Navigating Mental Health Issues in College: A Comprehensive Guide

Between taking advanced courses, making new friends, and juggling finances, the transition to college can take a toll on your mental health. In fact, we’re just starting to understand how difficult it is for many students to prioritize their well-being in the face of the unique challenges they experience.

As the world rapidly changes, it’s vitally important to understand the different aspects of mental health and ways we can support students.

Why are College Students Prone to Mental Health Issues?

Research by Frontiers in Psychiatry showed mental health diagnoses among college students have risen from 22% to 36% between 2009 and 2019. Different factors that may contribute to this increase include the rise of social media use—though researchers admit this possible contributor needs more study—and intense pressure to succeed. This pressure mounts throughout high school as the college admissions process continues to get exceedingly competitive, causing more and more students to neglect their mental health to get ahead.

A study performed by the World Health Organization found over one in three college freshmen worldwide report symptoms consistent with mental health disorders. By the time they get to college, students already feel overwhelmed by expectations, only to undergo a massive life change by transitioning to college.

The Frontiers in Psychiatry study also showed barriers to treatment contribute to the rise of mental health issues among this population. Many students assume symptoms of anxiety and depression represent natural parts of college life, while others don’t know where to find help.

Mental Illness in Healthcare Students

While students from all different backgrounds and areas of study are affected by mental health issues, healthcare majors may have a larger incidence of anxiety, depression, and suicide. Between the rigors of healthcare education programs, financial stress, and the pressures of caring for others, healthcare students and practitioners face unique challenges in terms of their mental health.

Common Types of Mental Illnesses in College Students—and How to Get or Give Help

Depression, anxiety, and other mental health issues can seriously impact the way students move through their time in college. Here are some common disorders or challenges, their signs, and ways to give or get help.

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Depression

Warning Signs You May Have Depression

Depression is misconstrued as “feeling sad,” but it’s much more than that. One of the clear signs of depression is a lack of interest in things that once brought you joy or excitement. If this continues for a considerable period, the general disinterest can point to a larger issue. Other signs include:

• Struggling to get out of bed
• Not seeing the point in everyday activities
• Intense, persistent feelings of sadness
• Numbness to emotion and failing to feel anything at all
• Struggling to fall or stay asleep or, conversely, sleeping too much
• Eating significantly more or less than usual or making food choices you wouldn’t normally make, such as eating junk food over healthy fare

Warning Signs a Friend Might Have Depression

While depression isn’t always noticeable, it’s important to know some of the red flags. If your friend is generally disinterested in things they used to love or is struggling to get through the day without an intense outburst of emotion, you may be seeing indicators of a larger issue. Changes in eating habits may also be symptoms of depression–eating significantly more or less may be signs of needing comfort or a sense of control.

Additional symptoms to look out for include passively suicidal proclamations like “I might as well get hit by this bus” or alluding to not caring if they live or die. Combined with a lack of confidence, unpredictable behavior, and mood swings, these are signs your friend may be struggling.

The Effects of Depression on Academic Performance

It can be difficult for students who deal with depression to be fully present in their academic experience. A 2018 study by the American College Health Association (ACHA) found that almost 19% of college students surveyed reported depression affected their academic performance.

In being distracted by intense feelings of hopelessness or numbness, college students can face extreme difficulties balancing expectations and their mental health while worrying about their future.

Anxiety

Many young people struggle with feelings of anxiety. Particularly in college, with added external pressures, students may have feelings of nervousness, panic, or perpetual worry. The previously mentioned ACHA study found 63% of college students reported feeling overwhelming anxiety in the last year. From planning their futures to getting to class on time, students feel the pressure in more ways than one.

Different types of anxiety disorders exist, including:

Generalized Anxiety Disorder
According to the Anxiety and Depression Association of America, this disorder includes “persistent and excessive worry about a number of different things.” People who live with GAD may panic over anticipated disasters and obsessively worry about money, work, family, or other issues.

Obsessive-Compulsive Disorder (OCD)
This is a disorder involving unwanted thoughts urging a person to perform actions repeatedly, worry about specific things like germs or whether you turned off the stove, or become aggressive toward other people or oneself.

