DEALING WITH ANXIETY IN COLLEGE

What Every College Student Needs to Know

Anxiety in College by the Numbers

College is a time of major changes, so it’s no wonder it is also a time when many students experience anxiety. When you know what you’re dealing with, know how to cope and can find the right help, you can manage anxiety.

A survey that asked college counselors about anxiety issues found that anxiety is the top issue for college students (41.6 %). About 25% of college students were taking medications to treat mental health issues.

Another study done by Penn State found that more than 60% of college students report anxiety as one of their major health concerns. College students struggling with anxiety cuts across all sexes and races. One study found that the rates of anxiety disorders reported by US college students doubled from 2008 to 2016. During this time, the rates for anxiety disorders rose by 65% for transgender students, 67% for male students, and 92% for female students.

Asian or Pacific Islander 10%
African America 14%
Hispanic or Latino 15%
White 23%

College Students Treated for Anxiety by Race

Students of color were half as likely to report a diagnosis or treatment of anxiety disorders compared to white college students.

anxiety vs. stress

Stress and anxiety may seem the same at first glance. While both can be touched off by the same things and signal the body to be on alert, anxiety has the additional element of fear and sometimes a feeling of doom.

Another difference is that anxiety is not the same as stress, but rather a reaction to stress. When anxiety happens frequently, it can become a problem because it interferes with college life.

Video: College Anxiety and Depression

Symptoms of Anxiety in College Students

Anxiety affects students’ physical well-being, emotions, how they think, and how they behave. Let’s take a closer look at each of these areas.

Physical Symptoms

Anxiety can have negative physical impacts on the body, both in the short- and long-term. Short-term effects include rapid breathing rate, elevated heart rate, and muscle tension, which are normal responses that help prepare you for facing intense situations.

But if the anxiety is continuous or extreme, it can have crippling effects on your body, including:

Lightheadedness

Nausea/upset stomach

Leads to alcohol or drug abuse

Headaches

Fatigue

Dry mouth

Loss of sex drive

Muscle aches/body pain

Irritability

Insomnia

High blood pressure

Emotional Symptoms

Prolonged anxiety can affect your emotions to the point where panic attacks happen. When anxiety and stress get intense and it causes a panic attack, you can experience symptoms like you’re having a heart attack, your tongue swells, or you feel like you are choking.

Fortunately, a panic attack doesn’t last long, but it can be such an intense experience that you change your life to avoid situations you think can lead to attacks. Anxiety can also lead to other mental health issues, such as depression. You may also start to isolate yourself socially to avoid other people so you won’t be judged. You may worry that you are going crazy.

Cognitive Symptoms

Cognitive thinking is the mental processes that you use to learn, reason, understand and concentrate. Anxiety can negatively affect these thinking processes. Research suggests that anxiety overpowers the brain and greatly changes nervous system activity. Anxiety can slowly weaken your thought processes. Your ability to make rational decisions can degrade. Anxiety can blacken your thoughts, making you feel fearful of what is going to happen. Feelings of not being good enough and memory problems can also happen as cognitive effects of anxiety.

Behavioral Symptoms

When your thinking processes change from anxiety, it leads to changes in the ways you behave. Common effects anxiety are behavior that is feeling “out of it,” unhappy or bored. This can lead to a life where you want to be alone with your thoughts and deal with your anxiety. You also don’t want the help of others and shy away from enjoying the activities you like.

When you have anxiety, these behaviors may seem like good choices because you are tired. You feel that being alone helps you recuperate. While recuperating in isolation seems like a good choice, it’s not the best one. Isolation without distractions can lead to you becoming lost in your own thoughts. When you are struggling with anxiety, too much time with nothing but your own thoughts will likely cause more anxiety. Spending too much time alone can lead to agoraphobia, where you become fearful of leaving your home or dorm. When you avoid situations where a panic attack or anxiety episode can occur, it can result in an overall feeling that the only safe place is home.

Things to Avoid when Anxious

Coffee

Avoid drinking too much coffee. Caffeine can make you jittery and increase anxious feelings. Drinking large caffeine doses of 200 mg or more can produce negative effects. Increased anxiety, nervousness, and jitters can all happen. Too much caffeine can also produce withdrawals if you try to stop abruptly. Keep your caffeine intake low or slowly wean yourself from it.

Keep in mind coffee isn’t the only thing that contains caffeine. Certain teas, sodas, yogurts, ice creams, chocolates, candy and over-the-counter medicines contain caffeine. At the end of this article in the resource section, there is a link for a list of foods and drugs and their caffeine content.

