When Jason Selby found himself paralyzed at the thought of his usual trek downstairs to get water, he knew something was wrong.
Walking downstairs to get water meant the possibility of tripping and falling.
Missing his alarm in the morning meant failing classes and flunking out of school.
Selby, in fact, experienced massive anxiety about “every little thing in life,” the University of Oregon student said.
Selby is not the only college student to experience overwhelming, if not paralyzing, anxiety.
In a Spring 2014 National College Health Assessment, 33 percent of students surveyed reported feeling so depressed within the previous 12 months that it was difficult to function.
Almost 55 percent reported feeling overwhelming anxiety, while 87 percent reported feeling overwhelmed by their responsibilities.
Almost 9 percent seriously considered suicide over the past year.
In addition, a 2015 survey from the Center for Collegiate Mental Health at Penn State University revealed that 20 percent of college students seeking mental health treatment were taking up half of the appointments at campus counseling centers.
Gregg Henriques, Ph.D., professor of graduate psychology at James Madison University in Virginia, says these numbers are clear indicators that college students are experiencing what he calls a “mental health crisis.”
According to Henriques, mental health survey results from the mid-1980s indicate that 10 to 15 percent of young adults could have been characterized as having significant mental health problems. Today, he said the number is anywhere from 33 to 40 percent.
“The issue is absolutely clear,” Henriques said. “College students are endorsing on these surveys many more symptoms associated with depression, anxiety, and stress. The data is very clear. There’s a lot more mental stress than there was 23 years ago.”
Counseling center directors seem to agree. In a 2013 survey by the American College Counseling Association, 95 percent of those directors said they had noticed a greater number of students with severe psychological problems than in previous years.
While depression and anxiety are the most commonly reported mental illnesses, eating disorders, substance abuse, and self-injury are close behind.
The pressure to succeed
Selby believes his anxiety was triggered by a multitude of social and academic stresses.
“The pressure to succeed during school is oftentimes overwhelming,” he said. “I know for a fact that students spend a majority of their time worrying about how to add things to their resume, instead of worrying about how to better themselves as individuals.”
As Selby said, college is often the first time in a young person’s life where they have the freedom to make their own choices, a change that can often be daunting.
“College is great. It's the first time in a young person's life where they can experience freedom and make choices that could really impact the rest of their lives,” he said. “At the same time, the fear of the unknown is a ‘reality’ that becomes all too familiar in college.”
Henriques agrees all those options can be a double-edged sword.
“We have an economic system that rewards people with certain kinds of talents very well, but it also creates a lot of cracks,” he said. “If you don’t know who you want to be, and what you’re going to do, and how you’re going to do it, you set the stage for some trouble.”
Selby believes it is this pressure to do well in the future, coupled with financial strain, that contributes to the decrease in students’ mental health.
“My parents have spent so many thousands of dollars on my education and I would feel awful if I don’t end up successful,” he said. “Our economy is not great, so paying for college has become tougher than ever. And to be paying all of this money to get a degree, only to be placed in a very difficult workforce upon graduation, makes things seem bleak for most.”
The growing number of options for young people and lack of a clear “life path” could prompt existential depression or anxiety, Henriques said.
“We certainly see a lot of confusion about students’ identity and how they’re going to contribute to society,” he said. “They don’t really have a clear, easy track into a job, or a career, or a marriage, and so they sort of stagnate in adolescence. They struggle in finding a purpose.”
Pressure mounts before college
For college students with mental health issues, college is often not the first time they’ve experienced overwhelming amounts of stress.
According to Monica, a junior at Barnard College in New York, even before college students experience massive pressure to perform well so they can be admitted to increasingly selective universities.
“I was always a really anxious child, but I definitely think that the pressures of high school, and specifically the college admissions process kick-started a lot of the symptoms,” she said. “And as doctors have told me, if you're already anxious or have obsessive tendencies, those tend to come out when you're in a high-pressure environment.”
Monica's struggles with mental health began when she was 10 or 11 years old, but were exacerbated by increasingly high academic pressures.
Like Selby, her anxiety resurfaced in college due to fear of failure.
“In the following semesters [of college], when you've settled in and have more time for yourself, you realize you don't have that safety net of 'Oh, this is my first semester of college, it's OK if I mess up,’” she said. “When you lose that safety net, a lot of bad feelings tend to resurface."
Social media can make it worse
For former University of South Carolina student Margaret Kramer, it was this combination of academic and societal pressure that brought about her eating disorder during high school.
The growing presence of social media and the internet only contributed to the pressure she felt to be perfect, she said.
