When you send your kids to college, you undoubtedly worry - about safety, about grades, about career and friend choices...and about mental health.
Nearly 30 percent of college students said they felt "so depressed that it was difficult to function" at some point in the past year, according to an American College Health Association-National College Health Assessment survey. Research suggests that these young adults are more likely to smoke, to drink to get drunk, to self-medicate with illicit drugs. They're also at greater risk for suicide.
"The ordinary college experience requires considerable independence on the part of the student: making decisions about when to work and when to play, managing social and romantic involvements, and attending to the needs for sleep, food, and routine medical care among other demands," says child psychiatrist Elizabeth Berger, author of Raising Kids with Character. "Parents really cannot manage these elements from afar - it is up to college students to take care of these ordinary aspects of life on their own."
Of course, not every young adult is "up to these challenges," says Berger. What can you do to help?
Talk to your kids about good mental-health habits. Encourage them to exercise — and to participate in social activities such as the band, student clubs, and the campus newspaper.
Be aware that some disorders can start when college begins. "The transition to college is the first time for most of us when we're away from the family," says psychiatrist Jason Bermak, medical director of SF-Care, Inc., a clinical research organization. "It really produces a great deal of anxiety, and if anyone has a predisposition to feeling depressed or anxious or even having a first psychotic break, that is a period of time when serious mental illness can appear." The average age of onset for bipolar disorder is 18 and for schizophrenia is 18 for men and 25 for women. (To see video clips of young people with the diagnosis, visit choicesinrecovery.com.)
Know the good (and not-so-good) ways some young adults cope with college stress. U.S. university students who have been diagnosed with depression talk to friends, exercise, keep journals, use marijuana, and listen to music, according to a study published in the August 2012 issue of the Journal of Child and Adolescent Psychiatric Nursing. (The study found that sources of stress included roommate issues, academic problems, financial and career concerns, and family pressure.)
Be proactive. In high school, kids can give you clues to potential problems. They may be impulsive and disorganized, and they may experience anxiety or develop an eating disorder, says Berger. "Don't wait until the student is packing for the dorm room to put plans into place for mental health services." Explore support groups and ongoing treatment arrangements. To get started, check out websites for groups such as the National Alliance on Mental Illness, the National Institute of Mental Health, and the National Mental Health Association's National Council for Community Behavioral Healthcare.
Reach out. Make sure your kids understand that getting help can help them do better academically - and encourage them to make contact with the school's counseling and disabilities office. Universities typically offer a first session for free. (Some never charge for any sessions.) "Most all campuses have very rich resources to help students address any concerns they have," says psychologist Sam Cochran, director of the University of Iowa counseling service. "They should take advantage of them if needed." Know important ways to get help, such as calling the suicide hotline at 800-273-TALK. (More Americans die from suicide than from homicide - a fact noted in the new National Strategy for Suicide Prevention, announced this week as part of National Suicide Prevention Week.)
Listen to your kids. "All college students rely on a trusting and honest communication with their parents for support during the inevitable terrible exam grade, unfriendly roommate, broken heart, and discouraging moments of college life," says Berger. "Let your student know that you value his or her news updates, and that you are there to lend an ear when things get rough. A good relationship with parents is the young person's greatest emotional buffer against the difficulties of life."
Be positive. "Sometimes it is the parents, rather than the students, who suffer most from the separation," says Berger. "Parents can be wet blankets when their secret wish is that the student return to the shelter of family relationships rather than move on to independence. In these cases, parents may convey anxiety and pessimism about their offspring's capacity to cope - when it is really the parents who are having a hard time with the separation!"
Increase the odds that your young adults take any prescribed medications. If your kids have a diagnosis and an Rx, help them figure out a system, such as taking their drugs at the same time each day or using a pillbox organized by day of the week, suggests Cochran. Half of patients with schizophrenia miss doses of their medication, which leads some doctors to recommend long-acting medications, given by injection every few weeks. For some patients, "every time they have to swallow a pill comes that reminder that 'I'm not normal in some way,'" says Bermak.
See if your child might want someone to check in. Services such as A Mom Away from Home can be available 24/7.
Know red flags. Be aware of warning signs, such as changes in sleeping or appetite or being unable to get to class, keep up with homework, or connect with activities on campus, says Cochran. Also be on alert if your child starts asking questions like, "'How come it seems like everybody is against me?' — kinds of comments that really seem to sound like it's the world against me," says Bermak.
Don't worry too much. Cases like that of James Holmes, who failed an oral exam for his PhD in neuroscience the month before he fatally shot a dozen people at a Colorado movie theater, are "very extreme" and not the norm, says Bermak. "It is quite possible to have a mental illness and lead a meaningful life in society. As long as we can all remember that, it enables us as parents and us as patients to stay together and to not lose our cool with one another and to stay connected and to really keep our eye on engendering hope and recovery."
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