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When you’re all revved up for the new semester, it’s easy to skip sleep in favor of diving into your new coursework. OK, it’s easy to skip sleep in favor of Insta-scrolling, Netflix-watching, nacho-eating, just about anything. If you find yourself going too far into the wee hours of the night too often, you can technically make up a few late nights by sleeping in for a few days—but you might still be racking up serious sleep debt.

“Sleep debt is an accumulation of sleep deprivation,” says Dr. Michael Breus, a clinical psychologist in California and fellow of the American Academy of Sleep Medicine. Think of your sleep like a savings account, where the minimum balance has to be roughly eight hours a night (some of us might need more or less)—for every night you don’t put that amount in your sleep account, you accumulate overall sleep debt. And trust us, that can add up fast. Sleep debt is pretty common—70 percent of college students reported that they snag less than eight hours a night, according to a 2010 study in the Journal of Adolescent Health. 

Why does it matter? Not unlike managing your bank account, accumulating sleep debt can leave you feeling depleted. Lack of sleep can mess with:

Academic performance Students who are sleep deprived struggle more academically and are at a higher risk of failing compared with those who are getting enough rest on a consistent basis, says a 2014 study in Nature and Science of Sleep. “Sleep deprivation affects cognitive function directly and quickly,” says Dr. Breus.

In studies, sleep and GPA are related, but not necessarily in the ways you’d think. Consistent sleep and wake times may have more of a grade-boosting effect than logging more hours, according to a 2014 analysis of recent research in Nature and Science of Sleep. It’s not just about how long you’re sleeping, but how consistent your sleep schedule is (or isn’t).

Mood Female college students who reported nightly sleep debts of two hours or more were significantly more likely to report depressive symptoms than those with smaller debts, a 2010 study in Psychiatry Research found. What are depressive symptoms? They include everything from changes in appetite to lack of focus to blues you just can’t shake. (And this is a serious thing: If you’re experiencing symptoms of depression, reach out to a friend, trusted professor, or a counselor on your campus or in your community. Because help is out there, and you matter.)

Body Sleep debt affects your bod in a number of ways: It increases the production of your hunger hormones (while suppressing the hormones that tell you you’re full), raises levels of your stress hormones, and even messes with your body’s ability to use sugar effectively, according to a 2010 meta-analysis of studies in Pediatric Endocrinology.

Sleep debt can snowball fast. The more sleep deprived you are, the less likely you might be to notice. So how do you know—and how do you fix it?

How to tell if you’re in debt

The simplest way to tell if you’re racking up sleep debt is to do the math. If the average young adult needs eight hours of sleep each night and you get only six most days of the week, by the time Friday rolls around you’re 10 hours in debt.

In most cases, the ideal level of sleep needed to keep your balance in the black is individual, says Dr. Shelley Hershner, director of the Collegiate Sleep Disorder Clinic at the University of Michigan. The average person needs somewhere between seven and nine hours nightly, but “your absolute best judgment of whether you are getting enough sleep is if you can wake up at the time you’re supposed to without an alarm clock,” she says.

Here are some other signs you might be in sleep debt:

• You can’t sit through a lecture without getting drowsy or even nodding off.
• You fall asleep the second your head hits the pillow.
• You don’t wake up until the second your alarm goes off. (During a healthy night’s sleep, you should actually go through cycles of slight wakefulness.)
• You feel drowsy during downtime, like while reading or watching TV.

To figure out how much sleep you need, test your sleep limits during a break from school when you have a solid three to four weeks to sleep as much as you want, says Dr. Hershner. “For the first week or two, you’ll probably still be catching up, but by the third week, how much you’re sleeping should be a good indication of how much your body actually needs.”

How to get out of debt

Technically, you can “pay off” your sleep debt by making up those missed hours every weekend, but playing catch-up by sleeping your weekends away isn’t ideal, partially because you’ll throw off your sleep schedule for the following week. That contributes to—you guessed it—more sleep debt. The most realistic way to get out of sleep debt is by preventing it in the first place. And the beginning of the year is the best time to do that. Here’s how:

[/vc_column_text][vc_custom_heading text=”15 minutes earlier to bed; 15 minutes later to rise ” font_container=”tag:p|font_size:20|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%20Condensed%3A300%2C300italic%2Cregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal”][vc_column_text]“Would I like students to get eight hours every night? Yes. Do I think that’s realistic? No,” says Dr. Hershner. If getting to bed an hour earlier every night seems about as likely as your professors canceling lecture in favor of a class party, try to make small schedule changes like getting to bed 15 minutes earlier and streamlining your morning routine so you can sleep 15 minutes longer. You just clocked 30 more minutes.[/vc_column_text][vc_custom_heading text=”Take one less social media break a day (Just. One.) ” font_container=”tag:p|font_size:20|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%20Condensed%3A300%2C300italic%2Cregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal”][vc_column_text]An easy way to score yourself those extra 15 minutes at night is to cut out one social media break during the day. We know tech use affects sleep, but interestingly enough, sleep also affects tech use: When you’re sleep deprived, you spend more time aimlessly scrolling on Facebook, suggests 2016 research from the University of California, Irvine. The higher your sleep balance, the more time you can bank toward an earlier bedtime.[/vc_column_text][vc_custom_heading text=”Be strategic about your class schedule” font_container=”tag:p|font_size:20|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%20Condensed%3A300%2C300italic%2Cregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal”][vc_column_text]“If you can have a 9 a.m. or 10 a.m. class, you’ll probably do better than if you schedule an 8 a.m. class,” says Dr. Hershner. Look for classes that have later schedules or offer recorded video lectures so you can tune in anytime.[/vc_column_text][vc_custom_heading text=”Learn to love the nap” font_container=”tag:p|font_size:20|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%20Condensed%3A300%2C300italic%2Cregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal”][vc_column_text]

