Mind matters: coping with mental health issues on a college campus

Bethany Beckham ’18 walked into a campus coffee shop on a recent afternoon and spotted a friend sitting behind a laptop and latte. A smile immediately spread across her face. “I just got into grad school!” Beckham exclaimed. The news was still fresh. There was no time to really take it all in. At another table, a group of friends caught Beckham’s attention. “I got in,” she mouthed excitedly, hurrying over to accept congratulatory hugs.

A self-described high-achieving, type-A person, Beckham’s admittance into the speech language pathology program at the University of Memphis is par for the course. She hopes to one day help singers who have hurt their voices. An Honors Fellow, music in liberal arts major, admissions tour guide and a regular on the President’s and Dean’s lists, Beckham worked hard to get to this place. Graduate school was part of her plan all along, but she wasn’t 100 percent sure she would get accepted into a program.

It was just a year ago that she returned to Elon for spring semester after an extended break. The stress of school, the pressure to meet all the demands she placed on herself and a host of other worries and concerns overwhelmed Beckham in the fall of her junior year. The anxiety disorder and depression she was first diagnosed with in ninth grade increasingly worsened. “I was not coping well,” Beckham says. “Untreated, it was affecting me and the people around me. My friends convinced me to take time for healing and recovery.”

Beckham withdrew from classes that November via a medical withdrawal and spent Winter Term at home in Tennessee, using the time away for intensive therapy. “I needed to be focused on just healing and not school and everything else,” Beckham says. “I’m very grateful I did that. I was a little worried with my grad school applications that it would deter me from getting into programs, but it didn’t. I think it was important that I showed initiative and got better.”

While anxiety and depression don’t always rise to the level of taking a leave of absence, Beckham isn’t alone in her mental health struggles. Between 2009 and 2015, the number of college students visiting counseling centers in the United States increased by an average of 30 percent, according to the Center for College Mental Health 2015 report. Students sought services for a variety of reasons, with anxiety, depression and relationship issues topping the list. In spring 2017, 62 percent of students “felt overwhelming anxiety” and 40 percent “felt so depressed that it was difficult to function,” according to an American College Health Association survey of more than 63,000 students at 92 schools.

Elon students are not exempt from this trend. About 9.6 percent of students (621) used Elon’s Counseling Services in the 2014–15 academic year. That number jumped to 12.6 percent of students (846) in the 2016–17 academic year and is still on the rise, says Marie Shaw, director of Counseling Services. Of those seeking services in the past academic year, 72.7 percent cited anxiety and 53.5 percent depression as the reason for seeking help.

The reasons for the increase are complex. “We know that generalized anxiety is much higher in this generation,” says Jana Lynn Patterson, dean of students and associate vice president for student life. “We are not exactly sure why, but we know it’s higher.”

Parents arranged play dates and activities, ensuring highly- structured, safe experiences. Risk-taking wasn’t always encouraged and the sting of failure avoided, all while the expectations to fit in socially and excel academically were constants. Resumé building started early with a continual flurry of activities and leadership roles checking the necessary boxes for college acceptance—a proven path to a successful career. “When you consider the number of ways parents want to make sure their children have positive experiences, I think we unintentionally shield them from the kind of difficult experiences that help them grow and learn to navigate challenges,” says Jon Dooley, vice president for student life. The fact this generation of students grew up at a time when terrorism, school shootings and political conflicts are the norm adds to the anxiety.

The result: a generation of students who strive for perfection, fear failure and struggle with anxious and depressive feelings that often rise to a level requiring behavioral therapy and psychotropic drugs. The increased use of social media also instills the idea that others are accomplishing more and at a quicker rate. “You only see an embellished picture of others and you have this impression that you have to compete with that,” says Bilal Ghandour, an assistant professor of psychology at Elon and a practicing clinical licensed psychologist. “It creates a tremendous amount of pressure, especially for young adults who are developing a sense of identity.”    

