Anxiety, although felt in moderation by everyone, can be both physically and mentally debilitating when intensified, and few places foster anxiousness with more intensity than college campuses.
According to the University of Georgia’s Counseling and Psychiatric Services (CAPS), anxiety is the most common reason for a student’s admission into on-campus treatment at the University Health Center, followed closely by depression and relationship issues. From July 1 to Dec. 31, 2015 alone, CAPS had 5,643 face-to-face encounters with students. Yet despite its prevalence, the treatment of anxiety and other stress-related issues still have the furthest to go in terms of optimized care.
Dr. Philip Holmes, professor of neuroscience and chair of the neuroscience program at UGA, summed up the ever-present stressors faced by college students as “physiological responses to environmental challenges.” Unlike ancestors facing primal predators, college students are exposed to different, but still pressing stressors.
“Nowadays people live in very non-naturalistic environments,” Holmes says. “And so stressors are much more chronic and uncontrollable. There’s no more predators, but now there are things out of our control like exams and bills.”
In essence, college is a veritable pressure-cooker of stressful situations that can lead to a clinical, anxiety-fueled mental disorder.
Those suffering from generalized anxiety disorders may encounter physical sleep problems, stomach problems, tenseness and a fast heartbeat, in addition to excessive worry, self-doubt and other dysfunctional day-to-day thoughts. This is where CAPS enters to provide students with resources and staff.
CAPS counseling psychologist Dr. Shannon Bowles offered insight into the approaches used at the UHC for students with anxiety. Like Bowles, a majority of the staff members working on-hand at CAPS are described as generalist practitioners — professionals who aid students on a wide spectrum of issues — although many have areas of expertise. Mental health issues are just as debilitating as physical problems, and therefore require the same level of specialization.
Upon initial phone screenings, online questionnaires or early sessions with counselors, students at UGA can be placed into the care of staff whose individual expertise aligns with their needs. Sometimes initial appointments reveal an additional need of a student, which then requires further work with a provider whose area of expertise aligns with the need.
“If I met with a student for an initial consultation and the student talked more about an eating concern, I would contact the coordinator of the eating disorders treatment team and let them know the student needs to be seen by someone else more tailored to their needs,” Bowles says.
Even within these issues, however, there is innumerable diversity as to which treatments would most benefit a student. Depending on the student’s needs, extended therapy outside of CAPS’ domain might be recommended, along with other resources off campus if needed.
According to UGA alumna Eva Nemeth, who is certified in general, child and adolescent psychology, taking an individualized approach such as this is undoubtedly the most important aspect when dealing with mental health.
“There is no cookie-cutter treatment for people with anxiety,” Nemeth says. “So the important thing is to look at each person individually.”
Although CAPS provides opportunities for cognitive-behavioral therapy, other forms of therapeutic treatment and antidepressants, specialized care has to be given to examine the exact course necessary for each patient.
The brain is inarguably the most complex part of the human body, and as research continues the importance of specialized care only increases. Therefore it doesn’t make sense that common diagnoses for mental health issues would be boiled down into concentrated, universal treatments that will affect all regions in the same way.
“The brain is the last frontier of medicine,” Nemeth says. “And traditionally it’s been so hard to study because you can’t just cut a hole in someone’s head and examine it. We still don’t know everything we need to know, but what I’ve come away with from 35 years of experience is that it’s complicated. The variables are so unbelievably complex, so there’s no quick answer.”
Nemeth, who worked at the UHC in 1987, states the goal of CAPS then and now is to employ staff with enough expertise to work within the fluidity of mental health care. When asked if the UHC staff works to the fullest of its abilities for students, he answered with positivity, while acknowledging room for improvement.
“What may be difficult for people to understand is there are certain resources that we have and certain ones we don’t,” Bowles says. “And if a student requires a resource we don’t have then it’s in the student’s best interest to be referred to another resource. We all work very hard but because there are restraints the perception can be that we’re not doing everything we can for students.”
Bowles discussed improvements that could be made with increased resources as well as a larger staff to deal with the wide spectrum of issues students seek therapy for.
“I think if I could come up with a CAPS wish list, having more clinicians on staff would be on top because with only the specific number of staff we have it’s really difficult to address everyone’s needs when we feel like there needs to be more of us,” Bowles says.
One freshman UGA student, who wished to remain anonymous, spoke about their CAPS experience when seeking treatment for generalized anxiety, as well as other symptoms of PTSD, manic depression and other debilitating disorders. Due to the severity of their needs and the limitations of CAPS services, the student could not continue treatment on campus.
This student, when asked what could improve their personal treatment and the systems involved with diagnoses in CAPS and other healthcare establishments, had a few suggestions. First, like Bowles herself, they would like to see more available psychiatrists to see patients with more specialized needs.
“Everybody should be able to get help, but I think the people who are the most severe should be the top priority because these people are the most volatile,” the student says.
The other recommendation made by this student pertains to streamlining the process of gathering information from patients. CAPS, like many other health care institutions, first employs a phone screening followed by an on-site questionnaire asking similar questions. A consolidation of this process would not only reduce the time it takes for patients to become acquainted with a professional to meet their needs, but also reduce wait time for treatment.
“The repetitive questions could be triggering, and asking the same questions over and over imply that the answers aren’t used at first,” the student says. “Streamline that process to make it less time consuming and more efficient.”
This would also aid in students being able to receive treatment in a more timely manner.
“The earlier we can identify students and the earlier we can encourage them to come in the better so that they aren’t waiting until their concerns have gotten so severe that their functioning is compromised,” Bowles says.
With enough resources, staff at CAPS and similar establishments on college campuses would be able to not only streamline the admittance process, but also provide more specialized treatment to students to meet their unique needs.
In the words of Nemeth, “We try to look at every angle, every treatment modality, whether it’s medication, whatever it takes to make people feel better.”