Studies show that students who take more naps do better in class. College students with GPAs of 3.5 and higher were much more likely to be nappers than were their peers with lower GPAs in a 2010 study in Sleep and Breathing. Just make sure you don’t snooze after 3 p.m., says Dr. Hershner. “That can throw off your nighttime sleep.”[/vc_column_text][vc_custom_heading text=”Be consistent” font_container=”tag:p|font_size:20|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%20Condensed%3A300%2C300italic%2Cregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal”][vc_column_text]According to Dr. Hershner, you want to try to prevent sleep debt by getting into good sleep habits—so it’s not great to fall back on the idea that you can make up all that lost sleep on the weekends. “Don’t sleep more than one to two hours longer on the weekend than you do during the week,” she says. “Say you sleep until 1 p.m. on Sunday—then it makes it hard for you to fall asleep by the time you need to get enough sleep for Monday. You’re already starting the week off behind.”[/vc_column_text][vc_custom_heading text=”Keep your tech at arm’s length” font_container=”tag:p|font_size:20|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%20Condensed%3A300%2C300italic%2Cregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal”][vc_column_text]The blue light emitted from your laptop or phone suppresses your levels of melatonin, a hormone that affects your circadian rhythms, says Harvard Health Publications. And that isn’t a good thing for your sleep. If you’re not going to unplug entirely, at least switch on your phone’s blue light filter and don’t hold it so close to you. “You want [your tech] as far from the face as possible,” says Dr. Hershner.[/vc_column_text][vc_custom_heading text=”Use your computer after class and books before bed” font_container=”tag:p|font_size:20|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%20Condensed%3A300%2C300italic%2Cregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal”][vc_column_text]

To cut out computer usage before bed, schedule your studying so you can get any computer work out of the way earlier in the evening and switch to books in the hour before bed. “If your reading is all online, print out a few chapters to read so you can shut off the computer,” says Dr. Hershner.[/vc_column_text][vc_custom_heading text=”Track your Zs” font_container=”tag:p|font_size:20|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%20Condensed%3A300%2C300italic%2Cregular%2Citalic%2C700%2C700italic|font_style:700%20bold%20regular%3A700%3Anormal”][vc_column_text]

“I have a Fitbit that tracks my sleep, so I know how much I get,” says Brandon B., a fourth-year graduate student at the University of California, Los Angeles. “Seeing the numbers helps me.” Dr. Hershner cautions that wearable trackers aren’t always accurate, but the idea behind tracking your sleep is solid if seeing your stats motivates you to stay on track. If you don’t use a wearable, explore other options that help you feel accomplished for getting a good night’s sleep, like keeping a sleep journal or using an app. We like Sleep Cycle alarm clock, and we think you might too.

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Ironically enough, the more you worry about getting into sleep debt, the harder it might be for you to fall asleep. To avoid the anxiety, don’t keep a clock within view, says Dr. Hershner. Turn your alarm clock so it faces away from you and flip your phone over and put it on airplane mode when you go to sleep.

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Meditation can be “really good for helping people transition into sleep,” says Dr. Hershner. To help you keep a consistent sleep schedule, make your bed into a relaxing sleep oasis. “Do not study on your bed. Let your bed be for sleeping only,” says Jieying Q., a second-year student at Notre Dame of Maryland University. Close the books and download a meditation app to help quiet your mind before bed—just make sure you’re not taking the phone into your sleep zone.

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Student loan debt isn’t the only deficit students have to worry about—sleep debt can also leave them feeling depleted. “Sleep debt is an accumulation of sleep deprivation,” says Dr. Michael Breus, a clinical psychologist in California and fellow of the American Academy of Sleep Medicine. It’s a big issue: Nearly 70 percent of college students reported that they sleep less than eight hours a night, according to a 2010 study in the Journal of Adolescent Health. Sleep problems rank third on students’ list of issues that affect their academic success, according to the American College Health Association’s National College Health Assessment (Fall 2016).

Sleep debt can affect students’ overall mental, physical, and emotional health, including:

Academic performance Students who are sleep deprived struggle more academically and are at a higher risk of failing compared with those who are getting enough rest on a consistent basis, says a 2014 study in Nature and Science of Sleep. “Sleep deprivation affects cognitive function directly and quickly,” says Dr. Breus.

Mood Female college students who reported nightly sleep debts of two hours or more were significantly more likely to report depressive symptoms than those with smaller debts, a 2010 study in Psychiatry Research found.

Short of physically putting students to bed each night, how can administrators, faculty, and staff build a campus that promotes healthy sleep rather than one that glamorizes all-nighters? Here are some places to start:   

Spread sleep hygiene awareness

Only a quarter of students report that they’re getting information from their colleges about healthy sleep habits, according to the National College Health Assessment (Fall 2016). But over 60 percent of students say they want that information. To close the gap, launch a public awareness campaign and train student leaders and staff to share strategies for building healthy sleep habits. A semester-long study at Macalester College in Minnesota, found that students who received sleep health information from campus staff two or three times throughout the semester reported fewer negative sleep habits.

Offer a sleep course

Creating a class about sleep is a way to boost students’ sleep hygiene. Stanford University in California created a course dedicated to sleep behaviors back in the 1970s. Today, it’s so popular there’s a wait list. Based on Stanford’s success, New York University, the University of Missouri, and others have implemented similar courses. And so can you.

Educate your educators

Campus staff can sometimes be in the best position to spot widespread sleep deprivation, so don’t stop the awareness campaign with students. Train college professionals to be able to provide information to students and intervene if they notice their students are routinely nodding off in class.

Create a sleep-friendly space on campus

Studies show that students who take more naps do better in class. College students with GPAs of 3.5 and higher were much more likely to be nappers than were their peers with lower GPAs in a 2010 study in Sleep and Breathing. With that in mind, nap pods, library cots, and special nap rooms on campus are becoming more popular. Schools like the University of Michigan and James Madison University in Virginia have established campus nap zones to make it easier for students to practice good sleep habits with the same diligence they approach good study habits.

