December 10, 2021 • 17 mins
College is a time of new experiences and ideas, but it can also give rise to loneliness, anxiety and depression—something that’s been exacerbated by the pandemic. Dr. Saltz tells parents how they can help children stay happy and healthy.
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Speaker 1 (00:05):
These are challenging times, but you don't have to navigate
them alone. Welcome to How Can I Help? I'm Dr
Gayl Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight, and advice. Increasing numbers of college
students are struggling with anxiety and or depression, to the
point of overwhelming the mental health services available on college campuses.
The reasons run from the fact that ages eighteen to
(00:51):
twenty two are a peak time for the first presentation
of certain mental health issues, issues like a first oppression
or a first anxiety disorder, schizophrenia, or first bipolar disorder,
to the fact that college is often the first time
many kids first live and try to function away from
(01:12):
home and all of its supports. In addition to the
stresses of also having to perform at a very high level,
college provides wonderful opportunities to learn, grow, socialize, and find yourself.
It also provides, however, temptation and access to alcohol, drugs,
(01:37):
social pressures to belong and often social pressures to be sexual.
If a young adult is already struggling, these temptations can
cause them to become really self destructive and to suffer
more and to function less. More kids are leaving school
(01:58):
now because they can manage it, or because the school
worried about the safety of that kid and has therefore
asked them to leave. So today I am answering a
listener question about their college students. College was already the
first time many kids leave home and face the stresses
(02:21):
of functioning independently, but now enter the age of COVID,
all colleges have seen an uptick in the number of
students struggling with mental health issues. The American Academy of
Pediatrics just refer to the increase of mental health problems
(02:41):
for children and teens as having risen to a crisis level.
College campuses are grappling with how to identify and then
provide services for students who have overwhelming anxiety and stress
or a mood disorder and our feeling very isolated and
(03:01):
lonely and generally not thriving emotionally. Often enough, a student
won't realize they're having a psychologically difficult time until they
are truly unable to function, and even then they may
not realize that they can and should get treatment. Mental
(03:25):
health problems can be made worse by over consumption of
alcohol and of drug use, but these behaviors are typically
normalized in college and not seen by peers as attempts
to self medicate, which they often are, or escape difficult emotions,
(03:46):
which they also often are. This makes it more likely
that a college kid will escalate what is actually serving
as a self destructive behavior, and less likely that their
friend will suggest to them that maybe, hey, they're drinking
too much or they're not doing well. They may rather
(04:07):
see it as their friend is part of the fabulous
social scene. Because your child is over the age of eighteen,
the school and the school's house center are legally required
to have your child's permission to speak with you about anything,
(04:28):
even if your child is really not faring well. Relying
on the school for information about your child therefore may
not work. This is a frustrating situation for parents and
for schools, but it is the law. Staying a tune
to how your child is feeling, what they are doing
(04:51):
actually doing, and do they sound engaged in classes? Are
they sleeping? Do they speak of friends, asked them if
they are feeling anxious or down, give them an opening
to let you listen, and here if they are struggling.
Due to recent awareness of mental health struggles, specifically on
(05:13):
college campuses, more colleges are raising awareness on campus with
students about mental health, encouraging more dialogue about the importance
of mental health, and working to destigmatize getting help. So
with that, let's get to my listeners question and ask
(05:34):
how can I help? Dear doctor Salts, My son left
for college for the first time this past September. He
was already very nervous about being comfortable there, being able
to do the work, and making friends. I was nervous
for him, and so I have anxiously awaited news of
(05:58):
how he is doing. I am not hearing a whole lot,
which already has me worrying, but what I do here
doesn't sound great. He has met some people, but he
still says he misses home a lot and feels kind
of lonely. While he's not doing poorly academically so far,
(06:21):
he sounds very stressed that he thinks he has to
do very well and he is not. He is doing average.
I have a sense he is in his room a lot,
but also not able to sleep very well at night
and is up late a lot doing work. I have
(06:42):
been making suggestions of things to try or things to
do to meet people, but actually he is not doing
any of them. The longer this goes on, the less
good he sounds on the phone, and I am feeling
perpetually worried, which I fear is actually straining our conversations
when we do speak. What can I do to help
(07:05):
my son adjust to being at school, and how can
I tell if he's really in trouble or just still adjusting. First,
let me say I know that few things are more
anxiety producing than when your child is really miserable and struggling.
