FALL UPDATE: Mental Health on Campus

Our Friends and Neighbors 

A recent report in the U.K. revealed that not only are universities unable to cope with the increasing numbers of students suffering from mental health conditions but also that students are killing themselves at an alarming (and increasing) rate.  Another report from UniHealth stated that 82% of university students in the UK experience anxiety and stress and 1 in 5 have suicidal thoughts. In Canada, the situation is much the same. Recent results of the National College Health Assessment Survey (NCHA) demonstrate high rates of mental health issues in students. Thinktank Institute for Public Policy Research (IPPR) released a report showing that a record high 26% of students are utilizing counseling or mental health services, yet this still isn't meeting the need. 

I chose to revisit this topic because these recent reports about college campuses in other countries are a reminder that across the United States, universities are facing a similar student mental health crisis. 85% of college student feel overwhelmed by their responsibilities and 30% report that stress negatively impacts academic performance. Things look even worst at the Post Grad level, Ph.D. Students have twice the risk of developing a psychiatric disorder. This issue needs our continued attention. 

Identifying the Stressors 

As I've noted in previous posts, the number of students reporting mental health concerns in the first year of college has grown dramatically over the last several years and continues to increase.  Academic and financial pressures are crippling students and leading them to unprecedented rates of stress and anxiety. Many students say that the pressure to participate in activities and/or sports while also excelling academically can put them over the edge. In addition, young adults can be unprepared for the stresses of living away from families for the first time while managing school responsibilities and often jobs as well.  

Universities are Taking Aim 

Universities across the country are working to improve behavioral health services for students. UCLA has just launched a large-scale study of college freshman, called the Depression Grand Challenge,  aimed at uncovering the causes of depression. As part of the initiative, the participating freshmen will receive depression screening to help uncover and treat mental health concerns early.  Stanford is similarly screening incoming students for mental health problems with the aim of early diagnosis and treatment of issues.  The University of Pennsylvania reconvened a Student Psychological Health and Welfare task force after a 2016 student suicide, the 14th since 2013. This group recommended expansion of I CARE training, and increasing the hours of their Counseling and Psychological Services hours, among other improvements.  

There is Help

With all of the news from across the country, the United Kingdom, and Canada, it may seem like there is no good way to approach the issue. Below are several different options for students suffering from anxiety, depression, addiction, or other mental health issues.  

• Hotlines
  Some universities have hotlines for students, but there are also national hotlines. 
• Peer support groups & local support groups
  Many universities have set up local peer groups that give students a stigma-free environment to discuss issues.  
• University health & wellness centers
  Many universities now provide counseling services.
• Therapy with licensed counselors, therapists, etc.Finding a local therapist can be a great weekly anchor, enabling students to discuss issues and plan interventions. 
• Online screening  tools
  (While these will not help you manage all the symptoms, they can help you to see if you have symptoms of depression)

Depression is the world's leading cause of disability, according to world health experts and it is believed that 800,000 people commit suicide annually. If you or a loved one is feeling distressed, call the National Suicide Prevention Lifeline. The crisis center provides free and confidential emotional support. If you are in crisis and need help, call this toll-free number, available 24 hours a day, every day: 1-800-273-TALK (8255). This service available to anyone. You may call for yourself or for someone you care about, and all calls are confidential. You can also visit the Lifeline’s website at http://www.suicidepreventionlifeline.org

If you are feeling anxious or depressed, I am available to help develop coping strategies that will put you on the path to feeling better. I work primarily with college students and young adults. Talking about your issues and developing an action plan can help you to deal with stress and anxiety in a healthier way. 

References

http://www.huffingtonpost.ca/robertwhitley/this-year-lets-ensure-students-mental-health-isnt-their-top-worry_a_23192386/https://www.healthline.com/health/depression/college-studentshttp://www.independent.co.uk/student/student-life/health/suicides-rates-double-uk-university-students-134-2015-depression-anxiety-services-overwhelmed-a7925631.html
https://www.theguardian.com/education/2017/sep/02/suicide-record-level-students-uk-universities-study
http://www.mercurynews.com/2017/09/22/depression-major-study-of-college-freshman-kicks-off-at-ucla/
http://www.impactnottingham.com/2017/09/mental-health-concerns-universities/
http://www.thedp.com/article/2017/09/penn-reconvened-its-mental-health-task-force-a-year-ago-heres-what-it-concluded
https://adaa.org/finding-help/helping-others/college-students/facts

How Peer Support Can Increase Student Mental Health

A number of great interventions for improving student mental health have been gaining recognition lately.  Among them, increased mental health services in schools and universities, links to off-campus therapists, anti-stigma campaigns, and numerous efforts at raising awareness of mental health issues.