Drugs and Alcohol

It may be tempting to try and relieve anxious feelings by taking drugs or drinking. In the long run, they will make things worse instead of better. At first, drugs or alcohol may help you feel better. They mask anxious feelings, but as soon as they wear off, you’ll feel anxious once again. It’s better to get to the root of your anxiety rather than temporarily mask it. Many drugs and alcohol will build a tolerance in your system if you keep taking them to cope with anxiety. Tolerance means that you will gradually need more to get the same effects from before. This results in taking larger quantities, which can lead to dependence and addiction. Instead of dealing with just anxiety, you’ll be dealing with a substance abuse disorder as well.

You may try alcohol or drugs to relieve your anxiety, but when you’re anxious, this can worsen anxiety instead of making it better. A drink or drug may hit you the wrong way; then you may find yourself dealing with an unstable frame of mind and a dangerous situation.

Focusing Too Much on the End Result

When you focus too much on the end result, it can be exhausting. Overthinking can overwhelm you as it consumes your time, energy and thoughts. Continuous anxiety puts you in a state of high alert all the time. You will be looking for pitfalls, dangers, and worries at every turn.

Overthinking can take the form of racing thoughts about what you should do or say. It’s also about creating endless worst-case scenarios. Moreover, you may worry all the time about how you look to others and if you measure up. After a while, this kind of thinking can become disordered and cloud your mind. Stop yourself when you think, what if? Turn to a relaxation technique for a much-needed break from jumbled thoughts.

How to Fight Anxiety

The good news is that there are positive ways you can deal with anxiety to keep its effects to a minimum.

Get Enough Sleep

College students typically have hectic schedules. School demands include classes, homework, studying and exams. Finding time for activities outside of school may be difficult. Many students cut into their sleep time to fit it all in. But lack of sleep can cause anxiety because of the fatigue that results.

If you’re running on empty, everything suffers, including maintaining your mental health. Be sure to get about 8 hours of sleep every night. Take naps if you need them, and don’t pull all-nighters.

Make sure the sleep you do get is restful, quality sleep. Don’t sleep with the TV on, because the TV light and sound will prevent you from reaching deeper levels of sleep.

Deep Breathing

When you find yourself becoming anxious, take several deep breaths. Deep breathing from your diaphragm is a powerful way to reduce stress because it starts up the body’s relaxation response. Deep breathing helps your body go from the fight-or-flight response to a relaxed response within the nervous system.

Slowly inhale to a count of 4, filling your stomach area first and then your chest. Hold your breath while you count to 4, then slowly exhale while you count to 4. Repeat a few times or more if needed. The fantastic advantage about deep breathing is you can do it anywhere at any time to reap its calming benefits.

Talk to Someone

You could talk to friends and family about your anxious feelings, but sometimes it’s better to talk to someone who is not in your inner circle. A therapist or peer counselor from the college student center can be good sources for advice. Talk about what is troubling you and how to handle it. An online resource that can help called College Confidential is a forum that allows you to talk about anything with other college people.

Stay in the Here and Now

When you feel anxiety building, stop and use your deep breathing technique. At the same time, focus on what is around you at the present moment. By focusing on the present moment, you’ll be able to better manage what is going on around you.

Eat Healthy

Proper eating habits help you maintain a healthy brain and body while you tackle college life. It’s tempting to eat junk food on the run when you have a busy school schedule, but food that isn’t nutritious will harm you in the long run. Be sure to eat plenty of fresh fruits and vegetables. Eat breads, grains and protein for energy boosts. Also, always drink lots of water to stay hydrated.

Think Positive

The power of positive thinking can be tremendous when preventing or dealing with anxiety. If you are stuck in dark thoughts, it increases anxious feelings. More anxious feelings make for more negative thoughts; it’s a vicious cycle.

When you think positive, you are conditioning parts of your brain that control thinking and behaviors to work better. These brain improvements can help you perform better when you’re dealing with difficult tasks or negative emotions.

Take Part in Relaxing Activities

Anxiety is filled with tension and fear, so relaxation can be the perfect way to tackle these feelings. Take a mental health day to unwind from your fast-paced college life. Do things you enjoy in your spare time. Yoga classes can go a long way in helping you control stress and anxiety. Go for a walk or practice deep breathing. You can repeat a silent prayer or mantra. These are all simple, easy to do ways of relaxing without spending a lot of time or money.

Create an Independent Study Routine

It’s smart and helpful to develop a study routine. Set aside time on a regular schedule to study. Be sure to stick to your schedule. By having a regular routine, you’ll avoid having your studying activities build-up. When studying builds up, it can easily lead to you pulling an all-nighter. Cramming lots of studying into small windows of time can cause or worsen anxiety and stress. A routine can help prevent cramming from happening.