Panic Disorder
The National Institute for Mental Health characterizes panic disorder as having “sudden and repeated attacks of fear that last for several minutes or longer.” If you have consistent panic attacks, this may be an issue.

Post-traumatic Stress Disorder (PTSD)
PTSD develops in people who have witnessed or experienced a deeply traumatic event. The National Institute for Mental Health explains, “Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD.” For some, it isn’t one specific event that caused PTSD, but a series of major or minor events leading to these symptoms. Though not yet officially recognized by the DSM, many doctors recognize complex PTSD, as this is called, as a reality.

Social Anxiety Disorder
Social anxiety disorder involves constantly feeling judged and watched by others, creating a sense of fear in social settings. Being intensely self-conscious and afraid to meet new people, students with social anxiety can struggle to feel safe around others.

Warning Signs You May Have Anxiety

Feeling nervous, worried, or anxious during big transitions in life is normal and expected. However, if your feelings take over your life for an extended period, it may be a larger issue. Signs you may have an anxiety disorder include restlessness and an inability to stay in the moment. You may find yourself constantly looking for external stimulation to let you “escape” your anxious thoughts.

Irritability, mood swings, and trouble sleeping can point to anxiety. In addition to constant worrying, there are physical symptoms like muscle tension and tightness that can characterize anxiety as well. Trouble with digestion is often linked to feelings of anxiety due to shortened breath and increased tension in the body.

Warning Signs a Friend Might Have Anxiety

If your friend is avoiding new situations and interactions, they could be dealing with anxiety. When a person is feeling anxious, they tend to want to stay close to what they know. In addition to this, they may be having a hard time making decisions without worrying obsessively. Small triggers like tests, confrontations, and money issues can send them spiraling into intense experiences of panic.

Furthermore, if your friend has panic attacks, they’re likely a sign of anxiety. Feelings of anxiety can lead to people leaving situations; these can be study sessions, parties, relationships, or other experiences. If your friend has a hard time sticking around for things, it may mean they’re struggling with anxious, racing thoughts.

The Effects of Anxiety on Academic Performance

While anxiety can seriously impact your daily life, it can also affect your grades. Nearly 26% of college students said anxiety had affected their individual academic performance within the last 12 months. Since anxiety makes focusing difficult, it can make studying and retaining information much more challenging, leading to lower grades.

Substance Abuse and Addiction

While “substance abuse” and “addiction” are frequently used as though they’re synonymous, they’re different things. This can be doubly confusing because addiction is also called “substance abuse disorder.” In simplest terms, “substance abuse” is when people use drugs or alcohol to cope but still can control their use of the substances, and their daily lives aren’t severely impacted. In contrast, “addiction” or “substance abuse disorder” is a disease that takes over all or nearly all aspects of one’s life. Either of these issues can affect college students, and both should be taken seriously. While many things contribute to addiction, abusing substances can open the door.

The National Survey on Drug Use and Health found 19.7 million Americans who are 12 or older experienced substance abuse disorder in 2017. Whether the issue is alcohol, marijuana, or prescription medication, addiction impacts many lives around the world – including the lives of college students since many substances are readily available on university campuses. The issue can become chronic, with people struggling to live their lives without their substance of choice.

According to the American Addiction Centers, college students are most likely to abuse the following substances:

Alcohol
Particularly among college students, alcohol is often considered an accepted part of the experience, but recreational drinking can open the door to a larger issue.

Marijuana
Smoking weed is a pastime of many college students, with social activities often centered around the drug. In fact, one in nine college students reported daily or near-daily use of marijuana, compared to the one in 17 people of college age who aren’t attending school. Many people use it to ease stress and those with legal prescriptions are monitored by their doctors to ensure they’re not experiencing negative side-effects, like difficulty focusing and memory problems. These issues can lead to lower grades and a risk of not graduating from school, and it’s often a “gateway” to other substances.

