Information for Parents: Helping a College Student with an Anxiety Disorder

What is an anxiety disorder?

Anxiety disorders are a unique group of illnesses that fill people's lives with persistent, excessive and unreasonable anxiety, worry and fear. They include generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder (SAD) and specific phobias. Although anxiety disorders are serious medical conditions, they are treatable.

How common are anxiety disorders in college students?

Anxiety disorders are the most common mental health disorder in children, adolescents and adults. 40 million American adults - over 18 percent of the population - suffer from an anxiety disorder each year. According to the National Institute of Mental Health (NIMH), almost 75 percent of those with an anxiety disorder will experience their first episode before they are 22 years old, making awareness of these disorders among college-aged students and their parents essential.

For many of the individual anxiety disorders, the age of onset often falls during the college years. The median age of onset for OCD is 19, agoraphobia is 20, and PTSD is 23 years of age.

What special circumstances exist for college students with anxiety disorders?

As mentioned above, students are faced with emotional, physical, financial and other life changes during college. While the stress of these events do not cause anxiety disorders, they can serve to make the symptoms of an anxiety disorder worse or can trigger an anxiety disorder in someone who is pre-disposed.

In addition to these challenges, many aspects of a student's lifestyle changes once he or she is away from home - which can also affect his or her mental health. Unhealthy and irregular eating and lack of adequate sleep - along with increased use of caffeine - can exacerbate anxiety problems. Alcohol and substance use - extremely common among college students - may trigger anxiety symptoms and panic attacks, interfere with medication a student may be taking for anxiety or lead a student to alter the use of his/her medication as he/she sees fit (i.e., "I want to drink tonight, so I'm not going to take my medication"). This can be a dangerous habit. Parents should help educate students about the effects their lifestyles can have on their anxiety disorder, as well as the complex issues surrounding anxiety disorders and alcohol/substance use.

What are the consequences of not treating an anxiety disorder in a college student?

Serious consequences can result when anxiety disorders in college students go unrecognized and untreated. These students may isolate themselves from their peers, have difficulty in their classes or drop out of school completely. In fact, panic disorder is frequently cited as a top reason for women dropping out of college.

If left untreated, anxiety disorders can also lead to the development of secondary conditions such as depression and substance abuse. The good news is that research shows early intervention for an anxiety disorder can prevent the onset of depression and other secondary conditions.

In extreme cases, students with anxiety disorders may attempt suicide. Studies suggest that several symptoms of anxiety disorders, including severe anxiety, panic attacks, agitation and insomnia, are predictors of suicidal behavior. Two anxiety disorders - panic disorder and agoraphobia - are specifically associated with increased risks of suicidal ideation and attempts. This makes it crucial for parents to pay attention to the fears and anxieties their child is expressing when he/she calls home. Tips for helping a child who you think may be experiencing anxieties beyond those that are part of the normal college transition are included later in this piece.

What barriers prevent college students from seeking help?

Stigma, embarrassment, not knowing their symptoms are treatable or where to turn for help, "self-medication" with drugs and/or alcohol, and financial concerns regarding treatment can all be roadblocks to seeking help. Parents can be an essential resource for educating their child on how and where to find help in the face of such barriers. Some tips for parents are included in the next section.

What can a parent do to help their college student with an anxiety disorder?

It can be difficult for a parent to know how to help and what their role is once a child leaves for college. However, parental support is extremely important for college students, especially those who may be dealing with an anxiety disorder. Below are tips for helping your child.

• Be an active listener - lend an open ear when you child is feeling stressed or overwhelmed. Listen to what he or she says, as well as to what is not said (i.e., is there no mention of friends, social activities, etc?). Respect his or her feelings even if you don't understand exactly what he/she is going through. This will encourage your child to start talking and serve as a source of comfort when he or she is feeling overwhelmed.

• Educate yourself about the differences between normal stress and anxiety versus an anxiety disorder - this will help you learn what to listen and look for.
• Encourage participation in social, sports and other extracurricular activities - these can help to relieve stress, assist young people in making new friends and build self-esteem.

• Explore opportunities for seeking help - if you think anxiety is affecting your child's daily life, investigate what mental health and other treatment options are available on campus and in the local community. Call the counseling center to inquire about the availability of individual counseling sessions, group counseling, support groups and referrals to local off-campus centers, and the payment issues surrounding the use of these resources (many schools offer these for free or reduced cost). If your child is still on your insurance, find out what kind of mental health coverage is available.

• Share what you find with your child - once you've accumulated information about getting help, pass it along. Having the information available will give your child the option to get help when he or she feels ready.

• Be patient if your child doesn't seek help right away - sometimes it takes a while for a person to take the first step. It's important especially for teenagers that they feel treatment is their decision.

• Provide your child with resources that let them know that he or she is not alone and can be helped - the ADAA college program Got Anxiety? provides young people with information on anxiety disorders; how to manage stress and anxiety; personal stories from college students; treatment options for anxiety disorders; and a variety of other resources. Visit www.gotanxiety.org for more information.

Where can a college student seek help, especially if they are away from home?

The college counseling center is often the best place for a child to seek help. However, the services offered can vary dramatically based on the school. ADAA's recent study found national universities are three times as likely to offer professionals who specialize in treating anxiety disorders than liberal arts colleges. Of course, this is an overall figure and some national universities may not offer this, while some liberal arts colleges may. It is important that parents know how their child's college counseling center can assist him or her. The next section identifies specific questions a parent can ask a school about the counseling services available on or near campus.

Many online resources are also available to students suffering from an anxiety disorder. These are often a good first step for students to seek help. ADAA's college site - www.gotanxiety.org - is a valuable place to refer students to help them determine whether their anxiety is normal or may be a sign of an anxiety disorder. The web can also be used to help find support groups, chat rooms and message boards for people with anxiety disorders, and more. Most students are savvy at finding this information online after this suggestion is offered to them.

What questions should parents ask a college before their student gets to campus about mental health resources?

During college tours and the college application/admission/decision process, parents often ask questions about everything from financial help to class size to the dining hall options. However, many parents do not ask questions about the mental health resources available to students once they arrive on campus - a major oversight that doesn't occur to many parents with all the other variables involved. This could be one of the most important - if not the most important-factor in the success of a child in college, particularly if he or she has an anxiety disorder or other mental health problem. Parents should ask a school the following questions to assess whether it will adequately meet the needs of a student struggling with stress and anxiety, an anxiety disorder or other mental health problem:

• Do you offer free counseling sessions to students - individual and/or group? How many and at what frequency? If not, how much do sessions cost?
• Do you accept private insurance for counseling or psychiatric services?
• Do you offer health insurance to students? If so, what psychiatric services are covered?
• Do any employees at your center specialize in treating anxiety disorders?
• What services specifically for anxiety disorders (i.e., support groups, relaxation techniques, stress management resources, etc.) do you offer?
• Is there a counselor on call 24 hours a day? If no, what is the process for handling crises after hours?
• Does the college run a suicide hotline?
• Under what conditions (if any) would the counseling center notify parents of a student's mental state or treatment?
• What kind of follow-up do you conduct if a faculty member, parent or friend expresses concern about a student?