Anxiety Disorders in College Students

While anxiety is a normal human emotion, felt by most people on a daily basis (at least to some degree), when it rises to the level of causing significant distress or interferes with activities, then it may be a disorder.

If you have an anxiety disorder, even NORMAL college stress can make your problem much worse. If you do not have an anxiety disorder, but are at risk for one, then normal college stress can bring out a full-fledged anxiety disorder.

WHAT IS THE DIFFERENCE BETWEEN COLLEGE “ANXIETY” AND COLLEGE “STRESS?”

“Anxiety” involves thoughts that most people would find not logical. They are very unlikely to be true.

  • If I get rejected by the cute person in economics class, I won’t be able to show my face around there anymore! (You may get rejected but will you really have to leave school in shame?)
  • If I don’t get 100% on the test, my career will be ruined!
  • If I make a mistake during public speaking, I’ll be the school outcast!
  • If I don’t wash my hands just right, I’ll get a catastrophic disease!

College “Stress,” on the other hand, involves the perception that you have more challenges on your plate (tests, papers, social life, exercise, and so on) than your resources (time, organizational strategies, brain power, etc.) can handle. Sometimes stress thoughts are true. For example, if you are on academic probation and you sleep through two out of three hours of your final exam—you very well may get kicked out of school! That’s realistic stress!

Anxiety and related disorders in college students that I see most often include:

  • Pathological Perfectionism: Since, by definition, you can NEVER be perfect (socially, academically, personality, cleanliness, appearance, etc.), my perfectionistic clients and students are most often frustrated and disappointed with both themselves and other people who fail to meet their unrealistic expectations.
  • Panic Disorder: I treat a lot of college students for panic attack concerns. Panic attacks among students are actually very common and may be triggered by a combination of stress and poor behavioral habits (such as skipping meals, over-indulging in alcohol, pot, and/or caffeine, and getting insufficient sleep).
  • Social Anxiety Disorder: Many college students are plagued by high levels of social anxiety. Some colleges, like Cal Poly, require a public speaking communications course, which has even caused some students to drop out of school rather than face that class. Dating, small-talk, internship or job interviews and so on, can feel like insurmountable obstacles!
  • Separation Anxiety: Some college students have never lived away from the comforts of their own home with their loving parents and close high school friends. Moving away may feel like their life has been violently ripped away from them. They may spend more energy on relationships at home rather than forming new attachments at college. For some, it means dropping out and moving back home.
  • Phobias: College students experience phobias (irrational fears) just like the rest of the population. I regularly see students with fears of driving, elevators, airplanes, vomiting, needles, small spaces, and so on.
  • Body Dysmorphic Disorder (BDD): I often see college students who (very mistakenly) believe that they are horrifically unattractive. In fact, the average college student I see with BDD is much more attractive than average and believes (quite deeply) that they are the most unattractive person on campus. It becomes a daily and even hourly obsession and typically leads to a severe depression.
  • Obsessive-Compulsive Disorder (OCD): OCD comes in many forms. I see college students who are germ-phobic and are compulsively washing and cleaning, as well as students suffering with unwanted intrusive thoughts such as being dangerous, gay, perverted, and so on. The thoughts could really be about ANYTHING. The common thread is the desperate struggle for 100% certainty.
  • Health Anxiety: Students with health anxiety may become obsessed that a rash may be a deadly STD (despite medical evidence to the contrary) or that a headache or stomach ache means they have cancer. They may spend many hours a day scouring the internet looking for reassurance that their symptoms are safe, but end up more and more paralyzed with fear.
  • Posttraumatic Stress Disorder (PTSD): Some students come to college haunted by a trauma from car accidents, abuse, rape, and so on. Some students are returning combat soldiers bearing physical and mental scars of war. The hallmark of PTSD is a near-constant attempt to push away (or numb out) the thoughts and feelings associated with the trauma, which tends to make those thoughts and feelings sneak out in unpleasant ways.
  • Generalized Anxiety Disorder (GAD): In this disorder, people feel plagued by worry. The college student with GAD may spend their days in a never-ending worry buffet over a wide range of topics (parents, health, academics, friendships, and so forth). Most people worry in short doses, but with GAD worry can be about every conceivable thing. Students with GAD hate uncertainty and worry as a way to feel certain they can handle anything that comes their way (the opposite usually results and they feel unable to handle their future and then that further increases worry!).

It is normal for people dealing with an anxiety disorder to have more than one of the above. In fact, they tend to cluster since anxiety disorders tend to be maintained by similar factors. Learning the skills for dealing with one, therefore, tends to help with dealing with others. They are all basically the same dance, but with different tunes!

Eric Goodman, Ph.D.

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