The rise in depression among college students (and how to help)

College is liberating, fun and exciting, right? Not for everybody. In the fall of 2020, 47% of college students reported depression and/or anxiety, according to a University of Michigan Healthy Minds Study. And a recent survey of freshmen at the University of North Carolina at Chapel Hill found a 48% increase in the rates of moderate to severe depression since the pandemic began.

It’s no wonder, considering the challenges of living and learning in a COVID-19 world, plus the usual pressures of college: being away from home for the first time, economic stress, social concerns and academic demands.

But there are effective ways are available to not only cope with depression once it’s started, but also to head it off. Here’s what students and parents can keep in mind to help navigate this important life stage.

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Depression is a mood disorder that negatively affects emotions, thinking and how you act. It can happen to anyone. But for college students, especially freshmen, certain issues they experience can make them more vulnerable to depression. Here are some factors that can set the stage for depression or worsen a mild case.

• The pandemic. “There’s a lot of worry and anxiety over COVID. Am I going to get it? Is one of my parents going to get it?” says Ann Kearney-Cooke, PhD. She’s the director of the Cincinnati Psychotherapy Institute in Ohio. In a 2020 survey, 71% of Texas college students said they had increased stress and anxiety because of COVID-19. They reported fear and worry about their health and the health of loved ones. They also cited decreasing social interactions due to physical distancing and difficulty concentrating. 
  
  And even though cases have been coming down recently, COVID anxiety can linger. 

• Isolation from family. “For students who have moved far away from home, it can be hard not having family and friends nearby,” says Melissa Hopper, PsyD. She’s a clinical associate professor in the department of pediatrics at the KU School of Medicine-Wichita in Wichita, Kansas. “There can be increased feelings of loneliness as the students try to find their place in the larger college community.”

  Relationship issues with friends and significant others can compound this sense of disconnection, says Kearney-Cooke.

• Academics and the outlook for their future. Concerns over grades can also contribute to depression, says Kearney-Cooke. “Students might need to take courses in areas that they may not think they are good at,” she says. That struggle can impact self-esteem and trigger depression or anxiety.

  And looming large is how classes and grades can affect life after college: Students also may feel pressure to figure out their career and “life plan,” Hopper says. Making important career decisions can feel overwhelming, as it may make the future seem more uncertain.

• Lack of sleep. Worries about all sorts of things, including money, relationships and academics, can affect sleep. Not getting enough shut-eye can make it harder to regulate your emotions and leave you more vulnerable to depression. Even one night of poor sleep can affect mood. One study from Johns Hopkins found that people with sleep interruptions experienced a 31% decrease in positive moods the next day.

Signs that you might have depression

Remember that it’s normal to feel overwhelmed and even sad while at college, Hopper says. “College is a time of many transitions,” she says. Experiencing stress and disappointment doesn’t necessarily mean you have depression. That said, here are some signs that you may be drifting into depression territory:

• Feeling very down most of the time
   
• Feeling emotionally numb and unable to experience joy in ways you used to (this is also called anhedonia)
   
• Physical fatigue or lack of energy almost every day with no other obvious reason for it
   
• Feelings of hopelessness, worthlessness or excessive guilt almost every day
   
• Difficulty concentrating
   
• Thoughts or talk of suicide (if you’re experiencing these specific symptoms, call the National Suicide Prevention Lifeline at 1-800-273-8255, or go to suicidepreventionlifeline.org/chat for a live chat)

“If you start to find that your negative feelings are affecting how you function, I recommend seeking help,” says Hopper.

How to get help for college depression

Most colleges have mental health services for students. But many students are reluctant to seek professional help.

“The student may think that it’s seen as a sign of weakness and that only weak people ask for help,” says Kearney-Cooke. But they should know that seeking care for mental well-being is just as valid as going to the doctor for a physical issue such as a muscle strain. Both are normal and acceptable.

Even if a student does reach out to campus mental health resources, increased demand may make it hard to get immediate help. Many colleges are struggling to meet the mental health needs of students, and while institutions have been putting more funding toward mental health over the years, it often still isn’t enough to provide help for every student who needs it.

Students can spend days waiting for an appointment. Some colleges don’t have mental health counseling, period. In fact, 21% of 2-year colleges in the U.S. provide no mental health services, according to a 2020 survey by the American Council on Education.

Students seeking help off campus — because their college doesn’t provide the service or resources are stretched thin — may struggle with not having transportation, Hopper says. Insurance coverage may add another obstacle.

One helpful solution is teletherapy, which can be a great resource for college students, says Hopper. For one, “it means that you don’t have to travel to see a provider,” she says. It’s also much more popular now than it was pre-COVID,” she adds. “But finding a private location to have your appointment can be a challenge if you share a dorm room.”

If you or a student you know needs help right away, you can make a virtual appointment now with an Optum network therapist, from anywhere.

How parents can help

While depression often comes with clear and common signs (see above), the condition doesn’t always show up as sadness and crying. Parents should watch for other mood changes or even physical complaints.

“A depressed [college] student also can be very irritable and angry,” Kearney-Cooke says. If your child seems testier or more brooding than normal or is complaining of general fatigue or an inability to concentrate, you should consider that your child may be depressed, she suggests.

Try initiating a conversation from a curious, non-judgmental mindset. Start by noting something you may have observed about their behavior and ask a follow-up question, she recommends. “It’s also okay to ask your child if they’re feeling depressed or overwhelmed,” Hopper says.

If you believe your child is experiencing ongoing sadness or irritability, they should seek professional help, Hopper says. “When the negative feelings affect their academic, social, physical and even financial functioning, they should get help.”

Suggest that they connect with their resident adviser or college counseling center. And recommend that they spend time with friends. “It’s all too easy for students who are depressed to isolate themselves,” Kearney-Cooke says. “Encourage them to go to events so they have something to look forward to, or to plan or attend a study group at the local coffee shop.”

If your child is diagnosed with depression, they’ll probably need ongoing treatment. So traveling back and forth from home typically isn’t realistic. Help your college student find a mental health provider to rely on going forward, whether that’s at school, in the town where the school is or virtually. 

If your child seems reluctant to make a phone call to get help, you may be able to schedule an appointment for them. But be aware that due to confidentiality laws, the college won’t give you information about your child’s health unless the student has authorized the school to do so.

Also, if your son or daughter is already on medication for depression, stopping it before going to college isn’t recommended. It can be risky because the first year of college is stressful for many students. It’s never a good idea to stop cold turkey either. If they want to stop gradually, they should be monitored during the process.

One of the best things a parent can do is listen, says Kearney-Cooke. “Let your student know that you hear them,” she says. “Help them focus on the choices that they have made that they feel good about.”

Keeping perspective is key, too. Students may not realize that it can take a year to make friends at college, says Kearney-Cooke. “Perfection does not exist,” she says. “Remind your student of this.”
 

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Additional sources
University of Michigan Healthy Minds Study: University of Michigan (2021). “Anxiety, Depression Reached Record Levels Among College Students Last Fall.”

Covid-19 survey data:
• PLOS ONE (2021). “The Covid-19 Pandemic and Mental Health of First-Year College Students”
• Journal of Medical Internet Research, 2020 “Effects of COVID-19 on College Students’ Mental Health in the United States”

College kids and depression tips: Child Mind Institute (n.d.). "Helping College Kids with Depression"

Mental health services at 2-year colleges: American Council on Education (2020). “College and University Presidents Respond to COVID-19: 2020 Fall Term Survey, Part II”