Final Draft
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Kristen Barry
ENC 2135
July 19, 2016
Rachel Efstathion
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Stressed Out: Anxiety in Students
Final Draft
Introduction
As my fellow college freshmen would agree, entering college is an extremely scary and stressful time. Of course, it also opens the door to a world of new opportunities, independence, and friendships. But, all these things start to add up and when the teenage mind tries to balance all these things, it gets stressed, anxious, or even depressed. Anxiety and anxiety disorders are problems of increasing magnitude, especially in the college population. This new world of opportunity that creates stress in students and can intensify pre-existing mental health conditions. I want to research the problem of anxiety in college students because my sister and I both have anxiety and anxiety attacks and I know anxiety is one of the most prevalent mental health conditions in teenagers, regardless of the stigmas that keep mental health issues on the “down low”. I will explore causes and symptoms of anxiety in students, as well as treatments and processes that can help reduce anxiety and stress. Many students experience stress or anxiety that is not of the clinical level, so I am also interested in researching things students can do to reduce stress to prevent future anxiety. For treatments, I will be focusing on the resources available to Florida State students at the University Counseling Center.
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Literature Review
Anxiety and Disorders in General
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All my sources except for “Treatments for Anxiety” (Crosta) give some definition of anxiety, anxiety disorders, or symptoms. All the authors of these sources would agree that anxiety is a common problem; “everyone experiences stress and anxiety at one time or another,” the Anxiety and Depression Association of America’s website blatantly states. It is commonly accepted that normal stress and anxiousness become an anxiety problem when someone “finds it difficult to control worry on more days that not for at least six months” (“Generalized Anxiety Disorder”). Many of the authors, especially Lamis, Jahn, Mahmoud et al, and Weaver, would also agree that anxiety and stress are increasing problems especially for college students. Increased levels of stress and anxiety may put the body at risk for other health or mental problems, as shown by Kolar, Kolar, Lamis, Jahn, and McGonigal. Brenda Spriggs, who has a PhD in public health and medicine, lists some common physical symptoms of anxiety, including “racing heart, shortness of breath, shaking, sweating, chills…” and many more. These symptoms are accepted generally as the most common physical symptoms of anxiety. When three or more symptoms are experienced for a period of six months or longer, that is when stress and anxiety become an anxiety disorder (“Generalized Anxiety Disorder”).
Diagnosis and Problems if Left Undiagnosed
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McGonigal may have been the only author to go as far as to explicitly state that we can, and should, use our own stress to our advantage. Kolar, Kolar, Lamis, Jahn, Lindsey, Spriggs, and Weaver would agree that leaving anxiety to fester isn’t the way to go. These sources would agree that anxiety can worsen over time if the stressors causing the anxiety aren’t addressed or treated. Therapy and medication are common treatments for anxiety disorders once they are diagnosed, but many cases remain undiagnosed and treatments do not always work as they should. Kolar and Kolar smartly put it that “prescribing medications that could provide an instant [relief]... is popular nowadays in the era when quick solutions… are expected” (172). The same article also describes the common medicines used as treatments and their fallacies (172-175). There is no simple cure for anxiety just like there is no single cause of it (Spriggs 1), and anxiety can worsen cases of other health problems, as Spriggs claims that “untreated anxiety can increase your risk of more severe conditions” and Lamis and Jahn reported that “depressive and anxious symptoms have been identified as strong predictors of suicide risk in college students” (107). This means that anxiety is a problem if left undiagnosed and untreated since it could lead to additional problems down the road. Lindsey, Spriggs, and Weaver all commented on patients seeking treatment for their anxiousness, but Weaver reported that 40% of college students “[did] not seek help” for their problems. Spriggs revealed the problems of diagnosis of generalized anxiety disorder by primary care physicians (2). Based on Weaver’s study, primary care doctors only diagnosed their patients with GAD about two out of three times, leaving roughly 33% of the diagnosable patients without professional treatment (5).
Treatment Types
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Crosta reports that anxiety “can be treated medically, with psychological counseling, or independently” and the ADAA, Kolar, and Kolar also explore different types of treatment and their benefits. Crosta, the ADAA, and McGonigal have particular focus on self-help methods for dealing with anxiety and reducing stress to improve life overall. Crosta lists specific self-help tactics, like “[practicing] deep abdominal breathing… [learning] to replace ‘negative self talk’ with ‘coping self talk’, and [talking] with a person who is supportive”. Many of these items are discussed by McGonigal, whose main purpose is to help her audience realize how they can positively react to their own stress and improve their long term help. Both Crosta and McGonigal particularly acknowledge that talking or confiding in a friend or family member can help with stress and anxiety. The techniques from these authors can be done by anyone who wants to reduce their own stress, not just those experiencing diagnosable levels of anxiety. The ADAA offers many “Self-Help Publications & Materials” in addition to many resources, like counseling centers, they offer connections to for their readers. Crosta, Kolar, and Kolar give more detailed insight into the common medications used to clinically treat anxiety and also report some information about possible problems with these medicines. Treatments and treatment methods are still being researched and developed and Kolar and Kolar show that even with benzodiazepines, “commonly prescribed medications in the treatment of anxiety disorders in the last few decades of the 20th century” (172), “strong opposition to the use of BZDs in psychiatry and strict monitoring of benzodiazepine prescriptions started in the last decade” (172). The “challenges to detection and treatment of mental disorders” (Spriggs 2) is an ongoing issue that is continuously trying to be relieved. The article by Kolar and Kolar shows that there is not one “best” medication to treat these problems and that the medications that were seen as better in the past have now been found to cause additional problems for the user. Anxiety is a difficult problem to treat in these ways and treatments are still being researched and improved upon with additional studies.