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Reading Time: 12 minutes[vc_row][vc_column][vc_column_text]Rate this article and enter to win 
Deliberately hurting oneself is among those human behaviors that seem baffling and counter-intuitive from the outside. A student who parties, gets depressed, and ends up cutting himself may fear that his peers just wouldn’t get it. A student who realizes that a friend pulls out her own hair may have no idea how to help. While most college students do not deliberately harm or injure themselves, it’s certainly happening on campuses, studies show.

“Self-injury tends to go through jags,” says Dr. Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recovery at Cornell University, New York. “It’s not uncommon for someone to not injure for a year and then start again in college when they get triggered by a variety of stressors—everything from academic to romantic problems.” Understanding self-injury can help clue us in to the complexities of our own and others’ experience, and lead us to healthy ways to handle the stresses of school, however they manifest.

What is self-injury?

When people intentionally cause harm, pain, or damage to their own body, without the intent to die, it’s called non-suicidal self-injury (or self-harm). We tend to think of self-injury as cutting. In reality, it can be any type of behavior that intentionally causes tissue damage to the body, so it could involve burning, pulling out hair, or some acts of externalized aggression, such as punching walls. Self-injury may happen under the influence of drugs or alcohol (though using alcohol or drugs is not itself considered self-injury). Self-injury is different from suicidal self-harm, which is motivated by the intent to die and includes suicidal thinking. That said, people who self-injure are more likely than others to consider suicide (see: What raises the risk for self-injury?).[/vc_column_text][vc_tta_accordion shape=”square” color=”blue” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”Attention-seeking, eating disorders, piercings, sex: Which behaviors are part of self-injury?” tab_id=”1501534356754-0bf85a4b-4500″][vc_column_text]

• Self-injury is not necessarily used as a way to get attention from others. However, some people may self-injure because they haven’t yet learned how to ask for what they need in healthier ways. If someone needs attention, take it seriously.

• Self-injury may co-occur with other issues, such as depression or anxiety, but it is not itself a disorder, diagnosis, or disease. Self-injury is a symptom.

• Eating disorders, such as anorexia or bulimia nervosa, are different from self-injury, though people with eating disorders are at higher risk of self-injury compared to the general population, according to a 2015 meta-analysis by the Cornell Research Program on Self-Injury and Recovery.

• Tattoos and piercings are not considered self-injury, unless someone is seeking out pain as a substitute for healthier ways to handle distress.

• Heavy drinking or drug abuse is not technically a form of self-injury, though the behaviors are often related. A 2011 study in the Journal of American College Health found that almost one in five students who self-injured did so when under the influence of alcohol or other substances.

• Self-injury is not the same as BDSM, erotic practices that involve submission and dominance, which may include consensual behaviors that cause physical pain. Self-injury is about seeking emotional release, while consensual BDSM practices are about sexual pleasure.

• Self-injury may be a means by which some people feel more in control of how and when they experience pain.

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Why do some people self-injure?

Self-injury can happen as a result of not being able to cope with certain stressors or emotions. “The behavior is seen a lot in college because the pressures during this timeframe—like grades, relationships, and jobs—increase,” says Dr. Retta Evans, associate professor of Community Health and Human Services at the University of Alabama at Birmingham.

Self-injury is more common in young adults who are also experiencing depression or anxiety, sexual abuse or trauma, eating disorders, or substance abuse. People who are LGBTQ are also at relatively high risk, perhaps because of the stress of social judgment. “Self-injury was a way to release inner pain that I didn’t know how to talk about,” says a third-year undergraduate at St. Clair College, Ontario.[/vc_column_text][vc_tta_accordion shape=”square” color=”blue” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”6 reasons why people self-injure” tab_id=”1501534423916-b4714236-f07e”][vc_column_text]People self-injure for a variety of reasons. Sometimes those reasons evolve over time. In our survey, many students referred to self-injury as a temporary behavior that they had managed to move past. “When I was in foster care I began to self-injure. I had recently been removed from a very dangerous situation and was dealing with what I had survived. I stopped harming myself when I was ready; I meditated a lot and worked through my issues,” said a fourth-year undergraduate at Portland State University, Oregon.

These are among the most common reasons for self-injuring:

1  To experience emotions differently

“I have severe anxiety attacks. Self-injury is a form of manifesting the emotional pain into physical pain. By doing this, I tell myself my pain is real.”
—Second-year undergraduate, Portland State University, Oregon

2  To “take away” or escape from unwanted feelings or thoughts

“Self-injury to me meant an escape from emotional pain that I did not understand and did not want my family to see. It happened because I did not want to be seen as weak in my family’s eyes; I was supposed to be a role model.”
—Fourth-year undergraduate, Dominican University, California

3  To bring recognition to their problems

“For me, it was a cry for attention. I was not getting the help I needed and had no real coping mechanisms.”
—First-year undergraduate, East Tennessee State University

4  To avoid taking anger out on someone else

“I got so angry that I hurt myself because I couldn’t hurt the other person. I am a nice person, but when people do mean things toward me, I hurt myself instead. It’s the only way I can vent.”
—Fourth-year graduate student, Berea College, Kentucky

5  To punish yourself or help you deal with a failure

“For me, self-injury was my way of punishing myself for who I was. I hated myself for things I did and the way I was. I hated who I was and thought I didn’t deserve happiness.”
—Fourth-year undergraduate, California State University, Stanislaus

6  To continue the habit

“Self-injury was a form of punishing myself for perceived ‘stupidity’ when it began. But it’s currently a compulsion when I experience severe frustration or stress.”
—Second-year graduate student, University of Rhode Island[/vc_column_text][/vc_tta_section][vc_tta_section title=”Who’s self-injuring in college?” tab_id=”1501535536126-1d4e3a40-24bb”][vc_column_text]Most people who self-injure start as teens—but self-injury is not a problem that goes away when they graduate high school. It can continue into college, restart when pressure builds, or begin later, experts say. “It’s very episodic, for a lot a people,” says Dr. Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recovery at Cornell University, New York.

