Anxiety and the First-Year College Experience

Written by Jared Blackwell, Kara Livingston, & Sophie Behzadi

Abstract

Within this ethnography, we set out to explore the relationships between our participants’- J, Margaret, and Maia- mental health conditions (i.e. anxiety, ADHD, depression, etc.) and their experiences as first-year female college students. We chose this topic because we wanted to help provide these sorts of stories in an effort to help others (parents, other students, educators, etc.) understand these kinds of experiences. These findings are also significant because it may help someone who may also be either beginning the process of or is currently in the process of having a similar transition feel less intimidated by it. Through individual interviews with our participants (Jared interviewed J, Kara interviewed Margaret, and Sophie interviewed Maia), we found that this transition from high school to college had actually been fairly beneficial for our participants, allowing them to escape the constraints and workloads of high school and immerse themselves into the freedoms of college life. Additionally, the participants’ individual backgrounds, specifically family structure and socioeconomic status, seem to directly impact the likeliness of acceptance within their lives.

Introduction

Our project is on mental health conditions (namely anxiety, since it is the constant among our interviewees) and how it coincides with the experience of students, more specifically first-year college students, who are in different geographic locations and attend different types of institutions within the US. Anxiety is often both underrepresented and misrepresented in teenagers, stemming from the shame or disgrace our society has linked to anxiety disorders. It is unfortunately seen as a weakness to have this disorder, which often leads to misdiagnosis and lack of adequate treatment for that demographic. We plan to interview three college freshmen on their experiences of moving to a new environment for their education and having anxiety. Jared will be interviewing his girlfriend, while Kara and Sophie will be interviewing their friends. Jared’s interviewee, J, is an African American woman originally from Columbus, Ohio but moved to San Diego, California. Kara’s participant, Margaret, is a white female going to school in Tennessee, but is originally from Tucker, Georgia. Sophie’s participant, Maia, is a white female from Madison, Wisconsin, currently attending George Washington University in Washington, DC. Through this research, we hope to diversify and contribute to the ethnographies concerning this topic, hopefully providing stories that may be missing from this area. Our intended audience includes first-year college students. These students may be able to benefit from this research, as it provides a detailed look into the personal experiences of people that may be similar to them, which could grant them a sense of understanding as well as plans of action that could positively affect their own lives.

J: “the main struggle is dealing with people that don’t care”

Ever since she was a child, J “had anger outbursts and problems with large crowds,” but only began to realize these patterns when she was “about 12” years old. This was when she “realized that neither of those things were necessarily normal” and it would turn out that J was not the only one exhibiting these symptoms. She happened to be “mirroring” her dad, “who had been previously diagnosed with anger issues.” Furthermore, the source of her father’s symptoms ultimately “derived from anxiety” as determined by doctors, but it would be quite some time before J would be able to receive her own medical evaluation or help.

J reveals that by the time middle school came around “school stressed me out to the point in which I couldn’t even get out of bed.” She was only 15 years old at that point. As J puts it when she reflects upon that time in her life: “[m]y anxiety was so bad that I would only go to school only like 1 or 2 times a week.” Her academic performance overall took a hit as well, as she states, “[my straight As] fell to Cs and Bs which was not normal for me.” Her symptoms started to increase in severity, so they also began to dictate what she could and could not. This translated into “trouble socializing in large groups without having anxiety attacks,” until eventually J stopped “hanging out with people in general.” “I became a recluse,” J recalls. Her eating habits and appetite were also affected to the point where she “didn’t really…eat.”

Things turned for the worst when J was approaching the end of her junior year of high school. She had become suicidal and even planned to take her own life. Thankfully, help did finally come, but only at “the last [possible] moment” when she was admitted to a mental health hospital on her 17th birthday. There she was definitively diagnosed with anxiety as well as depression. Although she was diagnosed with both at the same time, J argues that “my experience with anxiety lasted close to a decade and was the catalyst for my depression.”

From that moment, J remembers that “I attended therapy for about six months” and took anti-depressants “for about two years.” J believes that all of these additions into her life were beneficial to her growth and recovery. “My experience with professional help was positive…and I believe they helped me get where I am now,” J claims. Nowadays, “they’re [not] necessarily beneficial anymore [because I have] learned to take time throughout [the] day to take care of myself,” J asserts. For J, that means “going to bed at a certain time every night, or putting aside time every day to dance to my favorite songs.” The common denominator being that J plans her days with more structure and schedule now, “so that I can prioritize my time.” As a result, self-care has become much more of a priority for her. These lifestyle changes have thus translated into kindness and understanding for J regarding how she treats as well as perceives herself and those around her. J now sees herself as beautiful and acknowledges the worth she has, not only to herself, but to her family, her friends, and her community. J reflects that, “[f]or a long time I was angry at the world, but as I’ve been more kind to myself, I’ve been more kind to others.”