Opioids
Opioids are technically pain relievers, and both legal (such as oxycodone and fentanyl) and illegal (such as heroin) ones exist. People become addicted because they release endorphins, which “muffle your perception and boost feelings of pleasure, creating a temporary but powerful sense of well-being.” If you’re stressed out, anxious, or depressed, these feelings can be a welcome relief; but they’re temporary, and people often end up immediately looking for their next “fix.” Frighteningly, an addiction to opioids can begin after only 10 days of usage, and 130 people die due to their use every day.

Sedatives
Sedatives are typically prescribed to help people sleep or handle anxiety and panic attacks. When appropriately monitored by doctors and used without substances like alcohol, they can be helpful to many. However, many are both addictive and tolerance-building, meaning users may find themselves increasing their dosages unsafely. When combined with alcohol, they can easily result in death.

Stimulants
These are drugs people feel help them stay awake and focused and include legal substances for treating ADHD (such as Adderall and Ritalin) and illegal ones like cocaine and methamphetamine (meth). Those with prescriptions for the legal options are closely monitored for signs of addiction and are given dosages appropriate to their unique situations, while those who obtain these medications without prescriptions aren’t given these benefits. Additionally, taking them without a prescription can get both you and the person you got the pills from in legal hot water. When it comes to illegal stimulants, cocaine is easy to overdose on, as you build a resistance to it over time and take more and more, and meth can result in the destruction of both mind and body.

Warning Signs You May Have an Addiction

One of the key signs of addiction is feeling unable to function without your substance of choice. If you only feel good while drinking, smoking, or using drugs, it’s time to evaluate your usage. Additionally, feeling anxious or uncomfortable without your substance often shows the body and mind are dependent upon whatever substance you’ve frequently been using.

Addiction can also take the form of disruption. Has your habit made you change your plans? Are you willing to take risks to use your preferred substances? If these risks seem beyond what you take for most things in your life, this may point to a larger issue.

Warning Signs a Friend Might Have an Addiction

There are many signs someone may be living with an addiction. The main question to ask is if they need the substance to function in their regular capacity. One clear sign is if your friend is displaying withdrawal symptoms such as shaking, insomnia, anxiety, or headaches, unattached to anything but a lack of access to their substance. Behavioral changes also underpin a struggle with addiction—is your friend lying about little things? Are they drinking or using any other substance alone frequently?

The Effects of Addiction on Academic Performance

Repeated use of alcohol and drugs can alter the way the brain functions, negatively impacting performance in college classes. Plus, withdrawal symptoms like a hangover, headache, stomach ache, or increased anxiety can lead to less motivation to study or go to class. Since addiction walks hand-in-hand with other mental health issues like anxiety and depression, substance abuse can catalyze intense struggles that deter from academic progress.

Eating Disorders

Contrary to popular belief, eating disorders aren’t a choice—they’re a mental illness. An estimated 30 million Americans will experience an eating disorder at some point in their lives, and these disorders have the highest mortality rate of any mental illness. College provides the perfect storm for them to take root because, according to ULifeline, a couple of factors that can contribute to eating disorders are “feelings of hopelessness and inadequacy” and “perfectionism,” both of which many college students live with.

There are many types of eating disorders, including (but not limited to):

Anorexia Nervosa
This type of eating disorder involves restricting food consumption and an intense fear of gaining weight. People who have anorexia may also over-exercise, obsessively count calories, or purge food via vomiting or laxatives if they feel they’ve overeaten. You should keep a special eye on yourself if you have a family history of anorexia.

Bulimia Nervosa
Bulimia looks similar to anorexia in many ways, but the biggest difference is there’s often binge eating and a heavier focus on purging rather than restricting intake. Those with bulimia often maintain a “normal” weight, unlike those with anorexia, but they’re still obsessed with the idea that they’re overweight. Like anorexia, watch for bulimia symptoms if you have a family history of the disorder.

Binge Eating Disorder
People with this disorder feel they can’t control their desire to eat, often consuming food until they feel painfully stuffed. Unlike anorexia or bulimia, they don’t purge after food consumption, though they may feel shame about the binging.