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Treatment Availability: Getting Help
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Lamis, Jahn, and Lindsey assess the importance of college students trying to seek help or at least consider what may be causing their anxiety, along with repercussions because of this mental illness. Lindsey presented statistics about the numbers of students who seek help for anxiety during college and found that anxiety is “the most common presenting problems that mental health practitioners encounter” for patients in this demographic. While Lamis, Jahn, and Lindsey took a clinical approach to the effects of anxiety, Crosta, the ADAA, and McGonigal give more informal help methods, since not all anxiety is at the clinical level. Anxiety is reported as a major concern of college students and “40% of college students surveyed identified anxiety as their primary reason for seeking help” (Linsey 407). “Treatment-resistant conditions” (Kolar, Kolar 172) are a whole other problem because they “require [a] more intensive multimodal treatment approach” (Kolar, Kolar 172). Anxiety can be particularly difficult to treat because there isn’t any one exact cause, but many symptoms and stressors that must be addressed to help the problem. Regardless of how well professional anxiety treatments work, the majority of students do not get diagnosed, but they can use some of the methods taught by McGonigal for using stress to their advantage or use the self-help resources that are available (Spriggs 4).
Reducing Stressors and Helping Others
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As previously mentioned, there are self-help methods to treating anxiety in additional to the more formal approached. Crosta states that “in some cases, anxiety may be treated at home, without a doctor’s supervision”. This type of treatment is in line with McGonigal’s main idea of “how to make stress your friend”. These two authors would agree that not all cases of anxiety are clinical cases, so sometimes just reducing stressors in life and practicing a healthier lifestyle can reduce the anxiety and prevent it from becoming a more extreme case or disorder. Crosta, the ADAA, McGonigal, Kolar, Kolar, and Mahmoud et al emphasize the importance of “support from family and friends” (ADAA) to coping with stress and anxiety. Having a healthy support system is critical for any case of anxiety, whether it has been diagnosed or not. A good support system can help create an environment that makes it easier for the patient to reduce stress and overall anxiety if their friends and family are supportive of them making the problem better. Crosta and the ADAA provide information and resources of various types of things that can help reduce anxiety and ways to help others who may be struggling. McGonigal explains dealing with the stress in our body on a chemical level, which is not a topic the other sources do not address in the same way. She proposes that “when oxytocin is released in the stress response, it is motivating you to seek support” and that “this stress hormone strengthens your heart” and can even reverse previous stress-related damage on the heart. Anyone can use this as a natural remedy to the toll of prior stress on their heart. By comforting physical contact and reaching out to trusted friends or family to talk, the oxytocin can help heal the heart.
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Interview
I reached out to the University Counseling Center (UCC) for an interview about anxiety in college students, and I was able to interview with a university counselor, Madalyn Conetta. Even with the quick turnaround I needed to meet the deadlines for this paper, Ms. Conetta went out of her way to make some time in her busy schedule, with many students who make appointments especially during this time of transition to college, to schedule an interview with me. She could’ve told me she was “too busy” to sit and talk with me, but her care to make the time for me increased the credibility of the UCC and how much they really do care for their students. Ms. Conetta graduated with her degree in social work in 2009 and has been a counselor since then. She has worked as a university counselor here at FSU for two years, but previously worked at a center that focused on treating eating disorders, a juvenile justice program working with boys who had court-ordered therapy, and a hospital memory disorder clinic. With this background, she has a wide range of experience in multiple areas of her field.
For my interview, I brought some facts and statistics from my research to see how they compared to Ms. Conetta’s experienced. I had found that about 20-25% of teens have some degree of an anxiety disorder (“Generalized Anxiety”) and she wasn’t surprised by this number, even saying that “like 90 percent of people have a mental illness at some time.”. She informed me of the alarming fact that anxiety is the top reason students on campus seek help from the counseling center, followed by depression, relationship problems, and adjustment to college. This fact wasn’t surprising to me based on my introductory research, but it further solidified the importance of my topic, since anxiety is so prevalent in college kids, especially freshmen who have just left home for the first time. We discussed the many ways the transition to college life is cause for increased anxiety in the freshmen college kids and then focused more specifically on my research problem.
Ms. Conetta’s insight into the reasons for lack of diagnosis and the possible treatments available here on campus helped shed some light on my research problem.
