Back in November, when life felt pretty normal, college students participated in a speaker series called "This Is My Brave" on campuses across the Boston area, sharing their mental health challenges.
Twenty-five-year-old Ali Gold from Medfield told an audience at Tufts University how as a teenager she struggled with anxiety, obsessive compulsive, eating and bi-polar disorders. After high school, Ali said she felt so lost, overwhelmed and unfulfilled that she began cutting herself. Then one night six years ago, she overdosed on prescription pills.
“I wrote a suicide note to comfort and apologize to my family and friends,” she said, standing on stage. “I wanted to escape the endless cycle of shame, guilt, feeling like a burden. Inside my mind, I had convinced myself that everyone would be happier without me.”
Through therapy, Gold’s outlook has improved significantly, and this month she graduated from Boston University with a bachelor’s degree in health science and psychology. But the pandemic forced Gold's final classes online, postponed commencement ceremonies and terminated her internship at the same psychiatric hospital in Brighton where she had twice been a patient.
“The lack of social connection has really influenced my anxiety. I just think, day-to-day, it's a bit higher,” Ali told WGBH News, reflecting on how the pandemic and resulting lockdown has affected her own mental health. “Just having less structure has really shown me how much I'm fueled by the in-person connection.”
The COVID-19 pandemic has undermined the mental health of many college students, including Gold's, upending their academic, work and social routines. For many, being sent home abruptly this spring was heartbreaking, and widespread uncertainty — about next semester and about job prospects — has amplified their anxiety and depression.
A national survey of more than 2,000 college students finds a vast majority — 80 percent — say the pandemic has negatively affected their mental health in some way.
“One-in-five report their mental health has significantly worsened during this time,” said Laura Horne, chief program officer withActive Minds, a nonprofit that promotes mental health awareness and education for young adults.
Horne directed the survey and points out that even before this unusual period of social distancing, young people were experiencing unprecedented rates of isolation, anxiety and depression.
“A crisis like a pandemic can significantly exacerbate symptoms for students who have pre-existing mental health issues,” she said.
The economic downturn, which is hitting younger workers especially hard, has added to their distress. Recent graduates saddled with debt are entering a devastated job market, with the unemployment rate rising most sharply for Americans under 25.
“Forty percent of students in our survey are experiencing a financial setback of some kind,” said Horne.
Many students say they’re struggling to focus and, Horne said, few colleges had solid plans in place to provide help remotely because none could have anticipated sending students home this spring.
“So many colleges were scrambling to figure out what to do, including how to support students online with mental health services,” she said. “Many of our students have reported that they've just been bombarded by e-mail.”
Advocates recommend that colleges provide clear, empathetic communication about where students struggling with mental health can find help and move that information from email to the top of the syllabus.
Faculty and administrators, though, maintain that the volume of digital communication is necessary.
“We need to be telling students that we care about them — that we see them,” said Sarah Lipson, an assistant professor at Boston University’s School of Public Health.
Even though eight in 10 college presidentssay mental health has become more of a priority in recent years, Lipson says most campuses are still highly reactive.
“That’s not a good thing,” she said. “Every opportunity for prevention of mental health problems requires being proactive.”
Lipson sees the current crisis as an opportunity to increase access to mental health services by transitioning to therapy delivered over the phone or online.
“Particularly for students who are just extremely busy, teletherapy is just a really convenient option,” Lipson said, adding that these online services can also work well for international students who prefer to talk about their mental health in a language other than English.
For the past 10 weeks, Gold has been going to therapy appointments via Zoom. She says it helps, but she misses her in-person support system.
“It’s not the same, because I think body language says so much,” Gold said. “At the same time, I feel like I’m still having the same types of conversations I’d be having otherwise.”
Gold said Boston University staff and faculty have been supportive and, inside her off-campus apartment, she’s managing social isolation and anxiety by binging on TV shows like "Parks and Recreation" and "Curb Your Enthusiasm." As the weather improves, she has been running a lot.
“Of course, it's not a bad thing to exercise,” she said. “It's a stress release. We get outdoors, but it’s a fine line.”
A fine line because the lack of structure gives her so much time to exercise and feel a momentary sense of accomplishment — or what she calls illusion of control.
At the end of the day, though, Gold says it can be hard to relax — to turn off her brain — and she’s worried about launching a career in mental health in this economy.
“Are people going to be hiring? What’s going to be out there? Because there’s anxiety that comes with applying for jobs, trying to figure out, ‘What are the next steps? What does the future look like?’" she said. "I think that anxiety can sometimes be more paralyzing.”
One thing is clear: the field of mental health is not going anywhere. In fact, the need for counseling is growing during the pandemic — on and off campus.
If you or someone you know is having thoughts of suicide, please call the National Suicide Prevention Lifeline at 800-273-TALK (8255) or use the Crisis Text Line by texting “Home” to 741741. More resources are available at SpeakingOfSuicide.com/resources.