Anxiety and 7 Ways to Help Your Struggling College Kid

As excited freshman or experienced sophomores, juniors and seniors settle in for another Fall semester around the country, I wanted to put together a quick list of 7 things parents can do to hep their college kid suffering from anxiety. It’s scary to put so much freedom and responsibility into the hands of your son or daughter when you know worry and fear is always lurking around social, academic or career decisions. Before I discuss what to do about anxiety, I think it’s important to review some details about anxiety.

Everyone feels uneasy or anxious occasionally like when we are running late for a meeting or got caught doing something we’re not supposed to. It’s a normal.

Anxiety disorders are different than regular, situational anxiousness. They are a group of mental illnesses that are characterized by intensity, duration, origin and how they impact life domains like work/school, relationships, and health.

For people who have an anxiety disorder, worry and fear are constant and overwhelming, and can be disabling. With the correct treatment, most can overcome the anxiety disorder and lead a fulfilling life.

Types of Disorders

Anxiety disorder is a broad category that includes:

  • Panic Disorder. Feeling overwhelming sense of terror or dread that seemingly strikes randomly. During a panic attack, the person may sweat, have chest pain, and feel unusually strong or irregular heartbeats. Sometimes they may feel like they’re choking or having a heart attack.
  • Social Anxiety Disorder. Also known as Social Phobia, this is when someone feels overwhelming worry or judgement while in social situations. They may obsess over others judgment or being embarrassed or ridiculed.
  • Specific Phobias. This is when someone has a very specific fear of something such as spiders, heights or flying. The fear goes beyond what’s appropriate based on actual risk and may cause them to avoid regular situations.
  • Generalized Anxiety Disorder. This is what I see most when working with college students. They describe having excessive, unrealistic worry and tension with little or no reason.

Risks

Early signs of anxiety are super subtle and include distractability, avoidance and sleeplessness. Students with anxiety disorders often report to me that semesters generally start fine but as papers, tests and social pressures mount, their anxiety builds to the point where they start consider drastic changes like dropping out of school. Untreated anxiety can lead to depression, severe drug use and in some instance, suicide. Anxiety and depression seem to be best friends, often presenting together in college students I’ve worked with. 

What to Do

Though anxiety disorders can make someone feel hopeless, there are very effective treatments and interventions we can implement to get their life back on track. Here are the 7 I think are most important for parents to be aware of if they need help with their college kid.

1. Counseling

Right out of the gate, the first thing parents should do is link their child with a) campus health services (often called Counseling and Psychological Services or CAPS) and b) a therapist or counseling like me specializing in college student anxiety in the community close to campus. Ideally, find a therapist/counselor that uses Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT). Waiting until the first big meltdown could be too late. Loads of freshman fail to share their struggles with their parents until Thanksgiving and Christmas which, by then, is too late in their minds and they end up not returning for their Spring semester. Invest the time on the front end.

2. Scheduling

Anxiety is fed by fear. Fear is often the by-product of lack of predictability about social events, academic outcomes, and career failures. One solution is increasing predictability. I accomplish this with students by teaching them to download the semester schedule onto their phone calendars before the semester starts. Next, after they’ve received their syllabi, I coach them to put in every single date for every single assignment/test possible. This also includes social events and any non-academic stuff they know about. This may sound like it could be overwhelming, but I’d rather have them feel a bit overwhelmed when looking at the calendars rather than anxious about remember when that next big thing is due.

3. Resources

Not the most used suggestion but one we have to put here – make sure your son or daughter has a list or access to resources that can help them reduce stressors or mitigate things when they’re already starting to spiral down. These resources could include the academic supports found at nearly every university or within the community. Universities have a vested interest in making sure your son or daughter doesn’t bail at semester’s end. Another form of ‘resource’ is the on-call list. Create a formal or informal list of people they can call/text when they are starting to feel overwhelmed. I am on-call for all of my clients and often receive texts from students the night before big tests asking for help in quiet their brains down. I call them or text back strategies and remind them to call if they want to talk through things in more detail. Just knowing there is a safety net and team of support can have a dramatic reduction effect on anxiety.

4. Medication

I am super conservative with medication use and recommendations for students I work with at Indiana University. But, with that said, we also recognize that some folks simply need a bit more support than what counseling and academic support can provide alone. If your college does not have a psychiatrist on staff, we highly recommend finding one in the local community. We rarely encourage use of primary care physicians or nurse practitioners for medication management since they are not specifically trained to diagnose and medically treat those suffering from anxiety. You also want your college kid to work with someone who genuinely understands the risk of some medications that have the potential for addiction. Good kids get hooked on meds the same as bad kids. It’s also important to avoid illegal or non-prescribed drugs (like the roommate’s Xanax).

