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'A Perfect Storm': College Students Face Incredible Mental Health Stressors During COVID-19 Pandemic

Discussion in 'Psychiatry' started by Mahmoud Abudeif, Nov 23, 2020.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    It's a hard time to be in college. It's never easy, of course, as a major life transition into a new social setting on top of the actual school work.

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    But this year is proving to be especially difficult, with a pandemic and multiple hurricanes impacting classes, student activities, people's jobs and their health.

    "So during January everything was fine; I really enjoyed going to school," said Jordyn Ratliff, 19, a sophomore chemistry major at the University of Louisiana at Lafayette. "March came around and everything crumbled so quickly."

    Most of Ratliff's classes are in math and science, which have not translated well to online learning. Plus, there's the lack of socialization.

    "It's hard to stay motivated," she said. "I'm just sitting on a computer screen all day. It's become a lot harder to cope with all the stress I've been feeling."

    Her grades have slipped this semester, despite doing more work than she ever has, she said.

    "I get up at 6 a.m. every day and get on my computer, and I'm not really done at about 7 p.m.," Ratliff said. "The workload is still extreme. That has to do with teaching yourself. It takes more time."

    Her mom had coronavirus at the beginning of the fall semester when Ratliff was taking 15 hours, she said. She's since dropped one chemistry class to lighten the load a bit.

    "It was really difficult to focus on anything during that," Ratliff said.

    She also deals with increased nausea when her anxiety is high.

    "My anxiety takes on a really physical form," she said. "I'm nauseous all the time. I haven't really been able to have consistent meals in the past three weeks."

    Ratliff works about 20 hours a week at Clean Juice, so when she's not doing school she's working.

    "I haven't really had time to hang out with friends," she said. "It's hard to designate time for that. It makes me feel hopeless. It makes me feel really alone."

    But Ratliff isn't alone.

    All the extra stressors are doing a number on students' mental health, affecting them disproportionately worse than others, according to a survey by the Centers for Disease Control and Prevention in June. Adults age 18-24 reported having experienced disproportionately worse mental health outcomes, increased substance use and elevated suicidal thoughts due to the pandemic.

    "It has surely been a difficult nine months," UL Lafayette Dean of Students Margarita Perez said. "We're seeing stress, anxiety, worry, loneliness, depression."

    What officials are seeing

    Brian Frederick, psychologist at the University of Louisiana at Lafayette's Counseling and Testing Center, said this is a more vulnerable time for college students because transitions typically lead to fear.

    "They're leaving home for the first time," Frederick said. "Classrooms have a different structure, or they're online. It's a whole different way of teaching and learning. There's been a transition in the amount and type of contact we can have with family and friends."

    Like schools across the country, UL Lafayette and others in the University of Louisiana System have tried to relieve some of that pressure academically by offering grade options that won't factor into a student's GPA and extending the drop date for fall classes, as well as socially and emotionally by continuing mental health services virtually even when campuses closed this spring.

    "When there is a massive disruption to life that has put all of us in a state of uncertainty and anxiety, it becomes all the more important that we maintain mental health services," UL System President Jim Henderson said.

    He said all nine physical campuses that comprise the UL System were impacted by a major storm this fall, meaning that students at all nine institutions have been impacted by either a storm, the pandemic or both.

    "Every university is taking a slightly different approach, but they're all working toward the same goals — to meet students where they are, help them to achieve successful outcomes, but to be very empathetic," Henderson said.


    UL Lafayette has alert systems that allow faculty or others to report when a student is struggling via the "Students of Concern" team, Academic Success Center and more, Perez said.

    "Everyone is trying to catch things early," Perez said. "We have a higher success rate getting those students back on track. It's really hard to pull people back up once they are really down in a hole."

    The Students of Concern team within the Student Affairs Division meets every other week to discuss plans of action to reach students put on their radar. "This team was in place well before COVID," Perez said, "but we are a little bit more concerned now."

    "Everyone is working together and is kind of on alert and mindful," Perez said. "You can't turn your head to it. I'm telling students we want to deal with it head on, but we have to be aware of it. We can't help students or solve issues we don't know exist."

    The school's Counseling and Testing Center also is being proactive by reaching out to former clients and every student who submits for isolation or quarantine as a general "check-in," rather than waiting for them to come in for counseling, Perez said.

    "There's a lot of pressure in college anyway," said Karen DuBois, program and education director for the local chapter of the National Alliance on Mental Illness. "It can be a time when mental illness is triggered. These are our leaders of tomorrow. We need to do everything we can to support these young people."

    Frederick has been a psychologist on campus for two decades, experiencing and helping others with the effects of such traumatic events as Sept. 11, 2001, Hurricane Katrina, the 2016 flood and COVID-19.

    They're all comparable, he said.

    'It seems to be everybody'

    Staff at UL Lafayette's counseling center are seeing many more clients this semester, especially after a 30% decrease in clients taking sessions when COVID-19 hit in the spring, Frederick said.

    The center is still about 10% below its usual number of sessions being offered, but Perez doesn't think numbers tell the whole story.

    "Our counseling center has seen an increase, maybe not in the number of sessions, but in the depths of those sessions," Perez said. "While a student might have been dealing with just one issue in a normal year, those issues have been compounded by COVID or hurricanes or thedeath of Trayford Pellerin."