One helpful strategy for improving mental health that has not gotten as much attention as it deserves is peer support. A number of peer support programs are popping up across the country and throughout the U.K. and Canada, with the aim of filling some of the gaps in mental health support for university students. Particularly on campus where counseling staff and other providers struggle to keep up with the ever-increasing demand for mental health services, peer support is another tool to help students cope with stress and anxiety.

State of Emergency

About 13% of young people suffer from mental health issues ranging from anxiety and depression to ADHD and other disorders that can impact them well into adulthood. While some stress is normal, youth ages 15-19 experience the highest rates of emerging depression of any age group. These issues are often exacerbated by the move from high school to college. Recent research has uncovered the fact that 6% of undergrads and 4% of grad students consider suicide while attending university.

How Peer Support Can Help

In the mental health world, peer support programs allow individuals who have already experienced a high level of recovery, to assist others who are not as far along on their journey. Peer supporters use their experiences and successes to help others navigate mild mental health issues. The idea behind peer support in universities is similar. Connecting with peer supporters or mentors can help students feel less alone. It is natural for young people to reach out to friends when they are struggling, but if one has just moved to a new city to attend college, it can be easy to feel swept up in a sea of new faces. Peer support can ground new students and give them a sense of familiarity, someone to ask when they have questions, or even just someone to vent to when they feel overwhelmed. Those who have received support can later return the favor by helping other students. This creates a support network that can benefit everyone involved.  

Peer support can be particularly helpful in the case of first generation college students whose parents are not as adept at offering support as they move through the maze of financial aid paperwork, online course registration, dorm room selection, and maneuvering around campus (or even a new town). Is such cases, peer support can make all the difference. Having the ear and support of someone who has experience with university life and who also understands the stress factors unique to a college student can be reassuring and beneficial.

Making Mental Wellness a Priority

Demand for mental health services is at an all-time high. The evidence is clear: we are experiencing a mental health crisis. The more resources young people have available to them, the better their chances of overcoming anxiety and depression. While peer support cannot replace the help of an experienced mental health professional, it can help ease the stress of transition and provide an extra level of support for individuals struggling with anxiety. Reaching out to others is an important step toward greater wellness.

Sincerely,

Eileen Wynne PhD

References:
http://www.ibtimes.com/how-help-college-students-experiencing-mental-distress-including-suicidal-thoughts-2577859
http://www.thepublicopinion.com/neighbors/spotting-mental-health-issues-in-college-students/article_fb609538-7ea5-11e7-ad32-4fe92fbee05b.html

Signs of an Eating Disorder

In the United States, it is estimated that between 24-30 million teens and adults have eating disorders. Women and girls tend to have eating disorders more frequently than men and boys, but in recent years, the number of males with eating disorders has increased to about 10-15% of the overall number of individuals with eating disorders. Living in a culture that is pretty much obsessed with image, in which magazines and online sources crop and airbrush models and celebrities to perfection, can have an impact on how people see themselves. This can be particularly damaging to emerging adults who are in the process of refining who they are as autonomous individuals. It is between the ages of 12-25 that eating disorders are most common. It can be difficult not to feel hyper-conscious of your body when society is telling you that to be happy and successful, you must look a certain way, it is almost impossible to escape the pressure to look perfect.

While being fit and taking care of the body is very important for good health, sometimes a person can take it too far and become obsessed with how they look, deriving feelings of success and self-worth from appearance. The need for control over the body can lead to anxiety and depression. In fact, about half of people who have an eating disorder also meet the criteria for depression. Eating disorders can be very dangerous, leading to increasing feelings of anxiety and, in extreme cases, death. Of all mental illness, eating disorders have the highest mortality rate.  Eating disorders are especially tricky to deal with because they are not actually about weight or food intake. They tend to be a way of dealing with emotional issues, stress, and anxiety. It may seem like a problem that is easy to fix, but it is more challenging to deal with an eating disorder than you may think, as the root cause is emotional. People with eating disorders tend to use their relationship with food to cope with uncomfortable or painful emotions.

