Social anxiety, also known as social phobia, is a fear, anxiety and avoidance surrounding normal social situations. This is different from shyness, as there is an intense fear that cannot be controlled rather than discomfort. Symptoms of social anxiety include: anxiety or fear surrounding social interactions, being observed, and performing in front of others; fear that anxiety will be apparent to others; social situations almost always provoke fear or anxiety; situations are avoided or endured with intense anxiety; anxiety or fear is disproportionate to the actual threat posed by the situation. This must cause significant distress that lasts six months or longer without being attributable to any other substance or mental disorder. It is estimated that about 7% of Americans suffer from social anxiety at any one time. Treatment involves typically a combination of psychotherapy and medication. Psychotherapy can be in the form of cognitive-behavioral therapy or group therapy. Medications like anti-anxiety, antidepressants, and beta-blockers can be helpful in reducing symptoms. Beta-blockers, instead of targeting the brain, target the physical symptoms that appear while anxious. This may help sufferers with panicking about being anxious or panicking that others can see they are anxious.
Much of the college experience is about navigating differing social situations. Someone with social anxiety has almost an inability to do this. They have such intense fear and anxiety surrounding the situation that they cannot enjoy the interaction or take anything away from it. Going to class, speaking up in class, and doing presentations cause so much fear and anxiety that they are avoided, which can cause academic decline. Social situations like going out with friends or even meeting new people are difficult. College is all about thriving in these interactions and getting the most out of these experiences, and someone with social anxiety will try to avoid all of that even if it would be beneficial to them. Some people will attempt to use drugs or alcohol to cope with the anxiety, which can lead to a substance abuse problem and does not actually relieve the anxiety. The best thing for someone with social anxiety is to go to therapy and/or take medication. This will help them navigate social situations better and lead a more fulfilling life.
Panic disorder is characterized by recurrent panic attacks. These panic attacks cannot be explained by any other means (like PTSD, drugs, etc.) and are follow by a period of at least a month where the individual performs behaviors to prevent panic attacks or is generally intensely afraid of having another panic attack. Panic attacks consist of sudden feelings of fear or dread, an overactive fight or flight response when there is no reasonable risk. Panic attacks, along with the intense emotions, have many physical symptoms like shortness of breath, chest pain, shaking, feelings of numbness, or sensations of unreality. Because panic attacks do not typically have a specific cause, they can happen at any time. This simply perpetuates the fear around even having a panic attack or having someone see you have a panic attack. Intensity and frequency can vary by person. About 2-3% of the US population has panic disorder, and it is 2x more prevalent in women than men. Treatments include psychotherapy, like cognitive behavioral therapy, and medications, like antidepressants and beta-blockers.
As stated previously, panic attacks can happen at any time. This makes life very difficult for a college student with panic disorder. They live in constant fear of having another attack or having someone witness an attack. This avoidance gets in the way of what you’re really supposed to be doing: school. Many school environments cause lots of anxiety for any student, but a student with panic disorder is more likely to have a panic attack when already anxious or stressed. Avoiding that stress can simply look like avoiding school in general. Sometimes it can be so debilitating that sufferers prefer to stay locked inside rather than go out. Students miss out on college experiences. Those with panic disorder have a higher risk for drug or alcohol abuse. It’s hard to achieve when you are afraid of something you have no control over. But therapy and medications can help dramatically. Medications can lessen the load while going through therapy, or may be used long term. Therapy works by training your brain to react to stress in healthy ways, recognize panic attacks and stop them before they can fully develop, and be able to enter into situations where panic attacks have previously happened. It can become completely manageable with treatment.
Obsessive compulsive disorder, or OCD, is characterized by disruptive obsession and compulsions. Obsessions are recurrent and persistent thoughts that are both unwanted and cause distress. The individual attempts to neutralize them by performing an action. Compulsions are repetitive behaviors or mental acts that the individual feels compelled to complete. These acts aim to reduce anxiety and distress, even though they may only be loosely related to the cause of distress or are excessive. The individual may even be aware that the thoughts and actions used to reduce them are unreasonable and unlikely, but they have no power over them. Obsessions and compulsions usually occur together, though only one may be present in some individuals. These obsessions are time consuming or cause significant distress and impairment in several areas of functioning. Obsessions can take up anywhere between 1-3 hours per day in more mild cases, and in more severe cases consuming most of the day. Symptoms cannot be associated with substance use, medications, or be better explained by another mental illness. About 1.2% of Americans have OCD. Treatment consists of typically a combination of medication and psychotherapy, though medication will not work for all cases. Medications for OCD are most commonly antidepressants in high doses. Psychotherapy focuses on reducing anxiety surrounding obsessions and reducing compulsive behaviors. Eventually, after managing the anxiety, the individual will feel less and less anxiety around the obsessions.
Depending on the obsessions and compulsions, OCD can be very disruptive in a lot of different areas. But specific functioning differs between sufferers. Some have problems with relationships because they obsess over losing or hurting loved ones. Some have rituals that make completing school-related tasks difficult or time consuming, such as needing to read each page a certain number of times or anxiety surrounding a task becoming so overwhelming that the task is avoided altogether. Those without OCD have a hard time understanding that these are not made up, that someone with OCD cannot control what they obsess over or what compulsions are needed to reduce anxiety. And because these thoughts can pop up at any time, it is difficult to predict what the student will need to succeed. Many of the more common accommodations are of no use to a student with OCD. Students are encouraged to seek help in managing their symptoms, as this will aide them in the long run for reducing stress. While in college, it may be helpful to contact the disabilities office and set up specific accommodations for what the individual needs to function in college while being treated. Not all accommodations will look the same from one OCD student to the next. This illness is completely manageable, and success in a college environment is very possible.
Post-traumatic stress disorder, or PTSD, is characterized by negative symptoms and behaviors surrounding a traumatic event or events. Not all traumatic experiences lead to PTSD, and not all PTSD is chronic. The lifetime prevalence rate is about 8.7%, with 3.5% of Americans dealing with PTSD per year. Exposure to trauma can be direct or indirect, like sexual assault or the death of a loved one. Afterward, a number of symptoms occur: one or more symptoms of intrusion, where the trauma is re-experienced. One or more symptoms of avoidance, where anything related to the trauma is avoided. Two or more symptoms of negative alterations in mood or cognition, where beliefs surrounding the event or self are skewed. Finally, two or more alterations in arousal and reactivity, where the body reacts to stimuli in a different way than before the trauma. These symptoms must last for at least one month, cause clinically significant distress, and are not attributable to any other condition. Treatment consists of medication and psychotherapy. Medication is usually an antidepressant, though there is a medication used for treating sleep problems and nightmares. Cognitive behavioral therapy works to restructure thoughts surrounding the trauma, creating healthier responses to the event and reminders, and dealing with guilt or shame surrounding the event. Unlike some other mental illnesses, it is possible to recover from PTSD completely.
PTSD can be overwhelming. For a college student, this can mean a variety of things. Concentration is inhibited, making it difficult to complete assignments or study for exams. Depending on the trauma, certain normal college situations may be triggering to the individual. Students with PTSD can be self-destructive in a number of ways, including not going to class and alcohol or drug abuse. Many people with PTSD also have other mental illnesses, like depression, anxiety, or eating disorders. These problems simply compound the issue. Students with PTSD may need accommodations specific to reducing stress and anxiety, like more time for assignments or exams. Treatment is also essential to this process. Students with PTSD can and do succeed in college, they just need the right support in order to cope with their trauma and reduce its effects on their ability to function.