Previous to being on a college campus, the “financial barrier” from the cost of professional treatment along with the “mental health stigma, from society or family” were major reasons that stand in the way of adults or teens getting help for their anxiety or mental disorders (Conetta). The stigma may come from the client’s own family, society in general, or even from their peers. This problem especially arises with the massive changes that happen as students enter college. They may have had pre-existing mental conditions, or the transition caused abnormal levels of anxiety, but when the student sees that everyone else appears to be fine, without any therapy, they should be able to manage on their own, too. If a student beats the odds and is in the minority that does get professional help (Weaver), what kind of help can they expect from the UCC? If a student comes to counseling for help with their anxiety, whether it be a disorder or unhealthy stress or anxiousness, they can expect free counseling and therapy from university counselors, and may be referred to a psychiatrist if medicine is found to be helpful as part of their treatment plan. Since “not everyone has clinical level anxiety” (Conetta) or they might just be stressed, they have the options of individual or group therapy, biofeedback (a individual, computer-based program with relaxation training that teaches how to deal with stress or anxious systems), or RENEW (peer based mentoring for stress management and study skills). All these options are free, on campus, and can be accessed through the UCC.
The final segment of my interview focused on what we, as students, can do to reduce the stigmas on anxiety and treatment and how we can make college a less stressful environment. Ms. Conetta informed me that “de-stigmatizing” mental disorders would be a good way to make it easier for students to get help. On a more personal level, she told me that “engaging in self-care” and maintaining a healthy diet and sleep schedule are all important, seemingly simple things that can quickly make us more prone to stress if we aren’t taking care of our body. As far as reducing the stress in our environment to prevent development of further disorders, she recommended balancing priorities, since we are now more responsible for ourselves than ever before, establishing a new support system since “we are interpersonal beings”, and “[decreasing] the pressure students put on themselves” (Conetta), just to name a few tactics. Overall, Ms. Conetta’s knowledge about anxiety in students aligned with my research and she gave me lots of different resources I can look into for ways students can get help and reduce their own stress and anxiety.
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Conclusion
Before doing the research specifically for this paper, I had some knowledge already about anxiety, stress, and mental disorders in general, but my research problem helped me gain new know of the problem of stress and anxiety in college students. I knew anxiety was a big problem and that anxiety rates in teens and kids are higher now than ever before, but I was surprised by my research and interview to learn the true significance of the problem. From my interview with a university counselor, I learned that anxiety is the top reason students seek out counseling at most universities and here at Florida State. I also learned that stress and anxiety are much higher in college kids than in the general population. My opinions about this topic haven’t changed so much as they have developed, from discovering that anxiety is a much bigger problem than I originally thought. The information from my own research aligned with what I learned from my interview, but Ms. Conetta was able to provide a deeper look at solutions to these problems that will especially useful moving forward with this topic. For my next project, I will take this information and further research into the resources available on campus for students and things students can do to reduce anxiety and stress.
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Bibliography
Conetta, Madalyn. Personal Interview. 12 July 2016.
Crosta, Peter. “Treatments for Anxiety.” Medical News Today. MediLexicon International Ltd, 23 July 2009. Web. 9 July 2016.
“Generalized Anxiety Disorder.” Anxiety and Depression Association of America. Anxiety and Depression Association of America, 2016. Web. 11 July 2016.
Kolar, Dušan and Kolar, Michael V. "Critical Review of Available Treatment Options for Treatment Refractory Depression and Anxiety - Clinical and Ethical Dilemmas." Medicinski Pregled / Medical Review 69.5 (2016): 171- 6. Print. 9 July 2016.
Lamis, Dorian A. and Jahn, Danielle R. "Parent–Child Conflict and Suicide Rumination in College Students: The Mediating Roles of Depressive Symptoms and Anxiety Sensitivity." Journal of American College Health 61.2 (2013): 106-13. Print. 9 July 2016.
Lindsey, Cynthia. "Trait Anxiety in College Students: The Role of the Approval Seeking Schema and Separation Individuation." College Student Journal 48.3 (2014): 407-18. Print. 9 July 2016.
Mahmoud, Jihan S. R.; Staten, Ruth; Lennie, Terry A,; and Hall, Lynne A. "The Relationships of Coping, Negative Thinking, Life Satisfaction, Social Support, and Selected Demographics with Anxiety of Young Adult College Students." Journal of Child & Adolescent Psychiatric Nursing 28.2 (2015): 97-108. Print. 5 July 2016.
McGonigal, Kelly. “How to make stress your friend.” Online video clip. TED Talks. TEDGlobal (2013). Web. 5 July 2016.
Springs, Brenda B., ed. “Anxiety Diagnosis.” Healthline. Healthline Media, 18 August 2014. Web. 6 July 2016.
Roberge, Pasquale; Normand-Lauziere, Francois; Raymond, Isabelle; Luc, Mireille; Tanguay-Bernard, Marie; et al. "Generalized Anxiety Disorder in Primary Care: Mental Health Services use and Treatment Adequacy." BMC Family Practice 16 (2015): 1-11. Print. 6 July 2016.
Weaver, Sandra Long. "High Anxiety." Chronicle of Higher Education (2016): 25-7. Print. 6 July 2016.