It’s Not Just You—Almost Everyone Is Having a Hard Time with Their Mental Health Right Now
Students, faculty, and staff urged to get screened virtually during today’s Depression Screening Day
Editor’s note, 3:20 pm: A note from the Center for Psychiatric Rehabilitation: We received a notification from Mindwise that their screening sites continue to experience service disruption and they are currently working to fix the issue. Here is the link to the survey that you can take at any time. We apologize for the inconvenience.
After being diagnosed with an anxiety disorder in high school and bipolar II disorder freshman year at BU, Flannery Abbey finally felt she was starting to thrive, thanks to the right mix of medication and therapy, while studying abroad in Ireland this spring. But as the coronavirus started to sweep through Europe, Study Abroad programs came to a halt and BU students were sent home. “I was doing really well,” she says, “but then everything came crashing down.”
Abbey (CAS’21), who contracted the virus while abroad, but fortunately experienced only a loss of taste and smell, was upset about moving home—she felt like she was stuck back in high school, and that a formative part of her college experience had been suddenly taken away. It didn’t help that she had to quarantine in her childhood bedroom to keep her family safe when she returned from Ireland. She went weeks without a hug. “I felt so lonely, and I became very depressed,” she says. “I went from being pretty stabilized to then feeling wiped out.”
When Abbey experienced a combined anxiety and depressive episode, her mom helped her reach out to her former therapist in Boston (a therapist Student Health Services Behavioral Medicine team had helped her find), and she began teletherapy. She has steadily improved and has returned to a routine of school and work.
Her experience is one shared by many college students. In addition to the physical and financial toll the coronavirus pandemic has taken, many students have found their mental health has been rocked by it, too.
A June study by the Centers for Disease Control and Prevention reports that young adults, minorities, and essential workers say they feel higher levels of anxiety, depression, are increasingly abusing drugs and alcohol, and have suicidal thoughts. Another study, by the Kaiser Family Foundation in August, reports that more than 45 percent of Americans say their mental health is worse compared to a year ago.
And a survey of more than 18,000 college students in the United States conducted by the Healthy Minds Network and released in July, finds that 80 percent report that COVID-19 has negatively impacted their mental health, and one-fifth of respondents feel their mental health has significantly worsened during this time.
That study was led by co–principal investigator Sarah Ketchen Lipson, a BU School of Public Health assistant professor of health law, policy, and management, who says that there were already high rates of depression, anxiety, and suicide pre-pandemic, and they’re increasing now, given the risk factors and emotional health factors that the pandemic has triggered. “One category would be financial stress, which many students and their families are experiencing,” Lipson says. “Maybe they’re graduating, thinking about going into a job market that has so much uncertainty. Another is isolation; students are experiencing this more than ever, and for those who struggle with depression and anxiety, social connections can be a protective factor, but those connections look very different right now or might not be possible.”
Carrie Landa, director of Behavioral Medicine at Student Health Services, says we’re living through an extraordinary time in history: the COVID-19 pandemic, a divisive election, racially based violence, and a level of uncertainty about the future. “It is overwhelming to think about and take in all the information around us, which can indeed be stressful,” Landa says. “Not to mention, there are normal stressors associated with being a student that are experienced as the semester progresses, on top of the environment we are all living in.”
With that in mind, BU students, as well as faculty and staff, are encouraged to take a free virtual screening today as part of National Depression Screening Day. Find out how to participate in the attached sidebar, “Depression Screening Day at BU.”
What’s normal, and what’s not
Dori Hutchinson (Sargent’86,’95), BU Center for Psychiatric Rehabilitation director of services, says college is often the time mental health issues first become apparent. “It’s when students leave home for the first time, and these issues may have been bubbling under the surface and now there are all sorts of new demands on them—socially, academically, environmentally,” Hutchinson says. “It’s kind of this combination of stress, vulnerability, the model of biopsychosocial factors all coming together. And if you have any kind of genetic vulnerability to depression or anxiety when you go to a new environment, and there are new demands on you and you’re on your own…it can really surface.”
Mental health is this “bidirectional aspect of young people’s lives that is affected by, and affects, so much,” Lipson says. Anxiety is more about fixating on the future, she says, and experiencing fear, whereas depression is a feeling of hopelessness. “It’s less forward-thinking. It’s feeling hopeless, that there isn’t a purpose,” she says. “It’s easier than ever to look around and to feel that way.”
Everyone has days where they feel overwhelmed and stressed by their workload (welcome to adulthood). And it’s normal to have days where you feel down. But “when anyone has a persistent feeling that is negatively impacting day-to-day functioning, it is important to take inventory about what is going on,” Landa says. “Speaking with a professional is a great place to start. It may be that treatment is warranted, sometimes some simple shifts in lifestyle or behavior can make a significant difference, or it can be a combination of both.”
