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New class expectations, new living situations, and navigating newfound independence can give us all the feels—from super psyched to super stressed. Even if you’re loving your student life, dealing with all the stressors that come with college can be a lot to handle. According to experts, the best time to handle that stress is now. “If we don’t take care of our mental health, we may not be able to reach our goals, maintain good relationships, and function well in day-to-day situations,” says Dr. Chrissy Salley, a psychologist in New York who works with students of all ages. “Taking care of mental health is one of the best things someone can do.”

Now really is the time to start tuning into your mental health—the majority of mental health issues appear to begin between the ages of 14 and 24, according to a review of the World Health Organization World Mental Health surveys and other research (Current Opinion in Psychiatry, 2007). But help is available. Along with methods like mindfulness and meditation, talking to a therapist (such as a counselor, psychologist, or psychiatrist) can be a super-effective way to manage any mental health issue you may be facing or just a way to get extra support during times of stress, challenge, celebration, or change.

There’s a ton of research on how effective therapy really is—a 2015 meta-analysis of 15 studies of college students with depression found that outcomes were nearly 90 percent better for those who received therapeutic treatment than for those in control groups, most of whom received no treatment (Depression and Anxiety).

One of the most common and effective therapies is cognitive behavioral therapy (CBT), a short-term, goal-oriented therapy where a pro helps you find practical ways to deal with specific problems.

[/vc_column_text][vc_tta_accordion shape=”square” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”More on CBT ” tab_id=”1508289452900-d340d698-c737″][vc_column_text]The goal of CBT is to help you change or reframe certain thought processes—the idea is that by changing your attitude about something, you can change your behaviors. For example, if you think something like, “I’m terrible at chemistry, so I know I’m going to fail this test—there’s no use studying,” you probably won’t ace your test. CBT can help you shift your thinking to something more like, “I know chemistry is really hard for me, but studying will help me do better.”[/vc_column_text][/vc_tta_section][/vc_tta_accordion][vc_column_text]And it works. There’s strong evidence that this therapeutic technique can help you handle just about anything you might have going on, according to a 2012 analysis of over 200 studies on CBT published in Cognitive Therapy and Research. The researchers found that CBT was effective for people struggling with anxiety, bulimia, anger issues, stress, and a number of other mental health issues.

OK, so we know that therapy is an essential and effective tool for keeping your mental health at its peak, but making that first appointment can feel intimidating. It doesn’t have to be. Our experts break down the therapy basics so you can embrace whatever you need to feel your best. Here’s what the pros want you to know.

Surveys show it’s not out of the ordinary to see a therapist—55 percent of college students have used campus counseling services, according to a 2012 report from the National Alliance on Mental Illness. If you feel uncomfortable with the idea of going to see a therapist, you’re not alone—and that’s totally OK, says Zachary Alti, a licensed social worker, psychotherapist, and professor at the Fordham University Graduate School of Social Service in New York. “Few people look forward to therapy, but students should be aware that therapy exists to help them, not to judge them,” he says. The process might not always be comfortable, but that doesn’t mean it’s not worth it. “I’d encourage students to keep an open mind and try it,” says Dr. Salley.

“Many [young people] tell me they’re reluctant to participate in therapy because they don’t want to talk about their feelings,” Dr. Salley says. Again, that’s totally normal. But going to therapy isn’t just about talking about how you feel; it’s also about walking away with real tools you can use in your life. “Therapy should also be action oriented—a time to learn new skills for coping and figuring out ways to solve problems,” Dr. Salley says.

“Therapy is like physical exercise,” says Alti. Just like hitting the gym is good for everyone’s physical health—not just those with diabetes or heart disease—seeing a therapist can benefit everyone’s mental health.

