10.1 Barriers to Well-Being

Anxiety Disorders

We all experience the occasional feeling of anxiety, which is quite normal. New situations, meeting new people, driving in traffic, and public speaking are just a few of the common activities that can cause people to feel anxious. It is important to seek help when these feelings become overwhelming, cause fear, or keep us from doing everyday activities. Anxiety disorders are the most common mental health concern in the United States, and while there are many types of anxiety disorders, they all have one thing in common: “persistent, excessive fear or worry in situations that are not threatening” (NAMI, 2015). Physically, your heart may race, and you may experience shortness of breath, nausea, or intense fatigue. Talk with a mental health care professional if you experience a level of anxiety that keeps you from your regular daily activities.

Eating Disorders

Eating disorders are not uncommon among students. Stress or anxiety may create a desire for some students to overeat, while others may develop a concern about body shape or weight and significantly reduce their food intake.

Anorexia nervosa is a potentially fatal illness marked by self-starvation. People with anorexia usually have an irrational concern about body shape or weight and eat a very restricted diet. They may also feel the need to exercise all the time, even when they are sick or exhausted.

Binge eating is frequent consumption of large amounts of food in a short period of time. People who binge regularly (more than once a week) and feel a lack of control over their eating may have binge eating disorder (BED). It is important to seek treatment if you suspect there is an issue with binge eating. Treatment can address any underlying psychological issues that will help control urges to binge eat.

Bulimia involves cycles of excessive eating followed by eliminating food through vomiting or with laxatives. Eating disorders can lead to many complications, some of them very serious, like heart conditions and kidney failure. It is crucial for anyone with an eating disorder to stabilize their health, then continuing medical care and counseling to reach full recovery. Eating disorders can be treated successfully with medical care, psychotherapy, counseling, or coaching.

If you think you might have an eating disorder, visit a doctor or your campus health center. The National Eating Disorders Association also offers information, help, and support.

Depression

Most people feel sad at times. This is a normal reaction to loss or struggles we face. Being sad is not the same as having depression. When intense sadness lasts for several days or even weeks and you are no longer interested in activities you once enjoyed, it may be depression. Depression can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

Depression does not have a single cause. It can follow a life crisis or physical illness, but it can also occur spontaneously. Several factors including trauma, a significant life change, brain injury, and drug and alcohol misuse may contribute to depression. Depression is a treatable medical condition. Talk with a mental health care professional if you experience an ongoing level of sadness that keeps you from your regular daily activities.

Suicidal Behavior

Suicide is when people direct violence at themselves with the intent to end their lives, and they die because of their actions (National Institute of Mental Health, 2023).

People who contemplate suicide often experience a deep feeling of hopelessness. They often don’t feel they can cope with challenging life events and are not able to see solutions to problems. In the moment, they are unable to see that the challenges are really only temporary. Most survivors of suicide attempts go on to live wonderful, full lives.

Help is available all day, every day, for anyone who might be in crisis. By offering immediate counseling to everyone that may need it, crisis centers provide invaluable support at the most critical times. If you or someone you know has warning signs of suicide, get help as soon as possible. Family and friends are often the first to recognize any warning signs and can help take the first step in finding treatment.

If someone is telling you that they are going to kill themselves, do not leave them alone.

Crisis Lines

National Suicide Prevention Lifeline/988 Lifeline is available 24 hours a day, 7 days a week at the new, easier to remember 3-digit number: 988 The original phone number (1-800-273-TALK [8255]) is still in service.

Crisis Text Line – text “HOME” to 741741

GiveUsAShout – text “SHOUT” to 85258

Kids Help Phone – text “CONNECT” to 686868

Depression is a key risk factor for suicide, along with substance abuse, chronic debilitating pain, mental health disorders, and a family history of suicide.

These are some of the warning signs to help you determine if a friend or loved one is at risk for suicide, especially if the behavior is new, has increased, or seems related to a painful event (988 Lifeline, n.d.; NIMH, 2015):

• talking about wanting to die or to kill themselves
• looking for a way to kill themselves, like searching online or buying a gun
• talking about feeling hopeless or having no reason to live
• talking about feeling trapped or in unbearable pain
• talking about being a burden to others
• increasing the use of alcohol or drugs
• acting anxious or agitated; behaving recklessly
• sleeping too little or too much
• withdrawing or isolating themselves
• showing rage or talking about seeking revenge
• extreme mood swings

Additional Resources

Because entering college is such a big transition, it is important to know what health services are available on your campus. Some help may be beyond the scope of a college counseling program, and if this is the case, your college health center can refer you to off-campus resources to support you.

Regardless of where you attend college, NAMI offers online, text, and phone support.

• NAMI Teen & Young Adult HelpLine at 800-950-NAMI (6264), or txt “Friend” to 62640.
• NAMI HelpLine at 800-950-NAMI (6264), or txt “NAMI” to 62640.