5. Meditation

I recommend to nearly every client to start participating in weekly yoga, meditation or mindfullness classes. This is an evidence-based approach with only positive side-effects. Plus, every college offers these in their wellness programs for free so encourage your kid to take advantage and put it into the calendar. Meditation, counseling and medication are an incredibly complimentary approach to combating anxiety.

6. Sleep

Not easy when kids have more freedom than ever away from home but we nonetheless push parents to encourage sleep. Not binge sleeping but a healthy 8 hours per night. The ideal for anxiety reduction is a steady sleep pattern so that bedtime and wake time are pretty standard every day. Staying up late on Thursday, Friday and Saturday, sleeping in till 1:00pm and then dragging out of bed Monday morning for an 8:50am class is terrible for anxiety.  Sleep meds only make things worse and really should only be taken with the psychiatrists oversight.

7. Exercise

Encourage your kid to sign up for the intramural leagues, especially for sports where there is little standing around time. Distraction and flow experience are essential in helping him or her focus on non-academic activities. It’s also a great way for them to be social without needing a drink in their hand.

Ok folks. Hope this helps you figure out the best way to help that college kid who may be struggling as you’re getting through the fear of letting go. It’s an exciting time and, with the right strategies in the beginning, can be the start to a fantastic semester.

Why Entrepreneurs Kill Themselves

First of all, a disclosure: I’m a therapist. I work with individuals and families. I meet with people in their homes and offices. Many of my clients from around the country are entrepreneurs. Many are high income earners. A few are on the post-exit side, financially comfortable but bored as hell. I’m also an entrepreneur. I consider my behavioral health agency a business with a product. I consider my patients as customers and treat them as such. I’m not sure which came first, entrepreneurship or being a therapist. Both have existed since I can remember (though not always tied together). When I hear about another entrepreneur’s suicide (referring to Austen Heinz), I cringe. I react as an entrepreneur and I react as a therapist who knows how to stop this. I also beat my head against the wall trying to figure out how to get those hurting to connect with those, like me, that can help. 

Entrepreneurs are a unique bunch. They (…we?) have large egos, low self-esteem (when no one is looking), we work stupid hours, are running from fear, elated when the needle moves slightly in our favor, we are hard to live with, have unrealistic expectations, are judgmental of others (more so of ourselves). There’s a ton of research that affirms this (borrowed from FeldThoughts):

Of the 242 entrepreneurs surveyed, 49% reported having a mental-health condition. Depression was the No. 1 reported condition among them and was present in 30% of all entrepreneurs, followed by ADHD (29%) and anxiety problems (27%). That’s a much higher percentage than the US population at large, where only about 7% identify as depressed.

What’s Helpful? Posting the National Suicide Prevention Hotline (1-800-273-8255) might make some bloggers or journalists feel like they are contributing to the solution. A few folks reading articles might actually call and some might find some solace. But for most entrepreneurs, it’s way more complicated. I’d also like to dispel another myth that most, if not only, tech entrepreneurs struggling with launching a product and desperately reaching to become the next unicorn, are the ones hurting. Not true. You do not need millions of dollars from a VC to have anxiety, depression, imposter syndrome, fears that at any moment it will all come crashing down and your ego will get sucked down with it. Pain comes from only a few places. The major one I’ve seen as a therapist for years is the gap between our expectations and our reality.  

 

What’s the Problem?

 

Therapists don’t advertise. They don’t connect to the outside world. When was the last time you read coverage of a therapist’s thoughts in Business Insider, Forbes or Inc.com? You don’t because we don’t think about communicating to the outside world. We hide in our comfy offices waiting for nice people with insurance (…or those few souls left that private pay) to trip over our profiles on antiquated therapist database websites. 

Therapists are not well-trained. We have minimum continuing education requirements, most of which are required to be on ethics (Don’t have sex with patients!). Even when we are trained to handle suicide intervention, only a handful of us are available 24/7 unless they work for behavioral health company that requires on-call responsibilities. I’ve been ‘on-call’ my entire professional life. At first it sucked. I felt tethered to my cell phone. But as I matured and as I started and ran my own agency, I understood that being available for those in pain is part of my business. It’s not only me being a good person, it’s a good business model and excellent customer service. 

No One Talks Prevention. Let’s get real. In the world of entrepreneurship, whether you are in tech, making widgets, or busting it out with an Etsy project, there are no systematic behavioral health solutions that cut across industries. Closest thing is Employee Assistance Plans (EAPs), but those are for large companies and tend to be low quality perks. There are a handful of VCs that provide informal emotional support to companies. There are some incubators that do the same. But overall, there is little formal or informal discussion about behavioral health prevention, intervention and resiliency. 