But really, any time is a good time to go. While anxiety and depression are still the most common reasons students seek counseling, according to a 2016 annual report from the Center for Collegiate Mental Health, you don’t have to be in the midst of a crisis or feel like you’re nearing a breakdown to see a pro—seeing a therapist can be helpful even when things are all good. “There are a lot of pink flags before you get to red ones,” says Dr. Dana Crawford, an individual and family therapist in New York. “Keeping things from becoming extreme is always better.” In other words, don’t wait for an emergency to take care of your mental health. “When bad things do happen, mental health will protect against the impact of these unfortunate events,” adds Alti.

Student perspective

“Being able to just have someone to really listen has promoted a lot of self-discovery. I trust my therapist with everything and I feel like he genuinely cares about what I have to say. He asks me questions that make me think about why I feel and do the things that I do. Once I know where something comes from, I can change it. It’s easier said than done, but it’s not something I think I could do on my own.”
—Second-year undergraduate student, University of Alabama[/vc_column_text][vc_column_text]

Real talk: College is full of huge life changes. “Even positive changes can be stressful,” says Dr. Salley. Luckily, therapists are particularly skilled at helping their clients deal with these transitions. “Having someone to talk to can be helpful, especially as you encounter new situations and people,” she says. While you’re dealing with a new set of responsibilities and expectations (everything from picking the right major to sorting through awkward roommate issues), a therapist can help you pinpoint how all the changes are impacting you and sort through the onslaught of emotions that everyone feels during this time.

Therapists aren’t one-size-fits-all—sometimes you have to try a few before you find the right fit. Don’t get turned off if your first therapy appointment isn’t super helpful—if something feels uncomfortable, listen to your gut, but don’t give up, says Dr. Crawford. “You would never go to the store, try on a pair of jeans, and say, ‘Oh, those don’t fit, I guess I won’t wear jeans.’ You would keep trying jeans until you found the right fit,” says Dr. Crawford. Same goes for therapists.

Finding that fit with a therapist is just as important for the outcome as the actual therapeutic technique, according to findings presented in Psychotherapy Relationships That Work (Oxford University Press, 2004). The research analysis found that three key things had a measurable positive impact on the outcome of individual therapy: 1) the strength of your collaborative relationship with your therapist—aka are you on the same page and making goals for your treatment together?; 2) your therapist’s ability to empathize or see where you’re coming from; and 3) the degree to which you and your therapist outline goals and reevaluate them together.

In other words, to get the most out of a therapy session, take the time to find someone you feel like you’re on the same page with, who gets you, and who’s willing to listen to your goals for therapy and help you develop them.[/vc_column_text][vc_tta_accordion shape=”square” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”Ask these questions to help you find the right fit” tab_id=”1509035547084-fd2f65e1-167e”][vc_column_text]

• What types of therapy are you trained in?
• What issues do you specialize in?
• What populations do you specialize in? (While all therapists take on different types of clients, some specialize in specific groups such as working with LGBTQ+ people, people of color, or those who’ve been marginalized in some way.)
• How do you invite all aspects of your client into the room? (It’s important to know how your therapist will address all aspects of your culture, says Dr. Crawford. “You want to know that you can talk to your therapist about all parts of who you are.”)
• What are your beliefs about how people change?
• What’s your goal for ending therapy? (Some therapists believe therapy is an ongoing thing that you never really graduate from, while others see it as a tool to resolve a specific challenge. Make sure their goals line up with yours, and if not, ask if you can redefine them together.)

[/vc_column_text][/vc_tta_section][vc_tta_section title=”How to find a therapist ” tab_id=”1508289666996-a002b364-d7da”][vc_column_text]To find a therapist, start on campus—most schools offer a certain number of free counseling sessions through their counseling or psychological services.

Check with your insurance provider to see whether you need a referral to see a psychologist or counselor. If so, you may need to make an appointment with your primary care provider or the student counseling center to ask for one. Once you have the referral (if needed), you can seek out a therapist in a number of ways:

• Ask friends and family members if they have a therapist they recommend.
• Find out if your school counseling center has a list of recommended providers.
• Use the American Psychological Association’s online search tool.
• Call your insurance company or use their online services to find a list of therapists who are covered by your plan. If you get a personal recommendation from someone, you’ll also need to check that they’re covered under your insurance plan.