    Pellerin, a 31-year-old Black man, was shot and killed on Aug. 21 by Lafayette police officers who were responding to a disturbance involving a person armed with a knife. Protests erupted in the city with demonstrators calling for transparency in the investigation and the firing of the officers involved.

    Frederick said the center is seeing more general anxiety and depression, overall feelings of restlessness, irritability and discontent this semester, as opposed to situational anxiety or depression, which is tied to an event or triggered by a loss.

    "They can't determine a specific event that caused it," Frederick said. "Usually it's a combination of several factors, a perfect storm."

    Not only does the type of depression and anxiety seem to be different, but also whom it affects, according to DuBois with NAMI Acadiana.

    "It seems to be everybody, not just people with mental health diagnoses," DuBois said. "People who have never struggled really are. There are so many things out of our control. When people feel out of control in their lives it feels scary."

    And people are having difficulty coping with limited places to go. Perez said what people on campus seem to miss most is that in-person engagement, which comes in a different form than people are used to, if it comes at all.

    "Some of our most powerful coping skills we've had to adjust," Frederick pointed out.

    "We live in a community that is very much family-oriented and a large community of faith," DuBois said. "How many people have not been to church since March? They've lost that thread of continuity. Then what do they rely on?"

    That impact extends to treatment. NAMI Acadiana isn't able to take clients in-person, but has to rely on remote options. DuBois said there "absolutely" has been an increase in calls and people reaching out to NAMI Acadiana.

    "We can talk on the phone, but it's not sufficient," DuBois said. "It also puts us at a disadvantage when you can't have in-person conversations. It makes them feel isolated, like 'nobody knows how I feel.' That's not good for someone with a diagnosis."

    The group also offers support groups, which started back up under restrictions over the summer after abruptly stopping in March.

    "We just had to stop the support groups cold," DuBois said. "That is alarming to people. It takes a lot of people in your life to support you."

    It was the same way for NAMI on Campus at UL Lafayette, she said.

    "What happened to those students who were getting services?" DuBois said.

    Treatment is 'Simple, but not easy'

    Students, faculty and staff can take advantage of unlimited counseling sessions at UL Lafayette's Counseling and Testing Center, and they can do so in-person or virtually. There also are virtual support groups.

    Frederick said clients average about three sessions per semester, and a client averages about six sessions during their time at the university.

    Sometimes seeking help is harder than it sounds.

    "The most common reason people don't come is fear of being judged, fear of a stigma or being labeled," Frederick said. "They think they can tough it out, white-knuckle it and control their symptoms on their own."

    But that's just not the case, he said.

    "A client can't think their way through general anxiety," Frederick said. "A lot of times people think time heals. They just have to wait. But in order to feel better you need to take action. Time doesn't heal. Time passes. If you want that wellness you have to act."

    The center offers a three-step therapy approach — problem identification, intervention/problem solution and debriefing — tailored to meet needs of individual clients, Frederick said.

    "The treatment approach is a very simple approach but not always easy," he said. "It requires daily action, especially when you don't feel like it. That's when it's most needed."

    That includes prayer or meditation; forgiveness and kindness toward others and toward yourself; and shifting focus to others, paying it forward, Frederick said.

    NAMI Acadiana offers free support groups for people with mental health diagnosis and their families at two facilities as well as an evidence-based class called Families to Families.

    "We can't meet as often because groups are having to use the same room and they can't use them at the same time," DuBois said. "We also sanitize everything between them.

    "You do what you have to do to provide services people so desperately need," she continued. "We're pressing forward and going to try to provide everything we can under restrictions."

    She also mans the chapter's hotline in an effort to pay forward the help she received when a family member manifested mental illness.

    "I take calls seven days a week wherever I am," DuBois said. "When our world fell apart, they were there for us and helped us gain understanding. So it's extraordinarily important for us to be there for others."

    What can we do?

    University and mental health officials want people to understand this is a widespread issue, that they are not alone and that it's not only about COVID-19.

    "It's OK not to be OK," Perez said. "We want to let students know that's normal in life. It's not just right now. But when we're not OK, we need to raise the flag to get some help."

    One way to help others is to pay attention, Frederick said.

    Notice if there are any major changes in appetite or sleep patterns of our friends, family members, classmates and coworkers, and pay attention to what they are saying. Are they expressing feelings of hopelessness and helplessness, for example.

    Then, just keep it simple, he said. Ask "Can I help with this?"

    It's imperative that people come together to face this widespread mental health situation, DuBois said.

    "These are our neighbors," DuBois said. "They're the people who see at the grocery store. These are our people here. It's a challenging time, but I think we will come out of this if we continue to take care of each other."

    Perez said she's been inspired by students' resiliency and grit as they "pivot their lives in all manners." She wants to see that continue and believes it will with support.

    "We all just have to continue to support each other," Perez said. "Everyone is impacted by what is happening. Check on each other; show grace and kindness. There's support everywhere."

    Ratliff echoed that sentiment in some advice to fellow students, including a reminder that this situation won't last forever.

    "It's OK to take breaks," she said. "Your mental health and limitations are definitely more important than the grade you get in this class."

    "I definitely should take my own advice," she added.

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