Life Transitions: College
Your teenager has worked hard throughout high school and finally been accepted to college. There are cheers but deep down probably a lot of fears too—- the world your teenager knows (home, sense of belonging, community, childhood friends) will shortly become turned upside down. College is a place of growth, adventure, independence, and learning—many say the best period of their life. At the same time, the stresses from this transition can be a period where mental health and substance abuse problems emerge.
Mental Health/Substance Abuse Issues
Worry and stress are typical during this transition—through adversity, young people learn and grow, however, sometimes overwhelming stress leads to mental health problems. If there is a history of mental illness or substance abuse in your teenager’s family, the risks are even higher. Some common mental health issues that arise during college are eating disorders, substance abuse disorders, depression, anxiety; less common is bipolar disorder, schizophrenia, and personality disorders.
Here is a list of stressors and behaviors to be mindful of:
Your child has to rebuild their social network. This is not always the easiest thing to do. Pressures to fit in can be high. Doubts about their uniqueness, self-worth, and personality might arise. Rejections and losses can hit particularly hard without having their supports from home around them. Maybe your child used to have a best friend to help with disappointments who is no longer as available.
If your child is spending most of their time in their dormitory room alone or if they do not return messages or pick up the phone (for lack of a good reason), this is cause for concern. Loneliness is associated with many physical and mental health problems, including depression.
Striking a balance between academics, play, sleep, eat, work, and social life can be tough. Your child may not be able to get the same grades they did in high school, which can lead to feelings of frustration and thoughts they are a failure. If they always self-identified as “smart,” a drop in grades, although normal, can feel like a tremendous loss. Further, your child may realize they need to work much harder to obtain the grades they did in high school, ignoring their core needs, which makes them vulnerable to physical and mental health problems.
With all of these exciting changes, young people may put sleep as secondary. Too much or little sleep could be an indicator or contributor to a mental health problem. Ask how much your child is sleeping. Do they have trouble falling asleep? Do they wake up during the night? Do they have nightmares? Are they sleeping too much? Do they feel like they do not need to sleep?
One out of six females and one out of thirty three males become victims of an attempted or completed rape during their lifetime (RAINN, 2018). Often, the assault is something they conceal out of fear or shame, most of the time they know the perpetrator. The symptoms following a sexual assault can vary greatly, but some warning signs would be a drop in grades/school attendance, isolation, depressive symptoms, increased aggression and irritability, being “in the clouds” a lot, nightmares, increased sexual promiscuity, sleep problems, avoiding certain people or places that are reminders of the trauma, and anxiety symptoms.
Substance Abuse Problems
College is frequently a time when a young person begins to experiment with alcohol and drugs. If there is a family history of substance abuse problems or if your child has a preexisting mental health problem, they are more vulnerable to substance abuse. Behavior that could indicate a substance abuse problem could be a significant drop in grades and attendance, doing things the young person regrets later (getting a DUI, having unprotected sex), failing to meet other obligations, being in a social group that relies on substances to have a good time. If your child does not have healthy ways of coping with stress, they become more vulnerable to substance abuse.
What can be done?
The earlier your child recognizes and seeks help during their struggles, the better the outcome. Most universities have counseling services they can turn to or can provide referrals to outside providers. A therapist can help guide and support your child during their struggles. A therapist can also provide referrals to other providers, if necessary.
Parents can keep an open line of communication, be non-judgmental, refrain from comparisons, focus on the present issue, use good listening skills, share experiences of their own struggles and help guide their child to appropriate resources, all the while respecting their self-determination. (e.g. if a child turns down your offer to contact student behavioral health, respect that.)
Too much parental involvement can reinforce a child’s feelings of failure and inadequacy (e.g., I can never do things right on my own! My parents will always think of me as a child!). If your child studies in another part of the country, offer to visit them. They may say no. Let your child decide when and for how long you stay. Offer your child to come home during academic breaks. If your child is seeing a counselor or therapist, see if you can be involved in some sessions by phone or by person. Develop a line of communication with your child’s friends if they approve.