J states the number one reason why she was not able to get “proper help immediately” was her family. She is a “very honest and vocal person” so the problem did not have to do with telling people how she felt, “whether or not that’s friends or family or strangers.” Instead, the “biggest problem [was] dealing with peoples’ reactions,” namely when people simply “don’t care” because of the misconceptions associated with mood disorders. “There’s a lot of stigma around mental health and sadly the people around [me] believed [those stigmas] as well,” J noted. As a result, J remarks that it took “me telling my family that I was suicidal…for them to finally get me treatment.” Despite what the social taboos tried to shun or disgrace, J knows that “think I should be ashamed of these conditions.”

Since then, there has been much growth, not only personally, but within J’s family and friend relationships. Those that are close to her have begun to care for her conditions and acknowledge them. J’s family now understands the signs of when she is experiencing an anxiety attack and knows not to bombard her with words or actions while she is in that state as it only exacerbates the situation. J has “[l]uckily [not] had to deal with [negativity or indifference] from family or friends for a very long time.” They are much more proactive when approaching J’s condition as they now actively listen to her when J reveals her emotions and are accepting of how she feels. These changes around J have created an open-minded household environment which has allowed J to more publicly explore herself emotionally, which in turn translates into faster personal growth. In fact, J now swears that “my family has been the most important aspect in my development.” J argues that their much-needed support has enabled “[me to] be as strong as I am today” and J knows that “the situation in which I wasn’t being supported or heard” is a relic of the past.

With J recently being through the monumental transition that is going to college, she spoke on the fact that “[s]uprisingly the transition [out of] high school…has made me a better student, person and worker overall.” J didn’t really think fondly of high school because as she puts it “I never felt like I was being heard or that the work I was doing was important.” So, by contrast, J notes that her experience with “going to college and studying what I want to do in life,” which is biology at the current moment, “has really helped my…mental health.” This is due to the fact that J legitimately feels motivated in the environment she is in and in the roles she has: being a YMCA employee that works with kids as well as a student. J believes that her school, Southwestern Community College, “prepares you for real-life” as well as has professors that “are personable and understanding of circumstances,” ranging from professional responsibilities such as going to work, to personal complications such as depression that affects productivity at school. She doesn’t live on campus; however, she does still have a roommate that “happens to be my best friend,” J said, so their relationship is “very positive…because of [their] ability to communicate so well.”

Margaret: “Here, I don’t have to prove that I have a mental illness. In high school, I did”

Margaret’s mother has always encouraged open dialogue concerning mental health within her household, so it came to no surprise to her when her mother decided to have her evaluated for ADHD. Her brother had it, and she was convinced that Margaret had it as well, reinforced by all the research that she had put into the condition. And so, in fifth grade, Margaret was evaluated for ADHD and, at the time, she was told that she did not have it. What she was discovered to have, however, was anxiety. It would not be until seventh or eighth grade (the details were a bit hazy for her) that she had been told that she had ADHD. Around this time, she was also evaluated for a learning disability.

The evaluation process for ADHD and anxiety are similar, in Margaret’s case. Both involved a series of questions where various scenarios and circumstances were brought up in effort to see how Margaret would respond to them. They also asked her about school. For learning disabilities, Margaret remembers them being cognitive tests: word association, color and memory tests, et cetera. She would be pulled out of class, which was embarrassing for her (“people thought I was getting special privileges”). The overall experience of this process turned out to be rather frustrating for her. “It was fine at first,” she says, “but the amount of testing was what aggravated me. I fit into the group of people thinking ‘why am i a test animal?’”. Overall, the constant tests were annoying, and so Margaret did not necessarily see any benefits from this experience until much later in life, in high school.