What types of eating disorders are common?

An eating disorder can manifest in many ways. Basically, it is a distorted attitude about food, weight, and body image. You may observe a series of more and more extreme and restrictive diets and obsessive calorie counting. In cases where one eats less and less, becoming more thin and rigid about eating rules, you may suspect anorexia. In other cases, eating disorders can take the form of binge eating followed by the use of vomiting, laxatives, compulsive exercise, or fasting to counteract the effects of the binge. While individuals with this type of cycle, which is called bulimia, often stay about the same weight, the behaviors can be extremely detrimental to the body. Finally, binge eating disorder is an eating disorder in which people compulsively overeat, consuming large numbers of calories, followed by feelings of intense guilt and shame.  

Is it an eating disorder?

If you think the behaviors that you are observing in someone you care about may be an eating disorder, here are a few things to check for. The following list may help you to recognize the clear signs and red flags of an eating disorder. 

Someone with an eating disorder may do the following:

• Exercise all the time, even when they are already exhausted.
• “Compensate” for overeating or drinking too much by exercising, using laxatives, or fasting.
• Seem obsessed with calories, weight, and food intake.
• Avoid gatherings where friends are eating.
• Wear clothing that hides their shape.
• Visit the bathroom after eating or is heard vomiting.
• Buy laxatives often.
• Describe themselves as fat in spite of obvious weight loss.
• Focus and obsess about body parts they don’t like.
• Be competitive with others about minimal food intake.
• Gain weight  without ever eating in front of people.

If you observe several of these signs, you may want to consider discussing them with your friend. Be aware that people with eating disorders can be very uncomfortable talking about them.  Your support and encouraging your friend to seek treatment can make all the difference. Read my next blog post for advice on the steps to take if you suspect that a friend may have an eating disorder. 

Sincerely,

Dr. Eileen Wynne

References

http://kidshealth.org/teen/food_fitness/problems/friend_eating_disorder.html

http://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm

http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

Fighting for the Future: Students in Virginia Help Make Mental Health Resources Available to Everyone

As I noted in my previous blog on this subject, over the last decade, there has been a dramatic rise in mental health issues for students nationwide.  With a quarter of 18-24 year olds estimated to have diagnosable mental illnesses, we really do appear to be having a mental health crisis. An increasing number of colleges and universities are taking positive and responsible action to ensure the safety and well-being of students by setting up mental health centers and providing students with information about additional mental health resources. Still, the relatively limited reach of a university mental health center may not be enough for some students, particularly if they don’t even know the center exists. 

Coping with mental health problems can be extra challenging for emerging adults. Furthermore, dealing with things like anxiety and depression can be downright debilitating without the proper resources. To date, even at colleges and universities where there is a dedicated staff of counselors and psychologists available to offer services through student health centers, the  lingering stigma attached to mental health and the fact that students remain unaware that these resources exist, prevent many students from getting the help they need.

With all of this seemingly negative news on the subject, it is refreshing and inspiring to know that a group of students at UVa (University of Virginia), called the Young Legislators of Tomorrow, brought this issue to the attention of lawmakers in their state. The group introduced a Bill (House BIll 206) requiring universities to provide more and better information about mental health resources to students. 

In 2014, this legislation passed in the House 99-0, making it a huge win for those determined young people trying to raise awareness and make the world a better place for the students coming after them. It is also a victory for all the future students who will be better able to find the help they need as a result. 

According to Virginia’s Legislative Information System, the summary of the bill is as follows: Four-year public institutions of higher education; mental health resources. Requires each four-year public institution of higher education in the Commonwealth to create and feature on its website a page with information dedicated solely to the mental health resources available to students at the institution. (The bill has a delayed effective date of July 1, 2015.)

The combination of the stigma attached to mental health problems and students’ lack of familiarity with the resources available to them has allowed many to suffer needlessly. Thanks to this group of students, the awareness part of that problem is going to be significantly minimized in the future.

