College…. a rite of passage equally charged with excitement and a new era of debt. Your child is heading off, and your nest is down one (more) fledgling. He or she may not know it, but anxiety and depression in college students is a real thing. And you, as the parent who is also transitioning to a new reality, have every reason to be concerned.

Your child’s back-to-school checklist is a little more grown-up now. But you know there’s a lot more to growing up than car keys and another tech device. 

You know that when your son or daughter comes home for semester breaks, you’re going to be lured into debates and philosophical discussions with the smartest person on the planet.

The Brain

What your Young Sheldon probably doesn’t know is that his or her brain still has several years of maturing to do.

While the brain reaches its largest size in early adolescence, it doesn’t stop maturing until the mid- to late 20’s.

And one of the last regions of the brain to mature? You guessed it. The part responsible for things like planning, prioritizing, and controlling impulses: the prefrontal cortex.

That means that your child has “wide open spaces” in which to engage in risky behaviors without thinking through their consequences.

On a positive note, it means that these adolescent minds are still “plastic” and ready to learn and adapt. It’s the perfect time to continue education and increase exposure to diverse experiences like art, sport, and intercultural travel and events.

But you’re a parent who knows what it’s like to be your child’s age. You can at least vaguely remember the physical, hormonal, emotional, and social changes that took the helm of your young life.

What you may not have really thought about while your child was still living at home is that all the changes happening in the brain during adolescence come at a price.

It’s during adolescence that a lot of mental disorders emerge: schizophrenia, anxiety and depression, bipolar disorder, eating disorders.

And all that growing and changing – while bathing in those crazy hormones of youth – means that adolescents don’t handle stress the same way adults do.

This difference in stress management, coupled with a brand new environment with the stress of high academic expectations, makes anxiety and depression in college students more likely.

Mental health disorders often develop earlier in the teen years. But college life can also mark the onset of a new disorder or the triggering of an established one.

The COVID pandemic saw a spike in anxiety and depression in college students. And it hasn’t subsided. 

A study of 45,000 college students found that more than a third suffered from a major depressive or anxiety disorder in 2020. And up to 44% have reported having symptoms of anxiety and/or depression.

That’s double the depression rates and 1.5 times the anxiety rates for 2019.

What are some other factors contributing to anxiety and depression in college students?

• Being away from home and family (including pets) for the first time
• Having a heavy, demanding course load
• Not getting enough sleep (teens need 9-10 hours and rarely get it)
• Unrealistic expectations of hyper-achievement and perfection
• Financial costs of college
• Not having friends in a new environment
• Changing social pressures
• Being female, of color, LGBTQ, low-income, or a caregiver for a family member
• Not having sufficient life skills to match a new, “independent” life
• Previous or family history of mental illness

As a parent, what should you look for as signs of anxiety and depression in your college student?

• Difficulty with schoolwork, missing classes, and/or dropping grades
• Inability to concentrate
• Loss of social interest (not going out with friends, avoiding parties, etc.)
• Sudden changes in sleeping and eating patterns
• Visible change in weight
• Emotional outbursts (crying, anger)
• Sense of being overwhelmed
• Panic
• Physical symptoms like stomach aches, GI upset, headaches, rapid breathing
• Muscle fatigue or achiness
• Negative self-talk 
• Self-doubt
• Obsessing over potential outcomes
• Thoughts or discussion of suicide (since the pandemic began, 25% of young adults say they have seriously considered suicide)

But what are you supposed to do when your child is away at college and you can’t observe him or her every day? Are there ways that you can prepare your son or daughter for a healthy college experience and also put your own mind at ease?

Preparing your child for college begins long before the application process. And so does preparing for mental health stability once he or she is away.

Here are some ways to prepare your child for college and to watch for signs of anxiety and depression:

• Talk about mental health from an early age. Even if your child doesn’t suffer (yet), he or she undoubtedly has friends or classmates who do. Make sure there is never shame or judgment attached.
• Teach basic life skills from an early age – cooking, laundry, hygiene, self-care.
• Investigate medical and mental health services on and around campus and make sure both you and your child have the numbers kept in a handy place.
• Meet your child’s dorm director and have his/her phone number.
• Meet your child’s roommates and their families. Start communicating before the school year starts and exchange contact information. Roommates and their families have a way of becoming extended family, and that means more built-in support for each child.
• Make sure your child knows that you are always available to talk. And don’t talk only about courses and football games.
• Encourage more personal methods of communication than just texting. FaceTime, video chat, and even a phone call will provide more nuanced information for you to gauge your child’s wellbeing.
• Visit your child at college as often as possible. 
• Tell your college student to invite a friend or two home for a long weekend or holiday vacation. You can learn a lot by observing their interactions, and you can be a second set of eyes for the other child.
• Encourage healthy habits without nagging.
• If your child is already under mental health care, with or without medication, make sure plans are in place to continue that regimen. You may have to set up counseling appointments online or find a counselor at or near the university.
• Make a mental health plan in advance so your child knows what to do if he or she is ever in crisis. And remember that the new number for the Suicide and Crisis Lifeline is 988.

Young people are facing an unprecedented mental health crisis. And how tragic that anxiety and depression in college students has led to so many recent suicides among bright, talented, loved young adults.

When it comes to helping your college student, knowledge is power. The more you know about the developing brain and the impact of college life on mental disorders, the more you can help your child.

The good news in all of this? The young brain is very resilient, and most college students come through their experiences healthy and ready to take on the world.

Dr. Elayne Daniels is a private practice psychologist in Boston and international coach and consultant whose specialties include eating disorders, body image, and working with Highly Sensitive People.