By Jane Hurst with the assistance of Dr. Carlo Carandang
As a college student, you experience a number of stressors, such as living independently from your parents, keeping up with the rigors of your college courses compared to your high school courses, managing your time adequately, managing a budget, balancing your checkbook, figuring out what you want to do for the rest of your life, deciding on a major, worrying about getting a job after graduation, and managing your intimate relationships. When you are not able to cope with all these stressors, you begin to feel burnt-out (or stressed-out) and wonder if you will be able to continue with your studies in college. Eventually, if you do not handle these stressors adequately, you may go on to develop anxiety and/or depression. So having stress is part of college life…if you are resilient, then you will do just fine and may even benefit from all the stressors to push you to higher achievements. However, for those with maladaptive coping skills, the stressors can trigger you to develop anxiety and/or depression.
What is Anxiety?
Anxiety is characterized by worry, nervousness, or fear when you are exposed to a feared situation, person, or object. Anxiety disorders develop when you become fearful, worried, or nervous:
- out of proportion to the feared stimulus;
- in anticipation of being exposed to the feared stimulus; or
- when the feared stimulus is no longer present.
In addition, anxiety triggers the fight or flight response, which results in the release of adrenaline and is responsible for the physical symptoms of anxiety:
- muscle tension
- increased heart rate
- increased breathing
- butterflies in the stomach
- lump in the throat
There are 6 major anxiety disorders, and each has characteristic symptoms:
- Generalized anxiety disorder (GAD)– GAD is characterized by generalized worry about everyday events.
- Social phobia– It is also known as social anxiety disorder (SAD). SAD is characterized by fear of social scrutiny, or fear of being embarrassed when in front of people or when performing. Performance anxiety, such as stage fright, is a type of social phobia.
- Specific phobia– This is characterized by extreme fear of an object, person, or situation, such as fear of heights, flying, spiders, snakes, etc.
- Panic disorder– This is characterized by panic attacks, and you anticipate having the next panic attack.
- Obsessive compulsive disorder (OCD)– OCD is characterized by having recurrent, intrusive thoughts (obsessions) with compensatory actions/behaviors (compulsions) that decrease the anxiety associated with the obsessions.
- Post traumatic stress disorder (PTSD)– PTSD occurs after a life-threatening trauma, and it is characterized by re-experiencing the traumatic event through flashbacks and nightmares. In addition, you have hypervigilance and you are on guard all the time for any further danger in the environment. Finally, you try to avoid any reminders of the traumatic event.
What is Depression?
Depression is characterized by:
- low moods
- loss of pleasure in things
- sleep disturbance
- feelings of guilt or hopelessness
- low energy level
- poor concentration
- poor appetite
- being slowed down or revved up
- suicidal ideations
When triggered by stressors, a depressive disorder can develop, known as major depressive disorder (MDD). MDD, like anxiety disorders, will cause significant impairment to your functioning in college and your relationships. Additionally, MDD and anxiety disorders can co-exist at the same time.
Treating Anxiety and Depression
Fortunately, there are effective treatments for anxiety and depression. The treatments for anxiety and depression are similar:
- Psychotherapy– First line treatment for anxiety and depression is psychotherapy, or talk therapy. The most studied form of psychotherapy shown to be effective for anxiety and depression is cognitive behavioral therapy (CBT). CBT works on the premise that your thoughts about a situation cause you to be anxious or depressed, and it is not the situation that makes you sad or anxious. Also, your anxiety or depression can be made worse by your avoidant behaviors. CBT helps you to become less anxious and depressed by changing to more adaptive ways of thinking about a situation, and by addressing the avoidant and safety behaviors.
- Medication– Prescription medication treatment is last resort treatment for anxiety and depression. Prescription medication should only be prescribed when you do not response to CBT, or if you have a severe case of anxiety or depression. Contrary to what the drug companies advertise, their products should only be used as a last resort- when more benign and conservative treatments have been tried first.
- Self-help– You can also help yourself to get over anxiety and depression. There are many things you can do, including yoga, exercise, reading AnxietyBoss by Dr. Carlo Carandang, following a balanced diet, and getting plenty of sleep. You should also avoid too much caffeine and alcohol. Identify your stressors, and keep track of them by writing things down in a journal. Join a club or find a hobby to take your mind of things, and finally, find someone to talk to.
The article was written by Jane Hurst and revised by Dr. Carlo Carandang, MD, an anxiety expert. Dr. Carandang is a Fellow of the American Psychiatric Association, and he has a medical license from Washington State.