Genesis, at Howard U.: “I’m not that kid that’s going to waste my money and not show up to class, but sometimes it is hard.”Chronicle photo by Julia Schmalz
Y ou don’t have to look far to find a student suffering from anxiety. But it might be hard to tell.
More than one in four undergraduates and graduate students report symptoms, according to the national Healthy Minds Study. And anxiety is the main reason students seek mental-health services, college counseling centers say. But less than 40 percent of students who experience anxiety or depression have gone for such help in the past year. On campuses where students perceive a higher stigma, new research has found, they are less likely to pursue both treatment and informal support.
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Genesis, at Howard U.: “I’m not that kid that’s going to waste my money and not show up to class, but sometimes it is hard.”Chronicle photo by Julia Schmalz
Y ou don’t have to look far to find a student suffering from anxiety. But it might be hard to tell.
More than one in four undergraduates and graduate students report symptoms, according to the national Healthy Minds Study. And anxiety is the main reason students seek mental-health services, college counseling centers say. But less than 40 percent of students who experience anxiety or depression have gone for such help in the past year. On campuses where students perceive a higher stigma, new research has found, they are less likely to pursue both treatment and informal support.
But some students and advocates are eager to break the silence, sparking a more open discussion of the daily struggles that young people face and the support that could help them thrive.
“This generation really is much more willing to talk about mental health,” says Alison K. Malmon, founder and executive director of Active Minds, a national organization with nearly 450 campus chapters dedicated to mental-health advocacy. More conversation means fewer students believe that anxiety, depression, and other illnesses are their fault, she says, and more seek help, seeing such a step not as a sign of weakness, but of strength.
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More than one in four students report symptoms of anxiety.
Five students shared their experiences in December in the Chronicle video “Facing Anxiety.” In a partnership with Active Minds, we solicited responses from students across the country. If they have anxiety, we asked what form it takes, how their professors or administrators have helped or could be more supportive, and what they wish people on campus knew about students and anxiety.
“If we could ‘calm down,’ we would,” one student wrote. “Obviously.” Several fear that they are dismissed as lazy. If they don’t come to class, they say, sometimes it’s because they can’t come to class. If they don’t speak in class, they may still be engaged, just terrified. Some worry that anxiety prevents them from reaching their potential, and many feel uncomfortable asking for help — or they don’t know what to say or whom to ask.
When someone shows concern, or simply listens, that can make all the difference, students say. A few made specific suggestions: Find an alternative to class participation in calculating our grades. Schedule several smaller tests or papers throughout the semester rather than two big ones, which tend to cluster for all courses.
Being approachable is always salient: “If you are willing to talk to students,” one wrote, “or walk them to a counselor on campus who can, then you may be helping more than you know.”
Here are the words of 20 students, including three from the video. Their responses have been edited for length and clarity. Some chose to submit their names and institutions. All spoke up so that professors and administrators might hear them.
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'When I get anxiety'
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Carly, Emerson College
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Carly, Emerson College
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It’s very physical for me. It starts in my chest, and then I kind of get short of breath maybe. I get the chills a lot, when I get anxiety. It almost feels like you have the flu. Depending on the situation, it could be hard for me to hear things. It’s hard for me to listen or understand. I can get disoriented sometimes.
A lot of professors at a lot of different schools are not as supportive and don’t really understand the mental-health needs of their students as much as they probably should or could. And so that’s why I think it’s really important to normalize this conversation around taking a day off for your mental health just as you would for your physical health. —Carly, Emerson College
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‘I may seem scattered’
There are times when everything piles up, and it feels as though there was nothing I could have done to avoid it and nothing I can do to make it better. I just have to ride it out and do as best as I can. In these times, my work may not be as great of quality, or I may seem scattered and like I don’t care about that teacher’s class or about my academics, but I do. —Emily, University of Nebraska at Lincoln
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‘I panicked’
I panicked during a routine test. I forgot to take my medication, and I got the “deer in the headlights” feeling. Time stood still for me. I sat there racking my brain over what I had studied just a few hours ago. It was horrifying, and I cried afterward.