People don’t talk much about self-injuring, so it’s hard to know how commonly it happens. In a 2011 study, 15 percent of college students said they had self-injured at some point, and 7 percent had in the past year (Journal of American College Health), though estimates vary. In surveys, more women tend to report self-injury than men. On campuses, however, women and men may self-injure at similar rates. Most people who self-injure don’t seek support, research shows.[/vc_column_text][/vc_tta_section][vc_tta_section title=”6 risk factors for self-injury” tab_id=”1501534424005-20653fb1-b291″][vc_column_text]

What raises the risk for self-injury?

1  Age

• Most people who self-injure start in their early to mid-teens, according to the Cornell Research Program on Self-Injury and Recovery.
• However, two studies found that close to 40 percent of participants who self-injured first did so at age 17 or later (Journal of Mental Health Counseling, 2008).
• Most self-injurers (80 percent) stop within five years, research shows.

2  Depression and anxiety

• In a 2009 study, participants with depression, anxiety, and perfectionist personality traits were significantly more vulnerable to self-injury, according to Suicide and Life-Threatening Behavior.
• People who self-injure are more likely than others to consider or attempt suicide, research suggests. This may be because “people who have practice hurting their bodies may find it easier to hurt themselves lethally,” researchers say (Cornell Research Program on Self-Injury and Recovery website).

3  Child abuse and trauma

• Adolescents who had been abused as children were significantly more likely to self-injure than their peers who had not been abused—especially if they had been abused by more than one individual, a 2015 study in the journal PLOS One found.
• Even exposure to childhood abuse—for example, witnessing a sibling being abused—increases the later risk of self-harm, the researchers found.

4  Eating disorders

• A large cohort of people who self-injure—54–61 percent—also have some form of eating disorder, such as anorexia or bulimia, according to a 2007 meta-analysis in Suicide and Life-Threatening Behavior.
• Bulimia is more likely than other eating disorders to co-occur with self-injury, according to the Journal of Adolescent Health (2011).
• Women with eating disorders are more likely to also self-injure than men with eating disorders, according to the same study.

5  Substance abuse

• Drug use and frequent heavy drinking are associated with higher rates of self-injury, according to a 2010 study of almost 6,000 students in the Journal of Addictive Behaviors.
• The researchers also found that self-injurers who used drugs were more depressed (another risk factor for self-injury) than those who didn’t use drugs.

6  Minority sexual or gender identity

• Lesbian and gay adolescents are over twice as likely to self-injure as their heterosexual peers, according to a 2011 study in the Journal of American College Health.
• People who identify as bisexual have the highest rates of self-injury. The same study found that bisexual adolescents were over three times as likely to self-injure as their heterosexual peers.
• The higher rates of self-injury among the LGB community may be due to societal judgment about their identity, the stress of coming out, and the lack of belonging (especially among those who identify as bisexual), the researchers speculated.
• Self-injury is relatively common among trans youths, especially those with higher levels of transphobia (conflict about their own identity) and interpersonal tensions, according to the Journal of Sexual Medicine (2016).

[/vc_column_text][/vc_tta_section][vc_tta_section title=”Is gender relevant to self-injury?” tab_id=”1501535604596-d7f090d6-c070″][vc_column_text]Research is currently mixed on this issue. Girls and women seem to self-injure more commonly than boys and men do. But some studies suggest that during young adulthood, men and women may self-injure at similar rates. For example, the 2011 study of college students found that women were more likely than men to report that they had ever self-injured, but women and men were equally likely to say they had self-injured within the past year (Journal of American College Health). (The student comments in this article come from men and women.)

Researchers have two main theories that may help explain the perceived gender differences in self-injury:

• Women are more likely to speak up about self-injury; perhaps societal gender stereotypes make it easier for women than men to talk about emotional health issues.
• Men’s self-harming behavior may be brushed aside as “typical male aggression.”

“In some ways, men are better at hiding it than women [perhaps due to traditional gender roles]. If we see wounds on a guy’s knuckles we [might] assume he’s been working on a car or in a fight,” says Dr. Whitlock. “To an outsider, it looks like they’re trying to cause someone else pain, but the underlying motivation is often to cause themselves pain. For women, the telltale cuts on arms or ankles might be more obvious.”

Student voices

“My self-injury involved punching walls and seeking out fights to vent anger and frustration. Usually under the influence of alcohol.”
—Fifth-year undergraduate (male), University of New Brunswick

“For many years I cut my thighs. They are horribly scarred now. I chose my thighs because I was embarrassed and didn’t want it to be obvious. I did it to cope and calm down because it always cleared my head. I was in a dark place, but I hid it from my friends and family
—just like the scars.” —Fourth-year undergraduate (female), University of New Brunswick [/vc_column_text][/vc_tta_section][/vc_tta_accordion][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

How to help yourself or a friend who self-injures

Usually, when people learn how to cope with their emotions and talk about how they feel, they experience less of an urge to hurt themselves. Simple techniques and skills can decrease the intensity of emotions and make them more manageable. “Finding a different outlet [for distress] was the key to my recovery,” says a second-year undergraduate at SAIT Polytechnic, Alberta. These three approaches can help you or a friend:

1  Reach out and talk

If you are self-injuring, reach out. Talk to a friend, mentor, RA, professor, member of your religious community, or member of your support group (in person or online). Ask for their support, and spend time with people who make you feel good.