Orthorexia Nervosa
Though this isn’t yet officially recognized by the DSM, doctors are becoming increasingly aware of orthorexia nervosa as an issue separate from anorexia. Unlike anorexia, in which people often restrict food entirely, those with orthorexia symptoms become hyper-focused on which foods they’re eating. They cut out entire food groups they deem unhealthy, leaving them with few choices, and feel distressed when no foods they feel they can eat are available to them. There may or may not be concerns about their appearance; this is often about control, and it’s viewed as a “hybrid” of anorexia and obsessive-compulsive disorder.

Warning Signs You May Have an Eating Disorder

If you find yourself obsessing over food, purging your food from your body, or constantly worrying about your exercise routine, it may be time to take a step back to consider why this is happening. Other warning signs include constantly weighing or measuring yourself, an ongoing concern with weight, and withdrawing from regular activities.

Warning Signs a Friend May Have an Eating Disorder

Constant exercise, an intense desire to control everything they eat, and other changes in behavior often characterize symptoms of an eating disorder. Another sign includes eating separately in social situations. They may make or bring their own food for family dinners or avoid going out to eat.

Pay attention to changes in mood and strange bathroom habits around mealtimes. Panic about not being able to exercise or obsessive calorie-counting can be signs as well.

The Effects of Eating Disorders on Academic Performance

Between worrying about being food and exercise and juggling schoolwork, eating disorders can take away from students’ focus on their studies. These students often have trouble with concentration and retaining the information they need. With fewer nutrients in their bodies, students with eating disorders can feel distracted by physical discomfort and the psychological distress of disliking their own bodies.

Self-Harm

According to Higher Ed Today, non-suicidal self-injury is “deliberate, direct damage to one’s body…but without conscious suicidal intent and for reasons falling beyond the purview of socially or culturally accepted practices.” Self-harm doesn’t necessarily mean someone is suicidal, though it can lower inhibitions if suicidal thoughts later occur. There are two peak ages for this: adolescence (mean age 14-15) and college (mean age 20). Studies on college students vary widely, with some saying 7% have engaged in self-harm and others reporting numbers as high as 44%. While it’s sometimes a symptom of another mental illness, it can exist in a vacuum.

Warning Signs You May be Engaging in Engaging in Self-Harm

Forms of self-harm can include cutting or burning your skin, hitting or punching objects, or pinching, scratching, or hitting yourself hard enough to cause injury. If you find yourself doing these types of things, or if you find yourself fighting these urges, it’s time to seek help.

Warning Signs That a Friend is Engaging in Self-Harm

There are obvious and subtle signs a friend may be self-harming. The obvious ones include visible bruises, scratches, burns, or cut marks, often focused on the arms or the thighs. However, many who self-harm attempt to hide any marks. So, if your friend is inexplicably wearing long sleeves in hot weather or suddenly wearing baggy clothing, you may be seeing some subtle signs of self-harm. They may also avoid social situations, particularly ones that involve barer skin like going dancing or swimming. If you notice these issues, ask them if they’re okay in a calm, non-judgmental manner. Bear in mind, they might make blame injuries on something else, like bumping into a table or cutting themselves while cooking, or say fashion changes are simply because they feel like it. Keep an eye on them and reach out to other resources, like an on-campus counselor, about what you should do.

The Effects of Self-Harm on Academic Performance

Since self-harm can seriously hamper the student’s self-esteem, confidence, and overall comfort. This lack of confidence and mental distress can take away from classroom presence and hamper the ability to focus. Furthermore, someone dealing with this may avoid being in social settings and feel depressed, which often negatively impacts academic performance as well. And, of course, self-harm hurts, and lingering pain may make it hard to focus.

Bipolar Disorder

While everyone has good days and bad days, bipolar disorder is more than just “mood swings.” Bipolar disorder is characterized by “extreme changes in mood, thought, energy, and behavior.” This isn’t a rare condition: over two million adults in the United States have bipolar disorder. College presents a unique time in this trajectory because many receive the diagnosis in their teen years or early 20s.