By the Numbers: Students’ Mental Health
More than one in four students report symptoms of anxiety. — The Healthy Minds Study, 2016-17
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More than four in 10 freshmen say they feel overwhelmed by all they have to do, compared with fewer than two in 10 freshmen in 1985. — The American Freshman: National Norms Fall 2016
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26 percent of undergraduates and 17 percent of graduate and professional students report that anxiety has affected their academic performance. — American College Health Association National College Health Assessment, Spring 2017
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For seven straight years, anxiety has been the top complaint among students seeking mental-health services. — Association for University and College Counseling Center Directors Annual Survey, 2015-16
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24 percent of all students but only 37 percent of those who report symptoms of depression or anxiety say they have received counseling or therapy for mental or emotional health from a health professional in the past 12 months. — The Healthy Minds Study, 2016-17
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27 percent of students say that if they needed professional help for their mental or emotional health, they wouldn’t know where to go on campus. — The Healthy Minds Study, 2016-17
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Nearly three in four students who have used counseling services say doing so has helped their academic performance. — Association for University and College Counseling Center Directors Annual Survey, 2015-16
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Only 6 percent of students say they would think less of someone who has received mental-health treatment, but 47 percent of students say most people would. — The Healthy Minds Study, 2016-17
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Students who study for three hours a week are least likely (18 percent) to show symptoms of anxiety, while those who study for less than one hour (27 percent) or at least eight hours (29 percent) are most likely. — The Healthy Minds Study, 2014-15
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22 percent of students have used psychotropic medication in the past year. — The Healthy Minds Study, 2016-17
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Hospital admissions for suicidal teenagers doubled nationally in the past decade. — Vanderbilt University Medical Center, forthcoming research
—Compiled by Julian Wyllie
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Anxiety is not brought on just because we didn’t study hard enough. I had a teacher tell me that. It boiled my blood. —Kelly, Pensacola State College
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‘Fear of disappointing people’
I’ve struggled with mental-health issues for most of my life, but I wasn’t officially diagnosed with depression and anxiety until the start of my freshman year. While medication and therapy help, I still have bad days every so often. It’s especially difficult because I’m a STEM student, where heavy workloads and constant deadline pressure are the norm. There’s this expectation that if you can’t stand the stress, you aren’t cut out to be a scientist or an engineer — that you’re weak or lazy. Undeserving of your professors’ time and expertise.
Many of us wind up in these vicious cycles, constantly taking on more work, going without sleep and food, and pretending everything is fine, until it all gets to be too much. The fear of disappointing people, of being seen as a fraud and a failure — it’s a powerful motivator, but no one can keep going under constant stress.
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I can talk semi-candidly with classmates about my experiences with stress, but I’ve never told any of my professors about my diagnoses. It’s true that mental health is included as a disability at my school, and if I officially registered as disabled, I could probably get extra time or test accommodations. But I’m afraid that having that information on my record would make my professors see me as not taking my studies seriously enough. There’s a mandatory clause about mental health in every syllabus, but that’s essentially just lip service. What really makes a difference is when professors demonstrate through their actions that they accept mental-health problems as a reasonable explanation for struggling with a class.
I wish more professors knew that anxiety isn’t a personal failing. I don’t choose to get stressed out during exams. I don’t want to take ridiculous amounts of time to complete assignments because I don’t think my work is good enough. I want to contribute to my field. I just need to do things at my own pace, and for me, that means a less intense path than the “traditional” one. —Anonymous, University of Minnesota-Twin Cities
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‘I check and recheck my homework’
Sometimes it takes a lot for me to even make it to class because of my social anxiety. With my OCD, I check and recheck my homework and papers numerous times before I feel ready to turn them in, because I do not want to make any mistakes and have the professor think that I am not smart. It also takes me a really long time to read because of my OCD. If I ask for an extension, it is not because I am a bad student or because I am lazy. And it would help if there were other ways to receive credit for participation in class. I am thoroughly engaged in class and very attentive to what is going on even if I do not feel like talking. —Stephanie, Baker University (Kan.)