Alcohol

The statistics are sobering. Thirty-two percent of college students who drank alcohol reported doing something they later regretted, 27 percent forgot where they were or what they did, and 11 percent physically hurt themselves (American College Health Association, 2018). Many people consume alcohol to relax, socialize, or celebrate, but there are serious health effects attributed to too much alcohol consumption. You do not need to be an alcoholic for alcohol to interfere with your health and life, and the potential to become addicted to alcohol is a serious problem that can affect anyone.

Alcohol is classified as a drug and is a known depressant, making it the most widely used drug in the world. Alcohol interferes with the brain’s communication pathways and can affect the way the brain looks and works. These disruptions can change your mood and behavior and make it harder to think clearly and move with coordination. This is why it is critical to never drive a vehicle if you have been drinking. Drinking can weaken your immune system and damage your heart, increasing your risk for stroke and high blood pressure. Heavy drinking also harms the liver and pancreas.

The National Institute on Alcohol Abuse and Alcoholism (2025) offers the following guidelines:

• Moderate alcohol consumption: up to one drink per day for women and up to two drinks per day for men
• Binge drinking: typically occurs after four drinks for women and five drinks for men in a two-hour period that brings blood alcohol concentration levels to 0.08 g/dL
• Heavy drinking: drinking four or more drinks on the same day or eight or more per week, and for mean five or more drinks on the same day or fifteen or more drinks per week

Alcohol is a part of the social scene on many college campuses. If you choose to drink, you can avoid the devastating consequences of alcohol addiction by drinking responsibly and in moderation. The quality of your schoolwork can suffer dramatically if you drink beyond moderation. Too much alcohol can result in missing classes, performing poorly on exams, and falling behind in assignments. Have you ever decided to drink instead of study even though you had a big test the next day? Have you missed a class because you were too hungover to get out of bed? Did you hand in a project or paper late or not at all due to a series of nights spent drinking? If you answered yes to any of these questions, you are at risk of negatively impacting your success in college because of alcohol.

Tobacco and Vaping

Cigarettes and other forms of tobacco are also drugs. Tobacco contains nicotine, which excites the parts of the brain that make you feel good. Nicotine gives you a mild rush of pleasure and energy but soon wears off, which makes you want more. The more frequently you smoke, the faster your body and brain get addicted.

Tobacco is not healthy. Cigarette smoke causes lung cancer and emphysema. If you live with someone who smokes, you are also susceptible to these diseases, even if you are a nonsmoker. This is called secondhand smoke. Smokers are more likely to suffer heart attacks. Chewing tobacco can lead to cancer of the mouth. If you currently smoke, there are medicines and various treatments, as well as hotlines, to help you quit.

Electronic cigarettes are marketed as a way to help people stop smoking. Unfortunately, while they do contain less nicotine, they have many health risks (National Institute on Drug Abuse, 2020). E-cigarettes are battery-operated devices that people use to inhale an aerosol containing nicotine, flavors, and other chemicals. When you smoke an e-cigarette (also called vaping), the nicotine is absorbed from the lungs into the bloodstream, where it stimulates the adrenal glands to release the hormone epinephrine. Epinephrine (also known as adrenaline) stimulates the central nervous system and increases blood pressure, breathing, and heart rate. Like other addictive substances, nicotine activates the brain’s reward circuits and increases dopamine. This pleasure causes some people to use nicotine with increased frequency, despite risks to their health and well-being.

The Food and Drug Administration (FDA) has alerted the public to reports of serious lung illnesses and several deaths associated with vaping (2024). While the manufacturers of e-cigarettes would like us to believe they are less harmful than cigarettes, nicotine is a highly addictive drug. It is best to stay away from it in any form. E-cigarettes are not an FDA-approved smoking cessation aid, and there is no conclusive scientific evidence on the effectiveness of e-cigarettes to help stop smoking.

Smoking e-cigarettes also exposes the lungs to chemicals. A study of some e-cigarette products found that the vapor contains known carcinogens and toxic chemicals, and the device itself can contain toxic metals. If you are still in your teens or early adulthood, these years are critical for brain development. If you use nicotine in any form, or for that matter any substances, you are putting yourself at risk for long-lasting effects.

Marijuana

Marijuana comes from the cannabis plant. It can be rolled up and smoked like a cigarette, called a joint. It can also be smoked in a pipe, and edibles are becoming increasingly common. Marijuana can make you feel relaxed, silly, or for some people, nervous.

Marijuana makes it harder to pay attention and to remember things that just happened a few minutes ago. If you smoke before class, it is going to make it more challenging to learn. A recent study showed that if you begin regular marijuana use as a teen, you can lose an average of eight IQ points, and you do not get them back, even if you stop using (National Institute on Drug Abuse, 2020).

Using marijuana makes the heart beat fast and raises your risk of having a heart attack. Marijuana smoke can hurt your lungs. One of the biggest risks is drugged driving, which is driving when you are high. Marijuana makes it harder to pay attention on the road, and your reactions to traffic signs and sounds are slowed. It is dangerous to smoke and drive.