At Elon, students are very involved in activities, striving to be their best. “We have a very perfectionistic student body, a high-achieving student body,” Shaw says. College campuses are environments conducive to learning and growing but also breeding grounds for excessive stress and tension to perform and achieve. “If you are in that environment and you are friends with people who are in six different organizations, you feel the need to do the same,” Ghandour says. “You feel you are being left behind and that creates a loss of confidence and fear of failure.” When students struggle, it’s not unusual for them to feel they are alone in the experience. “On social media, people post the side of themselves that looks happy and that they are doing well,” Shaw says. “It is easy to craft what you outwardly portray on social media. For some people, they might feel so differently on the inside.”

Beckham first started seeing a therapist in ninth grade and went on antidepressants, but she wasn’t doing either when her anxiety levels rose during her sophomore year of college. Even with previous treatment, anxiety disorders don’t just disappear. “Anxiety is a continual thing,” she says. She started counseling again, that time with a therapist in Burlington, North Carolina, a friend had recommended. Now in her senior year, Beckham manages symptoms with a combination of antidepressants and coping mechanisms. “I got enough tools in my toolbox,” Beckham says about her decision to end regular therapy sessions. “But it’s an open communication. If I need to go back, I can.”

A major source of comfort is Beckham’s dog, Leo, named after President Emeritus Leo M. Lambert. A Shih Tzu mix with an uncanny ability to sense anxiety and panic attacks, Leo is a calming force in her life. The dog is a registered emotional support animal, which is permitted in campus housing if a student provides all the necessary documentation from a mental health provider, according to the Fair Housing Act. A total of 75 Elon students have been approved to have emotional support animals, says Susan Wise, director of disabilities resources. Unlike service animals, they are not permitted in the classroom. Most of the time, Leo merely serves as a companion, but he is also a reminder to Beckham that she can manage whatever comes her way. “On those days when you don’t want to get out of bed or be alone in your apartment, you know you are never alone,” she says. And if anxiety or panic sets in, which for Beckham means heart palpitations, shortness of breath and blurred vision, Leo senses it. “He sits on top of my chest,” she says. “If I’m actually having a panic attack, he will put a paw on me and then go tell someone.”

Stefanie Milovic’s anxiety flares up at different times but tends to be more situational. “The depression is always there though,” says the junior majoring in strategic communications. Diagnosed with both generalized anxiety disorder and severe depression when she was a junior in high school, there are days when Milovic struggles to get out of bed. Her hamster, Amber, provides the nudge she needs sometimes. “It’s another reason to remind myself to wake up and go to classes,” she says. “I can’t just lay in bed, at the very least, I have to get up and feed her.”

Consistent grades and a role in several campus organizations often mask the reality that keeping mentally healthy is a daily struggle for Milovic. While she’s an Honors Fellow, president of two organizations and holds two campus jobs, she also recognizes her need to see a counselor and continually manage her symptoms. “Keeping busy, for the most part, helps me. But I think it helps one disorder over the other,” she says, knowing that keeping active helps with depression but at times can be overwhelming. “It’s a tradeoff trying to decide what I can and can’t handle.”

Leadership roles give Milovic a sense of purpose. “I have a passion for the organizations I am part of,” she says. Keeping connected intellectually and socially helps. The relationships she has developed are crucial. “At the very least, I am surrounded by people who have a passion for me,” she says. “They ensure that I’m still here.”

One of the organizations Milovic serves on is the executive board of the DMAX Club, a student organization focused on improving mental health and increasing conversations about mental and emotional issues facing college students. “The idea is that everyone needs to be worried about mental health,” she says. “We have meetings that encourage you to speak what’s actually on your mind and what you are actually feeling.” Meetings usually involve a relaxing activity, such as making stress balls, followed by honest conversation.

The social life of students plays a huge role in the transition from high school to college life. Senior Perry Elyaderani, a journalism and chemistry double major, learned this the hard way his first year on campus. An extrovert who never had a problem making friends or fitting in, Elyaderani felt the sting of exclusion after deciding that Greek life wasn’t for him. “As a male if you are not affiliated, especially in your first year or two, it feels like you are out of it,” he says. “As a social person who wanted to be included in everything, that was really hard. I had never had a problem like that before.”