(07:27):
As a parent, you feel like your job is to
help them, and being far away at a time when
the task at hand is literally to separate from you
and to do this on his own, makes those feelings
all the more difficult to bear. But it's true that
his task is to find his way without you holding
(07:49):
his hand exactly. That doesn't mean you can't give him support.
I would also say that many many college students, even
pre pandemic, find the first few months of college very rocky. Emotionally.
It is, after all, a big transition, often a first
(08:11):
time away from home, living independently, and it is also
a time of big developmental change internally, trying on new identities,
often having first exposures to people very different from yourself,
first exposures to alcohol and drugs, first romantic relationships, many firsts,
(08:35):
and the stresses to perform are significant. Those who tend
to be high achievers have difficulty being in an environment
where everyone is a high achiever, and they may be
in the middle of the pack now, so some of
these things you describe are really not surprising. Kids often
(08:57):
go to school with the unrealistic idea that they are
supposed to be the best years of their life, super fun,
one big party, and though they do hear that from
other people, it's often just not the case at all.
In fact, it's better to have a difficult time sometimes
(09:19):
be more normalized, actually, because it can really be tough
for a lot of kids, and hearing it's supposed to
be great can make you feel more alienated. So letting
your kid know that a lot of people struggle at
the beginning and these might not be the best times
of his life would be a good start that being said,
(09:42):
you detect in fact your son is really struggling. Letting
him talk to you about how he is feeling is
a good thing. He does need an outlet, but you
do want to ask about how bad he is feeling.
If he has nervous much of the day, not able
(10:03):
to sleep for at least seven hours a night, having
a change in appetite, having trouble concentrating, feeling sad and lonely,
then more maybe going on than just struggling to adjust.
How can I help with Dr Gail Salts will be
(10:24):
back after the short break. I would suggest paying him
a visit. You'll get a much better sense of how
he is by seeing him in person. If his room
(10:45):
looks like a bomb blew up in it, if papers
are exploding out of his backpack and he looks really disorganized,
if he looks poorly groomed, if he looks to you
anxious or sad, this tells you he needs some help.
Ask him about his mood, and if he sounds depressed,
(11:06):
do ask him about any suicidal thinking. It's always important
to ask and head something off then not. It's better
to ask, and if he affirms such ideas, then getting
him to a psychiatrist in this case is emergent, but
if not, if he says no, help him navigate how
(11:30):
to get an appointment with the student health mental health
professionals for evaluation and treatment. These things are generally covered
by the school for all students if they are too
booked up. And I'm only mentioning this because lately, this
is what I've been hearing from various parents, concerns that
(11:51):
the mental health centers are so overwhelmed that their student
isn't able to get an appointment for months. Then instead,
help him find a per some locally that he can
commute to, whether it's a walk or a short drive,
something that he can get to easily from campus. Tell
him many kids are in therapy and it will help
(12:14):
him if he goes. If a student is at risk
of harming themselves, they may need emergent treatment and sometimes
they need to come home for a while to get better.
But if not, then treatment at school can help him
feel better and move forward while still staying in school
(12:37):
and therefore adjusting to both the academic and social life there.
I hope that was helpful. Failure to launch is a
growing problem in this country before college is an important
time to assess if your child is truly ready to
(12:58):
live and work independently, and if not, to institute a
plan that will allow them to do so responsibly. In
the name of love, many a parent does so much
for their child, including smoothing the way and preventing any
mistakes or failures, such that their child has developed no
(13:21):
skills of independent living nor coping skills for how to
manage disappointment and failure. Does your child get themselves to
the doctor if need be, go to teachers to discuss
a problem they're having in school, Take initiative to go
and meet new people. Can they wash their own clothes,
(13:44):
make their own food, take their own medication, balance their
own budget. As a parent, stepping away and transferring control
to them builds your child's confidence that they can take
care of themselves homes. Let them fail now at home
(14:05):
so they figure out how to handle failure before problems
become too big to fail later on. If they have
had plenty of practice at home fending for themselves, building
social skills, recovering from making mistakes or disappointments, they will
be better equipped and more importantly, no, they are better
(14:28):
equipped to whether their college existence. If your child is
a college and is having emotional difficulty, what can you do?
