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MIND

Anxious Students Strain College

Mental Health Centers
By
JAN HOFFMAN
MAY 27, 2015 12:07 PM May 27, 2015 12:07 pm 377 Comments
Photo

A therapy dog named Sparky gives some love to Ashley Perez, 18, and Nik Keebler, 22,
during an event at the University of Central Florida's Center for Counseling and
Psychological Services.Credit Douglas Bovitt for The New York Times

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ORLANDO, Fla. One morning recently, a dozen college students stepped out of the
bright sunshine into a dimly lit room at the counseling center here at the University of
Central Florida. They appeared to have little in common: undergraduates in flip-flops
and nose rings, graduate students in interview-ready attire.
But all were drawn to this drop-in workshop: Anxiety 101.
As they sat in a circle, a therapist, Nicole Archer, asked: When youre anxious, how does
it feel?

I have a faster heart rate, whispered one young woman. I feel panicky, said another.
Sweating. Ragged breathing. Insomnia.
Causes? Schoolwork, they all replied. Money. Relationships. The more they thought
about what they had to do, the students said, the more paralyzed they became.
Anxiety has now surpassed depression as the most common mental health diagnosis
among college students, though depression, too, is on the rise. More than half of
students visiting campus clinics cite anxiety as a health concern, according to a recent
study of more than 100,000 students nationwide by the Center for Collegiate Mental
Health at Penn State.
Nearly one in six college students has been diagnosed with or treated for anxiety within
the last 12 months, according to the annual national survey by the American College
Health Association.
The causes range widely, experts say, from mounting academic pressure at earlier ages
to overprotective parents to compulsive engagement with social media. Anxiety has
always played a role in the developmental drama of a students life, but now more
students experience anxiety so intense and overwhelming that they are seeking
professional counseling.
As students finish a college year during which these cases continued to spike, the
consensus among therapists is that treating anxiety has become an enormous challenge
for campus mental health centers.
Like many college clinics, the Center for Counseling and Psychological Services at the
University of Central Florida one of the countrys largest and fastest-growing
universities, with roughly 60,000 students has seen sharp increases in the number of
clients: 15.2 percent over last year alone. The center has grown so rapidly that some
supply closets have been converted to therapists offices.
More students are seeking help partly because the stigma around mental health issues is
lessening, noted Stephanie Preston, a counselor at U.C.F.
Photo

Stress kits were distributed at an event at the University of Central Florida's Center for
Counseling and Psychological Services. The kits included a stress ball, mints and
crayons.Credit Douglas Bovitt for The New York Times
Ms. Preston has seen the uptick in anxiety among her student clients. One gets panic
attacks merely at the thought of being called upon in class. And anxiety was among a
constellation of diagnoses that became life-threatening for another client, Nicholas
Graves.
Two years ago, Mr. Graves, a stocky cinema studies major in jeans, a T-shirt and
Converse sneakers, could scarcely get to class. That involved walking past groups of
people and riding a bus and Mr. Graves felt that everyone was staring at him.
He started cutting himself. He was hospitalized twice for psychiatric observation.
After some sessions with Ms. Preston, group therapy and medication, Mr. Graves, 21,
who sat in an office at the center recently describing his harrowing journey, said he has
made great progress.
Im more focused in school, and Ive made more friends in my film courses I found
my tribe, he said, smiling. Ive been open about my anxiety and depression. Im not
ashamed anymore.
Anxiety has become emblematic of the current generation of college students, said Dan
Jones, the director of counseling and psychological services at Appalachian State
University in Boone, N.C.

Because of escalating pressures during high school, he and other experts say, students
arrive at college preloaded with stress. Accustomed to extreme parental oversight, many
seem unable to steer themselves. And with parents so accessible, students have had less
incentive to develop life skills.
A lot are coming to school who dont have the resilience of previous generations, Dr.
Jones said. They cant tolerate discomfort or having to struggle. A primary symptom is
worrying, and they dont have the ability to soothe themselves.
Social media is a gnawing, roiling constant. As students see posts about everyone elses
fabulous experiences, the inevitable comparisons erode their self-esteem. The popular
term is FOMO fear of missing out.
And so personal setbacks that might once have become teachable moments turn into
triggers for a mental health diagnosis.
Students are seeking treatment, saying, I just got the first C in my life, my whole life
just got shattered, I wanted to go to medical school and I cant cope, said Micky M.
Sharma, president of the Association for University and College Counseling Center
Directors and head of Ohio State Universitys counseling center.
Photo

Stephanie Preston, a mental health counselor at the University of Central Florida, says
that more students are seeking help for mental health issues.Credit Douglas Bovitt for
The New York Times

