A summary of recent survey results regarding stress and depression symptoms in college students, performed by the American College Health Association.

1. Stress and Depression
in University Students
Pamela Coburn-Litvak, Ph.D.
www.leavingtheshadowland.com

2. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
140 schools
88,178 students2018

3. What is Stress?
Stress is our
RESPONSE
To Life’s Pressures

4. Heart rate &
blood pressure
Breathing
Blood clotting
Stress Hormones
Speeds up delivery
of oxygen and
nutrients
Protects against blood
loss due to injury
• Increases alertness
• Delivers energy
• Enhances immune function
STRESSOR

5. Heart rate &
blood pressure
Breathing
Blood clotting
Stress Hormones
Atherosclerosis – can
lead to stroke
Increased wear and tear
on the heart & arteries –
can lead to
cardiovascular disease
• Irritability, anxiety
• Energy problems
• Suppressed immune function
• Mental distress
Intensity & Duration
STRESSOR

6. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Main Stressors
in University Students
Avg
Academics 50% 53% 42%
Finances 36% 38% 29%
Sleep difficulties 33% 36% 28%
Family problems 31% 35% 21%
Personal appearance 31% 35% 21%
Romantic relationships 31% 33% 28%
Career-related 29% 35% 25%
Other relationships 29% 31% 23%
Health issues 22% 24% 16%
Death of family member/friend 17% 18% 13%

7. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Stress (over past 12 months)
Felt more than
average stress? 5
Avg
5 4

8. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Stress (over past 12 months)
Felt exhausted
(not physically)? 8
Avg
9 8

9. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Stress (over past 12 months)
Felt
overwhelmed? 9
Avg
9 8

10. What is Depression?
Major Depressive Disorder* occurs when you have at
least 5 of the following 9 symptoms daily for 2+ weeks:
• A depressed mood during most of the day, particularly in the morning
• Diminished interest or pleasure in almost all activities
• Significant weight loss or gain (more than 5% in a month)
• Insomnia (lack of sleep) or hypersomnia (excessive sleeping)
• Feeling restless, agitated or slowed down
• Fatigue or loss of energy
• Impaired concentration, indecisiveness
• Feelings of worthlessness or guilt
• Recurring thoughts of death or suicide (not just fearing death)
*The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, published by the American Psychological Association in 2013
Anxiety symptoms (irrational worry; fear that something
terrible will happen) may accompany depression

11. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Depression
(over past 12 months)
Diagnosed or
treated? 2
Avg
2 1

12. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Depression
(over past 12 months)
Depression
impaired normal
life?
4
Avg
4 3

13. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Depression
(over past 12 months)
Felt
extremely sad? 7
Avg
7 6

14. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Depression
(over past 12 months)
Felt
hopeless? 5
Avg
6 5

15. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Depression
(over past 12 months)
Felt overwhelming
anxiety? 6
Avg
7 5

16. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 10:
Signs of Depression
(over past 12 months)
Felt very
lonely? 6
Avg
7 6

17. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 100:
Signs of Depression
(over past 12 months)
Intentionally hurt oneself
(cutting, burning, bruising, etc.)? 8
Avg
8 5

18. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 100:
Signs of Depression
(over past 12 months)
Seriously considered
suicide? 12
Avg
12 11

19. American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: American
College Health Association; 2018.
Recent Studies
University Student Mental Health
?? out of 100:
Signs of Depression
(over past 12 months)
Attempted
suicide? 2
Avg
2 2

20. Depression is caused
by a depletion of
brain chemicals
(“monoamines”)
–Serotonin
–Dopamine
– Norepinephrine
Monoamine Hypothesis
Bear: Neuroscience: Exploring the Brain. 3rd ed.
Neurobiology of Depression

21. Bear: Neuroscience: Exploring the Brain. 3rd ed.
Neurobiology of Depression
Diathesis-Stress
Hypothesis
Diathesis:
Genetic or other
predisposition for
disease
Stress: Exposure
to intense or
chronic stress

22. Viewpoint
Prefrontal
Cortex
Limbic
System
Interpreting a
Stressor

23. Imbalanced
Viewpoint
Prefrontal
Cortex
Limbic
System
Interpreting a
Stressor

24. How Stress leads to Depression
Stress
Response
Stress
Hormones
Brain
Damage
Brain
chemicals
Negative
emotions
• Sadness
• Anger
• Guilt
• Despair
• Anxiety
3
4
Pre-conditioning
factorsStress
1
2

25. KNOW THE SIGNS
• behavioral or emotional change; someone who doesn't
seem like themselves
• withdrawal from others and/or favorite activities
• change in hygiene or appearance, not taking care of
oneself
• decline in academic performance
• alcohol or drug abuse
• excessive or inappropriate anger
• bizarre thoughts or behavior (e.g., out of touch with
reality, talking about suicide)
• others feel uncomfortable or worried about them
• decline in functioning (e.g., not attending class, not
sleeping or sleeping too much