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Campus isn't the most stressful thing

Whether in college or not, young adults have a lot of mental health issues to sort out.

March 02, 2009|Judy Foreman

A troubled, gun-wielding 23-year-old student at Virginia Tech goes on a campus rampage, killing 32 people and eventually himself. An MIT student commits suicide by ingesting cyanide, and another dies in a fire after a drug overdose.

Such highly publicized incidents underscore the sense of personal angst on today's college campuses. But contrary to popular belief, the stress on today's young people has nothing to do with meeting the demands of higher education.

It comes simply with being a newly minted adult.

Whether in college or not, almost half of this country's 19- to 25-year-olds meet standard criteria for at least one psychiatric disorder, although some of the disorders, such as phobias, are relatively mild, according to a government-funded survey of more than 5,000 young adults, published in December in the Archives of General Psychiatry. The study, done at Columbia University and called the National Epidemiologic Survey on Alcohol and Related Conditions, found more alcohol use disorders among college students, while their noncollegiate peers were more likely to have a drug use disorder. But, beyond that, misery is largely an equal-opportunity affliction.

Across the social spectrum, young people in America are depressed. They're anxious. They regularly break each other's hearts. And, all too often, they don't get the help they need as they face life's questions: "Who will I be? Will I make friends? The romantic relationships, planning for the future . . . there is all kinds of stuff going on at the same time, including raging hormones," says Ronald Kessler, a medical sociologist at Harvard Medical School.

Some evidence suggests that college students may even be less miserable than non-students their same age. Suicide -- the third leading cause of death for teenagers and young adults, according to the federal Centers for Disease Control and Prevention -- is one-third lower among the college than noncollegiate set, says Dr. Paul Barreira, a psychiatrist who is director of Behavioral Health and Academic Counseling at Harvard University Health Services.

The reason is not entirely clear, but studies have shown that, generally, higher education is often linked with better mental health. Mood disorders such as depression and anxiety affect slightly fewer college students than noncollegiate peers, researchers say.

And the biggest cause of despair? Even among college students, it's not academics, but love that hurts most. Emotional problems were more than twice as common among students who had recently had a major loss -- typically a romantic breakup -- than among those who had not, says Dr. Mark Olfson, the Columbia University psychiatrist who led the research for the National Epidemiologic Survey on Alcohol and Related Conditions.

The universality of youthful angst may come as a surprise in light of tragic college incidents. But to the experts, it makes perfect sense.

For one thing, early adulthood is the time when serious psychiatric problems such as bipolar disorder and schizophrenia often surface. For another, unhappiness in general follows a U-shaped curve, with the greatest unhappiness among young and very old adults, according to Kessler, the Harvard medical sociologist.

For the young, the trick is navigating a steep developmental curve -- figuring out who you are; getting work, family and finances on track; and generally stumbling toward independence.

An open question is whether life has always been this way for the young, or whether psychological problems are on the rise.

A 2006 survey of directors of college counseling centers suggests things are getting worse. But Dr. Andrew Leuchter, a psychiatrist and associate dean of the David Geffen School of Medicine at UCLA, says, "We don't know to what extent kids are having more difficulties and to what extent we are much better at recognizing and diagnosing them."

Barreira of Harvard agrees. "Most college counseling people would say students are more depressed today. But my hypothesis is that we're looking for it more and better at diagnosing it in high school. More students are showing up in college on medications -- they've been successfully treated so that they can get into good colleges."

For its part, Harvard is conducting a multi-year survey of mental health among incoming freshmen. And UCLA, despite general financial austerity, has launched a new initiative to help students with psychological problems.

That said, the Columbia study suggests that mental-health treatment is actually better outside the ivy-covered walls. While only 1 in 20 college students with psychological problems gets treatment, 1 in 10 of same-age non-students gets help. It's not clear why, says Olfson, the Columbia University psychiatrist.

"College students may be more concerned" that if they seek help they might jeopardize career opportunities or academic achievement, Olfson says, though he adds that, even so, "colleges should make more of an effort to make services available and acceptable, particularly for alcohol use problems."

Worried parents can help, too, whether their offspring are in school or in the job market. They can reassure their sons and daughters that it's not necessary to get all A's or move like lightning up the job ladder.

And perhaps most important, that broken hearts usually do heal.


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