Once you have a name or a list of names and you’ve checked that the providers are covered by your insurance plan, call each therapist and leave a message to ask if they’re accepting new patients and to call you back with their available hours. When you hear back from the therapist, you may want to discuss what you’re looking to get out of treatment, what days and times you’re available to meet, and what their fees are—confirm that they take your insurance (it never hurts to double check this)—and ask about their training and make sure they’re licensed. Sometimes it can take a few tries to find someone whose schedule works with yours, but don’t let that deter you.[/vc_column_text][/vc_tta_section][/vc_tta_accordion][vc_column_text]

“Therapy can be useful by helping people acquire a better understanding of themselves and develop healthy habits,” says Dr. Salley. For example, if you have trouble getting up in time to make that optional early-morning lecture, but then you beat yourself up about missing it, a therapist can help you identify what you really value and then help you make decisions based on that. “It can be helpful to talk to someone who’s objective and not a friend to bounce your experiences and feelings off of,” says Dr. Crawford. “A therapist’s only investment is for you to be your best self.”

Once you’ve identified what’s really important to you, a therapist can help give you the tools to make your value-driven goals a reality. “Problems that are unaddressed remain problems,” says Dr. Crawford. “When you’re ready for something different in your life, it can change. Therapy can help you create the future you want.”

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You may be worried that all that talking might get out or that your therapist might tell your advisor or RA about what you’re struggling with. “A therapist isn’t allowed to do this unless the student poses a threat to themselves or others,” says Alti. “A therapist’s effectiveness is dependent on maintaining trust.” Bottom line: Unless they believe you’re in imminent danger (e.g., at risk of being seriously harmed or harming yourself or others), they can’t share what you say.

In short, everyone can benefit from talking to a therapist. “In the same way that everyone can benefit from going to the dentist, sometimes therapy is just a routine cleaning,” says Dr. Crawford. “Sometimes it’s just a time to reflect on where you are and where you want to go.” Whether you’re wrestling with anxiety and depression or mildly stressed about finding a summer internship, seeing a therapist can help—even if it’s just for a few sessions. (According to the CCMH report, the average student who uses campus psychology services attends between four and five sessions.)

Student perspective

“Therapy was a good way to talk through anything weighing on my mind. My therapist was very understanding, kind, and, of course, confidential. I’d recommend going to counseling services to everyone.”
—Third-year undergraduate student, Elizabethtown College, Pennsylvania[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text] [school_resource sh101resources=’no’ category=’mobileapp,counselingservices’] Get help or find out more

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Grades. Roommates. Relationships. Competition. Decisions. Obligations. Finances. College life is filled with stress generators. Stress is normal, but it can cause anxiety, and sometimes that anxiety becomes severe enough to interfere with your daily life and functioning. Left unchecked, it can lead to emotional illness, social isolation, academic failure, dropping out of school, and other unhappy outcomes.

If you—like so many students—are experiencing anxiety, you can find help. “Anxiety disorders are treatable,” says Dr. Eric Goodman, clinical psychologist at the Coastal Center for Anxiety Treatment in San Luis Obispo, California. “Often, avoiding the problem feels better in the short term. However, in the long term, you get more stuck, miss out on valued activities, and inevitably suffer more over time. Facing the problem is much scarier, and uncomfortable, but you get to reclaim your life and well-being. You become free.”

Is all stress bad?

Stress is a natural and sometimes useful response to life’s demands, experts point out. “Stress in and of itself is not bad. Sometimes stress is a motivator,” says Dr. Carol Lucas, director of counseling and support services at Adelphi University, New York. For example, being a little stressed about your work may make you sit down and do it.

On the other hand, some stressors can create “mental, emotional, or physical strain,” says Dr. Lucas. We often use the words “stress” and “anxiety” interchangeably, but they describe different states of mind. Understanding that difference can help you recognize when and how to take better care of yourself.

