.

But for some students, anxiety “runs amok and becomes out of proportion to what’s actually in front of them,” explained Anne Marie Albano, PhD, ABPP, professor of medical psychology in psychiatry at Columbia University Medical Center and director of the Columbia University Clinic for Anxiety and Related Disorders (CUCARD). “It’s future-oriented worry, and it keeps you ruminating and stuck on things that then make you not problem-solve appropriately and take control of the situation.”

It’s an all too common issue. The 2014 National College Health Assessment found that more than half of all college students felt overwhelming anxiety within the previous year, and more than a fifth said anxiety affected their academic performance. But only about 14% were diagnosed or treated for their anxiety, the assessment found. Of those who sought help for emotional issues, anxiety was the most common problem, according to the 2014 annual report from Penn State’s Center for Collegiate Mental Health, which pulled together data from 140 college and university counseling centers. Close to 20% of that number considered anxiety their top concern.

It’s these numbers that Dr. Albano and her colleagues seek to change through a variety of anxiety management and life-skills programs designed for people in college, those of college age and high school students preparing for college. Parents can also take part, learning ways to give their child the best start, as well as how to let go.

Making the LEAP

The model in CUCARD’s offerings, Dr. Albano said, is the Launching Emerging Adult Program (LEAP) geared toward 16- to 28-year-olds with anxiety and mood issues. About 10 years in the making, the program’s been running successfully for about five, Dr. Albano said. In fact, her team hopes to release a LEAP manual next year that can guide others.

Through LEAP, “we work with the parents and the young adults not just to understand anxiety and what the young adult has to do to overcome it, but also developmentally what people their age are doing on their own that their parents have been doing for them, inadvertently contributing to them remaining stuck.”

The student might learn, for example, to go to doctor’s appointments alone, handle their own scheduling, even do a solo college visit. “It’s developmental steps,” Dr. Albano said, “kind of like when they were little and their parents eventually had to let go of the bicycle seat and let them ride on their own. The same thing with getting into life.”

Groups are another important part of the program offerings, Dr. Albano said. “We group young adults or adolescents who are close in age, and then we recreate scenarios that produce anxiety. They then work to manage those and learn how to use the skills for anxiety management and also for moving along the developmental path.” A student might role-play meeting with a college professor, for example, or inviting a fellow student to lunch.

“One of the big things we work on is helping the college student learn to ride out feelings of anxiety,” Dr. Albano said. “We’ve all had those feelings of dread, those knots in the stomach. Understand that those are normal. If you pull the covers over your head and just stay in bed, it doesn’t get any better. If you avoid, if you escape, if you hide, it only makes the anxiety go away momentarily, but then it comes back twice as strong each time.”

Why Anxiety Is So Prevalent

So why are so many of today’s college students struggling with anxiety? There’s the extreme competitiveness of the college application process, of course, which can cause some students (and their parents) to get caught up in the frenzy to get into the “right” school and keep up when they get there.

Some also point to the trend toward so-called “helicopter parenting,” in which meddling parents don’t allow adolescents a chance to fail. Thus, they never learn how to pick themselves up — a troubling situation for those suddenly on their own in a college atmosphere. Others note that social media boosts pressure by providing a global stage for missteps, as well as allowing for endless comparison, that thief of joy. On top of that, this is a generation raised on the anxiety of the 9/11 terror attacks and witness to an economic upheaval that’s erased any sense of job security even if they do get that college degree.

Dr. Albano agrees that there’s some truth in each of these ideas. “It’s a completely different age,” she said. But she’s wary of saying today’s students are more anxious than they used to be.

“One of the things I always tell people to understand is we actually didn’t start tracking anxiety disorders until the 1980s,” she said. That means valid studies weren’t available until the 1990s. Studies conducted then and since have found that anxiety remains the most common mental health diagnosis for any age group — children, adolescents or adults — and it’s most prevalent among those ages 18-29.