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‘I feel helpless’
I’ve had extreme panic attacks at school where I’ve had to leave class and go home because I was going to start hyperventilating. The first time this ever happened, the professor whose class I was in was very supportive of me and mental-health issues. She noticed something was wrong the minute I came to class, and she asked me if I was doing OK. When I told her I wasn’t, she just replied, “Do what is best for you.” So about 15 minutes into the class, I walked out, and she sent me an email later that day to follow up with me. Not all professors are like this. Actually, she’s the only one I’ve ever met who is like this. The rest of my professors separate me as a human from me as a student.
I want them to know that anxiety makes me angry. When I feel anxiety, I feel helpless. When I feel helpless, I get mad. I feel like a lot of people think I’m this raging college girl who hates everyone and everything, but really I just hate myself. —Anonymous, Kent State University
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‘Like everyone was staring’
Anxiety exhibits itself in different ways. Panic attacks do not always look like someone hyperventilating or having a nervous breakdown. It could looking like anger or withdrawing.
There were times I would have panic attacks about the amount of assignments and become so overwhelmed I could not bring myself to come to class, due to feeling like everyone was staring at me or that the professor would be disappointed in me. —Lea, University of South Alabama
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‘Not because I’m lazy’
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You can’t just “get over” your anxiety of being called on or speaking in front of the class by the professors calling on you and forcing you to speak in front of the class. I’m pretty sure if that’s all it took, the problem would’ve been solved a long time ago.
Also, if I’m not in class, and I haven’t sent an email explanation as to why, it’s probably because I’m sitting on the bathroom floor trying to stop myself from uncontrollably hyperventilating so that I can get to class, not because I’m lazy and blowing off class. —Anonymous, campus withheld
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‘I didn’t know how to ask for help’
When my anxiety was really bad, I approached my TA, not my professors. My TA was incredibly helpful and allowed me to leave class early when I couldn’t handle being around too many people. I didn’t approach my professors mostly because I didn’t feel comfortable enough. Based off of comments they made during lectures, I assumed they weren’t very empathetic toward this subject. I was also very nervous to talk to them about this, as it perpetuated my fear. I wish they knew how common it was, and the extent of how it affects individuals.
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My anxiety was co-morbid with depression during one of the lowest points in my life, and I almost failed a class during that quarter because I couldn’t focus or concentrate on studying or doing work. Hands-down one of the worst times in my life, and I didn’t let anyone know because I didn’t know how to ask for help or how helpful my professors would be. —Anonymous, University of California at Riverside
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‘I wish they would even care to ask’
I have never had a professor reach out to me when my grades began to drop. If they reached out at all, it was to warn me I was going to fail if I didn’t “try harder,” when in reality my anxiety was crippling me no matter how hard I tried.
I wish they knew the gravity of the problem. I wish they knew that my bad grades reflect my mental health and not how much I apply or don’t apply myself, and not their teaching abilities, either. I wish they knew my side of things, that I stay up worrying and get an unhealthy amount of sleep, and that’s why I can’t focus during lectures or do well on tests on certain days. I wish they would even care to ask, because maybe if they did, I’d feel more willing to explain. —Cammy, Fitchburg State University
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‘A lot of pressure on my back’
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Genesis, Howard University
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Genesis, Howard University
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Genesis, Howard University
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Genesis, Howard University
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I am not that shy student who just doesn’t want to talk. I’m also not not coming to class because I don’t want to learn or I’m not serious about my education. But sometimes it’s physically hard to just deal with certain things. So I’m not that kid that’s going to waste my money and not show up to class, but sometimes it is hard, and I would like the administration to take it more seriously because I feel like there are not enough things here at Howard — or maybe even other schools — that are able to accommodate students with anxiety.
I always grew up knowing that education was important, and I always felt like I needed to be better. I’m, like, first generation of my family to go to a four-year college, and hopefully I am going to be the first in my family to graduate and get a degree. So it’s a lot of pressure on my back to just want to do good. —Genesis, Howard University
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‘Sources of anxiety’
It’s not always brought on by the stress of classes alone. There can be many factors contributing to someone’s anxiety. For me, I had family issues and conflicts with friends on top of my classwork and living away from home for the first time.