One of the most memorable moments for Margaret occurred in the tenth grade. She wanted accommodations (which, at least for her, were very difficult to get in high school, she had to present a ridiculous amount of paperwork in order to be even considered for accommodations). “Because of my ADHD and anxiety, I have enhanced side effects, one of which are depressive episodes”, she says, “I’m an emotional, wear-my-heart-on my-sleeve person, and impulsive”. Because of this, a little bit into the school year, she had overdosed. She had done it in her mother’s room, having done her own research on what methods/ medications would be the safest to use. When asked why she had done it, Margaret states that she “wanted to feel something; the combination of my mental illnesses made me feel empty. ADHD meds can turn you into a ‘zombie’, going from being all over the place to being very focused”. In the aftermath of this event, Margaret was forced to sign paperwork stating that she would go to therapy, where she would talk to her therapist about developing more “non-medicinal” coping mechanisms for her illness (especially for when she has panic attacks), since medications “could only do so much”. Margaret keeps a page in her bullet journal, as well as a Pinterest board, dedicated to coping mechanisms.

Margaret’s mother is, in her words, her number one supporter. She is a life coach who works closely with parents and children in an effort to bridge the gap of understanding between them. Because of this, Margaret grew up discussing mental health, having open dialogue and discussions about her own with her mother, though she sometimes has to call her out when “she starts treating her like a client”. These conversations come up naturally and Margaret has no troubles in being open and honest with her mother, who is “all for it”. Whenever a situation comes up, they would sit down and discuss what happened, what caused it to happen, and how to prevent whatever happened from happening again. “I have a great support system”, Margaret tells Kara, “because I built it that way”.

For her, the combination of her anxiety and ADHD pose the biggest everyday challenges. One is impulsivity (“I don’t think before I do things sometimes”), causing her to do certain things without fully thinking through her actions and their potential consequences. The second is organization, her ADHD being the leading cause in that. This made college a particularly stressful thing to think about. In high school, there were multitudes of little assignments that kept piling, a nightmare for her organizational problems and causing her to fall behind on a couple of assignments. So college, with all its myths of sleepless nights and seemingly endless amounts of work, was an intimidating thing looming in the future.

On the contrary, the transition, at least for her, was not too difficult, despite going to a new school in a new state. Originating from Tucker, Georgia, the move to Nashville, Tennessee seemed a bit daunting at first, but she was able to adjust well, despite the new culture, timezone, and lifestyle she had to get accustomed to. However, there are always complications. Because she would be so far from home, she had to get her prescription transferred to where she is now, which proved to be more complicated than she felt it needed to be. Margaret ended up having to make the four-hour drive back home for a “five minute conversation”, which was completely and utterly inconvenient for her.

On top of this, her school clinic is lackluster, to say the least. Margaret had gotten a cold whilst at school, which soon turned into a sinus infection. She went to her school’s medical center, got a diagnosis, then a prescription for medication to help her recover. However, upon asking whether or not the prescribed medicine was safe for her to take, Margaret was surprised (and a bit disappointed) to be met with a physician who “did not know”. She then turned to a nurse, telling her what medication she was (is) taking and what she knows that she cannot take. Much to Margaret’s further disappointment, the nurse was surprised that she knew these things about her medication. This same nurse then proceeded to try to prescribe Flonase for her, which Margaret ended up having to tell her that she could not take it. It was rather frustrating for Margaret that these medical “professionals” were so ignorant and careless when it came to medication. Had Margaret not been so diligent in researching and understanding her condition(s) and treatment, what would have happened?

When she had the discussion about her mental health conditions with her roommates, she took a similar open and honest approach. “Here’s what happens and here’s what to do when that happens” is the general gist of the conversation. To her, it was paramount that she had that conversation with her roommates early on, knowing that her conditions (namely her ADHD) will have some effect on them at one point or another. Her and her roommates all get along well and they are supportive of her and her conditions.

Though, at first, college seemed daunting, Margaret seems happy where she is now. She actively surrounds herself with people who support her and never shies away from having a discussion about mental health. Though situations may arise, she knows that she has a strong support system standing behind her to help her in the event that she may need it. “It is a lot easier in college for my mental disabilities” she says, “they are better able to accommodate for me and I now have better ways of dealing with things”.