The best case scenario is that you can help your
child to find resources there to support them and treat
them while at school. It is better to be able
(14:50):
to continue being in their world while getting help as
long as they are not having any thoughts of suicide,
are not abusing drug ugs or abusing alcohol, and are
able to continue to function adequately and take care of themselves.
Mental health services at school is a fine place to start.
(15:13):
Many can do an evaluation and treat with therapy and
even medication if needed. However, if they are only able
to provide a few sessions something that does occur, you
may need to ask for referrals to local practitioners so
your child can be seen more frequently for a longer
(15:34):
period of time to feel better. If, however, your child
is thinking about suicide and do ask them if they
are not getting out of bed, if they are not
going to classes, if they are regularly using substances, they
have symptoms of losing touch with reality, then these are
(15:56):
red flags that a child needs emergent and significant treatment
and should come home. The number of kids coming home
has grown large enough that actually the Dear Presbyterian Youth
Anxiety Center in New York City began a launching Emerging
Adulthood program to help them. Treatment there ranges from group
(16:21):
therapy for eighteen to twenty three year olds that focuses
on rehearsing life skills with peers in a setting where
they can gain feedback and not fill alone. Such programs
I think exist in many places because there's become a need.
The program also takes young adults out into the community
(16:43):
to build social skills like asking for a job, ordering food,
and sending something back, asserting yourself, which can be very
difficult for young adults with anxiety, especially social anxiety. The
director at the center reports that when call each students
struggle with social anxiety, the most common of the anxiety disorders.
(17:05):
It makes college adjustment increasingly difficult, and treating this issue
helps a student to return with a much higher likelihood
of integrating and finding success. Do you have a problem
I can help with? If so, email me at how
(17:25):
Can I Help? At Seneca Women dot com. All centers
remain anonymous and listen every Friday to how can I
Help with me? Doctor Gail's Salts
These are challenging times, but you don't have to navigate
them alone. Welcome to How Can I Help? I'm Dr
Gayl Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight, and advice. Increasing numbers of college
students are struggling with anxiety and or depression, to the
point of overwhelming the mental health services available on college campuses.
The reasons run from the fact that ages eighteen to
(00:51):
twenty two are a peak time for the first presentation
of certain mental health issues, issues like a first oppression
or a first anxiety disorder, schizophrenia, or first bipolar disorder,
to the fact that college is often the first time
many kids first live and try to function away from
(01:12):
home and all of its supports. In addition to the
stresses of also having to perform at a very high level,
college provides wonderful opportunities to learn, grow, socialize, and find yourself.
It also provides, however, temptation and access to alcohol, drugs,
(01:37):
social pressures to belong and often social pressures to be sexual.
If a young adult is already struggling, these temptations can
cause them to become really self destructive and to suffer
more and to function less. More kids are leaving school
(01:58):
now because they can manage it, or because the school
worried about the safety of that kid and has therefore
asked them to leave. So today I am answering a
listener question about their college students. College was already the
first time many kids leave home and face the stresses
(02:21):
of functioning independently, but now enter the age of COVID,
all colleges have seen an uptick in the number of
students struggling with mental health issues. The American Academy of
Pediatrics just refer to the increase of mental health problems
(02:41):
for children and teens as having risen to a crisis level.
