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State of Mind 

In ever-demanding academic environments, student mental health concerns on campuses are becoming increasingly more acute, in both frequency and severity

click to enlarge Hang in there.

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Hang in there.

It's a hard life out there these days.

There is little means of escape, it often seems, from the pressure cooker that is our frightening global context, fed by increasingly violent wars and human suffering, fueled by the bubbling intolerance and fear that can only come when people split further apart on the spectrum of thought and opinion. And like whistling, searing steam rattling from the bottom of our collective lid, comes the constant flow of rhetoric from a multitude of media and platforms, many of it undiscerning but all of it accessible with a proper Internet connection.

For today's college student dealing with the microcosm of life that is university, the combined anxieties of navigating school and the ever-prevalent chaos of the real world can often prove difficult to manage.

In an annual survey by the Association for University and College Counseling Center Directors, 95 percent of center directors surveyed said that prevalence of students with significant psychological problems is a growing problem within their campuses. Seventy percent of those counselors said the number of students with these issues and concerns had increased just in the past year, depression and anxiety being the issues in the top percentage of sufferers.

Marian Binder, director of the UA's Counseling and Psych Services, says the demand for mental health services has increased in the past 10 years.

"What we notice, and I think what any of my counselors will tell you ... students are coming in with more acute levels of distress, with more significant mental health problems," Binder says.

The cause of the spike has no single answer, and is not the same for every student experiencing similar stressors.

"And in terms of the root of those problems, depression and anxiety, it's all over the board," she says. Life stress, sleep and behavioral changes and substance abuse are all factors that could induce mental health issues Binder says, but you can't point to just one as the main proponent of mental distress.

The 2014 National College Health Assessment conducted by the American College Health Association surveyed student health from 140 higher education institutions nationwide, a data set that included over 79,000 students.

The mental health section of the assessment reveals that, in the past 12 months prior to the poll, over 80 percent of student respondents felt exhausted (not from physical activity) and overwhelmed. Feelings of overwhelming anxiety in the past 12 months clocked in at 54 percent, and 32 percent of students "felt so depressed it was difficult to function."

Binder says the increasing array of expectations is also a contributing factor to anxiety and depression among newer generations of students who take on work and internship-related obligations outside of an already overwhelming academic experience. All this, she said, is layered by students' own predisposition to mental health issues, pre-college "functioning" and individual experiences within college that differ for everyone.

"Somebody could be very well-functioning in their life and they get sexually assaulted as a freshman," she said. "That could change the trajectory of their college experience."

For some students, it is not only the stress gamut of university life that provides the catalyst for depression and anxiety. According to Ole Thienhaus, department chair of UA Psychiatry, more serious mental illnesses usually begin to manifest in individuals right around their early 20s.

"So this happens to coincide with college time ... if somebody develops a serious mental illness, things like schizophrenia or bipolar illness, very often that first is diagnosed during these years," Thienhaus says.

Jordan Fernandez, who graduated in 2015, struggled for a long time in and out of school before he was diagnosed with bipolar II disorder at the end of his junior year. While disability resources were beneficial after his diagnosis, Fernandez said his uphill battle with a then-unidentified disorder made the first two years of college an undulating cycle of moods. One minute would at the peak of a good time, the next at rock bottom.

"So I spent a lot of the time just kind of depressed and just barely making it through [which was] interspersed by times where things were just kind of wild and fun and crazy," Fernandez says. "But that mood didn't last. It was kind of an up and down ride for me."

Fernandez withdrew during his first semester. Upon returning, things went south after his sophomore year. By his junior year, Fernandez hit a "major depression" and didn't attend classes.

He wouldn't be diagnosed with his disorder until after he left the campus counseling service, a move that led him to a practitioner who diagnosed his condition in the first visit. Since graduating in 2015, Fernandez has started a blog for others suffering from potentially debilitating mental health issues.

He says living a healthier overall lifestyle through fitness and activity was one of his keys to stability. He finds the argument that therapy and medication are cure-alls for mental health concerns problematic.

"All of these things that are good for anyone, really, are part of the wellness package when it comes to dealing with mental illness," he says. "I felt like a lot of the resources out there kind of just focused on getting through the worst days, but didn't really focus on how to not have as many worst days." 

Fernandez recommends engaging in self-fulfilling activities to aid in personal development and recovery, things that "will bring positive benefit in the future."

Binder at CAPS says students should never hesitate to call for services if they feel in trouble, even after hours a counselor is always available. New online services like WellTrack, debuting in the fall, will also help UA students in self-help of their behavioral health concerns.

Overall, both Binder and Thienhaus agree that the stigma around reporting mental health concerns is abating. More students come forward to report fears and concerns than in the past, leaving some to wonder if the demand for mental health services comes from more people coming forward or more problems manifesting than ever before, especially with regards to increased suicidal intention reporting.

"You hear somebody telling you, 'I'm not sure I can cope, I've been having suicidal thoughts.' You worry that this person is telling you 'I need help,'" Thienhaus says.

"That could be a positive thing. It's very hard to distinguish whether that's the case or whether it is more common because the challenges on campus have become more difficult. My hunch is there's a little bit of both."

At the end of the day, there is an entire "continuum" from basic stress to severe mental disorders that Binder and the team at CAPS must navigate when trying to care for student health needs. Trauma and personal experience will vary for every student, making the stimulating factors of rampant anxiety and depression an ever-sliding scale. "You'd kind of wish that people's lives could be simpler," she said. "But that's not the world we live in."

"And we're probably not physiologically or neurologically quite wired for the world we live in."

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