If you’re concerned that someone else may be self-injuring, check in with them. “Let your friend know you care,” says Dr. Lance Swenson, associate professor in psychology at Suffolk University, Massachusetts. “Remind your friend you are there to listen. Tell them you can help them get help. Most people who self-injure are not consciously aware of why they are [doing it], at least not in the moment.” Seek out support for yourself too, so that you’re in a strong position to be there for your friend.[/vc_column_text][vc_tta_accordion shape=”square” color=”blue” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”How to talk to a friend who is self-injuring” tab_id=”1501534549086-221d6f58-cc90″][vc_column_text]“Let your friend know you care,” says Dr. Lance Swenson, an associate professor in the psychology department at Suffolk University, Massachusetts. “Remind your friend you are there to listen. Tell them you can help them get help. Most people who self-injure are not consciously aware of why they are [doing it], at least not in the moment. They shouldn’t feel like they have to face it alone.”

That said, it’s not on you to solve this. “The roots of self-injurious behavior are likely very complicated. No matter how much you care about a friend, and how hard you try to help, they may continue this behavior despite your best efforts to help them,” says Dr. Davis Smith, a physician at the University of Connecticut.

How to talk to a friend you are concerned about:

• Ask straightforward, direct questions in a calm manner, such as, “Are you thinking about hurting yourself?”
• Actively listen—focus on what they’re saying—then offer support.
• Take your friend seriously. If your friend mentions any thoughts about suicide, especially a plan or method, call 911 or speak to a dean or campus counselor.
• Encourage your friend to talk to a trusted mentor, RA, professor, coach, or member of their religious community; be there for them, but do not take on the full burden yourself.
• Encourage your friend to consider seeking help from a licensed mental health professional (for example, a psychologist, social worker, or counselor—ask at your campus health center or counseling center).

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2  Test coping strategies and figure out what works

If you’re concerned about a friend, you may be able to help them explore these techniques. If you’re self-injuring, test these strategies and take note of what helps. “Distress tolerance skills” can be used in place of self-injury. See Get help or find out more (below) for more info.[/vc_column_text][vc_tta_accordion shape=”square” color=”blue” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”10 healthy ways to channel painful feelings” tab_id=”1501534597808-8048f0e1-8974″][vc_column_text]1  Do the opposite of what you feel:

For example, listen to your favorite upbeat song, or watch a funny YouTube video. Look in the mirror and smile—watch as your expression changes.

2  Exercise hard and fast:

Do 25 jumping jacks, go for a jog, or dance around the room. Research shows that cardio exercise can reduce your stress and improve your mood. Regular physical activity can be protective.

3  Use your five senses:

This helps you connect with what is going on around you and anchor yourself in the present moment. For example, sink your heels into the floor or ground and focus on how it feels beneath your body. Hold something soft or fuzzy. Squeeze a stress ball. Place a cool, wet washcloth on your face. Light a scented candle and breathe in deeply. Cook and/or eat your favorite food and really allow yourself to enjoy the flavor. Go for a walk or drive and take in the sights and smells. Take ice from the freezer and hold it tightly in your hand. Get into warm water (take a shower or bath).

4  Take slow, deep breaths:

Imagine you are blowing up a balloon. When you inhale deeply, your lower belly should expand. Count to three on each inhale and each exhale.

5  Think about your emotions:

Face them instead of pushing them away. Labeling an emotion (e.g., “My heart is racing and I’m feeling anxious”) can often help you figure out why you’re feeling that way (e.g., “I have a big exam coming up next week and I’m anxious about studying for it”). Write down how you’re feeling in a notebook or journal.

6  Focus on your heart:

Put your hand on your heart so you can feel your heartbeat and count the beats per minute. Try to slow down your heart rate by taking slow, deep breaths.

7  Actively cherish what you have:

Look at pictures on your phone or computer that make you smile. Make a list of all of the things you are grateful for or happy about in your life.

8  Actively cherish who you are:

Make a list of your accomplishments—e.g., “I do pretty well in school,” “I am a caring friend,” “I take excellent care of my dog.”

9  Sink into something else:

Read a book, story, or article. Listen to your favorite music, play an instrument, or sing (even if you have no musical talent!). Engage in your favorite hobby or master a skill, such as gardening, cooking, baking, playing a video game, knitting, painting, or drawing.

10  Prioritize sleep:

Get up as close to the same time every day as possible; this will help you go to bed at a more regular time too. Your bed is for sleeping only (no electronics or social networking). Relish it.[/vc_column_text][/vc_tta_section][/vc_tta_accordion][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

3  Consider seeking professional support

Checking in with a counselor can relieve some of the pressure and help you find strategies and resources you wouldn’t otherwise know about—whether it’s you who’s self-injuring or your friend. Your student health center or counseling center may be able to help directly or refer you to an expert medical provider. Certain therapeutic techniques—such as cognitive behavioral therapy (CBT) or dialectical behavioral therapy—are designed to build healthy coping skills directly. If you ever feel suicidal, call 911, go to the nearest emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-8255.

“I did not want to feel hopeless and alone anymore,” says a first-year undergraduate at California State University, Channel Islands. “I decided go to counseling to cope with my self-injuring tendencies. Every session I attended helped me gain the confidence to be myself, and most importantly, to love myself. Don’t be afraid to seek help.”

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Eating should be easy, shouldn’t it? It should work like this: We get hungry, we eat what feels good for us, and we’re all set. But in reality, eating is way more complicated. Too often, for too many of us, getting a snack or dinner involves confronting a messy pileup of conflicting rules, instincts, signals, and feelings. Ever wished you weren’t eating the thing you were actually eating at that moment? Ever hashtagged your life story #bodygoals or #foodguilt? Ever wanted a straightforward way out of this?