College campuses are grappling with how to identify and then
provide services for students who have overwhelming anxiety and stress
or a mood disorder and our feeling very isolated and
(03:01):
lonely and generally not thriving emotionally. Often enough, a student
won't realize they're having a psychologically difficult time until they
are truly unable to function, and even then they may
not realize that they can and should get treatment. Mental
(03:25):
health problems can be made worse by over consumption of
alcohol and of drug use, but these behaviors are typically
normalized in college and not seen by peers as attempts
to self medicate, which they often are, or escape difficult emotions,
(03:46):
which they also often are. This makes it more likely
that a college kid will escalate what is actually serving
as a self destructive behavior, and less likely that their
friend will suggest to them that maybe, hey, they're drinking
too much or they're not doing well. They may rather
(04:07):
see it as their friend is part of the fabulous
social scene. Because your child is over the age of eighteen,
the school and the school's house center are legally required
to have your child's permission to speak with you about anything,
(04:28):
even if your child is really not faring well. Relying
on the school for information about your child therefore may
not work. This is a frustrating situation for parents and
for schools, but it is the law. Staying a tune
to how your child is feeling, what they are doing
(04:51):
actually doing, and do they sound engaged in classes? Are
they sleeping? Do they speak of friends, asked them if
they are feeling anxious or down, give them an opening
to let you listen, and here if they are struggling.
Due to recent awareness of mental health struggles, specifically on
(05:13):
college campuses, more colleges are raising awareness on campus with
students about mental health, encouraging more dialogue about the importance
of mental health, and working to destigmatize getting help. So
with that, let's get to my listeners question and ask
(05:34):
how can I help? Dear doctor Salts, My son left
for college for the first time this past September. He
was already very nervous about being comfortable there, being able
to do the work, and making friends. I was nervous
for him, and so I have anxiously awaited news of
(05:58):
how he is doing. I am not hearing a whole lot,
which already has me worrying, but what I do here
doesn't sound great. He has met some people, but he
still says he misses home a lot and feels kind
of lonely. While he's not doing poorly academically so far,
(06:21):
he sounds very stressed that he thinks he has to
do very well and he is not. He is doing average.
I have a sense he is in his room a lot,
but also not able to sleep very well at night
and is up late a lot doing work. I have
(06:42):
been making suggestions of things to try or things to
do to meet people, but actually he is not doing
any of them. The longer this goes on, the less
good he sounds on the phone, and I am feeling
perpetually worried, which I fear is actually straining our conversations
when we do speak. What can I do to help
(07:05):
my son adjust to being at school, and how can
I tell if he's really in trouble or just still adjusting. First,
let me say I know that few things are more
anxiety producing than when your child is really miserable and struggling.
(07:27):
As a parent, you feel like your job is to
help them, and being far away at a time when
the task at hand is literally to separate from you
and to do this on his own, makes those feelings
all the more difficult to bear. But it's true that
his task is to find his way without you holding
(07:49):
his hand exactly. That doesn't mean you can't give him support.
I would also say that many many college students, even
pre pandemic, find the first few months of college very rocky. Emotionally.
It is, after all, a big transition, often a first
(08:11):
time away from home, living independently, and it is also
a time of big developmental change internally, trying on new identities,
often having first exposures to people very different from yourself,
first exposures to alcohol and drugs, first romantic relationships, many firsts,
(08:35):
and the stresses to perform are significant. Those who tend
to be high achievers have difficulty being in an environment
where everyone is a high achiever, and they may be
in the middle of the pack now, so some of
these things you describe are really not surprising. Kids often
(08:57):
go to school with the unrealistic idea that they are
supposed to be the best years of their life, super fun,
one big party, and though they do hear that from
other people, it's often just not the case at all.
In fact, it's better to have a difficult time sometimes
(09:19):
be more normalized, actually, because it can really be tough
for a lot of kids, and hearing it's supposed to
be great can make you feel more alienated. So letting
your kid know that a lot of people struggle at
the beginning and these might not be the best times
of his life would be a good start that being said,
(09:42):
you detect in fact your son is really struggling. Letting
him talk to you about how he is feeling is
a good thing. He does need an outlet, but you
do want to ask about how bad he is feeling.
If he has nervous much of the day, not able
(10:03):
to sleep for at least seven hours a night, having
a change in appetite, having trouble concentrating, feeling sad and lonely,
then more maybe going on than just struggling to adjust.
How can I help with Dr Gail Salts will be
(10:24):
back after the short break. I would suggest paying him
a visit. You'll get a much better sense of how
he is by seeing him in person. If his room
(10:45):
looks like a bomb blew up in it, if papers
are exploding out of his backpack and he looks really disorganized,
if he looks poorly groomed, if he looks to you
anxious or sad, this tells you he needs some help.