A common misconception is that people with bipolar disorder are dangerous. This simply isn’t true—unless combined with substance abuse, people with bipolar disorder aren’t any more of a threat to others than those without this diagnosis are.

A few terms to know are:

Manic Episode/Mania
Signs of mania can include highly elevated—even happy—moods, extreme irritability, massive amounts of energy, little need for sleep, racing thoughts and speech, distractibility, and impulsive behavior. Some people hallucinate or have delusions. People are sometimes highly productive during these periods, but not always. These must be sustained for at least a week to be considered manic episodes.

Hypomania
This is similar to mania, except it only needs to last for four days.

Depressive Episode/Depression
This looks identical to depression, and it’s why a lot of people with bipolar disorder go undiagnosed for a long time—they often spend more time depressed than manic or hypomanic. The depressions can be extremely hard, particularly if following a manic episode because it’s like a “crash” rather than a descent.

Though most people think there are only two types of bipolar disorder, there are actually four:

Bipolar I
Bipolar I means a person has at least one manic episode persisting for a minimum of a week or is so severe it requires hospitalization. They may also have depressive episodes for at least two weeks, hypomania, and mixes of all of these signs.

Bipolar II
This is a series of one or more episodes of depression and at least one hypomanic episode.

Cyclothymic Disorder
In this disorder, mania or hypomania need to happen over at least two years. The highs and lows aren’t as severe as Bipolar I or II but still require treatment.

Other/Unspecified
A person is diagnosed in this manner when they exhibit signs of mania, hypomania, and depression but don’t quite fit into one of the other categories.

Warning Signs You Might Have Bipolar Disorder

Many people don’t realize they’re bipolar because of the mistaken belief that it’s a quick back and forth between highs and lows: one minute, you’re happy and energetic; the next, you’re depressed. This is simply not the case. While some people with bipolar disorder do experience the occasional day like this, or a sudden change can be caused by a specific triggering incident, they’re not the norm—the highs and lows last for days or weeks. If you notice you’re feeling emotional extremes, both positive and negative, engaging in impulsive behaviors, feeling depressed, or experiencing hallucinations or delusions, you should consider speaking with a doctor.

Warning Signs a Friend Might Have Bipolar Disorder

Bipolar disorder is sneaky. After all, everyone has days where they’re extra energetic or excitable, and depression is a very common illness—and bipolar disorder hides behind these facts. Some signs to look out for are extremes: A friend isn’t just “on the go;” they’re unstoppable. A friend isn’t just distracted; they can’t focus at all or are constantly switching topics. A friend isn’t just buying a few new things; they’re spending uncontrollably. A friend isn’t just bummed out; they’re not engaging in normal activities because they can’t get out of bed. If you’re seeing potential signs of bipolar disorder in someone you care about and want to help, learn about the disorder, talk to them about the things you’ve observed, and listen to what they have to say. It’s hard, but try to not get annoyed when they’re engaging in manic behaviors—they’re doing their best.

The Effects of Bipolar Disorder on Academic Performance

Students who have this disorder are 70% more likely to drop out of college than students without a mental illness. As bipolar disorder can be extremely disorienting, with episodes of severe depression and opposing moments of overwhelmingly high energy, schoolwork can go on the back burner in the face of this illness. Bipolar disorder can also make it exceedingly hard to get out of bed or focus on the heavy course loads many students take during their time at university.

Schizophrenia

Contrary to popular belief, schizophrenia isn’t “split personalities,” and most people with schizophrenia aren’t more dangerous than people without it. Schizophrenia affects around 3.5 million Americans, with most showing initial symptoms between the ages of 16 and 25. This brain disorder blurs the lines between what’s real and what isn’t real within a person’s mind. That means a person with this type of disorder may struggle to think clearly, express emotions, and relate to the world as others around them do.

Warning Signs You May Have Schizophrenia

Signs of schizophrenia are divided into three categories: positive, negative, and disorganized. These terms may be confusing because “positive” doesn’t mean “good” and “negative” doesn’t mean “bad;” think of them as “addition” and “subtraction.”

Positive symptoms are “added” to your normal life and include auditory and visual hallucinations that don’t go away or frequently return, paranoia, and distorted or exaggerated beliefs or perceptions.