Eating intuitively—also known as eating mindfully or consciously—is a whole different way of thinking about how to eat. It can help us get healthier by various measures, and feel good too (about our bodies and in other ways), research suggests. Eating intuitively means clearing out some of the stuff in that messy pileup—so yes, it’s a departure from our cultural norm, something we need to think about and practice. Yet at the same time, eating intuitively is not a new skill.

Eating intuitively or mindfully is about cuing into our mind and body, figuring out what feels right, and acting on those signals, just as we evolved to do. “Eating intuitively is a way of using your body’s wisdom—your intuition—to guide your decisions around food,” says Lauren Fowler, RD, a nutritionist with expertise in eating disorders, based in Vermont. “Instead of following rigid, restrictive diets, intuitive eating is the process of tuning into your body’s cues for hunger, fullness, and what you want to eat in that moment.”

How eating intuitively helps

For many of us, decisions about how we eat are driven, to some extent, by our body image and ideas about how to control our weight. This is true of people who have a diagnosable eating disorder (a medical condition), and also, to some extent, true of many people who don’t. This motivation for food choices tends to backfire, research shows (see right). In contrast, eating mindfully or intuitively seems to set us up for positive outcomes. In a 2014 meta-analysis of 26 studies in Public Health Nutrition, researchers concluded that eating intuitively or mindfully was a better way than dieting to maintain a healthy weight. It also resulted in improved psychological health, lower blood pressure and “bad” cholesterol, and healthier eating habits, compared with weight-driven diets or nothing at all.

Eating mindfully is not about weight loss. That said, some studies suggest it can help with weight management as a side effect of developing a healthier relationship with food. In another 2014 meta-analysis, researchers found that a mindful eating approach helped participants ditch unhealthy (and ineffective) weight-loss strategies, improve their metabolic fitness, and be more satisfied with their bodies (Journal of the Academy of Nutrition and Dietetics). That’s a win-win-win.

Why weight-loss approaches can let us down

“Weight bias” or shame is disempowering and reduces our ability to take care of ourselves, according to a 2014 study in the I (and other studies).

Some health care providers who specialize in eating-related issues point out that body shame and dieting can contribute to stigma, anxiety, and disordered eating. “Diets require you to ignore hunger or cut out foods you may really enjoy. Often, this leads people into a cycle of obsessing about food or binging on food,” says Lauren Fowler, RD.

What works better? “By learning to trust your body [through eating intuitively], you can eat then move on with your day, instead of obsessing or feeling guilty about eating,” says Fowler.

Increasingly, eating mindfully as a positive approach to self-care is influencing medical research and practice. “Learning to eat for your body’s health needs, rather than for other reasons like image or social rules, leads to less stress, and less guilt and shame, and is associated with a number of health benefits,” says Dr. Marc Weigensberg, an associate professor at the University of Southern California’s Keck School of Medicine, who researches the psychological and physiological factors that influence obesity and chronic disease risk.

7 steps to becoming an intuitive eater

In some ways, this approach to eating may feel counterintuitive. Can we really lose the baggage associated with body shape and food—baggage that is so familiar we may not even see that we’re dragging it around? That’s a valid point. Still, think about this: Eating intuitively is about reconnecting with what our bodies and minds already know how to do. As we practice mindful eating, we may develop a healthy and pleasurable relationship with food, and with ourselves, research suggests. Check out these seven steps. Click on each one for more info and students’ perspectives.

[/vc_column_text][vc_tta_accordion shape=”square” c_icon=”chevron” active_section=”” collapsible_all=”true”][vc_tta_section title=”Build body awareness” tab_id=”1494997907691-a6b0f2b0-5355″][vc_column_text]Tune in to your cues. How hungry are you? What do you want to eat? How or where do you want to eat?  Check in with yourself before you pick up lunch in the cafeteria or hit up the vending machine. While you’re eating, be attentive to when your body becomes satisfied. No matter how good that froyo is, too much just makes you feel sick.

Three ways to build body awareness

1. Hear what your body is telling you

Once you’ve determined that you’re actually hungry, focus on what your body is telling you, says Lauren Fowler, RD, a nutritionist with expertise in eating disorders. If you can’t stop thinking about a bowl of pasta after track practice, it’s probably because your body needs carbs. Eating mindfully suggests you’re better off reaching for the rigatoni than trying to get by on a simple salad.

2. Check in with yourself every few hours

“You can work on this by checking in with your body every few hours to prioritize nourishment,” says Fowler. “You’ll find that you may be able to focus better, have more energy, and feel better throughout the day with consistent fuel.” To get into the habit of consistent check-ins, consider setting up an alert on your laptop or phone.

3. As you eat, focus on fullness

“A very small percentage of people have the full time and attention to eat a pea and say, ‘Am I full yet?’” says Dr. Brian Wansink, author of Slim by Design: Mindless Eating Solutions for Everyday Life (William Morrow, 2014), and director of the Food and Brand Lab at Cornell University, New York. Pay attention to portion sizes up front, and check in with yourself to see if your body wants seconds or if you’re actually full.

Student perspectives

“The college environment isn’t good for weight management. Students are pressed for time with studying, and fast food is both convenient and tastes good, which satisfies one temporarily.” 
—Fourth-year undergraduate, Temple University, Pennsylvania

“[Intuitive eating has helped me] listen to my body when it tells me I am no longer hungry instead of stuffing myself because the food is too good.”
—Fourth-year undergraduate, State University of New York at Oswego[/vc_column_text][/vc_tta_section][vc_tta_section title=”Eat for enjoyment” tab_id=”1494997907847-73313eff-0a49″][vc_column_text]Eating mindfully is about enjoying your food. If you’ve been thinking about treating yourself to a post-exam cupcake or slice of pizza, go for it. Cherish that mouthfeel. Equally, relish the kale chips and salad.