 

Solutions 

 

Yes, there are very real things we can do beyond just herding cattle towards the anemic volunteer force at the Suicide Prevention Hotline. 

1. StartUp: We need someone (maybe I’ll do it…) to start a biz which is the QuickBooks equivalent for mental health. Small/medium size business pays small monthly fee for ongoing support with behavioral health issues. Bizarre? I can think of a ton of services I first thought were stupid that soon became popular and financially successful. Either a platform or solution that cuts across industries, is inexpensive, super user friendly and deeply effective at preventing AND intervening with mental health and substance abuse problems. I imagine it being like a cool version of EAPs, but focused on startups and freelancers hoping to break through. 

2. Conferences: We need therapists to get invited to startup conferences and talk about how to reduce anxiety, depression and feeling like an imposter. Therapists also need to reach out to conference organizers and offer to speak. It’s great marketing for the therapist, it’s great value for participants and creates an opportunity for some cross-pollination between industries. 

3. Go to Therapy!: All entrepreneurs that have a history of depression, anxiety, substance use or other significant mental health issue should go and simply connect with a therapist while they are starting a business. Don’t give the bullshit line about not having the money. If you have enough money for an iPhone 6, you can find the money for a few sessions with a therapist.

4. Find a Qualified Therapist: Find a therapist with entrepreneurs and high achievement folks. You will know them when you first ask about their background. Their blogs will have entrepreneurial language. They will also be able to talk about depression, impostor syndrome, anxiety and money problems – all symptoms of the startup/growth world. Don’t count on finding this info on your basic therapist databases like Psychology Today or Good Therapy.

5. Kill Sacred Cows: You are not going to be a billionaire. Your startup will not change human history. Stop taking yourself so seriously and take a break. Learn to stop work at a certain time each day. Stop lying to yourself, families and friends that you are ‘killing it’ with amazing app or product. Get some sleep, eat some healthy food and get your ass moving for some exercise in the Sun (bright thing in sky from 6am-7pm). You get zero bonus points for how much you (and your family) have sacrificed. Chill out. 

Got your own experiences with entrepreneurship and how it affected your life or family? Email me and I’ll put together a ‘Part II’ of this post on entrepreneurship and behavioral health.  

5 Signs of Suicide Risk in College Students

FACT: 15% of graduate and 18% of undergrads have seriously considered attempting suicide

FACT: 15% of graduate and 18% of undergrads have seriously considered attempting suicide

There is nothing more exciting than dropping of your college freshman in late August as the cool nights of Autumn return. But not all students carry with them the same energy and positive outlook for the Fall. Some are carrying some heavy baggage from High School or even younger while others don’t start to develop any major issues until they first get to college (and their first taste of freedom from parents). What parents don’t know is that you likely know your college friends (or at least a side of them) better than their own parents do, and you may be able to tell that something is wrong way before anyone else. This quick list is as much for parents as it is for you students out there. 

The following signs might indicate a student is considering suicide:

  1. A good student who’s behavior suddenly changes – they start ignoring assignments and missing classes which are likely signs of depression or drug and alcohol abuse, which can affect their health and happiness and put them at risk of suicide. And yes, good students and good kids use drugs. Seriously. 
  2. Anyone who doesn’t have friends or who suddenly rejects their friends may be at risk. A friend who suddenly rejects you, claiming, “You just don’t get it,” may be having emotional problems.
  3. College students may be physically or emotionally abused by a member of their family or their girlfriend or boyfriend – or suffering from abuse that occurred long ago but triggered by the new college environment. Abusive relationships can make a college student feel like crap about themselves. Signs that a person may be in an abusive relationship include unexplained bruises or other injuries that he or she refuses to discuss. 
  4. This is a common one – Significant changes in a someone’s weight, eating or sleeping patterns, and/or social interaction style may indicate that something is wrong. Eating disorders are super common at college. Lot’s of perceived competition, anxiety and stress that translates into really unhealthy views of one’s self. 
  5. Coming Out? College students may suffer from depression or have thoughts of suicide if they have a difficult time adjusting to their sexual orientation or gender identity. Gay, lesbian, bisexual, and transgendered students have higher suicide attempt rates than their heterosexual peers.

We understand regret and their could certainly be a real consequence of getting help for someone who seems to be really hurting. They might get pissed at you for not minding your own business. But think of it this way – is the regret of possibly losing a friend better or worse than the potential of knowing you could have saved your friend’s life but did nothing? Tough choice but that’s part of the burden of mental illness.