Sincerely,

Dr. Eileen Wynne

References:

http://www.newsplex.com/home/headlines/As-Mental-Health-Issues-Rise-at-UVa-Students-Take-Action-246992811.html

http://leg1.state.va.us/cgi-bin/legp504.exe?141+sum+HB206

http://lis.virginia.gov/cgi-bin/legp604.exe?141+sum+HB206

http://college.usatoday.com/2015/01/27/one-students-fight-for-mental-health-awareness-inspires-a-movement/

http://www.activeminds.org/issues-a-resources/mental-health-resources

See yourself through someone else's eyes

Confiding her fears and doubts about her new internship wasn’t easy for my young friend Sarah. Because she feels like an impostor, she has a strong compulsion to hide her fears. After all, confident people who know what they’re doing aren’t afraid of anything, right? Admitting her insecurities would tip everyone off to her fraud.

Of course we know that’s not true. Self-assured, competent people are plagued by the same fears and doubts as everyone else; they just don’t allow those fears and doubts to halt their growth. They accept mistakes as a part of their development, welcoming errors as an opportunity to begin again more intelligently, as Henry Ford once said.

Confessing her fears was Sarah’s first step towards overcoming the limitations imposed by what psychologists refer to as impostor phenomenon. She bravely faced her fear of judgment and made room for the possibility that maybe what she was feeling could be simultaneously normal and irrational. Normal in the sense that an estimated 70% of the population experience impostorism at least once in their lives; irrational in the sense that her reasoning skills, her ability to accurately judge her own value, has been overcome by baseless self-doubt.

I have a strong suspicion that Sarah was awaiting confirmation that the advertising firm had goofed in their records of interviewees. However, by getting her fears out in the open, she was able to face the fact that maybe she was misjudging her future employers’ competence. After all, they didn’t become successful by haphazard hiring practices. 

It’s old hat now to say that the first step towards solving a problem is admitting you have one, but there’s a reason we’ve clung to the saying. It’s true. By sharing her fears, Sarah was able to begin playing with the possibility that they are unfounded, that the problem that she needs to overcome isn’t a lack of intellect or skill, but a burden of self-doubt, that the only person she’s fooling is herself.

That’s the problem with impostorism. The fact is, you got where you are because of your talents and your skills, your efforts and your perseverance. But impostorism feeds you a line about luck and lies. 

Your GPA isn’t a product of a professor’s generosity. Maybe we should give up that old idiom, “My teacher gave me an A.” In fact, in nearly every case that a student receives a high score on a test, it is the totally predictable result of the student learning the material. 

Your boss didn’t hire you based on false pretenses. You earned a degree. You gained experiences. You built a portfolio. 

You did that. You should be proud. While it’s a necessary part of growth to acknowledge your mistakes and weaknesses, it’s equally important to acknowledge your victories and accomplishments. 

If you’re feeling like a fraud, like you just lucked up when you got that promotion or passed that test, try sharing your fears with someone whose opinion you value. Don’t keep it to yourself. Let others help you see yourself the way that they do. It’s not a cure for the impostor blues, but it’s a step in the right direction.

Eileen Wynne, PhD.

References:

Alexander, J., & Sakulku, J. (2011). The Impostor Phenomenon. International Journal of Behavioral Science, 6, 73-92.

Cokley, K., McClain, S., Enciso, A. and Martinez, M. (2013), An Examination of the Impact of Minority Status Stress and Impostor Feelings on the Mental Health of Diverse Ethnic Minority College Students. Jnl Multicult Counseling & Dev, 41: 82–95. doi: 10.1002/j.2161-1912.2013.00029.x

Weir, K. (2013). Feel like a fraud? GradPsych, 11, 24-27.

The impostor's lament

Are high achievers only
fooling themselves?

“I don’t deserve to be here,” Sarah said, fidgeting with the corner of her blouse. 

A talented student with numerous academic accolades under her belt, Sarah had recently interviewed with a successful advertising firm. Though she still had two more classes to complete, the firm was eager to take her on as a paid intern to prepare her for a job upon her graduation the following semester. 

You might expect that Sarah would be brimming over with joy at the prospect, but instead, she felt that she had somehow conned the firm into offering her the position. This, in turn, caused her to doubt her ability to perform the responsibilities that came with her new role. Rather than experiencing the pride of accomplishment, Sarah was experiencing anxiety.

More specifically, she was feeling the pain of a very common phenomenon known as impostor syndrome. Though impostor syndrome isn’t listed in the Diagnostic and Statistical Manual of Mental Disorders as an official diagnosis, its effects are felt by most people at some point in their lives. 