Negative symptoms are everyday things that have been “subtracted” from your life, like no longer wanting to be social and struggling to find pleasure or even show emotion at all. You may also stop taking care of personal hygiene.

Disorganized symptoms make you feel like your brain is “jumbled,” and you have trouble organizing your thoughts or thinking logically, you’re more easily confused, and you may show unusual behavior or movements. If you’re noticing these signs within yourself, it’s time to seek help.

Warning Signs a Friend May Have Schizophrenia

There are several signs of schizophrenia you can observe. Hearing noises or seeing an invisible presence can be signs of schizophrenia. Additionally, sudden, extreme changes in beliefs or misunderstandings of everyday conversation can be indicators, as can a sense that this person just doesn’t care about anything. WebMD advises those who believe a friend has schizophrenia reach out to a doctor or therapist to ask how to proceed, as every case needs to be approached differently. Tell the professional what you’re observing and let them guide you.

The Effects of Schizophrenia on Academic Performance

Schizophrenia’s symptoms can make it hard to stay focused on school or think clearly about your work because of the symptoms above. The National Alliance on Mental Illness cited a report stating 47% of adults living with schizophrenia drop out of college. However, though this diagnosis can be scary, it needn’t cause your education to stop. With appropriate treatment, you can complete your education: 25% of people with this diagnosis recover completely, and 50% show improvement over 10 years. Your school may have resources for students with disabilities or a counseling center you can get help from, and they’re legally obligated to provide reasonable accommodations.

Attention Deficit Hyperactivity Disorder (ADHD)

While ADHD is often thought of as something only kids have, 4% – 5% of adults have ADHD—though few receive treatment or get a diagnosis if they weren’t diagnosed at a younger age. According to the American Society of ADHD and Related Disorders, at least 25% of college students receiving disability services have ADHD. ADHD can make concentration exceedingly difficult due to abnormal levels of impulsive and restless actions. Making it difficult to stay focused during class and study time, ADHD can affect college students in various ways.

Signs You May Have ADHD

ADHD is an interesting disorder because it involves two seemingly opposing challenges: a lack of focus and the ability to hyper-focus. For this to be ADHD and not just stress or an outside distraction, these symptoms need to last over a significant amount of time.

The lack of focus goes beyond just being easily distracted or daydreaming—a person with ADHD may find it hard to stay present within conversations or lectures, frequently fail to complete assignments or tasks, and overlook important details in work and everyday life. Acting impulsively and severely with time management may also indicate you have this disorder. Additionally, you might struggle with “sensory overload,” which basically means everything you see, hear, smell, and feel seems to be happening simultaneously and at an extreme level—for instance, if you’re in a classroom, you may end up taking in the tapping of someone’s pencil, the color of someone else’s hair, the smell of the room, and the texture of your sweater to the point where you can barely follow the lecture.

Conversely, you may be struggling with ADHD if you also get hyper-focused to the point where it seems as if nothing else exists besides what’s in front of you. You may not even hear people when they’re talking to you because of how focused you are.

If you’re experiencing these symptoms, speak to a doctor—and keep speaking to them if they seem dismissive of it at first, blaming it on stress or similar. These symptoms can be managed through a combination of medication, therapy, and self-accommodations like “fidgets” (small items you can manipulate with your hands) or standing up or, with permission, pacing at the back of the classroom during lectures.

Signs a Friend May Have ADHD

Signs of ADHD can appear in social interactions in which the person in question frequently interrupts, rushes through conversations, or says inappropriate things. Additionally, if your friend is exceedingly forgetful and often must be reminded over and over again, it could mean they’re experiencing ADHD symptoms.

Emotional highs and lows can also point to a larger issue with feelings of chaos ensuing. Anxiety and restlessness can come as results of the hyperactive experiences of ADHD, which can lead to moments of low self-esteem or depressed mood. If your friend is exhibiting these symptoms, it may be time to speak to a health professional.

