Welcome to our special section, Thrive on Campus, devoted to covering the urgent issue of mental health among college and university students from all angles. If you are a college student, we invite you to apply to be an Editor-at-Large, or to simply contribute (please tag your pieces ThriveOnCampus). We welcome faculty, clinicians, and graduates to contribute as well. Read more here.
By Juliann Garey
Tuition isn’t the only thing that’s relentlessly on the rise on American college campuses. Multiple studies show a significant increase in college mental health problems in the last few years, and campus counseling services report being overwhelmed with students seeking help.
Why so much emotional distress, especially during the first year away from home? Everything from academic pressure to over-protective parenting to excessive engagement in social media has been blamed for the spike in anxiety and depression.
What’s clear is that adolescents making the transition from high school to college need not only academic skills to ace the classwork, and time-management skills to stay afloat, but emotional problem-solving skills to handle the challenges. As parents, we can’t shadow them in the freshman dorm, but we can help supply them, before they leave home, with a toolbox of skills and habits to use when they become stressed or overwhelmed.
“What we’re seeing is a lot of kids are getting through middle school and high school doing okay, but they go off to college and it’s too much,” says Dr. Lindsey Giller, a clinical psychologist in the Mood Disorders Center at the Child Mind Institute. Some kids are just overwhelmed by organization and time management issues, increased academic pressure and managing their lives independently — the emotional roller-coaster of a new social universe.
And if they’re away from home, they don’t have the support network they’ve been used to. This is especially true of kids who find themselves on a large campus where it’s difficult to get to know their professors and harder to find their social niche.
“Often the result,” says Dr. Lindsay Macchia, an associate psychologist in the Mood Disorders Center at the Child Mind Institute, “is what’s called emotional dysregulation — their mood is all over the charts. What we want to figure out is what skills are going to help them re-regulate and take better control over their mood, so it doesn’t get in the way of their friendships, their academics, or typical day-to-day life.”
So how do we prepare our kids for the rigors and life challenges that college brings?
One increasingly popular answer is teaching them skills derived from Dialectical Behavioral Therapy (DBT). DBT was originally designed for adults with borderline personality disorder, who experience extreme emotional instability. But DBT skills are, more and more, being used successfully to treat almost any kind of emotional dysregulation.
While traditional DBT is an intensive, highly structured program, Drs. Giller and Macchia note that basic DBT skills can be adapted to help prepare incoming college students to better handle the challenges of college.
What would that look like? “Near the end of high school,” explains Dr. Macchia, “parents can shift the family dynamic to encourage kids to be more independent, and practice emotional regulation and problem-solving skills for themselves.” Here’s how you can help.
Many of us have grown used to jumping in at the first sign that our child is distressed, to come to the rescue.
“The first thing parents should do is stop trying to fix things,” says David Romano, a psychotherapist and member of Active Minds, an advocacy organization that works to encourage open discussion of mental health on college campuses, to avoid suicides. Romano, who sees a lot of college-bound adolescents, says that what teens need to hear, especially when they’re feeling depressed, anxious, or overwhelmed, is that “It’s okay not to feel okay.” The goal is to validate their feelings, but not solve their problems.
When parents notice that their teen is in distress, Dr. Giller suggests responses like:
And then, let them deal with the problem knowing you’re there as a support net. “That can build a bridge so the teen can start thinking on their own, using their own problem-solving skills, while still feeling listened to and heard by their parent and supported in that way,” says Dr. Giller.
Mindfulness, the ability to be present in the moment and to be nonjudgmental towards yourself and others, is at the core of DBT. It’s learning to live in the present moment — not project into the future — without judging your thoughts and emotions. An example of a nonjudgmental reframe to reduce emotional intensity could be to think, “Wow, I didn’t do as well as I wanted on that exam,” rather than “I suck, I can’t make it in this school” explains Dr. Giller.
Sometimes mindfulness means just stopping to notice how you’re feeling internally, noticing what’s around you and even taking some deep breaths before deciding how best to handle a difficult situation.
Self-care is often the first thing sacrificed in the first year away from home. Self-care involves “making sure to take care of your body in order to promote the best mood you can,” Dr. Macchia says. “And so it includes making sure your sleep hygiene is as consistent as possible, that you’re not staying up all night, you’re limiting drugs and alcohol, getting regular exercise, and healthy eating. All of it is an attempt to keep your mood as regulated as possible.”
Sleep is one of the first things stressed college students sacrifice, so helping kids establish and practice good sleep habits before they leave home is crucial. It’s important for college-bound students to understand that sleep deprivation can not only make academic functioning more difficult, it can also make it harder for them to exercise self-control, make good decisions and regulate their mood.
Eating habits also affect mood: the college years are when the majority of eating disorders develop, as overwhelmed students attempt to gain a sense of control by restricting their diet. Restricted eating, in turn, undermines judgment and contributes to depression.
“Taking care of themselves physically in order to take care of their mental health is one key to reducing the likelihood that unwanted emotions will flare in the first place, or become so intense they’re overwhelming,” says Dr. Giller.
A lot of distress can be avoided by helping kids learn to plan ahead. That means not only thinking through how they’re going to get a big assignment done, and thinking carefully about how they use their time, but planning how they’ll handle challenging situations. Hana, 17, is about to go off to college next year. She’s done two rounds of traditional DBT and she says it’s done a lot to prepare her for leaving home and college life. One of the key skills she is using to prepare is called “coping ahead.”
“It’s essentially just preparing yourself to be equipped to emotionally handle a certain experience,” she explains. That could involve practicing what you would say in different potentially triggering scenarios. Who would you call if you were feeling depressed? What would you do if you got a bad grade?
“More than anything I think people don’t like being blindsided,” she said, “and this is a way to sort of expect the worst but also hope for the best. I’m expecting the worst, which is why I’m coping ahead, but I’m hoping for the best, so there’s some optimism there.”
Even with a good foundation in practicing time management skills and “coping ahead,” there are going to be times when your teen will feel overwhelmed. But, borrowing from DBT skills, you and your child can make a plan for what to do when difficult emotions are threatening to take over. “They can come up with a written plan that includes weighing the pros and cons and thinking through consequences,” says Dr. Giller. “And then they can take a picture of it on their phone and have easy access to it when they anticipate or experience something that may be challenging.”
The goal is a toolbox of things to try when they are feeling highly emotional or overwhelmed — things that will make them feel better instead of spinning out of control. “It’s having some things that people can really use when they feel they’re on overload,” Dr. Giller says. It could include specific pieces of music, going for a run, or things to touch or smell that have a calming effect.
No formal training or individual therapy is necessary for establishing good habits and coping skills, but when a parent and teen work in tandem, they can establish a strong foundation for starting college. And starting early — before there’s a difficult situation to deal with — is a good idea. As Romano says, “If you don’t use the skills you lose them, so it’s about practicing them all the time. It’s about making and maintaining mental health.”
Originally published on Child Mind Institute.
Stay up to date or catch-up on all our podcasts with Arianna Huffington here.