It is only in sorrow bad weather masters us; in joy we face the storm and defy it. —Amelia Barr, British author

Mental Health Basics

Knowing how to take care of your mental health when you’re in college is just as important as maintaining your physical health. In fact, there’s a strong link between the two: doctors are finding that positive mental health can actually improve your physical health.

Mental health can be defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”^[1] Having good mental health doesn’t necessarily mean being happy or successful all the time. Most people feel depressed, lonely, or anxious now and then, but those with good mental health can take these feelings in stride and overcome them. When such feelings or moods persist and interfere with a person’s ability to function normally, though, it may be a sign of a more serious mental health problem and time to seek help.

The term mental illness refers to mental disorders or health conditions characterized by “alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.”^[2] Depression is the most common type of mental illness, and it affects more than 26 percent of the U.S. adult population. It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease.

Evidence has shown that mental disorders, especially depressive disorders, are strongly linked to the occurrence of many chronic diseases, including diabetes, cancer, cardiovascular disease, asthma, and obesity. It has also been linked to many risk behaviors for chronic disease, such as physical inactivity, smoking, excessive drinking, and insufficient sleep. In other words, if your mental health is poor, you may be at greater risk for disease and poor physical health.

Mental Health Indicators

In the public health arena, more emphasis and resources have been devoted to screening, diagnosis, and treatment of mental illness than to maintaining mental health. Little has been done to protect the mental health of those who are free from mental illness.

There are some known indicators of mental health, including the following:

• Emotional well-being: life satisfaction, happiness, cheerfulness, peacefulness
• Psychological well-being: self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one’s environment, spirituality, self-direction, and positive relationships
• Social well-being: social acceptance, belief in the potential of people and society as a whole, personal self-worth and usefulness to society, and a sense of community

The former surgeon general suggests that there are social determinants of mental health—just as there are social determinants of general health—that need to be in place to support mental health. These include adequate housing, safe neighborhoods, equitable jobs and wages, quality education, and equity in access to quality health care.

There are also some common-sense strategies that you can adopt to support and improve your emotional, psychological, and social health. Not surprisingly, they are very similar to strategies that help us cope with stress:

• Eat a balanced diet
• Get enough sleep
• Get regular physical activity
• Stay socially connected with friends and family
• Make smart choices about alcohol and drugs
• Get help if you are anxious or depressed

Depression

Depression is a common but serious mood disorder that’s more than just a feeling of “being down in the dumps” or “blue” for a few days. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

• Persistent sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Depression is one of the most common mental disorders in the United States. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. It usually starts between the ages of fifteen and thirty and is much more common in women. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter, when there is less natural sunlight. Depression is also one part of bipolar disorder.

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two.

There are days that you will feel down, especially when the demands of college get to you. These feelings are normal and will go away. If you are feeling low, try to take a break from the pressures of college and do something you enjoy. Spend time with friends, exercise, read a good book, listen to music, watch a movie, call a friend, talk to your family, or do anything else that makes you feel good. If you feel depressed for two weeks, or the feeling keeps coming back, you should talk to a counselor in the Counseling Center. They see lots of students who are anxious, stressed, or depressed at college.

Loneliness

Most people experience occasional loneliness, and it’s an especially common experience among first-time college students who find themselves in an unfamiliar environment with a completely new social scene. Loneliness isn’t necessarily about being alone—you can be surrounded by people and still feel alone. It’s the feeling of being alone that counts, along with feeling empty, unwanted, or isolated. In the following Ted Talk, Sherrie Turkle describes how, in this age of near-constant digital “connection,” loneliness is a challenge that all of us face:

If you’re feeling lonely, try taking Turkle’s advice and start a conversation with someone. College is a great place to meet new people and develop new and interesting relationships. Others in college are new, just like you, and will welcome the chance to connect with and get to know another classmate. Try joining a campus interest group or club, play a team sport, or ask another student if they’d like to meet for coffee or to study.

Too Much Social Networking

It’s pretty obvious that social media is an integral part of the social landscape in college. From tweeting about a football game, to posting an album on Facebook about your spring break, to beefing up your LinkedIn profile before a job hunt, to Instagramming pictures of parties, social networking is everywhere in college, and it’s likely to stay.

Despite the many benefits, as you know, social networking can be a major distraction. If social networking is getting in the way of any part of your college success, whether its social or academic success, take a break and disconnect for a while.

Here are ten reasons why you may wish to step away from social media, at least temporarily: When It’s Time to Unplug—10 Reasons Why Too Much Social Media Is Bad for You.

Anxiety Disorders

People with anxiety disorders respond to certain objects or situations with fear and dread. They have physical reactions to those objects, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if a person:

• Has an inappropriate response to a situation
• Cannot control the response
• Has an altered way of life due to the anxiety

Anxiety disorders include, but are not limited to, the following:

Panic disorder is a kind of anxiety disorder that causes panic attacks. Panic attacks are sudden feelings of terror for no reason. You may also feel physical symptoms, such as

• Fast heartbeat
• Chest pain
• Breathing difficulty
• Dizziness

Panic attacks can happen anytime, anywhere and without warning. Some people live in fear of another attack and may avoid places where they had an attack. Fear takes over their lives and they cannot leave their homes.

Panic disorder is more common in women than men. It usually starts when people are young adults. Sometimes it starts when a person is under a lot of stress. Most people get better with treatment, and therapy can show you how to recognize and change your thinking patterns before they lead to panic. Medicines can also help.

Post-traumatic stress disorder (PTSD) is a real illness. You can get PTSD after living through or witnessing a traumatic event like war, a hurricane, rape, physical abuse, or a bad accident. PTSD makes you feel stressed and afraid after the danger is over. It affects your life and the people around you. PTSD can cause problems like

• Flashbacks or feeling like the event is happening again
• Trouble sleeping or nightmares
• Feeling alone
• Angry outbursts
• Feeling worried, guilty, or sad

PTSD starts at different times for different people. Signs of PTSD may start soon after a frightening event and then continue. Other people develop new or more severe signs months or even years later. PTSD can happen to anyone, even children.

Medicines can help you feel less afraid and tense. It might take a few weeks for them to work. Talk therapy with a specially trained doctor or counselor also helps many people with PTSD.

Suicidal Behavior

Suicide causes immeasurable pain, suffering, and loss to individuals, families, and communities nationwide. On average, 112 Americans die by suicide each day. Suicide is the second leading cause of death among 15 to 24-year-olds, and more than 9.4 million adults in the United States have had serious thoughts of suicide within the past twelve months. Suicide is preventable, so it’s important to know what to do.

Warning Signs of Suicide

If someone you know is showing one or more of the following behaviors, he or she may be thinking about suicide. Don’t ignore these warning signs. Get help immediately.

• Talking about wanting to die or to kill oneself
• Looking for a way to kill oneself
• Talking about feeling hopeless or having no reason to live
• Talking about feeling trapped or in unbearable pain
• Talking about being a burden to others
• Increasing the use of alcohol or drugs
• Acting anxious or agitated; behaving recklessly
• Sleeping too little or too much
• Withdrawing or feeling isolated
• Showing rage or talking about seeking revenge
• Displaying extreme mood swings

Resources

OK2TALK is a community for young adults struggling with mental health problems. It offers a safe place to talk.

Lists of additional resources are available in Activities & Resources sections of this chapter.