When young adults go to university, they enter a different ‘world’. From food, to the people they meet on different levels, even their home life changes for those who stay at the student residence. Likewise children embarking on their primary or high school career, also have to contend with unfamiliar territory. Even though this may be an exciting chapter for some, for others these changes may cause a great deal of anxiety, which could negatively affect them. So says Tegan Rix, an occupational therapist at Akeso Clinic Milnerton.
“A change in environment and support structures when trying to create a home away from home, are some of the main pressures for students. As this adjustment may prove to be already an impossible task for some, the academic demands from university can be overwhelming. Students often experience what is known as test and exam anxiety which inhibits their ability to perform, as well as they otherwise could have.
“Other stressors include financial concerns, social and relationship pressures and worries about the future. The fear of the unknown is daunting and students face extreme anxiety about the next best step in the right direction to ultimately create a life worth living,” she explains.
Definition
Anxiety is a general term that is used to cover several different types of disorders, all of them having the feelings of nervousness, worry, fear and apprehension in common. This is often accompanied by physical symptoms such a sweating palms and a tight chest,” Rix points out.
“While a healthy measure of anxiety is essential for human survival as it serves as an emotional protective system, this response can become disabling when it results in excessive physiological arousal as well as cognitive, emotional and behavioural disturbances in everyday life. This can have a ripple effect on a person’s social and occupational functioning,” she adds.
Anxiety vs stress
According to Rix the words stress and anxiety are often used interchangeably in conversation, but there is a difference. “When we feel stressed, we are able to locate exactly where it is coming from: meeting a deadline for an assignment, an upcoming race or sports match, constantly butting heads with a loved one. After the route of stress is resolved, you feel relieved.
“The source of anxiety, however, is much harder to pinpoint. This, in itself, is frustrating as it can be a constellation of problems from all areas of life which contribute to this emotion and before you know it, anxiety takes on a life of its own and we feel like we are a victim to this sometimes debilitating emotional manifestation. We may also continue to feel uneasy after a perceived threat has passed.”
Prevalence
“Research suggests that as much as 15% of South Africa’s university students report moderate to severe symptoms of anxiety and this is on the rise. Studies furthermore show that as little as 8-11% actually receive the psychological care needed to counter their anxiety. This could be due to a variety of contributors, such as the lack of knowledge of symptoms, the stigma attached to seeking professional help for mental health disorders, traditional beliefs of mental health and a long waiting list for on-campus counselling services,” says Rix. More recently, Tegan Rix has been lucky enough to attend focus group discussion in which a broad panel of student representatives were able to voice their stories and ongoing difficulties with the tertiary system. “Common themes included arriving to university on a bursary without residency being finalised, and some faculties being under- supportive when asked to extend deadlines for assignments. This was more difficult in times of mental difficulties and considering the large amount of paperwork and long queues when applying for a leave of absence. It was heart-warming to see universities attentively listening to students and forming action plans; they are really working hard to be more solution based”, says Rix.
According to her South African researchers are part of a consortium of internal researchers who are currently investigating the prevalence of common mental health disorders among undergraduate students across the globe. “These researchers have identified a gap in the tertiary educational system when trying to meet the psychological needs of our students. We believe new epidemiological data collected in some countries will prove to be useful to help develop cost-effective and efficient interventions to help students suffering from anxiety at varsity.”
Potential comorbidities associated with anxiety
As if anxiety alone is not dreadful enough, some students aren't able to tolerate the discomfort and start to rely on substances to help soothe the manifestation of symptoms, Rix points out. “Many university students use a classification known as ‘downer’ drugs. These include substances such as alcohol and cannabis which are used to help them feel a sense of calm and relaxation quickly. Smoking tobacco, even though a stimulant, gives short-term relief of symptoms, however, in the long run adds to intense feelings of anxiety precisely because it is a stimulant. This can also be said for coffee, which can be another maladaptive way of dealing with anxiety. The problem is when we become over- reliant on one type of self- soothing behaviour, it can lead to dependency. Immediacy is sometimes the antidote to anxiety itself - we want to feel better and we want to feel better right now.
“Especially in our young adult years, anxiety and depression are also meaningfully linked”, says Rix.