Prescription Pain Medicine

Pain medicines help relieve pain from surgery or injuries. Prescription pain medicines are legal and helpful to use when ordered by a doctor to treat a specific medical problem within a specific time frame. It is vitally important to take any prescriptions according to your doctor’s instructions, and to carefully read all risks and food/medicine counteractions.

Unfortunately, people sometimes take pills without a doctor’s prescription to get high, believing they are safer than street drugs. Make no mistake, prescription pain pill abuse can be just as dangerous as heroin or cocaine. Drug dealers sell these pills just like they sell heroin or cocaine. The abuse of oxycodone has become well documented—sometimes it goes by the brand names OxyContin or Percocet. Hydrocodone is also often abused and is best known under the brand name Vicodin.

Prescription pain pill abuse can lead to many problems. Pain medicine abuse can slow down or even stop your breathing. Signs of a pain medicine overdose are cold and sweaty skin, confusion, shaking, extreme sleepiness, and trouble breathing. More people overdose from pain medicines every year than from heroin and cocaine combined. If your doctor prescribes any pain relief pills for you, it is important to ask a lot of questions and understand why your doctor is prescribing them. If after consideration you decide to take pain-relief pills, stop taking them as soon as you possibly can. The longer you take them, the higher the possibility of getting addicted.

Cocaine and Heroin

Cocaine and heroin are both powders, often snorted up the nose, smoked, or mixed with water and injected with a needle. It is easy to become addicted to both drugs, and many people who seek treatment find it hard to stay off the drug. It is not uncommon to feel strong cravings for heroin or cocaine years after seeking treatment. People who inject the drug using a shared needle put themselves at further risk of contracting blood-borne viruses, such as hepatitis or HIV.

Cocaine can make people feel full of energy for a period of time, but it can also bring about feelings of restlessness and anger. Cocaine raises blood pressure and makes the heart beat faster, which could lead to a heart attack or stroke.

Heroin brings a rush of good feelings after it’s taken. The feeling then wears off, and users often feel a strong urge to take more. The reason so many people overdose on heroin is because they can’t tell how strong it is until they take it. Heroin can slow or stop your breathing. It can kill you. Signs of a heroin overdose are slow breathing; blue lips and fingernails; cold, clammy skin; and shaking.

There are medicines that can help people recover from addiction, but the best course is to not start. Avoid any temptation to try heroin or cocaine. Experimentation can be deadly.

Methamphetamine (Meth)

Meth is a white powder that is sometimes made into a pill or rock. Meth powder can be eaten or snorted up the nose. Like cocaine and heroin, it can also be mixed with liquid and injected into your body with a needle. Crystal meth is smoked in a small glass pipe.

Meth at first causes a rush of good feelings, but then users feel edgy, overly excited, angry, or afraid. Meth causes many problems. It can make your body temperature so hot that you pass out and could die. If you look at pictures of meth users, you will notice how quickly the drug ages them. Teeth become stained, break, and rot. As the teeth go bad the mouth looks sunken. Meth users burn a lot of energy and don’t eat well, which leads to degeneration and a sickly appearance. The skin turns dull, and sores and pimples that won’t heal are common. Meth use can quickly lead to addiction and cause cognitive or emotional problems that don’t go away or that come back again even after you quit using. For instance, some users feel, hear, or see things that aren’t there and think that people are out to get them.

This is a dangerous drug that should be avoided at all costs.

Other Drugs

There are many other drugs of abuse, including Ecstasy, K2 (or Spice), LSD, PCP, and roofies. It’s best to avoid all of them.

If your use of drugs or alcohol is interfering with your life and negatively impacting your health, school, relationships, or finances—it’s time to quit and find help.

The first term is an especially critical and vulnerable time for most first-year students. It is often a time of heavy drinking and partying. The transition to college is often difficult, and while partying may feel like it is helping to ease the transition, the health risks are real: about one-third of first-year students fail to enroll for their second year.

If you are concerned about your drug or alcohol use, or you need help quitting, visit the student health center or talk with your college counselor. If you need additional resources, the following can help:

• Substance Abuse and Mental health Services Administration SAMHSA’s National Helpline – 800-662-HELP (4357)
• FindTreatment.gov, or text your zip code to 435748

If You Are a Victim of a Crime

If You Are a Victim of Sexual Assault or Rape

Sexual assault is any type of sexual activity you don’t consent to. This can include inappropriate touching, sexual intercourse, attempted rape, and rape. Sexual assault happens on college campuses as well as in communities.  Anyone can be a victim of sexual assault or rape regardless of their gender, sexual orientation, or age. However, certain groups of people are more likely than others to experience sexual assault. Women (especially women of color), LGBT-identified people, and people with developmental disabilities are more likely to experience sexual assault over the course of their lifetimes.  One in five women has been sexually assaulted while in college and eighty percent of female rape victims experience their first rape before the age of twenty-five. Sexual assaults usually aren’t random acts of violence carried out by strangers (National Sexual Violence Resource Center, 2015).