Maia: “When I don’t have motivation, my anxiety piles on”

Maia always found it difficult to focus in school. Shortly after her mother died of breast cancer, 8-year-old Maia from Madison, Wisconsin, lost focus even more. She found it to be difficult to focus in school after such a traumatic event, and school wasn’t at the forefront of her mind, resulting in worse grades and longer time spent on homework after school. After noticing her lack of focus, Maia’s father and stepmom decided to take Maia to a few doctors where she was soon diagnosed with ADHD. Maia says that she doesn’t remember much after she was diagnosed, but that she does remember getting on new ADHD medication and seeing new therapists, grief counselors, and many other doctors for various reasons. Maia said that as a younger child, she always had difficulty talking to those therapists because she wasn’t sure what to say. Her parents saw that she wasn’t able to finish her work in class and felt she was constantly unfocused, so they had her take “extra-help classes” after school each day. It was the only way for her to stay caught up with the other students in her class. However, after school time became an especially difficult time for Maia after starting her new medication. She found that the come down from her medication caused her to have mood swings which caused her to fight with her parents a lot more than before. Despite all of the tension, her parents were constantly by her side and supportive through the hard times.

In middle school, Maia found it especially hard to keep friends due to mood swings and lashing out. She said, “I was having trouble keeping friends and feeling like I had a stable friend. A lot of it was the meds but I had really bad mood swings. At the end of 8th grade, I had a big falling out with my best friend because of the mood swings. I didn’t want to hurt the person, but the meds make me a different person and very irritable. It was very hard to control it when I was around my friends' '. Due to the issues caused by her ADHD medication, she stopped taking them at the end of 8th grade. Not being on her meds, her focus was all over the place. Sometimes, she would lose an entire class due to her lack of focus. She remembers her afternoons after school doing homework, and how torturous she found it to be. Her lack of focus led to a lack of motivation in her everyday life. After some time in high school, she noticed that she was rapidly losing focus and motivation and although she created lasting friendships, she felt anxiety and depression creep in. It took Maia a while to fully realize that she had depression and anxiety, but once she was diagnosed she felt clarity and was happy to know that these feelings were in fact, very real. She started taking SSRIs for her anxiety and depression and went back on her ADHD medication by junior year of high school.

She found that the lack of motivation she struggled with only continued as time went on, and still does to this day: “Having a mix of ADHD, anxiety, and depression, my biggest challenge was keeping myself motivated. If I let myself fall, it’s harder to get back up. It can be weeks or months where I have no motivation. When I don’t have motivation, my anxiety piles on”. She has found that finding professional help since coming to GW has also been difficult. In the past, she had a good relationship with her therapist and pediatrician, as they encouraged her to start her medication again and helped get her back on a good path. However, at GW, she had to search for a psychiatrist by herself. In order to get the prescription she needed, she finally met with a psychiatrist in DC – however, this psychiatrist made Maia feel uncomfortable and she had to search again for another psychiatrist who did give her the prescription for her necessary medications. She has also met with primary care physicians and therapists in the Colonial Health Center who have provided her with good experiences thus far.

The transition from high school to college has been very beneficial for Maia, but also very hard. She said that she noticed her depression has reduced since coming to GW because of the new and exciting environment. When doing homework, her lack of focus has increased because of the intensity of the schoolwork given to her. Being in the Elliot School as an International Affairs major, she has found that the pressure causes her plentiful amounts of anxiety – not only because of the coursework but because of the pressure to become an adult. She often likes to take walks around campus when she feels the anxiety surrounding becoming an adult. She also discusses these fears with her peers who are having similar experiences to her, in order to find comfort. However, Maia has found a welcoming and supportive community at GW who are all experiencing the same anxiety-inducing issues. She finds solace in the fact that she has friends that have similar experiences to her and has found that they have made her transition even easier. Settled into her second semester at GW, Maia has never felt happier as she now has a supportive community, continual love and support from her family, and the means to suppress her mix of learning disability and mental illness. She believes that, “It is incredibly important not to shy away from sharing your experiences with mental illness so others know that they are not alone. I’m not ashamed to talk about it because it is something I can’t control. People have to learn about things they may have not personally experienced.”

Discussion

A commonality amongst each of our participants’ stories was the fact that the transition from high school to college was not as painful as they had originally thought. In fact, the new environment had positive effects on each of our participants. College life has proven to be, at least for our participants, a vast improvement from their years in high school. Our participants have been able to surround themselves with people who are understanding and sensitized to their conditions and thus provide them with the support that they had feared they would not receive once the school year started. Additionally, whereas college course loads tend to be on the weightier side (typically more essay and reading-heavy), these workloads seem to be much easier for our participants to handle than high school’s busy work (predominantly multitudes of worksheets and smaller essays). For Margaret, this shift has enabled her to truly see just how capable she is of succeeding when her organizational skills are not put on trial. For J as well, the new environment proved to increase her motivation and overall mental health. However, in Maia’s case, her course loads have led to an increase in her problems with focusing, perhaps speaking to the differences in programs and institutions that the three go to. Despite this, Maia has seen an improvement in her motivation and overall mental health since attending her university.