It can help to talk with your academic advisor early to find out how to get tutoring and other academic support if needed.

Video: College Life & Social Anxiety

Signs You May Need Help

Everyone gets anxious now and then. So how do you tell if you need help with anxiety? The following signs may mean you need to find help.

Social Isolation

Anxiety and isolation can be a dangerous trap. You may go into seclusion to avoid situations that may cause anxiety, or you may isolate yourself to avoid people from judging you. This can add up to a lonely life.

A lot of time spent alone can worsen your anxiety. You’re alone with your thoughts without any social support. This creates an isolated cocoon filled with disordered anxiety thoughts. You may start to question who you are and what your purpose is in life. You’ll only have your anxious thoughts to keep you company.

Emotional Outburst

Anxious feelings that are with you most of the time can make you feel stressed out. It’s like you are living in a pressure cooker that’s ready to blow. If you’re having angry outbursts, it might be due to emotional overheating from built-up anxiety.

Physical Signs

Many people with an anxiety disorder also abuse or are dependent on drugs and alcohol.

Abuse/Dependent on Alcohol
35%
Abuse/Dependent on Drugs
30%

Muscle Tension

Sometimes, a long day can cause tight muscles and pain for just about anyone. Anxiety-related muscle tension is different. Over the long term, it’s aches and pains that won’t go away in the back, neck, shoulders and jaw muscles. Muscle tension causes restlessness, fidgeting or teeth grinding.

Fatigue and Sleepiness

When you worry all the time, it is an exhausting way to live that makes you tired. Anxious thoughts can make it hard to go or stay asleep.

Shortness of Breath

Anxiety can make you feel like you are having trouble breathing. It can also make you feel like you’re not getting enough air. When your heart is racing, your blood pressure is rising. You’ll feel dizzy and shortness of breath can develop.

Difficulty Swallowing

Emotional distress from anxiety can make you feel like you have food stuck in your throat. It can also feel like it is hard to swallow.

Sweating

Sweating due to anxiety happens from feeling fear and worry. Anger or nervousness can play a part as well.

Chest pains

When anxiety is too much to handle, it can cause chest pain unrelated to the heart. Other chest-related symptoms can include a pounding or racing heart.

Headaches and Lightheadedness

Anxiety can give you headaches or migraines. It can also make you feel dizzy, unsteady or lightheaded. These symptoms can make it hard for you to maintain your balance. Feeling light-headed a lot without any other symptoms is often due to anxiety.

Irritability

Always feeling anxious can put you on edge. It can also make you feel irritated at even the slightest of events. If your irritability is persistent, it could be due to anxiety.

Numbness, hot, and cold flashes

Numbness or tingling in your extremities can be an anxiety-related physical symptom. Flashes of heat or chills in your upper body can result from anxious thoughts.

Substance use/abuse

Many people with an anxiety disorder also abuse or are dependent on drugs and alcohol. 30% to 35% of people with anxiety disorders also abuse or are dependent on alcohol, while 25% to 30% of people with anxiety disorders abuse or are dependent on drugs.

Stomach aches/Digestion issues

Your digestive system holds and shows anxiety. This can happen in different ways, like an upset stomach or stomach pain. Other ways are throwing up, moving your bowels too much or too little, and IBS (irritable bowel syndrome). Digestive problems can have a big impact on your everyday life.

Anxiety and Substance Abuse

Which Comes First

Figuring out which came first (the substance abuse or anxiety) is a bit more complicated and depends on the person. Anxiety may cause a person to use drugs or alcohol due to several possible reasons, such as to escape anxious feelings and/or thoughts and to feel normal. Anxious feelings also increase impulsive reactions to take drugs and alcohol.

Substance-Induced Anxiety Disorder

In other cases, drinking or drugs lead to anxiety. This is called substance-induced anxiety disorder. Sudden anxiety can happen in a person who is intoxicated. Anxiety can also develop when a person is not using drugs or alcohol and discomfort sets in. Many times, people don’t make the connection between drugs or alcohol and anxiety. This is because they don’t associate drugs or alcohol with feeling bad.

Substances that can induce anxiety are alcohol, marijuana, hallucinogens, inhalants, amphetamines, cocaine, and other stimulants. Many different prescription medications can cause substance-induced anxiety. Check with your doctor to see if your prescriptions could be causing issues.

Suicidal Thoughts

Anxiety can also lead to suicidal thoughts when there is also depression. Hopelessness, low self-worth, and no motivation to have fun can lead someone down the dark path to suicide. Though anxiety signs are most noticeable, suicide thoughts from depression can be lurking. See the section below entitled “Are You in Crisis?” to get help fast for suicidal thoughts.

