By Chelsea A. LeNoble & Tessly A. Dieguez

We don’t often put “high achievement” and “mental health concerns” into the same sentence, but we should. High achiever mental health is a serious and growing issue. For example, according to the 2019 American College Health Association survey, nearly 50% of responding students recently felt overwhelming anxiety. In addition the COVID-19 pandemic has exacerbated these mental health concerns, sending college student anxiety and depression rates skyrocketing (Anderson, 2020). Considering that attending a high-achieving school is now considered an “at risk” category for failing to thrive through adulthood (Luthar & Kumar, 2018), it’s hard to ignore how dire the undergraduate mental health crisis has become. When students are conditioned to keep quiet about mental health challenges, the imagined benefits of high achievement disappear. Burnout, depression, and suicide are left in their wake (Cook, 2007).

The Stigma of Mental Health Concerns

Despite these devastating consequences, stigma persists around mental health concerns, coupled with relentless pressure to prioritize achievement above all else. As a result, individuals with mental health issues can be viewed as incompetent, ineffective performers, unable to cope, and in extreme cases, violent (Boniecki et al., 2012; Britt, 2000; Campbell, 2018). This stigma may prevent students from disclosing mental health concerns or seeking help (Bandelow & Michaelis, 2015; Britt et al., 2008). Recently, the idea of “high-functioning anxiety” has become popular. People with “high-functioning anxiety” are described as productive, perfectionistic overachievers who suffer from fear and extreme self-criticism below the surface (Morgan, 2017). While it may seem appealing at first, this term further contributes to the stigma associated with mental health concerns by implying that pushing through without help is admirable and those with clinical mental health issues cannot truly be high functioning.

Supporting Mental Health

The science of stress and goal striving does not support these assumptions. A first step in dismantling this stigma and supporting the mental health of all students is to acknowledge that worry and anxiety are normal responses to stressful academic environments. Thinking and worrying about one’s goals creates the same type of fight-or-flight response as being chased by a bear (Verkuil et al., 2010). This stress response is a “default” state that must be inhibited by the recognition of safety signals. But for high-achieving students in high-pressure environments, such safety signals are often absent (Aloia & McTigue, 2019).

When High-Achieving Students are Struggling

There are a few key resources that can support high-achieving undergraduates struggling with mental health. The burden of seeking these resources for high achiever mental health should not only fall to students; the institution (and advisors, instructors, academic staff, etc.) has a substantial role. For example, professors can create classroom environments that strengthen mental health by providing resources in course syllabi and openly speaking about mental health in class. To reduce anxiety, students need reliable safety signals that indicate their goals won’t be threatened by seeking and accepting mental health support, and with the foundation of a supportive environment, individual coping resources become more relevant and useful.

Additionally, on-campus counseling centers provide therapy, peer groups, and presentations on college student mental health topics. One of the most effective exercises students can engage in is cognitive reframing (identifying and changing negative thought patterns). A list of resources to support college student mental health can be found below.

College Mental Health Support Resources

Campus Climate Matters (https://www.rand.org/pubs/research_briefs/RB9904.html): RAND Research brief of a college climate of mental health with discussion of intervention outcomes.

Shareable Resources on Anxiety Disorders (https://www.nimh.nih.gov/health/education-awareness/shareable-resources-on-anxiety-disorders.shtml): Infographics that can help build a positive mental health climate in the classroom

The Jed Foundation (https://www.jedfoundation.org/mental-health-resource-center/recommended-resources/): A collection of nationally-recognized organizations supporting mental health

Cognitive Distortions: When Your Brain Lies to You (https://positivepsychology.com/cognitive-distortions/): Website that explains common cognitive distortions, how to reframe them, and free worksheets for practice.

6 Things Every College Student Should Know About Therapy (https://www.self.com/story/college-students-therapy): Article addressing common concerns college students have about therapy.

The Student Counseling Virtual Pamphlet Collection (http://www.dr-bob.org/vpc/): Wide collection of university counseling center resources divided by topic

Anxiety and Depression Association of America (https://adaa.org/adaa-online-support-group): ADAA’s anonymous peer-to-peer online anxiety and depression support group.

Thnx4 Gratitude Journal (https://ggsc.berkeley.edu/what_we_do/online_courses_tools/thnx4_gratitude_journal): Online journaling challenge over 10 or 21 days. Gratitude reflection helps remind our brain of existing safety signals.

Moodnotes Mood Tracker (https://apps.apple.com/au/app/moodnotes-mood-cbt-tracker/id1019230398: App that helps develop healthy thinking habits.

References

Aloia, L. S., & McTigue, M. (2019). Buffering against sources of academic stress: The influence of supportive informational and emotional communication on psychological well-being. Communication Research Reports, 36(2), 126-135.

American College Health Association. (2019). Undergraduate student reference group data report spring 2019. https://www.acha.org/documents/ncha/NCHA-II_SPRING_2019_UNDERGRADUATE_REFERENCE_GROUP_DATA_REPORT.pdf

Anderson (2020, August). Students reporting depression and anxiety at higher rates. Inside Higher Ed. https://www.insidehighered.com/quicktakes/2020/08/19/students-reporting-depression-and-anxiety-higher-rates.

Bandelow, B. & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327–335.

Boniecki, K.A., Thomas, A.D., Gowin, K.C., & Britt, T.W. (2012). Prejudice towards people with mental illness: an integrated threat approach. In D.W. Russell & C.A. Russell (Eds.), The psychology of prejudice: Interdisciplinary perspectives on contemporary issues (pp. 155–174). Nova Science Publishers, Inc.

Britt, T.W. (2000). The stigma of psychological problems in a work environment: evidence from the screening of service members returning from Bosnia. Journal of Applied Social Psychology, 30(8), 1599–1618.

Britt, T.W., Greene-Shortridge, T.M., Brink, S., Nguyen, Q.B., Rath, J., Cox, A.L., Hoge, C.W., & Castro, C.A. (2008). Perceived stigma and barriers to care for psychological treatment: implications for reactions to stressors in different contexts. Journal of Social and Clinical Psychology, 27(4), 317–335.

Campbell, E. (2018). Reconstructing my identity: An autoethnographic exploration of depression and anxiety in academia. Journal of Organizational Ethnography, 7(3), 235-246.

Center for Collegiate Mental Health. (2019). 2019 annual report. https://ccmh.psu.edu/assets/docs/2019-CCMH-Annual-Report_3.17.20.pdf.

Luthar, S. S., & Kumar, N. L. (2018). Youth in high-achieving schools: Challenges to mental health and directions for evidence-based interventions. Handbook of School-Based Mental Health Promotion (pp. 441-458). Springer, Cham.

Morgan, L.T. (2017). High-functioning anxiety makes you a great student, but a miserable human being. Odyssey. Retrieved from https://www.theodysseyonline.com/reality-high-functioning-anxiety-college.

Verkuil, B., Brosschot, J. F., Gebhardt, W. A., & Thayer, J. F. (2010). When worries make you sick: a review of perseverative cognition, the default stress response and somatic health. Journal of Experimental Psychopathology, 1(1), jep-009110.