When does stress become anxiety?

If your stress is leading you toward unrealistic thinking, and fear of a threat that is not immediate or clear, you could use an anxiety check. That unrealistic thinking may be related to a specific situation or trigger, or it could be generalized and manifesting in various situations. See Students’ stories: Got anxiety?

When does anxiety become a disorder?

Anxiety becomes a disorder when it interferes with your daily life and you can’t free yourself from the intense physical sensations or worry.

• There are many kinds of anxiety disorder; they include generalized anxiety, panic, social anxiety, phobias, obsessive-compulsive disorders, and post-traumatic stress disorder.
• Anxiety disorders can coexist with other emotional health conditions; these include depression, substance abuse, eating disorders, and body dysmorphic disorder (when someone ruminates constantly over what they consider their physical flaws).

[/vc_column_text][vc_tta_accordion shape=”square” gap=”5″ c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”Who’s anxious in college?” tab_id=”1508190058336-dfb0e3c2-2a62″][vc_column_text] [/vc_column_text][/vc_tta_section][/vc_tta_accordion][vc_column_text]

Is it stress, anxiety, or an anxiety disorder? And is it specific or general?

	Stress Your challenges exceed your resources. Example Your exam is in two hours and you need another day to study.
	Anxiety Your thinking becomes less rational and somewhat catastrophic. Example Your significant other is losing interest and you worry that you’ll be alone for the rest of your life.
	Anxiety Disorder Your life and functioning becomes negatively affected by this “brain noise.” Example Your academic and social life take a serious hit and it’s more difficult to function.
	Generalized Anxiety Your worry persistently, excessively, and unrealistically about everyday situations and demands. Example When your friend isn’t there on time to meet you, you worry that they died.
	Situation-specific anxiety or phobia You worry excessively about a particular situation or demand. Example You’re so worried about an approaching test that you can’t study effectively.

A student’s experience with generalized anxiety disorder

Debbi*, third-year undergraduate, Elizabethtown College, Pennsylvania
(*Name changed)

“Part of the issue with anxiety is that it feels like it isn’t real, that you’re making it up. And nobody wants to report symptoms to the doctor that they’re worried aren’t even real. The nature of anxiety makes it hard to come out and say to someone, even a medical professional, ‘I don’t think that it’s normal to feel this anxious so often.’”

Debbi’s* story Is it time to seek help with anxiety? How does getting help early make a difference? Why talking lightly about “anxiety” is a problem[/vc_column_text][vc_tta_accordion shape=”square” gap=”5″ c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”Debbi’s* story” tab_id=”1508190159439-b46c3b1e-dc91″][vc_column_text]“This was no way to experience college”
A student’s experience with generalized anxiety disorder

By Debbi*, third-year undergraduate, Elizabethtown College, Pennsylvania 
(*Name changed)

What my anxiety looked and felt like 

I’ve always been an anxious person. Being away from home, an only child very close to my parents, factored into it. My college schedule, with my course load and extracurriculars, was crazy; I left my room at 7:30 a.m. and got back at 10 p.m. I started waking up nauseous. I often didn’t sleep well because I was paranoid about missing my alarm. My morning routine became: wake up, cough so hard that it made me throw up, pretend that I was fine so that my roommate wouldn’t worry, and then go to class. During finals week I broke out in hives.

What happened when I went to counseling 

When I eventually went to counseling services at the college, that helped. They’re free, and available to help us, so why not? You fill out a survey that rates how you’re feeling. Because it’s private, it’s easy to say, “My stress level is at a 9/10 right now,” and for the counselor to reassure you that it’s valid if that’s what you are feeling, and then to talk about why that is.