How to put the fun back into food

Enjoy everything, not just the treats

This goes both ways. Kale chips? Don’t just crunch them down and give yourself a pat on the back. Instead, savor the healthy food you’re eating and the feeling of satisfaction. “I like to look at how can you get the most satisfaction out of eating,” says Elyse Resch, MS, RD, a nutritionist who co-created Intuitive Eating—a specific program and brand. “I begin with satisfaction because, to me, that’s the driving force of Intuitive Eating. It has an impact on all your meals.”

Choose higher-quality foods if available

This isn’t always an option, of course. Budget is a major consideration for most of us. That said, if you love the cupcakes your roommate’s mom makes, don’t spoil your appetite with the subpar version from the café. “When you realize all food is fair game, why waste your time on anything that’s going to be inferior? As the intuitive eater emerges, you start going for better foods,” Resch says.

Student perspective

“[Eating consciously] allows me to really enjoy my food and ensure that I eat enough without eating too much. It helps me listen to the signals my body is sending me. I feel at peace when I’m able to live right in the moment and enjoy my experience to its fullest.”
—Fifth-year undergraduate student, Ball State University, Indiana[/vc_column_text][/vc_tta_section][vc_tta_section title=”Be open to more foods” tab_id=”1494998235657-c26bf78f-ecb7″][vc_column_text]Eating intuitively is not about “good” or “bad” foods. If you’re truly listening to your instincts, giving your body what it needs is something you do naturally, proponents of mindful eating say. Making peace with a slice of cake and striving to make healthy choices are not mutually exclusive.

Here’s why you don’t need those old rules

All foods are available

Guess what? You’re allowed to eat those Instagram-worthy desserts. You get to move away from self-denial and punishment. “Valuing yourself, and being gentle and compassionate with yourself, are keys to success,” says Dr. Marc Weigensberg of the University of Southern California’s Keck School of Medicine.

Think of foods as emotionally equivalent

It’s OK to find the happy feels in a bowl of ice cream—and also in a crunchy carrot. “All foods should be emotionally equivalent. That doesn’t mean they’re nutritionally equivalent, but you should be able to feel that you can look for the same pleasure and satisfaction out of any food without judging it,” says Resch. Eating intuitively means you’re not beating yourself up when you indulge.

Student perspective

“I’ve never felt better. Even on my so-called ‘cheat days,’ I am conscious and aware and still have very little regret afterwards. I have lost about 15 pounds because I am simply following my body’s needs and listening to what my body tells me. I’ve never felt better about myself.”
—Second-year undergraduate, Utah State University[/vc_column_text][/vc_tta_section][vc_tta_section title=”Move away from the diet mentality” tab_id=”1494998287976-95f0b73c-5233″][vc_column_text]Intuitive eating is about forming a better relationship between your body and what’s on your plate. It means letting go of goals that emphasize counting calories and dropping pounds, and finding the joy in food and your own self.

Make this about feeling good now and in the future

Focus on looking after yourself and feeling good

Always think health. “Rather than jumping on the latest fad diet, obsessing about a number on the scale, or worrying about the size of pants you wear, it’s helpful to instead focus your energy on healthy behaviors that you can engage in, regardless of body weight, and try to make these a regular part of your lifestyle,” says Dr. Rebecca Puhl, deputy director of the Rudd Center for Food Policy & Obesity at the University of Connecticut. When we diet, our intuitive wires get crossed, suggests a 2013 study in Eating Behaviors. Dieting participants in the study actually associated eating with satisfying an emotional need more strongly than with satisfying their hunger.

Think about the immediate benefits and be happy about long-term ones

Immediate benefits are more motivating than distant ones, so think about the ways that eating affects your feelings of pleasure, satisfaction, and self-care in the short term. Eating intuitively also sets us up for ongoing health and well-being, including long-term weight management, according to a 2016 study in JMIR Research Protocols. Participants who practiced eating intuitively experienced improved eating behaviors and more positive mental health, and they were still on track when researchers followed up three months later.

Student perspective

“[People criticizing my weight] made me more depressed and less motivated to make myself healthier. I ended up just eating more unhealthy food.”
—Fourth-year undergraduate, Temple University, Pennsylvania

“[Eating consciously] has helped me with portion size and making better choices in general. I don’t notice any difference on the outside yet, but I definitely feel different.”
—Third-year undergraduate, University of Hawaii at Manoa[/vc_column_text][/vc_tta_section][vc_tta_section title=”Eliminate distractions” tab_id=”1494998333262-24e6f48d-7c95″][vc_column_text]As scary as it sounds, try totally disconnecting while you eat. No Instagram, no texting, no binge-watching Stranger Things. Paying attention to what you’re eating is the whole point.

Why focus makes food so much better

Focus on your food

Intuitive eating is all about getting maximum pleasure from your meals. At the very least, that means remembering you ate them. When we’re distracted, we eat more, and we continue to eat more through the day, according to a 2013 review of studies in the American Journal of Clinical Nutrition. Researchers think that’s because we literally forget what we nommed down earlier in the day.

Beat the binge

Serve your food on a dish and make a point of enjoying each mouthful. Distracted munching can lead to accidental binge-snacking. That’s when you plonk yourself down with a bag of chips in front of the TV, and suddenly the bag is empty. In a 2012 study in Health Psychology, when there was no visual guide to portion sizes, students ate 50 percent more chips than than students who were cued into portion size through combinations of different-colored chips.

Get more enjoyment out of eating

Are you noticing how these steps reinforce each other? “When one is present while eating, that is a much more satisfying experience than being distracted while you’re putting the food in your mouth,” says Resch. “And let’s be honest, that fourth piece of pizza never tastes as good as that first piece of pizza.”

Reap the calorie benefits

Eating while distracted results in increased calorie intake, a 2013 study in the American Journal of Clinical Nutrition suggests. Again, eating intuitively isn’t directly about weight management—but for some that’s a side effect, because mindful eating can help us let go of attitudes and approaches that weren’t helpful.