If you are willing to talk to students about those sources of anxiety, or walk them to a counselor on campus who can, then you may be helping more than you know. —Meghan, campus withheld
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‘It shouldn’t be this hard’
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My anxiety as an M.A. and Ph.D. student has primarily been related to the management of everything I have to do. Not only am I taking a full load of classes that are rigorous and demanding, but I’m teaching, I’m working in the university writing center, I’m living on my own for the first time, and I’m trying to maintain normal human functionality. The anxiety is sort of never-ending at this point, and the knowledge that these three degrees may or may not actually amount to an academic job is pervasive in everything I do.
Promoting Students’ Mental Health: Questions to Consider
Does your college take a preventive, public-health approach to mental health? For example, does new-student orientation cover anxiety, depression, eating disorders, and other challenges? Do mental-health professionals or peer educators hold sessions throughout the year in residence halls or for student groups? Do you train faculty and staff members to spot students in distress?
Is your counseling staff representative of the student population?
Does your college have information and resources related to mental health specific to students’ demographic status? For example, undergraduate or graduate student, race, national origin (for international students), sexual orientation, or gender identity?
Does your college have partnerships with community providers that can serve students who prefer to seek treatment off campus, and that can accommodate increased demand for services during midterm and final exams?
Do your counseling services have written, legally vetted policies for treatment, as well as for students’ leaves of absence? Most campus counseling centers (83 percent) say they have the right to refuse treatment to students whose problems are beyond the staff’s capabilities, but only some of those centers (43 percent) have legally approved written policies, according to the American College Counseling Association.
Are mental-health resources listed on syllabi? Are professors and policies across departments consistent in responding to students whose mental-health challenges interfere with their academic work?
Are students who are struggling academically, and perhaps identified through an early-warning system, provided with information not only about tutoring, but also mental-health services?
Do you conduct campus surveys to assess need and evaluate programs?
—Julian Wyllie and Sara Lipka
Professors who have completed the same sorts of programs that we’re in seem to have entirely forgotten what it is to juggle all of that. Of course the expectations are high, and it should be hard, but it shouldn’t be this hard. It shouldn’t feel like I’m screwing up my life every time I fail to complete all of the reading. It shouldn’t require calculating the minimum number of hours that I can sleep and still function in order for me to get all of my work done.
I had the great good fortune of cultivating a mentor relationship as an undergrad that has lasted through the years. She’s been very instructive and encouraging, and that’s proved hugely beneficial. On the whole, however, I think that most universities struggle to provide the services they advertise to students. Counseling centers on campus often come with ridiculously long wait lists, and graduate students are not always offered the same services, or at least not at the same rate.
I don’t think I’ve ever been at an institution that really provided enough help, but Pittsburg State University has certainly been the best about this. They offer traditional counseling as well as prioritizing events on campus that are specifically designed to help manage anxiety, like self-care workshops, puppy-petting sessions, maintenance of massage chairs in a quiet room in the student center, etc. The thing that helped me the most during my time there was the community that they worked very hard to cultivate between students and their peers and professors. It made a lot of difference to be viewed as a human being rather than just another nameless student, and to know that life happens to all of us, and not just to me. —Jenna, University of Tulsa
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‘Meditative nook’
Our campus offers a meditative nook in which students can decompress, a cafe to recharge with coffee, a courtyard, and faculty are always available to try and talk out issues with you, especially if it’s affecting schoolwork. A classmate of mine even mentioned how our professor reached out to make sure she has a way to manage anxiety. That same professor (Hey, Dr. J.!) has even incorporated mindfulness-based approaches into our lectures, so that we have some tools to use to self-calm. —Ashley, Northern Virginia Community College Medical Education Campus
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‘Hiding how you feel’
I’m a first year Ph.D. student in an engineering discipline, and anxiety is just with me all the time now. I struggled with depression for a long time, too — but either to cope or just as a way to hide my emotions, I developed a lot of confidence, at least in front of other people.
