Leaving home has a way of bringing submerged difficulties to the surface. Throughout high school, parents have been there to clean up messes, to hold the line in terms of attending school, and to not allow the student room to not graduate. In high school, even very socially anxious teens can find niches for themselves that provide some sense of belonging and relief from feeling isolated and self-conscious. The high school years may have been about “getting by” and, because of that, no one paid sufficient attention to levels of academic skills and the role of anxiety in day-to-day functioning. With the new demands of college life, the young adult who was able to “get by” in high school can suddenly be confronted with overwhelming fears and anxieties. The two most common kinds of anxiety that bring the young adult into therapy during the first year of college are academic anxiety and social anxiety.
Anxious students will avoid going to class for fear of being called on to answer a question. These are the ones who study and study and then freeze on a test and wind up with a low grade. Some anxious students have an underlying wish to be perfect, or the best at what they do. The fear of failure or just of making mistakes can become overwhelming.
Avoidance becomes an easy way to not confront the doubts and fears. They stop going to class and/or stop studying. The illusion of perfection remains intact, e.g., “We don’t know that I am not the brightest if I don’t try.”
The socially anxious student can feel lost and adrift in a new environment with unfamiliar faces, It can become easier to stay in a dorm room, to play computer games, to not go to classes or functions, and to drink and use drugs--all are efforts to decrease the anxiety and fears. Many socially anxious college students have a world full of virtual relationships (on-line), but do not know the names of others down the hall in the dorm. Avoidance of venturing out is easier than confronting the fears when the young adult is lacking in skills and understanding of the anxiety disorder.
To develop the skills and understanding of the anxiety disorder, the young adult has to start talking. He or she has to let someone know what is going on so that they can get directed to a mental health clinician. Many people are chronically anxious and have accommodated to the anxiety in such a way that they do not realize how anxious they are. Only when the person has been in treatment and had experiences of not being anxious, does the person begin to appreciate how debilitating anxiety has been in his or her life.
Biofeedback, EMDR, cognitive therapy and medications are all good approaches to learning to manage anxiety. Developing skills to calm a nervous system, alerting to early warning signals of oncoming difficulties, and becoming competent in academic or social arenas are the primary elements of successful treatment of anxiety disorders. But first, the young adult has to let someone know that he or she is struggling.