The Effects of ADHD on Academic Performance

Students with ADHD face unique stressors. These include increased distractions, difficulty focusing, and relationship struggles due to these symptoms. With a heavy workload, students with ADHD may struggle to get through large amounts of course material in the allotted time and remember important deadlines. ADHD is very manageable, though, so be sure to get the help you need.

Suicide

A longitudinal study between 2005 and 2016 discovered nurses are at a higher risk of completing suicide than the general population. Additionally, suicide is the second leading cause of death of people aged between 10 and 34 in the United States. These numbers have spiked dramatically over the last decade, leading to increased questions about how to support those struggling with suicidal thoughts.

Those in college are also at increased risk of suicidal thoughts or actions, as they’re going through major life changes. They’re at an even higher risk if they have a mental illness diagnosis or symptoms thereof.

Signs You’re Struggling With Suicidal Thoughts

To an outsider, it may seem like it should be obvious to someone if they’re having suicidal thoughts, but this isn’t always the case. Some people do think about ending their own lives, but others think of it as simply wanting the pain to stop or removing some part of themselves. If you find yourself thinking you want to die or want the pain to stop, especially if you’re considering methods to make this happen, please seek help immediately.

Signs a Friend is Struggling With Suicidal Thoughts

Most people who are considering suicide say or do something to indicate this. If a friend is showing a preoccupation with death, giving away their belongings, or showing signs of depression or hopelessness, they may be experiencing suicidal thoughts. It’s also not uncommon for them to flat-out say they’re considering killing themselves—in this case, always assume they’re telling the truth.

If you believe someone is suicidal, ask them directly: have you thought about suicide? Have you made a suicide plan? You won’t plant the idea in their head. If you believe they’re in immediate danger and you’re with them, don’t leave them alone, no matter what; call or text 911 or a suicide hotline. If you’re not with them, try to keep them talking and contact one of those resources—if you’re on the phone with them, try to message one of these resources another way or message a friend via a web format to ask them to do so. If you don’t believe they’re in immediate danger, talk to them about their feelings and help them find resources, but keep an eye on them and don’t hesitate to reach out to a suicide hotline with questions.

The Effects of Suicidal Thoughts on Academic Performance

If you’re experiencing suicidal thoughts, you may begin to feel like nothing—including your schoolwork—matters. Even if you’re not making a plan to attempt suicide, this feeling could become pervasive enough to stop you from working hard for your classes. If you’re having suicidal thoughts, contact a doctor, your school’s counseling center, or a suicide hotline for help—even more important than saving your academic career, it can save your life.

Historically Underrepresented Groups Affected by Mental Health Disorders in College

Historically underrepresented groups are defined as ” groups who have been denied access and/or suffered past institutional discrimination in the United States”. While this term seems like it’s in the past tense, it’s simply referring to the fact that this discrimination has happened over generations, not ignoring that it’s still happening.

Students from historically underrepresented groups may feel isolated at their campuses. Because of feeling alone, LGTBQ+ (lesbian, gay, bisexual, transgender, queer/questioning, or another identity in this community that doesn’t fit with these letters), BIPOC (Black, Indigenous, and people of color), DREAMer, and low-income students face challenges in college that can seriously impact their mental health. If your school has a club for students of your identity, consider joining it to help stave off these feelings. Additionally, read our Common Types of Mental Illnesses in College Students—and How to Get or Give Help section above—symptoms of mental health issues are the same, no matter how you identify.

LGBTQ+ College Students and Mental Health

If you identify as LGBTQ+, you aren’t alone, even if it may sometimes feel that way. GLAAD reports 12% of the overall population identifies in this manner, with 20% of those ages 18-34—college age—considering themselves part of this community.

To be clear, being LGBTQ+ doesn’t mean someone is mentally ill. However, LGBTQ+ people are at a higher risk of developing mental health issues because they may struggle with discrimination, physical threats, and judgment. They may also feel anxiety because many choose college as the time to “come out,” as they’re away from home. Rutgers University reports LGBTQ+ college students deal with suicidal thoughts and depression at a rate four times higher than their cisgender (those who identify with the gender they were assigned at birth), heterosexual peers. If you identify as LGBTQ+, it may be worth looking into the Campus Pride Index’s list of LGBTQ+ friendly schools.

