Supporting Graduate Students with Mental Health Resources

Graduate students face many pressures. Measuring up to peers, the “publish or perish” mentality, and limited access to counseling services strain grad students’ mental health. According to the American College Health Association, about 67% of graduate and professional students report that they experience moderate to severe psychological distress.

Take a look at the six most frequent mental health conditions, explore signs and symptoms, and find compassionate, accessible resources. Plus, keep reading to hear from an expert about how grad students can recognize, understand, and manage mental health issues without derailing their studies.

Pursuing graduate education is mentally demanding. After all, you’re interacting with some of the foremost experts in your field. Add to that such factors as the mounting competitiveness of admission, the rising cost of education, the long-term impact of student debt, uncertain career prospects, and pandemic-related side effects. Many graduate students are dealing with life issues as well, such as settling into relationships, starting a family, and moving away from friends and loved ones.

Money issues can play a role too. While you’re in school, your earning potential may be hindered if you can’t start your career without your graduate degree. These limitations can be frustrating no matter how much you love your subject matter and program.

Many students downplay their symptoms as part of academic life (#GradSchoolLife), but experiencing these challenges and handling them in a detrimental way could lead to long-lasting side effects. Let’s look at some mental health issues that you or your classmates might be facing.

Anxiety signals to us that something important is happening. While anxiety’s evolutionary purpose is to help us focus on getting things done, it can very easily spin out to an unmanageable level and affect our habits, relationships, and well-being.

A grad student’s risk of anxiety and depression is more than six times higher than that of the general population. A study conducted in 2022 found that 22.6% of graduate students have moderate to severe anxiety symptoms, and 12.9% have moderate to severe depression symptoms. Of course, being in an environment with high-stakes deadlines and constant evaluation could put anyone on edge. But there’s a difference between being a highly motivated student and grappling with unmanageable anxiety.

Check Your Symptoms

• Do you worry about things excessively, without a rational basis?
• Do you have difficulty quieting your thoughts or sleeping at night?
• Are you preoccupied with anxious thoughts to the point that your focus is affected?
• Have you had a panic attack or symptoms of panic, such as rapid breathing, dizziness, accelerated heart rate, or sweating?
• Do you find it hard to express how you’re feeling to loved ones because their reassurance doesn’t make you feel better?
• Do you still feel anxious even after something that you thought was causing your anxiety, like a test or deadline, is over?

What to Do if You Recognize the Signs

• Seek counseling as soon as you recognize these symptoms. There are resources available to help you.
• If you think medication might help, schedule an appointment with a psychiatrist or nurse practitioner. Getting in to see the doctor can take weeks or months, so schedule a visit even if you’re not sure you want to follow through. Remember, even if a psychiatrist offers medication advice, you don’t necessarily have to begin that regimen. They’re offering you something that may help with how you’re feeling.
• Download a mindfulness-based app like Headspace or Calm to incorporate meditation and mindfulness into your day. Start with the beginner course and try to adopt these evidence-based strategies into your everyday life.
• If you notice that a friend seems to be struggling with anxiety, offer them a listening ear. You could start by saying, “You seem like you’ve been feeling stressed or anxious lately,” and then listen and offer support. Resist the urge to try to solve their problems unless they ask for advice. If applicable, consider sharing things that have helped you.

Depression can be one of the most impactful mental health challenges because it feels all-consuming and unrelenting. More than just a feeling of sadness, depression lasts for at least a few weeks and can last for much longer. In 2021, 41.5% of Americans reported anxiety or depression symptoms.

Depression can result from environmental factors, like a death, breakup, or move, or it can be idiopathic, meaning it doesn’t have a source, but you just don’t feel the way you used to. Depression makes it more difficult to focus on your studies, connect with friends, or function normally. Fortunately, you have treatment options while you are a student and beyond.

Check Your Symptoms

• Are you experiencing a depressed mood more days than not, lasting at least two weeks?
• Do you have a lack of interest in things you typically like?
• Are you either sleeping much more or much less than usual?
• Are you eating much more or much less than usual?
• Do you constantly feel fatigued?
• Are you having a tough time focusing?
• Do you find yourself thinking that you’re worthless?
• Are you having thoughts about suicide?