Abbey says she was in denial about the state of her mental health for a long time before seeking help. On the outside, she appeared fine. She adjusted to BU well, had friends, and was training for a half marathon. But she was also struggling. “I was sleeping all the time, I was either not hungry or too hungry,” she recalls. “All the color was leeching out of the world. I knew from experiencing depression in high school what was happening, but I thought when I left home I wouldn’t have these problems anymore.”
After having thoughts of suicide, she ended up at BU’s Center for Anxiety & Related Disorders. Staff there drove her to the hospital and called her mom. She was soon connected to a therapist in the Boston area. The National Alliance on Mental Illness reports that it has seen a 65 percent increase in people calling its help line since the beginning of the pandemic. At BU, Landa says, the number of visits to Behavioral Medicine has stayed relatively steady compared to last year: 2,941 visits from July 2018 to July 2019, versus 2,893 visits from July 2019 to July 2020.
But the number of students participating in Behavioral Medicine’s group therapy sessions has increased by 50 percent, she says. She speculates that students see these groups as a chance to connect with others, something that many people are currently craving during the pandemic. “We have also really expanded our groups programming over the past couple of years, and even as the campus shut down in the spring, we continued to have students zooming in from all over the globe to connect with others who may be struggling,” Landa says.
Behavioral Medicine’s group sessions deal with specific subjects, such as one for those who are new to BU, another for navigating relationships, and two specifically for managing anxiety.
Kesha Perkins (CAS’21), a coleader of BU’s newly formed Black, Indigenous, and People of Color Mental Health Collective (BIPOCMHC), decided to join Behavioral Medicine’s grief group after losing her grandmother and close friend Erin Edwards (COM’21). She says the group supplemented her talks with a therapist. “It’s a space to cry and to talk with each other,” she says. “No one really wants to talk about grief, or how you go through school when you are grieving, but this group is a place to do that. I didn’t feel like I was crazy or alone, and the moderator asks very broad follow-up questions to get the conversation going.”
Seeking out help, in one way or another
Since the pandemic, seeking help has become easier, with socially distant friendly teletherapy replacing in-person visits for many patients. Landa says she assumes some BU students have chosen to stick with their home therapists during this time. The American Psychiatric Association surveyed its members in May to find out how many of them were using telehealth visits, before and during the pandemic. Prior to COVID-19, 64 percent of psychiatrists were not using telehealth. Now, eight months into the pandemic, 85 percent of psychiatrists say they are seeing the majority of patients virtually.
Students, such as Abbey, who is participating in Learn from Anywhere (LfA) from her parents’ home in Vermont this semester, but still meeting virtually with her therapist in Boston, say they’re happy with the change. Appointments tend to take less time, because you don’t have to commute. Meetings can be held anywhere, so students don’t have to find a new therapist if they’re learning remotely but had been seeing someone elsewhere. And it’s now easier for new students to continue with therapists they had been seeing at home. At a recent Boston City Council meeting, Kenneth Elmore (Wheelock’87), associate provost and dean of students, told attendees that the University is considering ways to give students private spaces for virtual counseling sessions, as well as for private calls with family, for instance.
Looking out for one another
Healthy Minds study coinvestigator Lipson says it’s important that students, faculty, and staff ask one another how they are doing, and really listen. She opens her classes by doing exactly that, an exercise she says has worked well. She’s also honest with her students about how she’s doing during the pandemic. She told them she has been having trouble sleeping and says they seem to appreciate that she’s being honest about her own struggles, too.
“I’m teaching a class to doctoral students in public health, and there might be an expectation that you are bringing your full cognition into the class right now, but I don’t expect that,” Lipson says. “I put them into breakout rooms and ask questions like, what was the most challenging part of starting this semester? What has it been like the past two months? Tomorrow we are going to talk about self-care practices.”
Lipson says it’s critically important to make space for these kinds of discussions in the classroom since so many student activities and traditional social events aren’t happening right now (or are happening virtually). And fostering natural classroom conversation is a great lead-in to topics on the syllabus, she says. “I can say we talked about how this is affecting all of us earlier, and now we are going to talk about this research study that is directly related.”
This week, BU Student Government’s Mental Health Committee (MHC) launched Terriers Thrive Together, a monthlong series of virtual events designed to promote self-care and well-being on campus. Also during October, the University is drawing attention to many of its own events and resources as well, as part of the Wellbeing Project, which launched last year and is run by the Office of the Provost. Its goal is to support the health and wellness of the BU student body (find links to the full calendar of events here and here).
MHC cochair Savannah Majarwitz (CAS’22) says public events like this are important because they help to remove some of the stigma around mental health. Majarwitz struggles with depression and anxiety, and says she has benefited from journaling and art therapy.
“Both with COVID and the general climate we’re living in, right now it’s very hard to feel motivated, and very hard to find that sense of happiness, probably because it’s hard to go out and see friends, and feel normal,” she says. “So I think we’re all struggling a bit.”