How to Treat Anxiety in College Students

According to The Health Minds Study, anxiety among college students has been steadily increasing since they first reported findings in 2007.

When Not to Worry About Worrying

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. We can also feel anxious when we perceive a threat in the environment that triggers a neurological response to get our body prepared for running away, fighting something scary, or freezing and blending into our surroundings. This is all normal and helpful.

When to Worry About Worrying

Sometimes, our brain goes into overdrive and can’t differentiate between actual risks and perceived risks. This is often the case when someone experiences trauma or has poor attachment to caregivers—the brain is hypervigilant and perceives threats everywhere. Anxiety disorders are different from regular, situational anxiousness. This group of psychological disorders is characterized by intensity, duration, origin, and how they impact life domains like work, school, relationships, and health.

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 avoiding going to class and work. Untreated anxiety can lead to sleep problems, academic issues, depression, severe drug use, and in some instances, suicidal thinking or attempts.

Specific Diagnoses

Now, let’s take a look at the specific diagnoses I most often see in college students. You’ve probably heard of most of these but may not have a solid understanding of the specific criteria for each.

• Panic Disorders. This is when we feel an 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. Panic attacks rarely last more than 20 minutes.
• Social Anxiety Disorder. This is when students feel overwhelming worry or judgment while in social situations. They may obsess over others' judgment or have a fear of feeling embarrassed or ridiculed.
• Specific Phobias. This is when students have a very specific fear of something such as spiders, heights, or flying. It’s a disproportionate fear compared to the actual risk and may cause them to avoid regular situations. I see this most often materialize as a fear of failing a class or fear of something related to social media.
• Generalized Anxiety Disorder. This is when students describe having excessive, unrealistic worry and tension for no apparent reason. It’s like their brain is saying, “Hey, there’s something scary and dangerous out there. I don’t know what it is or what I’m afraid will happen, but I know I’m scared.”

How to Treat College Student Anxiety Disorders

Though anxiety disorders can make someone feel hopeless, there are very effective treatments and interventions we can implement to get life back on track, or at least make things easier. Here are the six most effective things parents can encourage their college students to implement.

• Counseling. The first thing parents can do is link their child with campus health services or a local therapist or counselor specializing in college student anxiety. Ideally, find a therapist/counselor that uses Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT). Waiting until the first big meltdown isn’t necessary.
• Scheduling. Anxiety is a disorder of fear. Fear is often the by-product of a lack of predictability about social events, academic outcomes, and career opportunities. One solution is to increase predictability. I accomplish this with students by teaching them to download the semester schedule onto their phone or laptop calendars before the semester starts. Next, after they receive 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 events they know about.
• Medication. Sometimes, students simply need a bit more support than what counseling and behavioral changes can provide. If your son or daughter does not have a psychiatrist on staff at their university health center, find one near campus.
• Meditation. I recommend to nearly every student I work with to start participating in weekly yoga, meditation, Non-Sleep Deep Rest (NSDR) or mindfulness classes. Meditation, counseling, and medication are complementary approaches to combating anxiety.
• Sleep. 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 medications only make things worse and really should only be taken with the oversight of a psychiatrist. The formula for the best sleep is: consistency (waking up and falling asleep), making the room as cool and dark as possible, and avoiding devices or food an hour or two before (and while they’re in) bed.
• Exercise. Exercise is one of the most effective behavioral changes for combating anxiety and works through the stimulation of different brain regions. The three easiest ways for students to get enough exercise to quiet their brain down are walking to class, signing up for club team sports, and setting up a routine at the school’s gym. Distraction and flow experiences are essential in helping students focus on non-academic activities. Exercise’s value can come from single episodes but consistency over weeks is where students will find the greatest benefit.

What to Cut Out

There are also a few things that the research shows is best reduced or flat out removed from life to also improve anxiety. Basically, weed and stimulants are the two biggest problems I see in college students that make anxiety worse.

Weed can have an anti-anxiety effect in small doses, but long-term use is linked to increased anxiety. Stimulants like caffeine and some medications like Adderall and Ritalin have been shown to increase anxiety, though there are some studies that show use of methylphenidate might actually decrease certain types of treatment-resistant anxiety which turn out to be more related to ADHD.

In summary, anxiety, if addressed early on, doesn’t have to ruin the semester. Just like attending to a medical issue that requires some modifications, treating anxiety with intentional practice and moderate lifestyle changes can significantly help most students.

To find a therapist near you, visit the Psychology Today Therapy Directory.