Obstacles to Treatment

“The other interesting thing that’s been shown is that an anxiety diagnosis is among the least treated in the college-age population,” Dr. Albano said. You’re more than twice as likely to get help for a mood disorder than for an anxiety disorder, she said.

Dr. Albano said she believes there are several reasons for this shortfall. One is the stigma of anxiety, she said. “It’s hard to admit, and it’s hard for people to understand some of the things that come with anxiety, such as fear of being away from home or the embarrassment of social phobia,” she said, adding that many who confess to anxiety are likely to simply hear “suck it up.”

Another reason students might not seek help is that it’s not always easy to determine when anxiety becomes unhealthy. “Anxiety is the big liar,” Dr. Albano said. “It fools a person into thinking they’re helping themselves when they’re not. It may take a person a little while to realize, ‘Hey, wait a minute. This isn’t good for me.’

“For example, a college student who has social anxiety problems may show up to the dorm, unpack their stuff, and while everybody else is mixing and mingling in the hallway and getting to know one another, they’re spending time rearranging their clothes in their drawers. Everyone goes off to dinner together and they’re telling themselves, ‘Well, it’s more important for me to get my room in order.’ And then this continues. They get to class right on time. They don’t get there ahead of time to meet the professor or talk to people. They eat oodles of noodles in their room in a hot pot rather than make their way into the social scene of the cafeteria on campus. And so it becomes something they don’t recognize right away, but they become more and more isolated.”

Anxiety’s Red Flags

Loved ones may or may not pick up on these problems. But Dr. Albano offers advice for parents trying to determine whether their college student is handling their anxiety or arranging their lives to challenge themselves as little as possible.

One is to seek details. For example, ask for the names of the fellow students they’ve met rather than asking only whether they’ve met anyone. “If you’re not getting specific information, that’s a red flag,” she said.

Your young adult’s extracurricular pursuits also matter. No matter how demanding their schedule, “there’s got to be a social life on campus because this is a time of great social emotional development, not just intellectual academic development,” Dr. Albano said.

If the answers you get concern you, encourage your young adult to talk about what’s getting in the way. “A lot of parents are going to hear, ‘It’s just that I’m overwhelmed. You don’t understand. I have so much work.’ And that’s where you can say, ‘OK, are you making use of the tutoring center? Have you met with your professors?’ Breaking down the stigma that some kids feel about asking for help is very important.”

Because of the party culture on most campuses, it’s also important that the student understand that drugs and booze only seem to offer relief. In reality, they’re more likely to create new problems. “Alcohol and other substances are things they use to try to comfort themselves when they’re challenged with anxiety,” Dr. Albano said. “So the co-occurrence of those conditions, especially in college age, is something that we see and that has to be addressed. You can’t treat one and not the other.”

When you talk to your young adult, “it’s not that you want to be drilling them,” Dr. Albano said. “And you don’t want to over-impose yourself on their life.” But as long as the student is dependent on the family, the family needs to be involved in teaching them how to become independent. “We want to change the helicoptering to helping,” she said.

Moving Beyond Anxiety

Dr. Albano began studying anxiety in the 1990s and was soon drawn in by the rewards of the work. “Seeing the ways kids blossom and the happiness of their families when they overcome an anxiety condition, whether it’s separation anxiety, social anxiety, obsessive compulsive disorder — it became a reinforcing experience.”

Through her progression to renowned anxiety expert, which includes credentials such as writing the book You and Your Anxious Child, Dr. Albano said she’s come to understand that anxiety can be “subtle and insidious in the way it grabs you” and that for those vulnerable to it, “anxiety is going to be their Achilles’ heel at different stages of change through their life — the transition to college, the transition to work, starting a relationship.”

The good news is anxiety is among the most treatable disorders. “You may be anxious,” she said, “but if you have the tools or access to groups like ours, you can shore yourself up and move along.”

One thing that can help all of us keep anxiety at bay, Dr. Alabano said, is coming to terms with the fact that missteps are a part of life. “Sometimes we make mistakes, and that’s OK,” she said. “We can mess up and we can deal with it, but then we have to profit from our mistakes.”

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