B (4:41)

Yeah, absolutely. Thank you. It is, it is a big adjustment. Right. And David, we also know that mental health issues often emerge or potentially intensify in college. Can you speak to some of the common mental health challenges that students may face and why these often appear for the first time during this transition?

D (5:02)

Absolutely, Morgan. So the biggest explanation, honestly is just the increase in stress. So we do sort of as a field understand that you have perhaps a genetic predisposition to mental illness, but if you're not that stressed, you're probably not going to have mental health symptoms. When you have enough stress like in your life, those symptoms may start to emerge. And the transition to college, as Adam alluded to, you have a whole new set of challenges and a change in your support structure. So that can be the sort of catalyst for some of these mental health problems to, as you said, either emerge or intensify. As far as what some of the more common ones are, I see very often anxiety disorders, including generalized anxiety or obsessive compulsive disorder, sometimes social anxiety as well. I see those emerge for the first time or maybe somebody who dealt with it in their middle school years and had it all under control during high school. Maybe it rears its ugly head again in college and that's because you might have some difficulties that you didn't have, right? So maybe you were a straight A student who you were disappointed from getting an A minus in high school, right? Like you, you, maybe you didn't even have to try all that hard to achieve that standard. Or maybe you were a B plus student, but you were perfectly content with that level of performance. And now suddenly in college you have a test that you think you're prepared for, you don't even think you need to study that hard, and you get a C minus or worse, maybe you get like a 47. You've never even seen a 47 on a test in your life, Right? And so, well, now you're starting to doubt, do I belong here? Can I handle this? And typically, once you start to have that level of doubt in an area where you were previously confident, sometimes kids start to, or teens, excuse me, start to avoid. The more you avoid, you sort of get like this short term relief, like, oh, well, I just won't think about it. And then it'll take care of itself. It doesn't take care of itself. And now maybe you're doing poorly on another assignment in that class and it sort of spirals and becomes a bigger problem. Similarly for people with ocd, maybe they would perform some sort of ritual to make themselves feel better. Well, oh, I'll, I'll just make sure I do. I don't know this exact behavior, this exact study pattern, and that'll, that'll take care of it. And maybe it does, maybe it doesn't. But either way, you're starting to lay the foundations of the pattern that does lead to OCD for students with ADHD Very often maybe they were just frankly smart enough to get by in spite of not having the best study habits. And maybe that did work for them in middle and high school and maybe that stops working for them when they get to college. And then with all of the above, I do often see with depression, we like to see and like to feel like our efforts yield results. Right. So I put in a certain amount of work. I should get a certain outcome. And when that stops being true, that is often the catalyst for depression starting.

B (8:27)

Yeah. Thank you both. I think this really helps normalize what so many students experience. I know it for sure resonates with me and kind of my experience in that big transition from high school to college. So the college years can be certainly an emotional roller coaster. What are Some of the most common transitions or challenges or adjustments that students face.

D (8:52)

Well, so the most obvious one for a lot of young adults is leaving home. There's a bunch of related challenges that come with that. When you leave home, you leave your family, you leave your long term friends. For many people, you leave the geographical region that you've lived in for much or all of your life, and you almost always leave a school that you were at for at least four years. There are some exceptions to that, but like there's routines that have been the same for a massive part of your life. There's company that's been the same for a massive part of your life. There's support structures that have been the same for a massive part of your life. And now, even if you stay somewhat local, you can feel like all that's gone. If you're going to school somewhere that's 1,000 miles away from your home, that is very literally gone. Right? So, you know, when it comes to leaving home, a lot of young adults in my experience underestimate that because very often they're excited to leave home, right? They want to be independent. Their brain is ready for them to, you know, separate from their parents and show themselves in the world that they're not a kid anymore. But your home is a very comfortable place and we do rely on comfort as the sort of foundation so that we can attempt new things, right? Like if you don't have a foundation of comfort to step from, it's a lot harder to step into and face a new challenge at home. You know, just the little stuff like you can make it from your bedroom to the bathroom without even thinking, right? That's not a challenge that you need to navigate. You've been doing that forever. It just happens thoughtlessly. That's one less thing that your brain has to worry about. Your first day of school in a dorm, who am I going to run into in the hallway? Am I dressed all right? How is my hair? What would I talk about if I run into somebody? Right? Like these are, these are considerations that you just never had to think about when you lived at home. And suddenly you do. So there's a fundamental new thing that is introduced to your life and it's replacing a thing that used to be not just not a stressor, but actually a source of comfort and ease and something that your brain could just file away as a non issue. Similarly with making new friends. It's actually very exciting. I still remember the feeling, and maybe you both too, of like my first time walking into a Common area in my freshman year dorm. And like, wow, I guess I'm going to maybe be friends with some of these people. Maybe some of these people and I won't get along. Who knows? But like, that, like, feeling of excitement and a little bit of nerves and like, I don't know, this is new and exciting. I don't want to scare anybody. That's great. You should look forward to that. And also, you might miss your friends, right? You miss your friends, have been there for you and for many people for years. Right. And again, that's like a sense of support. And it's also just a thing that you don't need to worry about. It's not a. Oh, no, what. What do I do? What will I say with these people who have just had your back for a long time? You probably know your friends personalities, you probably know their likes and dislikes, you know who you talk to about this, you know who you talk to about that. And just none of that applies when it's an entire floor or building full of new people. So, yeah, I mean, I guess to some it's just all of this contributes to while you're home and in your routine, comfort and familiarity. Whereas at school, all of this is new opportunities, but also new things that you might worry you'll get wrong. And you don't necessarily have that comfort to draw upon to give you that strength.

