Jessica A. Gold is an assistant professor in the Department of Psychiatry at Washington University in St Louis and a staff psychiatrist at Habif Health and Wellness Center.
In a few short weeks, many students will arrive on campus for the first time. Like any transition, starting college can be stressful. For some, it is their first experience away from home or with this much independence
College is exciting in many ways and allows students to explore their identities outside the confines of their families as they grow into their adult selves. Yet, exploration often brings social pressures to conform, and college students can struggle with issues of work/life balance, impostor syndrome (doubting one's accomplishments, particularly in comparison to others' perceived successes), and the pressure to sleep less, socialize more, and experiment with drugs and alcohol.
Young adults in college, particularly international students who may live thousands of miles from home, may also feel disconnected from their prior social support system as they encounter new people, values, and life experiences.
In addition to the changes that are a part of normal development and major life transitions, college students are at risk for developing mental illness. The stress of school may exacerbate existing conditions, and the onset of some psychiatric disorders — including serious ones like schizophrenia and bipolar disorder — typically happens before the mid-20s; some even peak during the college years. As such, prevention and recognizing the warning signs of deteriorating mental health are key to maintaining a healthy lifestyle.
While the transition to college can be challenging, most students eventually acclimate to their new surroundings. As a mental health provider on a college campus, I compiled some tips to help you make a smooth transition to college and maintain balance and well-being as a student.
1. Prioritize Your Sleep
Seemingly every day I advise students to sleep more and work less. It often feels like there are not enough hours in the day for college students to do everything they want to do, whether that means going to class, studying, socializing, working, sports, or other extracurricular activities. In this atmosphere of constant activity, sleep is often the first thing to go.
In college, it is almost a badge of honor to "pull an all nighter." It doesn't matter how cool it may be or how many more hours you could spend studying by staying awake, getting enough sleep is critical to your health and well-being in college. Without good sleep, you are at risk of developing both physical and mental illness, and you also become less able to function in all those areas you wanted to excel in in the first place (in particular, school).
You can often improve your sleep by practicing better sleep hygiene. Below are some practical tips to help you get a better night's sleep.
- Go to sleep and wake up at the same times every day
- Don't drink caffeine too late at night
- Avoid napping during the day
- Use your bed only for sleeping
Exercise can help with your sleep and also improve your overall wellness. Among students I see, their relationship with exercise varies significantly. Some students exercise to relieve stress, and even when they are very busy, will prioritize fitting it in. Others will let it be one of the first things to drop off when they get busy or overwhelmed.
If you are in the first category, be sure you are using exercise as a healthy coping mechanism and that you are not over-exercising to the point of hurting yourself or losing too much weight. If you belong to the second category, I recommend finding ways to incorporate exercise, even if it is just a walk around campus, when you are feeling stressed out.
3. Eat a Balanced Diet
Eating healthy in college can be a challenge when relying on dining halls instead of home-cooked meals, or when your finances limit your food options. The Center for Young Women's Health and Nutritious Life provide useful guides for how to evaluate your food options.
One key to healthy eating is to be aware that with odd studying hours and class schedules, you might get hungry. Get used to carrying healthy snacks that you like.
If you are a person who has struggled with eating, college can be a particularly triggering time. This is because restricting what you eat, binge eating, or purging is often about control and self-esteem. When you are stressed with school or sports, you can feel both out of control and bad about yourself.
If you notice you begin to resort to unhealthy patterns of behavior you had before college or you develop new ones, you should contact the student health center and they can help you get seen by nutrition, primary care, and/or mental health professionals. This is something you should do right away as eating disorders are some of the most dangerous illnesses we see.
4. Take Time for Self-Care
Yes, you are in college to learn and make new friends and experience new things, but it is easy to forget yourself in the equation. This can lead to worsening wellness and health overall. No matter how busy you are, you need to learn to schedule time to do something you will enjoy or that relaxes you. Some might enjoy a massage, going to a movie, or doing a hobby; others might prefer yoga or mindfulness. Students can greatly benefit from focusing on the here and now, particularly when anxious, and can improve their skills with meditation apps like Headspace.
5. Understand the Risks of Substance Use
College students struggle with the pressures to use and experiment with drugs and alcohol. This is particularly true given the normalization of binge drinking on college campuses, shifting attitudes towards marijuana use, and the prevalent use of JUUL and other e-cigarettes.
It is important that students understand the real risks associated with drug use and are making informed, not socially determined, decisions. For example, while students may think that marijuana is harmless, it carries many risks, particularly to mental health. As such, it is important that students monitor their behaviors and frequency/amount of use. It is also helpful for students to socialize outside of the parties and consider fun ways to be with their friends in substance-free ways.
6. Know About Sexual Health and Safety
When talking about health in college, sexual health cannot be neglected. Students should practice safe sex and understand methods of protection and birth control, as well as where and how to access STI screenings at a college health center.
Additionally, students should talk about consent and safety in intimate relationships. Sexual assault is, unfortunately, extremely common on campuses. Some schools have bystander trainings, which arm students with resources to help their peers in the moment. It can also help for students to familiarize themselves with reporting mechanisms on campus and their mental health treatment options, particularly for trauma.
7. Become Health Literate
One of the biggest struggles for students when it comes to wellness and managing their mental or physical health is that, for the first time, they have to do it completely on their own. This means they must make their own appointments, understand what is being said, ask their own questions, and take and refill their own medications.
Ideally, before arriving at school, health literacy should be something students talk about with their parents, especially if they are already on medication. Students can benefit from this conversation even if they don't have any health issues, as I cannot tell you the number of students who do not understand how to ask a doctor for a refill and simply run out of medication instead.
Understanding Mental Illness and How to Get Help
As a student health psychiatrist, I know that mental illness is not only common in college students, but the severity and need is increasing. If a friend in your peer group is struggling, it can also be difficult not knowing how to help them. Mental health challenges can be debilitating to you and your goals, as you may struggle socially and academically when your mental health worsens. Read on to learn more about how you can help yourself and your friends.
Know the Signs and Symptoms of Mental Illness
Besides changes in sleep and eating patterns, which are warning signs of worsening mental health, you may notice changes in behavior, such as not wanting to socialize or engaging in risky behaviors. You may also notice changes in mood and even speech, such as when someone is talking really fast or maybe they are "all over the place" in what they are saying. If you are noticing subtle changes to how you are feeling, track them using a worksheet like this one provided by Therapist Aid or on an app. If it feels like your mood is constantly changing or interfering with your life, get help! If you ever want to learn more, you can always turn to trusted resources like the National Alliance on Mental Illness or the American Psychological Association.
Know How, and Be Willing, to Get Help
Familiarize yourself with the resources available on campus that can help you cope with mental health challenges. A good place to start is the website of the student health center, which may have resources for dealing with crises and routine needs, such as therapy, psychiatry, group therapy, and online programs. Often, students struggling with their mental health wait too long to get help, coming in when their symptoms are already quite severe and more difficult to treat. It is better to use the system in a preventive manner. In the case of an emergency, however, familiarize yourself with the suicide hotline number (there is even a specific one for trans students) and other crisis resources.
Access Learning Resources on Campus
Many students, particularly those with learning disabilities or ADHD, require accommodations to better succeed in college. This may mean extra time on tests, or testing in a quiet environment, which can be key to academic success in college. For students who previously had high school accommodations, they should contact this office before school even begins to learn how the college can help. For others, particularly with new diagnoses, this is something they should be aware of, learn more about, and ask/advocate for. Often these centers can help with organization and tutoring in addition to testing and note-taking help.