College can be an extremely adventurous and exciting time in someone’s life. The beginning of a new age of individuality and learning can also present unique challenges and risks. The newness and exploratory nature of the college experience can lead to mental health issues, especially if someone suffered from pre-existing symptoms earlier in life. Additionally, drug and alcohol use is common and widespread in college students, and this can amplify or worsen any existing mental health issues. Here, we aim to illustrate the risks and pitfalls that college students face, as well as provide helpful resources for college students who may be struggling with mental health or substance abuse challenges.
Mental health conditions are quite common among college students, although they are similar to college-aged people who did not attend college. In fact, according to a study of NESARC survey results, almost half of college students and their peers who did not attend college meet the criteria for having at least one psychiatric disorder within the last year. While being a college student itself does not increase risks for mental health issues, there are some variables that can increase these risks and that commonly occur during college years. Some of the factors that can increase the risks of a mental health condition include experiencing multiple stressful events in the past year, losing a steady relationship, and living away from family.
College students not only experience more mental health issues than other age groups, but they also report distressing symptoms for longer periods of time. Some of the more common mental health issues that college students experience include anxiety disorders, depression, ADHD, suicidal ideation, non-suicidal self-harm, and eating disorders. The most common age of onset for many of these mental health issues is between the mid-teens to mid-twenties, and while attending college is not a cause of these issues, the stress of school, work, and separation from family may exacerbate a pre-existing mental health condition. Finally, alcohol and drug abuse is known to worsen many mental health conditions, and there is a significant amount of both drug and alcohol use among college students.
Drug and alcohol use is extremely common among college students, and of all substance abuse among college students, alcohol, marijuana, and prescription stimulants are some of the most commonly abused substances. One study estimated that 17% of college students regularly misuse prescription stimulants, while another study estimated 20%. The most commonly reported reason for college students misusing stimulants is the perceived benefit to their academic performance. Alcohol and marijuana, on the other hand, are usually used strictly for recreation by college students. Alcohol use, in particular, is closely associated with fraternity or sorority involvement; greater participation in these groups is directly correlated to greater and more frequent alcohol consumption. A SAMHSA report found that, between 2011 and 2014, the number of college students in America who used alcohol and drug use on an average day was as follows:
Substance abuse by college students is prevalent, and the college culture can encourage this kind of drug and alcohol use. One study from 2007 found that the risk for onset of alcohol abuse and alcohol dependence is 19 years old and around half of the people who have alcohol use disorder at age 19 continue to have this issue at age 25. The high rate of alcohol use among college students is noteworthy, as this can persist well past someone’s time at college. One of the most concerning issues of college student substance abuse is the relatively low rates of treatment-seeking among college students for substance use disorder or even substance dependence. Treatment for substance abuse or dependence can significantly improve someone’s chances of recovery, but treatment must be sought for this to occur.
There is a strong connection between mental health conditions and substance use disorders, and while these are distinct conditions, they share many contributing factors. While alcohol use is connected to mental health issues, among college students, the substances that are most closely associated with a co-occurring mental health condition include marijuana, prescription drugs, cocaine, and heroin. While drug use does not cause mental illness, college students with a mental illness are more likely to abuse drugs and alcohol.
The fact that co-occurring issues commonly arise during college years is no coincidence. While substance use disorders and mental health issues have no single causative factor, they can be influenced by multiple factors, both internal and external. This is a time of great change genetically, physically, environmentally, behaviorally, and otherwise and this can produce a great deal of stress. Any predisposition toward mental illness or substance abuse may be accelerated or amplified by this stress, and certain drugs can amplify this effect even further. Marijuana use, in particular, has been strongly associated with worsening certain mental health issues including psychosis and schizophrenia. Marijuana use may also accelerate the emergence of schizophrenia in someone who was predisposed to this condition, sometimes by several years. Again, marijuana use does not cause these conditions, but using marijuana can worsen symptoms, increase the risk of experiencing psychosis, and lead to more negative long-term outcomes for people with co-occurring mental health conditions and substance use disorders.
While drug and alcohol use is common at colleges, and mental health conditions most frequently emerge during this time in someone’s life, a college may be one of the best places to find help. College counseling departments can be extremely valuable resources for someone finding help for whatever issues they may be dealing with. Aside from having professional counselors and therapists on staff, these departments usually have a very close relationship with counselors, therapists, and psychiatrists in the local area. Additionally, they may be able to refer someone with co-occurring conditions to a dual diagnosis treatment center that can provide professional, comprehensive care. Professional help is highly recommended for anyone struggling with substance abuse or mental health challenges, and in cases of co-occurring conditions, SAMHSA states that receiving integrated treatment is the most effective way for someone to begin successful, long-term recovery.
Aside from college counseling departments, there is a wide range of other helpful resources for a college student who may be struggling with mental health issues. These can include local, state-level, or national resources. Some of the most helpful mental health resources for college students include:
Substance abuse and addiction can be an extremely difficult challenge to overcome, but it is possible with help. Thankfully, there are many programs, resources, and support groups to help college students who are struggling with substance abuse right now. Check with your college counseling department to see if there is an on-campus collegiate recovery organization, as these groups are designed solely to help college students improve and continue their sobriety. Just a few of the most helpful substance abuse resources for college students include:
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