B (12:51)

Yeah, thank you. Thank you for normalizing, you know, that the students who are transitioning from high school to college are probably feeling like multiple things, right. Excited for this new opportunity and, you know, adjusting naturally to these things that used to be muscle memory and now are looking a little bit different. We often hear, you know, know students say things like, I don't feel like I belong or like, I don't know that I fit in here. How do issues like adjusting to the different kind of social nature of college or lack of connection maybe impact young people's mental health so.

D (13:31)

Well, thank you for asking. It's a fantastic question because again, like, you still have your parents back home and you still have your friends back home. So it's not like suddenly you have no friends and you have no family anymore, but you're surrounded by new people, right? And those people that you had back home may not be readily available. And very often we're also putting pressure on ourselves. Like as my. I'm supposed to be independent now. I'm 18, 19 years old. I live far away from home. I'm not supposed to need all those people anymore, right? Which is totally A myth. You can rely on your friends and family as much or as little as you want, and there's no, no shame in any of it. But we do actually need to feel connected. There's been a tremendous amount of research on this in like the field of psychology and in social work. We research this when it comes to young children and trauma. We research this when it comes to navigating loss in like teenage dumb. Being connected to people who you feel you can trust and you feel understand you is one of the most important protective factors against mental health problems. It's one of the most important predictive factors in terms of what will your long term academic or professional outcomes be? Even predicting things like physical health problem outcomes to some extent. Having a support network, having at least one or two people that you feel connected to protects against all of the negative outcomes in those areas. And so when you don't have that, you're now at increased risk for negative outcomes in those areas. When it comes to a condition like social anxiety or depression, hopefully it sort of passes the common sense test that loneliness and not having a support network will be risk factors for those conditions. If you are feeling alone, you're probably feeling pretty sad, disappointed, bitter. And if you have somebody that you can reach out to, you will, and let's say they respond positively, then maybe you get to put aside your sadness for now and maybe you go spend some time with them socially and you feel better, right? And if you stack that on top of it, on top of each other a bunch of times in a row, you're probably not going to slip into depression. But let's say you're feeling sad and you're feeling lonely and you have no one to reach out to. You're alone with your negative thoughts, you're alone with your unpleasant emotions. They tend to spiral, right? Like being sad tends to beget more sad thoughts, which tends to begat more sad feelings. It's really, you know, I don't want to sound like I'm blaming anybody here because nobody signs up to be lonely on purpose, but putting yourself out there is simultaneously one of the hardest things to do when you're feeling lonely and one of the most important things you can do when you're feeling lonely. But we're not all necessarily able to do it just because we know it's a good idea. Related to that, you don't just need to put yourself out there when it comes to like trying to be social. You need to be able to put yourself out there in terms of just like doing Anything at all. Right. One of the biggest predictors of stepping into depression or developing, like, an anxiety disorder is a lack of achievement. And I don't necessarily mean academic achievement, although that is a form of achievement. But, like, if you moved a bunch today, you achieved something, right? You got your body from A to B and you did some stuff while you were at B and then you came back home to A, you achieve something today. Honestly, even, like doing your laundry, taking care of personal hygiene, all of those things are achievements on some level and achieving in even those seemingly small areas hugely protective against mental health problems. If you're so bored that you just kind of have no energy to do anything at all, that's actually when I start to be concerned as somebody's therapist.

A (17:40)

Right.

D (17:40)

Like, you don't need to be doing huge things. I don't need you to be curing cancer. I don't need you to be getting straight A's. But just feeling like you did a thing and it mattered, Right? Like, your life is different because you got up today and did stuff. If you are having that sense on a regular basis, you're probably going to be fine. And if you're not, I'm starting to be concerned for you. That's helpful.

C (18:05)

I just. Sorry. I just wanted to add something onto what David was saying. And the idea that human beings being social animals is, like, a really nice, protective factor is sometimes if you're feeling down academically or you're feeling like you're not really getting anything accomplished, just reaching out to somebody who is in your dorm to do a shared assignment together or to go get lunch together or go get coffee together or even, like, do your laundry with them. That kind of connection can be extremely motivating. And especially when you see this other person doing something, it makes us feel more likely that we want to do something similar, too, that we want to get out of our shell. And it's. Sometimes it's, as David was saying, it's just having at least one connection who might reach out to you when they haven't seen you in a day or two. And just like, that can be the motivating factor for getting the ball rolling and taking you out of that funk.

A (19:19)

Yeah.

B (19:19)

Yeah. Thank you both. I think it's so helpful to hear, like, of course this is a big adjustment in transition, you know, for. For everyone. But it sounds like finding your people leaning in and building on that connection and trying to do things that help, like, build your momentum and, you know, move you forward are super helpful. So thank you both.