Mental Health

Anxiety Goes to College

Houston-area campuses are scrambling to meet the mental health needs of a generation of students beset by an increasingly diagnosed condition.

By Marianella Orlando Photography by Brian Goldman November 3, 2015 Published in the November 2015 issue of Houstonia Magazine

Abigale Ramos remembers the moment vividly. Now a sophomore at San Jacinto College in Pasadena, the 19-year-old had a part-time job as a freshman at a mall crepe stand. Working a shift one fall day, she stood behind the register listening to the food court’s boisterous chatter and feeling the thrum of the indoor playground in the pit of her stomach. She took an order, waited for the crepe, served it; took an order, waited for the crepe, served it. Again and again … and again. Amid the monotony, her brain shifted into overdrive, and the worries started cascading: school, her classes, the mountain of assignments due, her new work schedule, her bills. She thought, If I don’t have this job then I can’t pay my car, and if I don’t have my car then I can’t go to school, and if I can’t go to school, what am I going to do with my life?

Her heart racing, she began to sweat and shake, and her thoughts grew louder and louder. Fighting tears, she rushed to the bathroom to collect herself. One break turned into many, and her apprehension worsened. Just two hours into her shift, she decided to leave work early. Unable to make herself drive home, she sat in her car and cried. “I was in a rut for three or four months,” says Ramos, looking back to last year. “It got so bad I didn’t want to leave the house.”


Anxiety like Ramos’s has overtaken depression as the most common mental health diagnosis in university clinics across the nation. According to an annual national study by the American College Health Association, more than half of US college students said they felt overwhelming anxiety in the past year, a huge spike from 2000, which saw only 6.7 percent report the same. In 2014, 14 percent of college students were diagnosed or treated for the disorder.

It’s a trend that’s plain to see locally. Counselors we spoke with at the University of Houston, San Jacinto College and Texas Southern University have all observed a marked increase in the number of students seeking their help for anxiety. (The condition has always been an issue at Rice University, which didn’t report an increase but maintains a 24/7 crisis hotline.) In an effort to reach out, these schools are variously offering clinics and educational workshops on stress and mental illnesses, as well as hosting campus events where students can pet dogs, create DIY stress balls, take yoga classes and meditate.

Bernadette Smith, the director of TSU’s counseling center, says she's asked professors to include a statement on their syllabi directing students with anxiety or other mental health problems to the university’s counseling center. “I don’t know how many people actually implemented it, but I plan to reach out to faculty and deans to make it a normal part of the syllabus,” Smith says. Chris Evans, a counselor at San Jac’s central campus, says more professors than ever are sending students his way. “Whenever I have an instructor that is worried about a student, they’re much more likely to contact me and follow up with a student than in the past,” says Evans. UH, meanwhile, has extended its counseling center’s hours to accommodate students’ needs. 

One of the most difficult aspects of a mental health disorder like anxiety can be skepticism among casual observers: Haven’t college students always freaked out a little? Living away from home, usually for the first time, navigating romantic relationships, feeling pressure to succeed—these things truly are nothing new. But not only do today’s students face increased pressure due to factors such as omnipresent social media and onerous student loan debt, but “they’re becoming more aware,” says Dr. Douglas Mennin, a member of the Anxiety and Depression Association of America’s Scientific Council. “And they start to think about what they don’t like about themselves and what they will be like in the future.” And that can be crippling.


Clinically speaking, anxiety is a feeling of fear, worry or unease that can be triggered by stress. Although the two often work hand-in-hand, stress is focused on the present, while anxiety is focused on the future. Being nervous about not having enough time to study for a test is stress; fearing that you won’t graduate is anxiety. The latter—which can manifest as crying, rapid heartbeat, shortness of breath, nausea or trembling—becomes problematic when it starts to interfere with a person’s daily routine. 

In its extreme form, the condition can be physically and mentally debilitating. Prolonged psychological distress can cause withdrawal from social situations, says Norma Ngo, the director of UH’s Counseling and Psychological Services. “A student may come to class and could be socially anxious and start to avoid the class,” she says. “They will feel more anxious about being behind in classwork, and that starts to affect their grade.” 

This, she adds, can lead to depression, as students who feel they’re not living up to expectations experience low levels of self-esteem, start to feel hopeless and, eventually, give up. In the worst cases, suicidal thoughts and attempts come in to play. “Students are being hospitalized,” says Ngo. “It’s a real problem.”