Think about a time when you experienced success. Now consider the following thoughts. 

• I just got lucky.
• I don’t belong here.
• Once they realize I don’t know what I’m doing, they’ll get rid of me.
• I’m not as smart/talented/skilled as they think I am.
• It won’t be long before they figure out I’m a fraud.

Do any look familiar to you? If so, you’ve felt the painful doubts created by the impostor phenomenon.

The irony of impostor syndrome is that high achievers tend to be the most susceptible to it. I see it often in students who have worked diligently, spending hours in studious labor, and in adults who have excelled at their chosen profession through hard work and high expectations. As we transition into new careers or life experiences, we're particularly vulnerable to these feelings of not belonging, of fraudulence. 

While research has shown women and minorities top the charts for these feelings of “passing themselves off” rather than authentically achieving, the phenomenon can be said to be a natural by-product of a society that puts perhaps too much pressure on its individuals to succeed at all costs. 

In schools and homes, we stress to our children the need to achieve, and it may be that the message is received and processed in ways that we don’t anticipate. It may be that we’re sending our children the message that the love, attention, and respect that they crave must be won through constant showmanship. What a heart-breaking idea.

During the next few weeks, I’d like to talk with you about overcoming some of the habits and mindsets that lead to this sense of being an impostor because I suspect that both you and Sarah have something to offer the world that is not only good enough but is much needed.

Dr. Eileen Wynne

References:

Alexander, J., & Sakulku, J. (2011). The Impostor Phenomenon. International Journal of Behavioral Science, 6, 73-92.

Cokley, K., McClain, S., Enciso, A. and Martinez, M. (2013), An Examination of the Impact of Minority Status Stress and Impostor Feelings on the Mental Health of Diverse Ethnic Minority College Students. Jnl Multicult Counseling & Dev, 41: 82–95. doi: 10.1002/j.2161-1912.2013.00029.x

Am I grown up yet?

Am I grown up yet?

This may seem like a funny question to ask. Surely, you must know if you’re grown up, right? Yet I find that’s often the very question that has my patients stumped and stressed out.

In the past, sociologists established pretty hard and fast rules about what makes someone an adult: finishing your education, getting married, having children among them. But do the same rules still apply as our timetables shift ever outward? Many of my young patients must believe they do or they wouldn’t be so worried about where they fall on the scales of adulthood.

It’s a tough road that our emerging adults face. While society has changed rapidly during the past few decades, our expectations have not changed as quickly. Many parents still worry when their children reach thirty and have no spouse or “grownup” job to show for it. Adult children feel the weight of their parents’ stress and wonder if they’ve somehow failed at being a grown up.

Though out-dated assumptions still inform these young adults, the world of possibilities is vastly different than it once was. Technology has created new career opportunities. Changing sexual mores have made alternative relationships more predominant. An ever-shrinking world has broadened their horizons.

Is it any wonder that they’d feel conflicted?

Should I play it safe and follow in my parents’ footsteps? Choose a secure job with benefits now and stick with it through retirement? Or should I experiment with different careers? Or strike out on my own as an entrepreneur?

Should I be on the lookout for a husband or wife? Am I ready to take the plunge? Or should I focus on figuring out who I am first?

Maybe it’s time we re-think what defines an adult. Marriage, parenting, career paths, these are the trappings of particular lifestyle choices, not necessarily eternal standards of adulthood.  

Adults are people who accept responsibility for their decisions. They may not know where they’re going, but they’re capable of weighing many options. They may not own a home, but they feel at home in their own skin and in the world. They may turn to their mentors for guidance, but they make decisions independently.

Adulthood is not a static thing. It is a process. It is the lengthiest phase of our life, and it can be the most rewarding phase, in particular if we give young adults the opportunity to savor it, to experiment with it, and to learn from it.

If you are a young person struggling with the new decisions before you and unsure of how to proceed, consider seeking guidance and insight from a therapist. One hallmark of maturity is knowing when to ask for help. As a therapist and life coach, I am available to listen and to offer an objective perspective as well as much needed support. Let's talk one-on-one about how my coaching and therapy practice can serve you. I can be reached at my Uptown New Orleans office at 504-481-8997.

Dr. Eileen Wynne, PhD