Depression in college students: How to help students manage their mental health

Parents hope college will be a time for their kids to spread their wings and fly. Yet college students are now experiencing record high rates of depression and anxiety. During the 2022-2023 academic year, 41% of students reported experiencing symptoms of depression and 36% said they experienced anxiety, according to the latest Healthy Minds Study. Understandably, parents want to know what they can do to help their college age kids manage their mental health so depression doesn’t dock their wings.

Any single case of depression can have multiple causes involving a mix of biological, genetic or social factors. However, one common cause of depression in college students is the sheer scope of change that comes with moving on from the familiar world of home and high school, according to Paige I. Partain, M.D., a pediatrician at the Mayo Clinic Children’s Center in Rochester, Minnesota, with expertise in child and adolescent mental health.

In addition to changes in housing and social connections, going to college typically accelerates academic expectations. It also scrambles students’ sleep, diet and exercise patterns. For some college students — even those with no history of depression — having so many facets of their lives suddenly challenged and changed can create enough stress to trigger depression, says Dr. Partain

She adds, however, that it’s important “for parents and students alike to recognize that depression can be totally untriggered.” Sometimes students can be on top of their coursework, getting along with new friends and otherwise outwardly crushing college when they sense that their moods have dipped.

If students are baffled about why they’re feeling down, helping them understand that sometimes depression occurs without an identifiable cause is important. It can help relieve the added burden of wondering what’s wrong with them — or blaming themselves — for feeling depressed.

Says Dr. Partain, “I can’t express enough what a difference it makes when I’m talking to teenagers or young adults in their early twenties and I can explain that sometimes it just happens. It can be even more frustrating when you don’t know why depression happens. But I can see the relief in their eyes. They’re like, ‘Yes, you get it.’ To be able to just empathize and label the phenomena can be incredibly powerful.”

Spotting signs of depression in college students

Along with feeling sad and down, common signs of depression in college kids include:

• Changes in appetite such as eating more or less than usual.
• Sleep disturbances, such as insomnia or sleeping too much.
• Losing in interest in favorite pastimes including playing sports, making art or hanging out with friends. “Isolation is a really key symptom, particularly for teens and young adults,” says Dr. Partain.

People often experience depression and anxiety at the same time, and college kids are no exception. Determining which one came first can be a “chicken or the egg” question, says Dr. Partain. But big shifts in a student’s mood and behavior may indicate underlying depression.

“If your kid is not one who tends to be anxious, and all of a sudden, there’s worry about everything, that might be an indicator of a problem with mood.” On the flip side, she says, if your kid is usually “a type-A go-getter, and normally a little more anxious, and all of a sudden the work isn’t getting done and grades are slipping, that can also be an indicator that there’s a problem with mood.”

Irritability is another common symptom of depression. “We think a lot about feeling sad or down, and that can certainly be the case for a teenager or a young adult. But there is good medical research to suggest that irritability might be an even better indicator of underlying mood problems,” says Dr. Partain. “It’s another textbook symptom to be aware of.”

What to say if your child seems depressed

Sometimes, parents who think their kids might be depressed are wary of butting into their business. Or they may keep quiet because they’re just not sure how to talk about depression. If parents ask Dr. Partain if they should try talking to their child’s friends or professors about their concerns, she advises them not to go around their child’s back.

Rather, Dr. Partain recommends that parents raise their concerns with their kids in a straightforward way. “As you’re trying to help children develop independence and capability — regardless of the dynamic that you have with your child — I advocate for talking with kids directly.”

To get a better sense of how children are feeling, Dr. Partain says it’s fine to initiate the conversation by text with a simple message like this: Just checking in to say I love you. How are you doing? I want to make sure you’re doing okay.

Let them know that you’re concerned and let them respond in their own time.

If your child shares feelings of being depressed or anxious, make it clear that you’re available to help in whatever way works. “You can ask, ‘Do you want my help, or is this something you want to take care of on your own?’ The biggest thing to avoid is invalidating language: ‘You’ll get over it.’ ‘Going to college is just hard,’ ” says Dr. Partain. “Parents might find a slightly different approach for every kid, but they should feel empowered to speak up because parents can play a powerful role in helping children understand what they’re experiencing.”

Help your college kid develop strategies to cope with depression

With college students experiencing depression or anxiety for the first time, parents can share self-care strategies that have been proved to ease symptoms of depression, including:

• Exercising.
• Connecting with friends.
• Eating healthy foods.
• Spending time in nature.
• Getting adequate sleep, as young adults need between seven and nine hours a night
• Finding a community on campus, whether it be with a group of fellow ultimate Frisbee fans or a religious or political organization.

If students are experiencing any kind of acute or prolonged dip in mood, their parents can also encourage them to seek treatment and help them navigate campus mental health resources. As students’ mental health becomes a central part of the conversation on college and university campuses, Dr. Partain says that more schools are preemptively providing students and parents with information about counseling and medical services.

“I encourage all parents to keep that information handy,” she says. “Even if you have a kid who’s done great and never had difficulty with mental health, it’s helpful to know about available resources, so if your child reaches the point of saying, ‘Mom, Dad, what do I do?’ you can help provide answers.”

Parents can also provide important support to students who have a history of depression, Dr. Partain says. If your child is taking an antidepressant, you can ask the healthcare professional to dispense the prescription in a 90-day supply, with refills that can be obtained at a pharmacy near campus.

As students in Dr. Partain’s care are preparing to transition to college, she has a conversation with them about their specific symptoms of depression. She also reviews the self-care strategies that have helped them feel better in the past. “Depression looks different for everyone, and it’s important for students to do the mental exercise of saying, What does it look like for me? Is it that I’m isolating myself? Is it that I’m less talkative? Is it that I’m more irritable? Is it that I don’t enjoy reading anymore?” says Dr. Partain.

The point of the conversation is to help students become more self-aware about what depression looks like for them, and spot early warning signs so they can act quickly to protect their emotional health. She encourages parents and children to have a version of this conversation together, too, and to develop a shared relapse prevention plan.

Then, if students begin to feel depression coming back while they’re away at college, their parents can reinforce whatever self-care strategies have helped get through rough patches before. For students already seeing therapists, noticing an uptick in symptoms can prompt them to reach out to ask for some extra sessions, with help from parents if needed.

“Almost all therapy providers have the ability to treat people who are in crisis or who feel like they’re significantly worsening. The same goes for healthcare professionals if students are on a medication. If I get a message from a college kid saying, ‘My mood is getting a lot worse,’ I’m going to get them seen within a week, and many other healthcare professionals will too,” says Dr. Partain.

Create a crisis plan

If students have had inpatient treatment or thoughts of suicide in any context in the past, it’s also critically important for them and their parents to have shared emergency safety plans. This can be activated if students ever becomes severely distressed again.

“Sometimes, depending on the family dynamic, the safety plan may not include having the child call the parent. The plan for the child may be calling Aunt Jane, or calling Grandma. But it’s really powerful for the parents to be able to reinforce that and say, ‘That’s OK. I want you to be safe,’ ” says Dr. Partain.

A common worry she hears from parents is that discussing suicide may make it more likely that their child will contemplate or attempt suicide. But, she says, there’s no data showing that talking about suicide makes people more likely to attempt it. In fact, it does the opposite: “Talking about it makes it easier for them to seek help in the moment. The way I phrase it to my patients is, ‘I’m really glad that you’re not having those kinds of thoughts. But I know things can change quickly, and this safety plan is just something we want to have in our back pocket.” Parents don’t have to hammer on the subject,” she adds, “but it’s an important conversation to have, and I wouldn’t avoid it.”