Aydan Delgado, a 19-year-old UH sophomore, fidgets, bites his nails and puts his hand over his mouth when he feels anxious. Sometimes his heart races; he also has rapid breathing and trouble sleeping. Delgado suffered from minor anxiety in high school, felt it start to increase his freshman year, and still copes with it today. Social media, he says, has only contributed to the problem. 

“Sometimes people post that they got an internship, and then I’m like, ‘Oh, I have to worry about it, too. I need to step it up,’” he says. Failure, he says, is just as difficult to witness as success. “I’ve seen at least one person not graduate with a job, and they’re on the path that I’m worried I’ll get into,” says Delgado. “Those are thoughts I’ve had because I imagine that’s where I’ll be if things don’t work out.” 

Add to that the constant barrage of information that is the hallmark of our current everyday existence, and things get even tougher. “We can’t run away from what’s happening. If we turn on the news, radio or Internet, we’re going to see it,” says Ngo. “And a lot of stuff in our culture seems to be fear-inducing, on top of what we normally deal with on a day-to-day basis.” Evans concurs: “You have all this information, and you don’t know what to do with it.”

The astronomical increase in student loan debt, meanwhile, is never far from college kids’ minds. In 2013, according to the journal Anxiety, Stress and Coping, “those with greater financial strain perceived more stress [and] had more symptoms of depression, anxiety and ill-health.” That same year, 7 out of 10 students from public and private nonprofit colleges graduated with debt, owing an average of $28,400 in both federal and private loans. To put that number in perspective, consider that the total student-loan-debt figure in the US has now surpassed $1.2 trillion, a tenfold increase from the first quarter of 1999. 

With unprecedented debt concerns, it’s easy to see why today’s students are way more career-focused than their forebears, who, says Mennin, “had more room to be uncertain” about their future. For his part, Delgado originally picked a career-track major (engineering) but found it didn’t interest him, so he switched to mathematics and economics—both ambitious areas of focus that are nevertheless a source of worry to him. “I know I’m going to graduate, but in terms of my two majors, there’s not necessarily a set job with it,” he says. “I’m still thinking about, What if I don’t enjoy this field or get into this field?” 

For Ramos, who’s gone from selling crepes to working a part-time job at Starbucks, debt is a source of intense worry. “My family can’t afford to send me to college with no student debt,” she says. “I think to myself, What if I’m going to be paying back my debt until I’m 50 years old and can’t go anywhere for the rest of my life because of it?” 


The best way to describe what students are experiencing, perhaps, is this: a loss of innocence. “Young people know more about the truth and the way things are,” says Mennin. “They’re much more negative and cynical, and don’t believe in a lot of institutions like governments and companies that employed their parents.”

Past generations of college students didn’t discuss anxiety the way today’s do. Facebook, Twitter and Tumblr have allowed kids to reach out to one another and share information in ways that previously weren’t possible. The Internet isn’t solely a source of stress, after all; it’s contributed to today’s more open environment, where there is far less stigma surrounding mental health issues. “People who are afraid to socialize often find a community online,” says Mennin, “and they feel less self-conscious.” And that could account for part of the increased number of students who say they suffer from—and who are seeking help for—anxiety. 

The percentage of college students taking anti-anxiety drugs has gone up, although the students we spoke to for this story have avoided taking medication because of fear of dependency and the costs that come with it. Delgado worries frequently but prefers managing his anxiety himself. He tries to cope on his own by reading manga and watching anime series online, although he did show up to cuddle some cute animals at a UH de-stressing event. “One time I went, but it wasn’t for my anxiety; I went to see the puppies,” he laughs. “I usually don’t have time, and I’d rather be doing my homework.” 

Ramos still experiences bouts of anxiety, suffering from the same barrage of thoughts that have plagued her since her days at the crepe stand. She uses meditation, rhythmic breathing drills, healthy eating and exercise to combat it—all methods commonly recommended by university counselors. She’s thinking about transferring to UH next semester, changing her major from general studies to life sciences and adding a second job to the mix, all of which could potentially add even more anxiety to her life.

But these days, she says, she’s better at handling it. “With every new place you go, there are always new fears you have to go through. I try not to let that be the focus,” says Ramos. “You really have to focus on the good things in life. That’s how you can control your anxiety.” 

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