At the time, Elyaderani says, he didn’t realize he was depressed. Fearing he’d isolate himself further, he didn’t share his feelings with friends. When he went home for the summer, he realized how much the situation had impacted him. That experience, combined with what he learned while working on a news report about male suicide after an Elon student took his own life, inspired Elyaderani to apply for and receive Elon’s Leadership Prize, a $10,000 award that supports the intensive study of an issue. He is now in his third semester of conducting research with mentor Alexis Franzese, associate professor of sociology, on the mental health of college students with a focus on gender. Elyaderani hopes to learn what type of issues males struggle with uniquely. “Women have incredible support networks,” he says. “They can talk to their friends about issues. Men share but they typically only share thoughts of self-doubt or sadness to a significant other, if they have one.”

Based on the rising number of students using Elon’s counseling center, it appears there is less of a stigma associated with seeking mental health help. “You hear more people openly share that they’ve been to therapy than you heard a decade ago,” Shaw says. “Progress has been made but there is ongoing work.”

Following the shooting at Virginia Tech in 2007 that left 32 dead and many wounded after a student with a history of mental health problems went on a rampage before killing himself, many college campuses formed behavioral intervention and threat assessment teams, Dooley says. “The goal was to try to identify students with serious mental health challenges and get them resources,” he says. “That’s a good thing.” As a result, students with less acute mental health concerns were also identified and additional support services developed. “We have students who are more willing to seek support, and we have better infrastructure to help identify and direct students toward that support.”

Many student organizations provide that support. Elon has a chapter of Active Minds, a national organization focused on reducing and eliminating stigma around mental health on college campuses. “[Mental health] seems like something people tiptoe around because they are uncomfortable,” says senior Kacie Lynch, co-president of the group. “And it is uncomfortable sometimes, but we need to do something about it. We need to talk about it and educate others.”

Understanding what resources Elon has available, whether it’s to address academic, social or mental needs, is vital for all students. “I think college students need to learn how to take care of themselves better,” Beckham says. She is confident the work she’s done to improve her mental well-being will take her far. “I think I am stronger because I understood that I couldn’t handle everything.”

She points to three small waves tattooed on her ankle—a reminder to ride the wave and a coping mechanism she learned in therapy. “Life will have ups and downs and your emotions will have ups and downs but don’t get off and swim to shore,” she says. “Ride the wave.”

It’s an ongoing struggle, but Beckham is learning she doesn’t have to be perfect. She doesn’t need to have everything figured out. “I wanted to be optimistic all the time and only experience the highs,” she says. “I didn’t want to be a burden on anyone but my treatment really showed me that it’s not bad to ask for help when you need help.”   

Prevention and intervention

In January President Emeritus Leo M. Lambert and President Connie Ledoux Book, who officially started her tenure March 1, sent out a joint email to the Elon campus community, outlining actions underway to address the issue of student suicide and mental health on campus. In recent years, Elon, like many colleges and universities, has experienced incidents of student suicide.

The university is adding three new counselors  to Counseling Services, including a case man-ager to do referrals and match up students with resources, as well as a group therapy expert  available free of charge. “A group setting  can sometimes be much more powerful and impactful than an individual session,” says  Marie Shaw, director of Counseling Services. 

“We are looking at how we can we help people with normal day-to-day stresses and anxieties that are typical for college students so that they don’t have to go seek professional help if they do poorly on a test or have a relationship that is not going as planned,” says Caroline Ketcham, a professor of exercise science and co-chair of the group. “That frees up our professional services for more imme-diate needs if a crisis comes up.” 

When a crisis does occur, especially if it’s when the counseling center is closed, students can use the counselor-on-call emergency service and get quick access to help in times of need, says Jana Lynn Patterson, dean of students and associate vice president for student life, who is also working on more effective ways to connect students with the vast resources available, whether it’s mental health services, tutoring or just a way to connect with peers and feel a greater sense of belonging. “We can’t control whether a student is going to have road blocks or adversity,” Patterson says. “But if we can help them gain confidence in accessing resources when they need them, it’s going to make them more resilient.”

Several mindfulness programs are offered that teach meditating skills, breathing exercises  and visualization, and there is a yoga program  specifically for trauma survivors. For students who aren’t sure if they need a licensed therapist, an online mental health screening is available on the Counseling Services website and an online platform—Therapy Assisted Online—will soon be available so students can work independently on a variety of struggles that impact mental health.