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Engineering is one of those programs a huge number of people don’t make it through the first year or two. I think there’s a lot of people like me with anxiety who fit into what I think of as the do-or-die mentality, where they do really well and get good grades but are so stressed out about it that they end up in a position where they just might not get through the semester, no matter how capable they are. You end up hiding how you feel from everyone, because if you try and open up to people, they can be really dismissive. You start to feel guilt and embarrassment and shame about asking for help. You can end up feeling pretty isolated, and when you get into a Ph.D. program it’s just like, “I really hope you know what you want, and you know what you’re doing.” Suddenly you have to stake your professional reputation on your work, and it’s crippling. You stop being able to do anything, because it won’t be good enough, etc.
After I missed about two weeks of class, my professor sort of just knew that I was having a hard time. He was really calm about it all and told me that if I really needed it, there was always the option to take an incomplete grade and finish the work after I had some time to get myself together. I was really grateful for that. On the other hand, my research advisers and even one of my TA’s have made my anxiety a lot worse. There’s this combination of being so busy they’re unavailable a lot and checking in to see your progress sort of at random. That just leads to this feeling that everything you do is being watched and evaluated, but they expect you to be capable of doing it with little to no input. The one thing I wish they understood is that at least for some of us, the lack of structure, especially as you get to smaller, upper-division classes, can be really stressful. —Anonymous, University of Arizona
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‘Respecting the diversity’
I come from a minority group that struggles to stay in college compared with other demographics, and a college education is even more important for our ability to thrive in society. Such groups should be more strongly targeted by their schools with outreach for mental-health purposes.
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I am not talking about babying entitled “snowflakes.” I mean respecting the diversity of students, which might include populations and cultures that might not even discover or be aware of a mental-health issue in themselves until the pressures of college courses come bearing down upon them, on top of the many other things they have to deal with, including financial burdens (rent, tuition, etc.). —Anonymous, campus withheld
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‘Paid for my therapy’
An administrator paid for my therapy session. I couldn’t afford (at the time) the $25 fee to see a therapist during summer semester. —Amelia, Salt Lake Community College
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‘A little bit easier every day’
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Julia, American University
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Julia, American University
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Julia, American University
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Julia, American University
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This semester I did have to drop a class, because it was too much for me, and I had been missing a lot of class. I’m also involved in a couple extracurriculars, and I had to just sort of drop off the face of the earth for a little bit. So there was about two weeks when I didn’t show up to anything. As of right now it’s been slowly reintroducing myself back into my day-to-day routine, which can be a bit demoralizing, but it gets a little bit easier every day.
The biggest thing that people don’t understand is it’s a very isolating experience. People say, “Oh, I’m anxious” or “I’m so stressed out, like I want to die,” like making very flippant remarks. I think it can be really harmful. I’m a comedian, so not that I take offense to those things, but I know a lot of people who really do.
The dean-of-students’ office at my school was really helpful. If you’re having trouble with mental-health issues, they will send out an email to your professors, and then professors are usually more than willing to work with you. Some give extra credit, some don’t. Some will say, “Well, just going forward, let’s do better.” But if my grade is already suffering, then that can be kind of hard to deal with. Then again, some are more lenient than others. But I think the most important thing is that a lot of times I’ll get the assignment to you; it’s just going to take me a little bit longer. —Julia, American University
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‘Instrumental music’
My professors during my finals have let me listen to instrumental music to keep myself calm. —Ryan, University of Nebraska at Lincoln
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‘What I am capable of’
I frequently worry about the toll that anxiety takes on my academic success, because I believe that my performance does not accurately reflect what I am capable of. Anxiety is frustrating because it is hard to tell when it will pop up, so it is hard to plan ahead so I can adequately accommodate it. I have coping skills, and I am in weekly therapy, but sometimes anxiety just has to take priority over academics. I work closely with the dean-of-students’ office and disability services. They have been very supportive and help with professors that are less understanding.
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I always fear that my professors think that my anxiety is not real, or that it is an excuse. The majority of my professors have been supportive and understanding, but there are always a few that are skeptical. I wish I could express that I am working my hardest and that I just need some help. —Jenna, University of Massachusetts at Amherst
Sara Lipka works to develop editorial products in different formats that connect deeply with our audience. Follow her on Twitter @chronsara, or email her at sara.lipka@chronicle.com.