Recognizing Mental Health Issues in College Students

Jeni Shannon, Ph.D. & Mary Stall, Psy.D. Regis University Presenting Concerns at University Counseling Centers

Anxiety 46.2% Depression 39.3% Relationship Problems 35.8% Suicidal Ideation 17.9% Alcohol Abuse 9.9% Sexual Assault 7.4%

 Based on survey of 380 University Counseling Center Directors (9/1/12 – 8/31/13) Anxiety

Feeling Stressed Adjustment Disorder with Anxiety Anxiety Disorder

 What it looks like:  Excessive worry  Difficulty concentrating  Irritability  Restlessness  Muscle tension  Sleep problems Depression

Homesick/Sad Adjustment D/O w/ Depressed Mood Depression

 What it looks like:  Changes in Appetite & Sleep  Loss of Interest/Motivation  Sad, Tearful  Social Withdrawal  Low Energy  Thoughts of Death or Suicide Suicide

 The Center for Disease Control and Prevention estimates that at least 1,350 college students die by suicide annually. This is second only to accidents as a cause of death in this population.  Risk Factors:  Depression, irritability, feeling alienated, hopeless, or helpless  Recent loss  Withdrawal from people and/or activities  History of prior attempt(s)  Substance use  Access to means Trauma

 Students can be dealing with past traumatic events (e.g. childhood abuse) or with more recent traumatic events (e.g. sexual assault, car accident)

 What to look for:  Distress in Particular Situations (triggers)  Nightmares & Flashbacks  Startle Response  Hypervigilence  Anxiety  Withdrawal Disordered Eating

Healthy Weight Weight/Body Shape Fasting Distorted Anorexia Preoccupation Body Image Healthy Orthorexia Eating/Exercise Dieting Food Bingeing Bulimia Restriction Steroid Use Positive Body Muscle Binge Eating Laxative/Diet Image Excessive Exercising Dysmorphia Disorder Pill Abuse Diagnosable Disorders

Anorexia Nervosa  Low body weight (<85% IBW)  Intense fear of weight gain  Distorted body image  Preoccupation with body shape or weight Bulimia Nervosa  Recurrent binge-eating  Compensatory behavior such as vomiting, use of laxatives, excessive exercise  Preoccupation with body shape or weight Binge-Eating Disorder  Recurrent binge-eating without compensatory behavior  Lack of control and marked distress What To Look For

 Emphasis on body image  Preoccupation and concern about weight or shape  Unexplained weight loss/gain  Extremes in eating: over‐eating or under‐eating  Avoiding eating with others, secretive eating  Food rules & rituals  Excessive exercise  Can’t judge on appearance Substance Abuse

Alcohol Binge‐drinking Illicit Drugs Marijuana Spice (Synthetic Marijuana) Ecstasy (MDMA) Cocaine Methamphetamine Heroin Ketamine, GHB, Rohypnol Prescription Drugs Binge‐Drinking

 The NIAAA National Advisory Council approved the following definition:  A “binge” is a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 or above.  For a typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours. Substance Use Continuum

No Use Use Misuse Abuse Dependence Addiction Problematic Patterns

 Hiding use or lying about use  Use substances to manage emotions  Isolation from others  Development of tolerance  Blackouts  Withdrawal symptoms after stopping use  Interference with school, work, relationships, etc. Athletes

 Athletes can be even less likely to self‐report potential mental health problems than non‐athletes (Glick, 2012).  Additional Risk Factors:  Schedule Demands  Pressure/Expectations  Concussion  Injury  Stigma Athlete Considerations

 Depression  Injury  Overtraining Syndrome  Anxiety  Demands & Pressure  Substance Abuse:  Student‐Athletes have higher rates of substance abuse than non‐athletes  Drug‐testing  ED Considerations:  Additional Risk Factors  Female Athlete Triad Being Ready to Step UP!

 Noticing

 Intervening

 Boundaries

 Guiding People to Appropriate Resources