(Get Help Now 911) 1-800-273-8255

If you are having suicidal thoughts, get help now.

Finding Help On- and Off-Campus

On-Campus Counseling

Finding help for anxiety, stress, or panic attacks on campus may take a little research. You can likely easily find resources at school for your concerns.

Student Center: Visit or call the student center for names of counselors available on campus that you can speak with. Your student center may be called the campus health or counseling center or student wellness center. Contact them to ask about their services. Don’t let lack of money stop you from seeking help. Many colleges provide counseling sessions free of charge.

Psychiatry/Psychology Department: Contact the psychiatry or psychology department at your school. Ask if they offer sessions with graduate students.

School Chaplain: Many private colleges with religious views have school chaplains. If one is available, visit your chaplain to see about counseling.

Residential Assistant: Talk with a friend or your resident assistant (RA). Ask the individual to help you seek professional help, or to go with you on your first visit.

Off-Campus Resources

Many counseling centers have limited resources, so you may have to seek help off-campus.

Insurance Company: Check with your healthcare insurance company about what mental health services they cover. Look over their list of counseling and therapy providers. Make an appointment with one of them.

Keep Your Options Open: Not every professional is a good fit for every client. If you don’t like the first one, try another. Keep trying until you find someone you are comfortable with and have confidence in.

Primary Care Physician: See your primary care physician who may be able to give you a referral for a mental health professional.

Support Groups: Find a local support group that meets off-campus. Check with the local counseling centers and community centers. Hospitals and places of worship may also host or run support groups.

See “Additional Resources” at the end of this article. There are several listings on how to locate low cost and confidential mental health services.

Additional Support for Anxiety

See Your Doctor to Rule Out a Medical Cause for Anxiety

For some people, physical anxiety signs can have medical causes. Go to your doctor for a checkup. Some medical conditions can cause anxiety-like symptoms. Certain drugs and supplements can also cause anxiety. Medications for asthma, cold remedies, antidepressants and ADHD medications can all cause anxiety. Talk to your doctor about any OTC drugs, prescriptions, supplements and other drugs you are taking.

Group Sports and/or Exercise Classes

Group sports or exercise classes are excellent ways to stay in shape. Group sports and classes are both good ways to get out of the house to make friends. They also help to get your body working and release some of those feel-good brain chemicals. Baseball, football, soccer and basketball are popular group sports choices. Exercise classes, kickboxing, cardio and yoga are some classes many colleges offer their students.

Visit the College Gym

Many college gyms are also health centers for students. They help students face the challenges that stress and anxiety can bring. It can be the perfect place for you to foster healthy habits and focus on self-care. If your gym has health coaches, get one for yourself. Together, you can work out a plan that improves your mental and physical well-being.

Meditation Area/Prayer Rooms

Meditation and prayer rooms at colleges help faith- and non-faith-based students. Students can visit a quiet and safe setting where they can meditate, pray or reflect. They are welcoming environments that are safe and secure. If you are feeling anxious, visit the meditation and prayer room at your school. Prayer rooms are sometimes called chapels.

Substance Abuse Support

Alcohol and drug abuse are major issues on college campuses.  22.5% of college students meet the criteria for drug addiction. 49% of full-time college students abuse drugs and/or alcohol, and 95% of violence on college campuses is alcohol-related.

Most schools know these numbers. They have responded by providing drug and alcohol abuse services and support for students. They also provide education about drugs and alcohol to help prevent abuse from starting.

Some on-campus substance abuse centers partner with treatment centers. These partnerships provide much-needed help to students struggling with serious drug and alcohol problems. Certain colleges also host outpatient programs. Students can attend both classes and rehab without leaving the campus.

Online Resources

Self-Assessments

Do I Have an Anxiety Disorder? Take The Anxiety Test.

A five-minute anxiety test that is based on the DSM-IV (Diagnostic and Statistical Manual of Mental Health Disorders – Fourth Edition).

https://psychcentral.com/quizzes/anxiety-quiz/

A two-minute screening test to see whether or not you have anxiety.

Anxiety and Suicide

Home

Help is available around the clock 7 days a week for people in distress or in crisis. Trained workers can also provide mental health referrals.

https://www.healthyplace.com/blogs/anxiety-schmanxiety/2018/9/suicidal-thoughts-anxiety-and-relief-what-you-must-know

A comprehensive look at the relationships between anxiety and suicidal thoughts.

https://www.medicalnewstoday.com/kc/suicidal-thoughts-ideation-193026

Learn more about the fleeting and long-term thoughts and plans that can lead to suicide.

https://www.webmd.com/special-reports/prep-teens-college/20180125/parents-teens-survey

A WebMD article about young people and mental health issues. It’s a bigger issue than most people realize.

