“Come on, Holly. Just shotgun one beer with me,” says Noah, a USC graduate student. The house overflows with people, each holding a drink in their hand.
“I told you. I can’t drink on my medication,” responds Holly, a USC senior.
“What like birth control? Everyone drinks on birth control,” Noah grabs two Coors Lights out of the fridge. “See, I even got you the good stuff.”
“I want to drink but my med–”
“One beer isn’t going to affect it,” Noah interrupts.
“Listen dude,” Holly snaps. “It’s my antidepressants. Yes, I’m depressed. Now leave me alone.”
Noah steps back, white in the face and apologizes.
“It’s okay,” Holly says. “It’s not something people think about.”
College can be difficult. Nancy Smith, director of Life Oak Counseling Center, which provides mental health counseling in Columbia, explains how students make many changes coming to college. They’re living on their own for the first time, away from family and friends, eating differently, exercising less and changing sleep patterns.
At the same time, the college environment foments competition between students, both academic and social. While everything about a student’s life is changing, they are also competing for friendships, a professor’s attention, internships, spots in exclusive programs and more. The combination of lifestyle changes and this constant competition can exacerbate mental illnesses in students, especially women, who haven’t suffered from mental health issues in the past.
Smith speaks on the USC students she treats, “Sometimes they’ve struggled with some anxiety or depression [before college], but they have breakthrough symptoms with the stressors of being a student.”
“I came to college a regular teenager, and I soon became diagnosed with insomnia, depression, bipolar disorder and obsessive-compulsive disorder,” says a sophomore marine science student, who, like others interviewed for this story, doesn’t want her name used. “I never experienced anything like this until I entered college,” she says.
A junior elementary education major has a similar story, but she was diagnosed with anxiety and depression prior to coming on campus. “Before college, I was on one medication. After my first year of college, I had to double my dosage and go on a separate medication for my anxiety.” In this woman’s case, the stress of college greatly worsened her condition.
According to Imagine America, a national foundation providing resources to college communities, women are considered a high-risk demographic for developing anxiety and depression in college. Regis College, a historically female college in Massachusetts, compiles statistics on its website:
- Women are twice as likely as men to have Generalized Anxiety Disorder, causing persistent worrying
- Serious mental illnesses are 70% more common in women than men
- Women are twice as likely as men to have Unipolar Depression, the most common form of depression
- Women are more likely to have Post Traumatic Stress Disorder and will wait four times longer than men to seek treatment
Students of all demographics are impacted by mental health issues. Women are uniquely challenged when it comes to social pressures, like making friends and going out, and academic pressures, especially in historically male-dominated sectors like STEM.
One of the first stressors a female college student experiences is the pressure to make friends quickly. Many underclassmen turn to Greek Life, a process of “finding your people” before the school year begins. This involves four rounds of talking to women in sororities, selecting the desired organizations and the selection being reciprocated.
“One of the biggest issues with sorority recruitment is it’s these girls’ first steps into college,” says Ansley Bryan, mental health advocate and USC student who served as a Pi Chi, a counselor helping these women navigate the recruitment process. “They don’t know anything about college and they’re immediately thrown into this competition.”
Nearly 2,000 women go through the USC sorority recruitment process each year, with just over 1,300 slots available in the 13 sororities. This means about 700 women enter the process but don’t end up in a sorority.
“You’re trying to prove your social worth to people you don’t know,” says Bailey Hoffert, a pre-med senior who also served as a Pi Chi. “If you and another girl both like the same sorority, do you wish her well or do you hope she gets dropped so you have a better shot at getting in,” she asks hypothetically.
Most women struggle balancing their time between friends and school. When Holly stays in to study but sees her friends out on social media, she says she experiences FoMo, or fear of missing out, social anxiety associated with watching others have fun without you. According to the National Institutes of Health, the average college woman experiences moderate levels of FoMo, oftentimes triggered by social media.
In addition to these social pressures, students also compete with their classmates to get the highest grades and best jobs after graduation.
“Being a nursing major, I have been competing since the moment I got into college, maybe even before,” says Mary Carson Dowis, a sophomore at USC. Nursing underclassmen compete via GPA for two years in the lower division, with the hope of making it into the upper division. “They accept 500-600 students into the lower division,” says Dowis. “Only 200 get into upper division.”
Half of the group struggles to replace those at the top, and the highest GPA students fight to keep their spots. Relaxation feels futile when that time can be spent studying, especially when fractions of a GPA point can make the difference between becoming a nurse and having to start over.
This feeling perpetuates throughout the STEM majors. Holly, an exercise science student on the pre-physical therapy track, says she feels pressure from family to go right into graduate school without taking a gap year. However, grad schools expect a large amount of observations hours, time spent volunteering with physical therapists, which is nearly impossible without taking a gap year.
“I had 300 observation hours, but they wanted thousands,” Holly says. It’s a cycle of wanting to be the best, or have the most hours, without the time to physically do so while in college.
Hoffert, who has not been diagnosed with a mental illness but admittedly struggles with her mental health, says the worst competition is student-on-student. “People will hide volunteer opportunities and not tell you how they got certain jobs to get the edge.”
“You only hear the people speaking the loudest about their achievements,” agrees Bryan, the mental health advocate who used to be pre-med, “So it seems like you’re alone in feeling the failures.”
When the pressures from institutions are already so great, unregulated competition between students adds anxiety to simple tasks like going to class or a study group.
“During recitation of my chemistry and biology classes, it’s always a competition of who can answer the most questions,” says Lydia, a microbiology and pathology major who already feels the pre-med pressure as a sophomore. “I wasn’t aware of mental health issues before college. I just got diagnosed with depression, probably caused by the extreme stress of my classes.”
“It’s a systemic issue from the top – the application system, the MCAT system – it’s all competitive all of the time,” says Hoffert.
While institutions perpetuate competition, change can start with the individual. A person must recognize the value of competition without letting it control them, and they must not feed into unhealthy forms of competition, like those Hoffert mentioned.
As a therapist, Smith tells her patients, “Choose a healthier lifestyle when it comes to exercise, eating good food, sleeping well and having good social connections with supportive people.” In other words, get on a schedule that promotes healthy habits. She also says to avoid drugs and alcohol, which intensify feelings of depression.
The NIH says students who maintain relationships with family and friends are more likely to do well academically. Phones and social media can be agents to collaborate and connect with these groups, thereby fueling academic success.
To combat FoMo that comes with phone usage, college women can temporarily delete social media on the nights they choose to stay in. Conversely, FoMo can be used as motivation, because it links academic responsibility to social engagements. If someone works diligently on their assignments, they’ll have time to be with friends and as a reward, they won’t experience FoMo.
Interpersonal competition among students may never improve without a culture change, but college women can control their narrative by finding an academic support system. This might consist of studying with like-minded students, implementing personal accountability systems, following lists and utilizing university resources like the Student Success Center. For example, students can experience little wins by checking off a small task like going to class.
“In college, I think most people have something they’re struggling with mental-health-wise,” says Bryan, “even though it may not warrant a diagnosis or therapist.”
Everybody jokes that we’re all suffering, she says, “but nobody talks about the lows that come with that. You get run down and it hits you all at once. You feel like you’re in too deep and you just push through it.”
“We preach to check in on our friends,” she continues. “But we are more focused on helping our friends rather than ourselves.”
“Life is a team sport,” says Smith. “People who do the best are people who ask for help.”