Treatment
Rix says that it is perfectly normal to feel stressed out at one time or another during the academic year, and to feel blue on some occasions too. The impact of our emotions goes far beyond our mental state of mind. Chronic stress and anxiety has an impact on our bodies physically, emotionally, cognitively and behaviourally. No two people have the same manifestation of symptoms. “However, when your emotions and behaviour change dramatically from your regular day-to-day functioning, you need to stop and ask yourself what is really going on - and seek professional help.”
“The hardest part for students tends to be the first step: locating someone who is able to help you, showing up for your appointment and being able to tell your story. It is important that take accountability of your process; use this opportunity to be proactive and do not downplay the difficulties that you have been experiencing. It helps to share your feelings, for how long you have been feeling this way and the functional implication this has had on all areas of your life.
“It is also normal to have mixed feelings after your first couple of sessions or you may even feel discouraged or just confused. Therefore make sure that you feel comfortable and safe with the person you are sharing your concerns with, that you follow a realistic plan and that you feel comfortable with all parts of the discussion before leaving a consultation. “Fact is anxiety needn’t be debilitating; it can be successfully treated with medication as well as with cognitive or behaviour therapy. In some cases psychiatrists and therapists use a combination of treatment to ensure that a person leads a full and productive life,” she advises.
Parents
The main aim for parents and family members is not to try and eliminate the feelings of anxiety, but to try and manage it effectively, Rix suggests. “This is by helping their children to tolerate their anxiety in such a way that would still allow for them to function whilst experiencing symptoms. While avoiding situations in the short term may seem effective, it reinforces poor coping skills in the long run.
“Change is possible and mental health issues arising from anxiety are common and treatable,” Rix reiterates. “As parents, we need to take time to do a bit of introspection about how we handle our own relationship with anxiety and uncertainty; and then to make sure we put in our best effort to model healthy behaviour when tackling these challenges. Use every opportunity to reassure your children that you have confidence in their ability and support their choices. Moreover, be realistic with your expectations - you cannot expect your children to be completely calm during a time of change.
“Equipping your teenagers and young adults with skills to manage their anxiety in a time of uncertainty can be one of the most empowering things you can do as a parent. Small gestures of support by
- offering compliments of how they handled challenging situations,
- asking open-ended questions about how they are feeling, and
- showing genuine interest in their emotions can all be subtle messages of telling them that they have your backing,” Rix concludes.
10 Tips to control anxiety
- Avoid some substances which may have mood altering properties such as caffeine and alcohol, as much as possible.
- Get active. Working out anxiety with a lot of sweat really works for some people. Do something that is fun! The more you do it, the more good hormones are released which can have a positive effect on sleep, digestion and mood.
- Eat healthily – anxiety can throw our bodies way out of control and may cause us to crave the wrong type of foods. Try eating more food that has vitamin B’s, Omega 3 and whole- grain carbohydrates.
- Control your breathing- learn to take slow, intentional belly breaths.
- Find healthy ways to soothe you - learn to engage your senses in a way that makes you feel relaxed. It is important to do these things regularly and work preventatively.
- Learn mindfulness; this helps us to stay in the present moment. By focusing on the present moment, you are not dwelling on the mistakes of the past, nor or you overwhelmed by thoughts of the future. There are amazing apps such as Headspace or Insight Timer that you can download on your phone to help reduce anxiety wherever you go.
- Get enough sleep - make sure your 8 hours spent sleeping is of good quality by following sleep hygiene principles. Sleep deprivation is a huge anxiety culprit as it amplifies the brains anticipatory reactions, upping our overall level of anxiety.
- Plan ahead. We can fight our anxious thoughts by learning to plan ahead. This can be done by scheduling a to-do list and developing habits that increase productivity; even if this means waking up a bit earlier.
- Meditate and not medicate. Calm is an inside job – take time out of your day to practice meditation or taking a time out where you can disconnect. This means no phone, no emails, no TV, no people.
- Practice acceptance – learn to accept anxiety and not to fight. We can’t control emotions, but we can control the way we react towards them.
References:
- The Child Mind Institute: How to respect feelings without empowering fears by Clark Goldstein.
- Study aims to unpack mental health issues facing university students - EWN News. http://ewn.co.za/2017/05/16/analysis-global-study-aims-to-unpack-mental-health-issues-facing-university-students
- Surviving stress and anxiety in college and beyond - Learn Psychology: Melissa Cohen.
- American Psychiatric Association: Diagnostic and Statistical
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