Ask him about his mood, and if he sounds depressed,
(11:06):
do ask him about any suicidal thinking. It's always important
to ask and head something off then not. It's better
to ask, and if he affirms such ideas, then getting
him to a psychiatrist in this case is emergent, but
if not, if he says no, help him navigate how
(11:30):
to get an appointment with the student health mental health
professionals for evaluation and treatment. These things are generally covered
by the school for all students if they are too
booked up. And I'm only mentioning this because lately, this
is what I've been hearing from various parents, concerns that
(11:51):
the mental health centers are so overwhelmed that their student
isn't able to get an appointment for months. Then instead,
help him find a per some locally that he can
commute to, whether it's a walk or a short drive,
something that he can get to easily from campus. Tell
him many kids are in therapy and it will help
(12:14):
him if he goes. If a student is at risk
of harming themselves, they may need emergent treatment and sometimes
they need to come home for a while to get better.
But if not, then treatment at school can help him
feel better and move forward while still staying in school
(12:37):
and therefore adjusting to both the academic and social life there.
I hope that was helpful. Failure to launch is a
growing problem in this country before college is an important
time to assess if your child is truly ready to
(12:58):
live and work independently, and if not, to institute a
plan that will allow them to do so responsibly. In
the name of love, many a parent does so much
for their child, including smoothing the way and preventing any
mistakes or failures, such that their child has developed no
(13:21):
skills of independent living nor coping skills for how to
manage disappointment and failure. Does your child get themselves to
the doctor if need be, go to teachers to discuss
a problem they're having in school, Take initiative to go
and meet new people. Can they wash their own clothes,
(13:44):
make their own food, take their own medication, balance their
own budget. As a parent, stepping away and transferring control
to them builds your child's confidence that they can take
care of themselves homes. Let them fail now at home
(14:05):
so they figure out how to handle failure before problems
become too big to fail later on. If they have
had plenty of practice at home fending for themselves, building
social skills, recovering from making mistakes or disappointments, they will
be better equipped and more importantly, no, they are better
(14:28):
equipped to whether their college existence. If your child is
a college and is having emotional difficulty, what can you do?
The best case scenario is that you can help your
child to find resources there to support them and treat
them while at school. It is better to be able
(14:50):
to continue being in their world while getting help as
long as they are not having any thoughts of suicide,
are not abusing drug ugs or abusing alcohol, and are
able to continue to function adequately and take care of themselves.
Mental health services at school is a fine place to start.
(15:13):
Many can do an evaluation and treat with therapy and
even medication if needed. However, if they are only able
to provide a few sessions something that does occur, you
may need to ask for referrals to local practitioners so
your child can be seen more frequently for a longer
(15:34):
period of time to feel better. If, however, your child
is thinking about suicide and do ask them if they
are not getting out of bed, if they are not
going to classes, if they are regularly using substances, they
have symptoms of losing touch with reality, then these are
(15:56):
red flags that a child needs emergent and significant treatment
and should come home. The number of kids coming home
has grown large enough that actually the Dear Presbyterian Youth
Anxiety Center in New York City began a launching Emerging
Adulthood program to help them. Treatment there ranges from group
(16:21):
therapy for eighteen to twenty three year olds that focuses
on rehearsing life skills with peers in a setting where
they can gain feedback and not fill alone. Such programs
I think exist in many places because there's become a need.
The program also takes young adults out into the community
(16:43):
to build social skills like asking for a job, ordering food,
and sending something back, asserting yourself, which can be very
difficult for young adults with anxiety, especially social anxiety. The
director at the center reports that when call each students
struggle with social anxiety, the most common of the anxiety disorders.
(17:05):
It makes college adjustment increasingly difficult, and treating this issue
helps a student to return with a much higher likelihood
of integrating and finding success. Do you have a problem
I can help with? If so, email me at how
(17:25):
Can I Help? At Seneca Women dot com. All centers
remain anonymous and listen every Friday to how can I
Help with me? Doctor Gail's Salts
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