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College kids’ mental health takes a hit

Bryn Mawr Hospital January 26, 2018 Child and Adolescent Health

When kids go off to college, there’s often a huge sigh of relief on both sides. Parents feel like they’ve helped their kids reach a major milestone and can finally relax a bit while the kids are glad to finally have their freedom. Many students seem to settle in well to the new college environment with its academic demands and thriving social scene. Yet we’re finding out kids may not have it together in spite of their cheery Instagram posts and laundry lists of achievements. For many, there’s a façade that communicates everything is just “fine” when in fact it’s anything but.

For a referral to a Main Line Health behavioral health specialist, call 1.888.227.3898.

For 24/7 emergency support, visit a Main Line Health emergency room at Lankenau Medical Center (Wynnewood), Bryn Mawr Hospital, Paoli Hospital or Riddle Hospital (Media).

If you’re in crisis and need to talk now, call the National Suicide Prevention Lifeline at 800.273.TALK (8255) or visiting suicidepreventionlifeline.org. You can also contact the Crisis Text Line by texting TALK to 741741.

Anxiety, depression, suicidal thoughts sometimes behind happy mask of college life

At University of Pennsylvania they call it Penn Face. Stanford students call it Duck Syndrome, referring to ducks that seem to glide without effort across the water yet they’re paddling frantically beneath the surface. At Duke, young women portray themselves and perceive others as “effortlessly perfect”—hiding the fact that they’re overwhelmed, plagued with self-doubt, and not measuring up to their own expectations or the perceived expectations of others.

Under the guise of having it all together, kids are dealing with college stressors such as tuition worries, concerns about acceptance into certain programs, maintaining grades for scholarships, final examinations, graduation, and future job prospects. On social media, the students may be comparing their own flawed college experiences to the seemingly superior experiences of their friends. College depression and anxiety are common, and thoughts of suicide more common than you would think. According to the Centers for Disease Control, approximately 1,100 college-age students take their own lives each year.

In a fall 2016 American College Health Association-National College Health Assessment (ACHA-NCHA) survey of students reporting on experiences within the last 12 months:

– 38.2 percent felt so depressed it was difficult to function
– 60.8 percent felt overwhelming anxiety
– 10.4 percent seriously considered suicide
– 1.9 percent attempted suicide

In college, be ‘real’ about how you feel

While it may be tempting to put on a happy face, being authentic about how you’re feeling and doing can be a relief in itself, and may be just what another person who’s struggling needs to hear. Also keep in mind that the way you’re feeling is completely acceptable and you’re not alone in feeling that way—even though it seems everyone else is doing fine. Be discerning about social media in particular. Your newsfeed just features the highlights of people’s lives. It’s not an accurate reflection of the whole person or range of human experience.

It may also be helpful to understand what’s happening in the young adult brain, particularly the prefrontal cortex, which is the area right behind the forehead. In a prolonged process dubbed by neuroscientists as “frontalization,” this area of the brain, and others, are still being developed well into the late-20s. Different parts of the brain mature at different times, and these changes in the brain’s structure may account for some of the emotional challenges that face young adults.

Explains Kelly Campanile, PsyD, MS, MA, a psychologist who treats young adults on an outpatient basis at Bryn Mawr Family Practice, “While you may be experiencing strong, uncomfortable feelings, your brain is still in development and making critical connections that will serve you throughout your life. Remember that most of the stressors you’re dealing with now are temporary, and there is effective treatment available to help you learn adaptive coping skills. These stressful situations may feel like they will last forever, but remember, they won’t.”

On the inpatient side, we see young patients who may be at a tipping point, emotionally and psychologically overwhelmed by school and social expectations as well as the challenges of self-discovery. Bryn Mawr Hospital has a dedicated unit for patients, ages 18 and over, who have been evaluated for and need intensive inpatient psychiatric care.

On the inpatient side, we see young patients who may be at a tipping point, emotionally and psychologically overwhelmed by school and social expectations as well as the challenges of self-discovery. Bryn Mawr Hospital has a dedicated unit for patients, ages 18 and over, who have been evaluated for and need intensive inpatient psychiatric care.