Student perspective

“Mindful eating helps me maintain my weight. [It] also helps me stop binge snacking. By eating more nutrient-rich food I have way more energy than usual.” 
—Third-year undergraduate, University of California, Davis[/vc_column_text][/vc_tta_section][vc_tta_section title=”Honor your eating instincts” tab_id=”1494998425671-bd90a71f-1293″][vc_column_text]Once you’re cuing into your instincts, it gets easier to stick up for them—even when Mom sends a care package full of treats, or your friends want to split a second pizza when you’re already stuffed.

Why it’s OK to honor your values

Stick up for yourself

Setting boundaries is not only OK, it’s part of the process. If someone is pressing food on you, you always have the option to say “No thanks.” You don’t need to explain. But if you feel awkward, or are concerned about seeming high-maintenance, offer to take some home for later. “A major portion of Intuitive Eating is to realize that you have a right to have your needs met, and that includes speaking up,” says Resch.

Honor the social aspects of eating in ways that work for you

That said, part of the pleasure of food is social. Eating intuitively can be helpful when your baby cousin offers you a cookie he baked himself, or your professor makes a big-deal dish for the holiday celebration. With no food rules, you can do what feels right—which may be a full serving, a taste, or “Not for me, thanks.”

Student perspective

“I find intuitive eating works well if you are strictly adhering to eating that way. However, once out with friends, out to dinner, etc., it becomes difficult to follow.” 
—Fourth-year graduate student, Memorial University of Newfoundland, Newfoundland and Labrador

“For me this is a more advanced piece of eating mindfully. Now, before I go out with friends, I think about the ways that their eating used to influence mine—like stealing half their fries, even when the fries weren’t that great. I even practice saying, ‘Not for me tonight, thanks.’” 
—Recent graduate, Tufts University School of Medicine, Massachusetts[/vc_column_text][/vc_tta_section][vc_tta_section title=”Make mindful eating part of your big picture #wellbeinggoals” tab_id=”1494998472018-d79e057b-5b40″][vc_column_text]Becoming an intuitive eater is a healthy approach to total wellness, so think big picture. There may a spillover effect here. The habits you develop to guide your eating may support your emotional health, work, and relationships too.

Notice how mindfulness can improve other experiences too

Reap the emotional benefits

If eating intuitively has emotional health benefits, as some research suggests, it may support our overall happiness. For example, mindfulness—savoring the moment—can become a way of valuing a brisk walk to the store, or that quirky interaction involving the classmate you don’t quite gel with. “If you’re looking to mindful eating as the basis of your relationship with food, it will leach out into other aspects of your life,” says Resch, “like finding meaningful experiences in life, and in your work and relationships.”

Student perspective

“[Intuitive eating] has helped with my psychological wellness. I, along with many others, have suffered with the emotions tied to food and eating. Mindful eating has helped me to eat better and without my emotions and therefore has helped me like myself more.” 
—Third-year undergraduate, Saint Louis University, Missouri[/vc_column_text][/vc_tta_section][/vc_tta_accordion][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Is eating intuitively a treatment for eating disorders?

Can eating disorders be fully cured? It’s not clear. Some nutritionists and health care providers see disordered eating as a chronic condition that calls for ongoing management and attention (in this regard, it is similar to diabetes or alcohol dependence). This may be because the underlying feelings about food and self-image are persistent. “I have seen so many people who are trying to heal from an eating disorder who really don’t heal, because their mind-set has not been shifted from feeling bad about food,” says Resch.

Disordered eating is about rigid food rules, and tends to involve an all-or-nothing approach to eating. This can hike up the pressures associated with food. Someone who declares an entire food group off-limits (carbs, dairy, or added sugars)—without a medical reason—puts themselves into a state of constant vigilance and self-denial. That’s difficult to sustain, especially when we’re tired or stressed. Feeling bad about eating a few candies (a forbidden food) may lead us into an all-out food binge.

Eating intuitively can help break those negative thought processes and behaviors, proponents say. “Intuitive eating work in eating disorder recovery is [about] making peace with food in order to break free of all the food rules,” says Fowler. The research is promising. A 2014 meta-analysis of 24 peer-reviewed studies suggested that an intuitive approach to eating could help treat binge eating, anorexic tendencies, and self-shaming in participants, while improving participants’ self-esteem, body satisfaction, and self-acceptance (Journal of the Academy of Nutrition and Dietetics).

That said, if your body image or eating issues are persistent, seek support at your student health center or counseling center.  “People meeting diagnostic criteria for an eating disorder probably can’t think or try their way out of their problem, at least not without professional help,” says Dr. Davis Smith, staff physician at the University of Connecticut.

Student perspectives

“I’ve been struggling with body images issues for the past few years, and once I discovered I can reinvent myself through healthy delicious food and fitness I’ve never looked back.”
—Second-year undergraduate, Lambton College, Ontario

“It helped me stop bingeing on foods when I didn’t need to. I learned to stop eating when I was full and to not eat snacks just for the sake of eating. I dealt with body weight issues because of my fluctuating weight due to bingeing, so this concept has been very helpful in keeping me grounded in what truly matters.”
—Second-year undergraduate, Stanford University, California

Your best Instagram

“Mindful eating is so important to me, especially in an age that is obsessed with dieting. Paying attention to how you eat, and why you eat, is more important than strictly controlling caloric intake. I listen to my body and eat when I am hungry, and use mealtime to turn off electronics and focus on food and friends. I get to enjoy my favorite foods (like frozen yogurt!) and still stay healthy and satisfied. This also helps me maintain a healthy relationship with my body.”

—Marielle Martinez, second-year student, Florida Southern College

Follow us on Instagram, and don’t forget to use the hashtag #SH101mindfuleating

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