How I recognized I needed more help  

[/vc_column_text][/vc_tta_section][vc_tta_section title=”Is it time to seek help with anxiety?” tab_id=”1508190279825-42b3226f-b729″][vc_column_text]By Dr. Carol Lucas, director of counseling and support services at Adelphi University, New York

Anxious about whether or not to seek support with anxiety? Here’s how to know:

• Listen to your friends Often, others will see symptoms or signs before you do. If a friend recommends that you check in at the campus counseling center, take that seriously.
• Look closely at your own feelings and beliefs about seeking help Probably the number-one barrier to students’ getting help is their own internalized attitudes about what it means to ask for help.
• Use this checklist If you answer yes to even one or two of these questions, it’s worth discussing your symptoms and experiences with a health professional.

[/vc_column_text][/vc_tta_section][vc_tta_section title=”How does getting help early make a difference?” tab_id=”1508190314595-c84659cc-53ef”][vc_column_text] [/vc_column_text][/vc_tta_section][vc_tta_section title=”Why talking lightly about “anxiety” is a problem” tab_id=”1508190364531-7d3edb4a-42f9″][vc_column_text]By Debbi*, third-year undergraduate, Elizabethtown College, Pennsylvania 
(*Name changed)

Truly anxious people don’t make light of anxiety

The term “anxiety” is thrown around loosely. Everyone seems to “have anxiety;” it has almost become a trend. Everyone gets nervous and stressed out sometimes, but having an anxiety disorder is different. I’ve seen shirts around that say, “Stressed, depressed, but well dressed,” and it bothers me, because there are people like me who have anxiety (or depression) that can really impact their ability to function. I don’t think someone with anxiety or depression would feel comfortable enough to wear a shirt like that.

I was afraid people would think I was just part of a trend

I was worried people would think that I was following some bizarre trend where people use the term “anxiety attack” to describe a time where they felt stressed, or say that they have anxiety when they have no reason to seek a diagnosis.

Emphasizing “stress” may also have a downside

It’s a catch-22 though, because if we present to a college campus, “Here’s what anxiety looks like, and here’s what average stress looks like,” people who are suffering from undiagnosed disorders will worry that their symptoms aren’t real enough [to be considered anxiety], like I did. The nature of anxiety makes it hard to come out and say to someone, even a medical professional, “I don’t think that it’s normal to feel this anxious so often.”[/vc_column_text][/vc_tta_section][/vc_tta_accordion][vc_column_text]

A student’s experience with specific (academic) anxiety

Dai*, second-year undergraduate, University of California, Los Angeles 
(*Name changed)

“College students face a unique stigma against reaching out to health professionals because entering college comes with the expectation that you will be stressed most of the time and that you will work late into the night. I am under the impression that all my peers are going through what I am going through, even if that isn’t actually the case.”[/vc_column_text][vc_tta_accordion shape=”square” gap=”5″ c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”Dai’s* story” tab_id=”1508190455012-4e5105c6-ccbf”][vc_column_text]

[/vc_column_text][/vc_tta_section][vc_tta_section title=”How can I make college manageable?” tab_id=”1508190455274-7b951716-126b”][vc_column_text] [/vc_column_text][/vc_tta_section][vc_tta_section title=”How can I prevent or manage anxiety?” tab_id=”1508190455567-a7337a41-378b”][vc_column_text] [/vc_column_text][/vc_tta_section][/vc_tta_accordion][vc_column_text] [survey_plugin] Article sources[/vc_column_text][/vc_column][/vc_row]

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This month (March 16—22) brings us Brain Awareness Week: seven days in the year when scientists tell us how much they’re learning about our brains and ask for funding so they can learn more. Turns out brains are complicated.

Emerging adulthood

Young adulthood (defined as 18—22 or 18—25) is a time of dramatic change in the brain, particularly its thinking structures. Scientists call this developmental period “emerging adulthood” or “the frontier of adulthood.”

Change, change, change

Brain development in early adulthood opens up more complex thinking, especially around relationships, moral problems, and abstract concepts. Young adults become better able to regulate their emotions and manage relationships.

Check out the research on emerging adulthood.