The college years can be a great time to explore activities that are interesting and enjoyable for you, and can help you manage stress your stress in healthy ways. Sign up for a meditation class, for example, or take tai chi. Find time in the morning to sit quietly and read, or go for a walk or a run. Connect with nature, whether in a city park or a national forest. Getting out of your head and being in tune with things you enjoy can provide much needed relief.

Students find support from on-campus mental health groups

Perhaps in response to a string of “suicide clusters” that occurred at Penn, NYU, Cornell, MIT, and others in recent years, many schools are taking a stronger stand for mental health in college students. Campuses are seeing the rise of student groups that promote open dialogue about college life and the perfectly acceptable feelings of doubt and imperfection most kids are dealing with. Organizations such as DMAX, founded here on the Main Line of Philadelphia, promote open dialogue and community through DMAX Clubs, organized on college campuses and in collaboration with campus counseling centers. The clubs provide “Conversations that Matter”—a way for students to get together and talk about how they’re doing and how they can help each other while also participating in fun activities and social events.

Laurie Burstein-Maxwell and husband Leland founded DMAX to honor their son Dan, a student at Radnor High School who killed himself in July 2013, one month after graduation. Dan was a well-liked friend, athlete, and National Honor Society student who had spent 18 months grappling with depression. The Maxwells were determined to have his life—and death—mean something to other young people and families dealing with mental health issues and often suffering in silence. Says Burstein-Maxwell, “With all you have to juggle in college, it is normal to experience stress and anxiety, but it is very important to place a priority on your health and well-being—and that includes mental health. We all experience stress at different times in our lives, and there is nothing wrong with reaching out and talking about it with friends, and seeking help when you need it.”

Parents: Know the warning signs of suicide in college students

Considering that most kids want to appear as though they’ve got the adult thing handled, it’s no wonder parents are missing the cues. It’s imperative that parents understand the complexities of mental health in their kids and be prepared to talk—and listen—openly for the sake of their children’s well-being. Accurate diagnosis of a behavioral health issue often occurs with a primary care provider who can connect you with outpatient services. In acute situations, admission to an inpatient unit may be necessary.

Many parents, and most young adults, have also known adolescents who have harmed themselves yet denied any suicidal intent—so-called nonsuicidal self-injury, such as cutting or burning oneself. Psychiatrists believe these behaviors are more common than previously thought, especially as we see them more and more in the media. Self-injury can be very frightening to parents, and it’s important to take it as a sign of distress in your child and to seek help. Watch Facebook Live video of Dr. Burock speaking on self-injury in teens.

If your child:

  • Has an unexpected change in behavior
  • Talks about or is threatening self-harm
  • Shows poor self-care
  • Shuts off from others
  • Expresses feelings of hopelessness

It may be time to step in as a parent and also seek outside help. It may also mean giving your child permission to take a break, such as dropping a class that’s particularly demanding, or taking a season off from athletics. For the college student who’s seriously struggling with anxiety or depression, just knowing that it’s okay to pull back from some of the college stressors can provide some mental relief and an opportunity to regroup and recover. Talking it out with close friends, a family member, coach, spiritual advisor, or an on-campus resource, can further help release feelings of being alone or being the only one who’s having a hard time handling college challenges.

College students who are seriously struggling need to know that it’s okay to take a break from school, or from sports or other activities. Mirmont Outpatient Centers, part of Main Line Health, has three outpatient locations to help. Our primary care offices also have providers trained in assisting patients with behavioral health issues.

College students who are seriously struggling need to know that it’s okay to take a break from school, or from sports or other activities. Mirmont Outpatient Centers, part of Main Line Health, has three outpatient locations to help. Our primary care offices also have providers trained in assisting patients with behavioral health issues.

In fact, getting in the habit of talking it out in the college years can help establish healthy behaviors for years to come. College is one of many milestones in life that can bring up feelings of inadequacy and self-doubt, but can also provide an opportunity for self-examination and growth—to become the best version of yourself you can be, in spite of and because of the changes and challenges.

For a referral to a Main Line Health behavioral health specialist, call 1.888.227.3898.

For 24/7 emergency support, visit a Main Line Health emergency room at Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital or Riddle Hospital.

If you’re in crisis and need to talk now, call the National Suicide Prevention Lifeline at 800.273.TALK (8255) or visiting suicidepreventionlifeline.org. You can also contact the Crisis Text Line by texting TALK to 741741.