Ultimately, your child is an adult and has to be treated as such. Top down efforts to control and fix situation, typically do not turn out well. Support your child in listening and finding out what’s most helpful in overcoming their challenges.
If you are on edge and can’t focus at work because you are waiting for the call from school or if you are worried your child is coming home sad or angry, you know what’s like to have a child with a behavioral or adjustment problem. School behavior problems develop for various reasons, but typically they are related to some underlying mental health problem or stresses in the home and/or social environment that overpower their ability to cope.
- High levels of conflict in the home due possible separation, economic problems, introduction of new family members, parental addiction, mental or physical health problems.
- Having poor social skills, social anxiety, lots of social pressure, low self-esteem or being different due to a disability
- Academic underachievement and not receiving the necessary support
- ADHD, depression, anxiety, or the effects of trauma
- Limited coping skills to express feelings of hurt or anger
What you can do?
Family therapy can help youth deal with changes in the household by giving them the space to be validated and heard by adults. If not understood by their caregivers, youth can do self-sabotaging behavior at school to get “even” or call attention to parents—negative attention can be better than none. Having low self-confidence and poor social skills, can lead to children being excluded and often bullied. This can create the child to take out their feelings of resentment and hurt through acting out. Poor social skills can lead your child to not take risks (e.g. starting a new activity) which can lead to isolation and pain. Academic underachievement can result in a young person giving up and not focusing on their work. With time on their hands, children get bored and often act out. This serves to get attention (negative), frequently as a way of saying they are not well and need help. Individual and group therapy can help with the abovementioned problems as well.
What do the numbers say?
When a teacher says your child is hyperactive, has difficulties paying attention, and misbehaves, professionals can be quick to say the child has ADHD, however, remember 11% of youth have a mood disorder (e.g. depression). 10% of youth have a behavior or conduct disorder (e.g. ADHD); and 8% of youth have an anxiety disorder ( e.g., social anxiety, PTSD). (National Alliance on Mental Illness, 2017). 20% of youth ages 13-18 live with a mental health condition.
Most mental health problems children suffer from mimic a handful of ADHD symptoms.
What’s often lacking?
Healthy coping skills are something all children need to develop to reach normal development and deal with adversity and create resilience. Sometimes youth use hitting or verbal disrespect to deal with feelings of frustration. Youth often cope with feeling of isolation and boredom by becoming addicted to electronics. Teenagers can turn to substances to help alleviate difficult feelings. Sometimes children are hard on themselves in order to motivate academic or social success—this has the exact opposite effect, typically. Having healthy thoughts about oneself is fundamental to a good self-esteem and normal social/emotional growth.
Gone are the days when your kid gets home from school and plays in the street until dusk with neighbors. Seeing a child spend dozens of hours per week gaming or watching Youtube videos of others gaming (yes, really!) is the new norm.
Question: But when does gaming become a clinical concern?
Answer: When it serves as avoidant behavior. Let me explain.
Maybe your child has social anxiety, low self-esteem, has been a victim of bullying and is using gaming to meet their social needs. In this scenario, their socialization is between other online players (not same-aged friends who have ransacked your refrigerator before) and usually scattered all over the country. Although your child may consider these people their good friends, their relationship is almost always superficial and hinders social confidence at school and in the community. There is a big difference between a rejection in the sandbox and pop-up box.
For your child, having safe online relationships where the burn of rebuff stings less, is better than no friends at all. Trust me! Stopping this relational pattern is tough. First, when they play video games so much they typically become good at them and feeling a sense of mastery is good for the self-esteem. Also, gaming becomes a community and part of their identity, which is especially important starting in middle school.
Just like any craft or skill, when your child does not practice how to engage with a group of teammates or how to handle feelings of sadness relating to being left out, they start losing their social skills —the old use them or lose them—and retreat. Your child starts losing confidence in their ability to socialize in person where they find richer, real life connections which will fuel their social, emotional, and intellectual development. Your child might learn to become satisfied with only online friends and stop pursuing friendships in school or the community.
Often, when gaming friends and time consumes their world, symptoms of depression and anxiety set in, which leads to other problematic behaviors affecting their school and home life.