Mental Health Matters: Anxiety and Depression

An article by Boston University that explains the difference between “normal” anxiety vs. anxiety that becomes an issue needing further help.

https://members.adaa.org/search/custom.asp?id=4685

A searchable directory of mental health providers by address and the disorders they treat. The list of disorders enables you to choose anxiety.

Managing Anxiety

https://adaa.org/living-with-anxiety/college-students/find-help

An article on 12 ways to find help for anxiety both on and off-campus.

The 50 Best Campus Meditation Spaces

A list of 50 of the best meditation spaces on college campuses across the United States with summaries and a picture of each.

https://www.rd.com/health/wellness/how-to-deal-with-anxiety/

The author interviewed therapists and developed a comprehensive list on dealing with anxiety.

https://students.dartmouth.edu/wellness-center/wellness-mindfulness/mindfulness-yoga

Learn how mindfulness, meditation and yoga can help college students relax and improve their health.

https://www.thoughtco.com/reduce-stress-while-in-college-793560

A quick and easy read on how to control your stress and ways to relax when you’re feeling overwhelmed.

https://www.verywellmind.com/anxiety-and-college-1393080

A guide for college students on coping with anxiety due to leaving home for school.

5 Ways to Help College Students Who Struggle with Anxiety

A guide for people who know college students who are dealing with anxiety and the best ways to help them.

https://www.nia.nih.gov/health/10-tips-eating-healthy-budget

Many college students have limited budgets. This article explains how to eat healthy on a budget.

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/relaxation-technique/art-20045368

The Mayo Clinic’s step by step guide to reducing stress by using relaxation techniques.

https://howtostudyincollege.com/how-to-get-good-grades/establish-a-routine/

A detailed analysis of how to use your time each day to allow for studying.

https://www.health.harvard.edu/blog/anxiety-in-college-what-we-know-and-how-to-cope-2019052816729

A guide from Harvard Health on coping with anxiety for students.

Anxiety Support Groups

https://findtreatment.samhsa.gov/

A confidential and anonymous website where you can find information about treatment facilities in the United States for addiction, substance use, and/or mental health issues such as anxiety.

https://adaa.org/supportgroups

An online directory of anxiety support groups that you can search by disorder and state. Some states have on-campus listings.

https://www.anxiety.org/university-student-anxiety-resources

A list of ways college students can get the help and support needed and how to get someone to talk to.

More About Anxiety

https://psychcentral.com/lib/learning-deep-breathing/

A comprehensive look at why deep breathing is healthy and deep breathing techniques.

https://www.realsimple.com/health/mind-mood/emotional-health/ten-ways-to-cope-with-anxiety

An article about 10 ways you can use to develop a different relationship with your thoughts and feelings.

https://pro.psychcentral.com/anxiety-disorders-with-comorbid-substance-abuse/

A comprehensive look at anxiety disorders that coexist with drug and alcohol abuse.

https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml

A look at the physical symptoms that are related to anxiety and panic disorders.

http://www.americanmedtech.org/files/STEP_Online_articles/353.pdf

A handy guide to the caffeine content of foods and drugs so you can keep track of your intake and avoid consuming too much caffeine. Table 1 with the caffeine dosage information appears on page 75.

Science Reveals How to Treat Anxiety with Positive Thinking

A detailed look at how positive thinking helps to rewire the brain and help combat anxiety.

https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

A comprehensive overview of anxiety including signs, symptoms, risk factors, treatments and therapies.

https://www.verywellmind.com/using-alcohol-to-relieve-anxiety-2584210

A quick and easy read on why you should avoid alcohol as a way to cope with anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/

A research article that does a deep dive into the relationships and consequences from the combination of drug abuse and anxiety.

https://www.psychologytoday.com/us/blog/what-mentally-strong-people-dont-do/201602/6-tips-stop-overthinking

An article that discusses overthinking, why it can be unsafe, and ways to stop it.

Are You in a Crisis?

The second leading cause of death in young people ages 10-24 is suicide. If you need immediate help or have thoughts of suicide, call or visit the website of the National Suicide Prevention Lifeline (1-800-273-8255). Trained crisis workers are there to talk 24/7 and your call is kept confidential. You can get crisis counseling and mental health referrals from them. If you are in a possible life-threatening situation, call 911 or go to the closest emergency room.