“During my eating disorder in high school, I felt like I didn’t fit in anytime I saw my friends’ posts on their fun, carefree lives,” she said. “Those feelings of isolation eventually transformed into fears that my physical appearance needed to ‘improve’ for me to fit in better … Those pictures, as well as other sources I found on the internet, served as monitors for my extreme dieting and exercising.”
According to Dr. Jason Addison, service chief of the Young Adult Unit at Sheppard Pratt Health System in Maryland, the growing role of social media might be to blame for increased levels of anxiety and depression.
“Social media has created a more fast-paced world in general, so in that way, I do think there are more stressors than before for patients who might suffer with depression or anxiety,” he said.
Addison also observed that social media could prompt unfavorable comparisons between peers, further exacerbating symptoms of mental illness.
While the internet may not cause mental illness, Henriques believes social media and technology in general might exacerbate some students’ already present symptoms, or cause them to rise to the surface.
“Our technology has added many valuable elements, but it’s also led our society to change so fast that our basic, core human needs, or what I call ‘relational values,’ are falling through the cracks,” Henriques said. “There’s a lot more vulnerability to become isolated.”
Nance Roy, Ed.D., clinical director of the Jed Foundation in New York, an organization that works to prevent suicide among college and university students, also noted that social media, combined with preexisting stigma, might play a part in students’ mental well-being.
“When you combine the fact that mental health is still highly stigmatized with the greater exposure we experience on social media, college students may be feeling more pressure to be perfect with less capability of expressing their true emotions,” she said.
However, according to Roy, the growing reports of mental illness might actually bear a positive indication.
“In the past, students [with severe mental illness] couldn’t go to college because their mental health issues were not being well-managed,” Roy said. “But with advances in psychopharmacology, people — students included — are able to function at a much higher level. That has helped a large number of students enter college when they couldn’t previously.”
Roy also said that a wider availability of mental services on campus has destigmatized mental illness, leading to students more willing to report their struggles.
“There’s less stigma attached to going for help,” she said. “That could also contribute to the increased numbers [in reporting] that we’re seeing. We still are battling stigma issues, and there’s still quite a large number of students who don’t access services due to stigma, but I think we’re breaking down those barriers.”
What colleges are doing about it
However, biases against mental illness are still apparent, even as the numbers of students seeking help from their campus’ counseling centers are growing.
A Center for Collegiate Mental Health study from the 2012-2013 school year found that 48 percent of students had sought counseling for mental health concerns, up from 42 percent during the 2010-2011 school year.
According to Kramer, although the demand for campus counseling might be growing, lack of funding for mental health resources can be an issue for students looking to seek help.
“On our campus, more students are seeking professional help, yet fewer resources are available,” Kramer said. “Our counselors work so hard to provide whatever they can to students, but a lack of funding makes that all the more challenging.”
Roy agreed that a lack of unlimited funds makes meeting every student’s needs difficult. She believes that counseling centers should establish partnerships with local providers in order to help every student get the help they need.
“[The counseling center] should facilitate the connection. [They] can’t just give the student three names and say ‘Here you go,’” Roy said. “The more work schools do with area providers to forge those partnerships, and make sure there’s a good working relationship, the easier it is for students to get really good care in the community.”
More mental health education needed
Still, many believe more mental health education is needed, and not just from a campus counseling center.
“We’re a society that is pretty ignorant about our feelings,” Henriques said. “We get these simplistic messages that you should be happy, that you shouldn’t feel your negative feelings because they just get everybody down. I think that people don’t know how to cope with their negative feelings, and that creates vicious cycles where people try to block their feelings and don’t know how to process them.”
Monica, who was encouraged by a friend to seek help from the Rosemary Furman Counseling Center at Barnard, agreed that more services outside of a counseling center are necessary.
She noted that Barnard students get eight free counseling sessions per semester, a policy she believes is “pretty progressive,” but that many students could benefit from more connection.
"I think that after those eight free sessions, a lot of students just feel abandoned and don't know what to do,” Monica said. “I know students who are 'saving' their free sessions for midterms or finals. Creating more spaces that are not just run by counselors, but more peer-based situations where students work with each other, would be helpful.”
Selby believes that more classes that teach life skills, in addition to open conversations about mental health, could help combat the fears of the future that he and many of his peers feel on a daily basis.
“Classes on how to speak publicly, what to say in an interview, how to start investing … will counteract all of the negative outside forces that stress college students out,” he said.
To Kramer, more discussions on campus mental health can positively impact students to live more positive, fulfilling lives.
“A university is responsible for creating an environment that fosters student development, as students are at a time in their lives where the behavior they instill in college can become permanent practice once they graduate,” she said. “A college has the credibility and power to discuss mental health with complete transparency. For the sake of its students, it should.”
This story was originally published on July 17, 2015, and was updated by David Mills on August 25, 2016.