Anxiety is an umbrella term for several disorders, including social anxiety disorder and
agoraphobia. It can accompany many other diagnoses, such as depression, and it can be
persistent and incapacitating.
Students who suffer from this acute manifestation can feel their very real struggles are
shrugged off, because anxiety has become so ubiquitous, almost a clich, on campus.
Alexa, 18, has been treated for an anxiety disorder since middle school, when she was
still feeling terrorized by monsters under the bed. She has just finished her freshman
year at Queens College in New York.
If she had a severe episode during a test, afterward she would try to explain to her
professors what had happened but they would dismiss her. Theyd say, Your mind isnt
focused, or Thats just an excuse, said Alexa, who wrote her college application essay
about grappling with the disorder. She asked not to be fully identified for privacy
reasons.
More often, anxiety is mild, intermittent or temporary, the manifestation of a student in
the grip of a normal developmental issue learning time management, for example, or
how to handle rejection from a sorority.
Mild anxiety is often treatable with early, modest interventions. But to care for rising
numbers of severely troubled students, many counseling centers have moved to triage
protocols. That means that students with less urgent needs may wait several weeks for
first appointments.
A month into the semester, a student is having panic attacks about coming to class, but
the wait list at the counseling center is two to five weeks out. So something the student
could recover from quickly might only get worse, said Ben Locke, associate director of
clinical services at Penn State University and the lead author of the Penn State report.
By necessity, most centers can only offer individual therapy on a short-term basis. Ms.
Preston estimates that about 80 percent of clients at U.C.F. need only limited therapy.
Students are busting their butts academically, theyre financially strapped, working
three jobs, she said. Theres nothing diagnosable, but sometimes they just need a place
to express their distress.
Even with 30 therapists, the center at U.C.F. must find other ways to reach more
students especially the ones who suffer, smoldering, but dont seek help.
Like many college counseling centers, U.C.F. has designed a variety of daily workshops
and therapy groups that implicitly and explicitly address anxiety, depression and their
triggers. Next fall the center will test a new app for treating anxiety with a seven-module
cognitive behavioral program, accessible through a students phone and augmented with
brief videoconferences with a therapist.

It also offers semester-long, 90-minute weekly therapy groups, such as Keeping Calm
and in Control, Mindfulness for Depression and Building Social Confidence for
students struggling with social anxiety.
The therapists have to be prepared to manage students who present a wide array of
challenges. You never know who is going to walk in, said Karen Hofmann, the centers
director. Someone going through a divorce. Mourning the death of a parent. Managing
a bipolar disorder. Or theyre transgender and need a letter for hormone therapy.
Indeed, Dr. Locke and his colleagues at Penn State, who have tracked campus
counseling centers nationwide for six years, have documented a trend that other studies
have noted: Students are arriving with ever more severe mental-health issues.
Half of clients at mental health centers in their most recent report had already had some
form of counseling before college. One-third have taken psychiatric medication. One
quarter have self-injured.
The fundamental goal of campus counseling centers is to help students complete their
education. According to federal statistics, just 59 percent of students who matriculated
at four year colleges in 2006 graduated within six years.
Studies have repeatedly emphasized the nexus between mental health and academic
success. In a survey this year at Ohio States center, just over half of the student clients
said that counseling was instrumental in helping them remain in school.
Anxiety-ridden students list schoolwork as their chief stressor. U.C.F.s center and afterhours hotline are busiest when midterm and final exams loom. Thats when the center
runs what has become its most popular event: Paws-a-tively Stress Free.
The other afternoon, just before finals week, students, tired and apprehensive, trickled
into the center. The majority were not clients.
Photo

Students gathered around a therapy dog during an event at U.C.F.Credit Douglas Bovitt
for The New York Times
At a tent outside, their greeter was the centers mascot and irresistible magnet: a 14pound Havanese, a certified therapy dog whom many clients ask to hold during
individual sessions, stroking his silky white coat to alleviate anxiety.
Bodhi! they called, as he trotted over, welcoming them to his turf with a friendly sniff.
For the next two hours, some 75 students visited the center, sitting on floors for a heavy
petting session with therapy dogs.
They laughed at the dogs antics and rubbed their bellies. They remarked on how nice it
was to get a study break.
On the way out, the students were handed a smoothie and a stress kit, which included
a mandala, crayons, markers, stress balls and Smarties candy.
Also tucked into the kit was a card with information about how to contact the center,
should they ever need something more.
Related: Times Insider: Anxiety on Campus: Reporters Notebook.
For more fitness, food and wellness news, like ourFacebook page.
377COMMENTS

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MIND, ANXIETY AND STRESS, APPALACHIAN STATE UNIVERSITY, COLLEGES
AND UNIVERSITIES, EDUCATION (K-12), MENTAL HEALTH AND DISORDERS, OHIO
STATE UNIVERSITY, THERAPY AND REHABILITATION, UNIVERSITY OF CENTRAL
FLORIDA
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