BIPOC College Students and Mental Health

Structural racism can lead to many issues with mental health throughout life. The Agency for Healthcare Research and Quality found BIPOC Americans are less likely to receive mental health care, and, when they do, it’s often of lower quality than their white counterparts.

Across racial groups, mental health issues can stem from different causes, and each group faces various struggles to receive the care they need. In college, their traumatic experiences facing racism and discrimination can lead to anxiety, depression, and trouble feeling safe.

College DREAMers and Mental Health

The Development, Relief, and Education for Alien Minors (DREAM) Act grants temporary conditional residency for those who entered the United States as minors. Undocumented students make up around 2% of the college population nationwide, with over 450,000 of them attending higher education institutions, so chances are you aren’t flying solo on your campus. However, DREAMer students may have spent most or nearly all their lives as undocumented immigrants, experiencing the fear of deportation and other discriminatory issues. Plus, they may have additional financial worries, as they aren’t always eligible for many kinds of aid. (However, you can find some information about DACA aid on our guide regarding ELL students and college—these aren’t only open to ELLs.)

In college, students may not feel as safe reaching out for help, especially as they worry about their families’ safety. However, FERPA prevents any school—K-12 or college—that receives money from the Department of Education from disclosing immigration information. By leaving home and possibly being separated from the only family they have in the United States, it can further exacerbate feelings of isolation and loneliness.

Low-Income College Students and Mental Health

Between 1996 and 2016, the number of low-income students enrolled in college increased from 12% to 20%. But, they’re more likely to attend the least-selective colleges, which may have fewer resources for mental health. Furthermore, youth from low-income households have a higher risk of developing a mental health disorder. Income inequality has long correlated with mental health issues such as depression, drug abuse, schizophrenia, and a negative academic experience. (Note: Being low-income isn’t a cause of mental illness—the correlation is because of people growing up in this situation may have higher rates of trauma and may have been unable to afford mental health services before issues progressed.)

In addition to their pasts, students who come from low-income households may constantly worry about both their families’ and their own financial situations. College is expensive, and it can be challenging to hold a job while also studying. If you’re interested in becoming a certified nursing assistant, Premier Nursing Academy—with currently-enrolling locations in Tampa and Bradenton, Florida, provides a free training program and guaranteed employment upon graduation for those who are accepted.

Mental Health for Online Students

Students are increasingly opting for online degrees, which come with both benefits and drawbacks. Benefits include more flexibility, as classes can often be taken on your schedule and allow you to keep a work/family/school balance. However, students can feel more isolated if they thrive on social interaction and face-to-face instruction. Additionally, increased screen time can impact circadian rhythms (i.e., sleep patterns), which may lead to higher incidences of anxiety and depressive mood.

It’s important to take breaks and get your body moving. Additionally, many universities provide mental health resources online to talk through any of the struggles you may face during remote learning. If you have the funds, websites like Talkspace and BetterHelp also offer online therapy, which can be done via video or chat function. The benefit of the latter is you can communicate with your counselor frequently, if not daily. While campus resources are free, they may have fewer slots available, so you’ll likely speak with a counselor less often.

Accommodations for College Students with Mental Illnesses

The American Disabilities Act disallows discrimination against people with disabilities in the public sphere–this includes college campuses. ADA accommodations must both help the person with the disability and not cause undue harm to the institution, meaning it can’t be a high financial burden on them. So, they don’t have to take your initial request, but they need to make counter-offers and come to an agreement with you.

How to Get Accommodations

Start by getting documentation from a healthcare provider like a therapist, doctor, or other professional. Contact the department at your school that helps students with disabilities and discuss options to help accommodate your mental illness with your schoolwork.

Common Accommodations

• Assignment due date extensions
• Check-ins for an understanding of class subjects
• Clear outlines of expectations for course curriculum (written and verbal)
• More frequent breaks during academic instruction or tests
• More time for tests
• Preferential seating
• Untimed tests