Another major similarity that we found was that each of our candidates were proudly outspoken about their mental illness and learning disabilities. Each of our candidates have made a point in their lives to be vocal about their experience with mental disorders and have found that being vocal has helped them cope and has allowed them to not let it define them Margaret, J, and Maia all believe that speaking about their experiences is extremely important so that others don’t feel alone and so that those who have not experienced difficulties with mental disorders can empathize and understand the experience of those who have struggled. It is also important to note that Maia and Margaret are both white and J is African-American - therefore Maia and Margaret both have the privilege to freely speak about their experiences in society and may not be judged as much for it whereas J may have a harder time being taken seriously and not being judged. This is due to the fact that symptoms of mental health are often wrongly attributed to race, and people of color who are diagnosed with mental illness are often not taken seriously due to the stigma surrounding mental health within their communities.

As a major point of contrast, Maia’s and Margaret’s family were a consistent source of support that enabled them to discover their condition, subsequently diagnose their mental disorders, as well as personally accept their conditions relatively early on, when compared to J’s family who was unsupportive or indifferent to her mood disorders for a considerable time. Fortunately, J’s family has since been supportive, but only recently and after many years of indifference and stigmatization. The way in which J’s family behaved towards her mental health conditions is part of a larger trend within the African American community. That being the “socioeconomic disparities” experienced by lower income minority households when compared to white households leads to “exclusion from health, educational, social and economic resources” necessary for treatment of mental health conditions (National Alliance on Mental Illness, 2020). From this lack of access to vital healthcare, there is subsequently a “lack of knowledge” regarding the validity, symptoms and severity of mental health conditions, which ultimately leads to many within the black community to believe mental health conditions are simply “personal weakness” (National Alliance on Mental Illness, 2020). Conversely, the economic privilege that Maia and Margaret enjoy due to their family’s income levels has enabled the resources necessary to treat their mental health conditions to be more readily available. Additionally, considering Maia and Margaret are/come from a white background and they received medical aid with relative ease, this is further evidence to support studies that have found that a child’s race will directly impact the likelihood of receiving treatment for their mental health conditions (Shefali Luthra, 2016). The conclusions being that white children see “someone for treatment far [more] often than [their black or Hispanic] counterparts” (Shefali Luthra, 2016), which was seen in the experiences of Maia and Margaret while J had to wait significantly longer to see medical professionals.

Another difference that we found was that Maia’s anxiety and depression came from the issues associated with ADHD among other things whereas J’s depression stemmed from the issues associated with anxiety. Specifically, Maia was diagnosed with anxiety and depression because of the frustration caused by her ADHD, such as a lack of motivation towards the important aspects of her life. The loss of her mother largely contributed to her oncoming anxiety and depression and this took a major toll on her academic and personal life as the years went on. On the other hand, J said that her depression stemmed from the anxiety that she endured for over a decade. It is plausible that J had depression due to the frustration towards her anxiety and the helplessness one may feel when diagnosed with anxiety. We found that it was important to note how mental illness can stem from multiple roots - and there is no singular reason as to why someone may be diagnosed with anxiety or depression.

Conclusion

In this ethnography, we explored the relationship between the first-year college experience and a student’s mental health; how one impacts the other and vice versa. As evidenced by this ethnography, there is, without a doubt, a connection between someone’s positionality and how well their mental disorder will be accepted by those surrounding them, whether that be stranger, friend, or family. Despite the inherent differences between each of our participants’ situations, we have found that there are some commonalities amongst their experiences, both positive and negative. We hope that this information helps others with similar circumstances feel less alone when going through a similar life change, as well as help sensitize their peers to their experiences.

References

National Alliance on Mental Illness. (2020). African American mental health. National Alliance on Mental Illness. Retrieved from https://www.nami.org/find-support/diverse-communities/african-americans

Luthra, S. (2016). Race, ethnicity affect kids’ access to mental health care, study finds. Kaiser Health News. Retrieved from https://khn.org/news/race-ethnicity-affect-kids-access-to-mental-health-care-study/