What to Do if You Recognize the Signs

• If you are concerned for yourself or a friend, go to your local Crisis Response Center immediately. You can also call the National Suicide Prevention Lifeline (1-800-273-8255) for assistance and support.
• Enlist friends and loved ones for social support; try to schedule a few fun activities each week to stay connected.
• Prioritize doing small things for yourself each day, like going for a walk, watching a favorite TV show, cooking a favorite meal, or getting cozy at home with a bath and some candles.
• Seek counseling as quickly as possible, either through your student counseling center or a provider in the community.
• Schedule an appointment with your primary care provider or student health services, where they can screen you for depression and possibly start you on medication. Consider making an appointment with a psychiatrist or nurse practitioner who specializes in mental health issues.

Eating disorders are prevalent in the United States, with an estimated 1 in 10 women and 1 in 15 men affected. Anorexia nervosa has the highest mortality rate of any mental health diagnosis. Even without a clinical diagnosis, the behaviors associated with eating disorders can be extremely disruptive to everyday life.

Eating disorders can be mistaken for just overzealous dieting. They might start as a popular diet or an honest try at losing weight, but they can mess with a person’s ability to handle their emotions. These mental health problems are more than just about weight and can seriously affect college students.

Some effects of eating disorders, like sudden weight loss, are easy to spot. But many people with eating disorders seem normal in public, even though they’re fighting hard behind the scenes. They might binge eat or go back and forth between binging and purging, making it tough to see what they’re going through. And remember, not everyone with anorexia nervosa looks super skinny. Eating disorders come in all shapes and sizes, so knowing the signs can help give support and resources to those who need it – especially grad students dealing with extra stress and pressure. If you’re facing an eating disorder, take it seriously. Seek professional help from a therapist or counselor, confide in someone you trust, and educate yourself on coping strategies.

Check Your Symptoms

• Do you have a difficult time socializing because you won’t be able to control the food at the restaurant/event?
• Do you find yourself bringing your own food when there isn’t a medical or religious need?
• Do you focus on your weight daily, such as weighing yourself each morning and making decisions about which foods you will eat based on calories or diet rules?
• Do you have so many food rules that it’s difficult to construct a complete meal due to the number of “bad” foods?
• Do you find yourself more likely to binge or to restrict your diet during times of high stress, such as when you’re working toward a big deadline or an upcoming exam?
• Do you hide food from others during meals so you don’t have to eat it?
• Do you purge, use laxatives, exercise excessively, or restrict your food intake the day after a meal or binge eating?
• Do you eat a lot of food you were trying to avoid eating (like sweets, desserts, snacks, etc.) in one sitting and feel guilty afterward? Have you ever snuck or stolen these foods from others because you feel too guilty or out of control to buy them yourself?
• Do you try to eat as little as possible throughout the day, only to end up eating a substantially larger dinner or late-night meal than you would if you eat balanced meals?

What to Do if You Recognize the Signs

• Begin working with a therapist and a registered dietitian trained in treating eating disorders. Sign information releases so they can communicate with one another and with your primary care doctor to provide team-oriented care.
• Clean up your social media consumption. Unfollow fitness and diet influencers and fill your feed with people in your chosen field/industry, people you find inspiring, or artists whose work you enjoy.
• If you notice that a friend is struggling, bring up what you’re observing using “I” statements, such as “I noticed that the cookies I bought for us to share yesterday are gone; it seems like you ate them. I’m not concerned about the cookies because we can always buy more; I’m concerned that you ate more than you might have intended, which sometimes means there is something else going on. How have you been doing?”
• Get an evaluation for an appropriate course of treatment. This may mean attending programming a few days a week or taking a leave of absence.

Sleep is crucial for overall well-being, especially when facing the challenges of graduate school combined with depression. The CDC reports that 78.2% of students with depression also have insomnia, and a 2023 study highlighted the connection between shorter sleep duration, irregular sleep-wake schedules, and lower GPAs.

Struggling with sleep can manifest in various ways, such as sleeping too little or too much, having difficulty falling or staying asleep, experiencing disrupted sleep, nightmares, or morning fatigue. Sleep disturbances can worsen mental health issues, leading to chronic fatigue, depression, stress, reduced optimism, anxiety, and a diminished quality of life.

Check Your Symptoms

• Do you have a hard time getting enough sleep?
• Do you sleep too much?
• Do you have trouble falling asleep? Staying asleep?
• Do you wake up too early and can’t fall back to sleep?
• Do you experience disturbed sleep, nightmares, or night terrors?
• In the morning, do you find that you typically don’t feel rested?
• Do you snore?
• Are you unable to fall asleep due to racing thoughts or the feeling that you can’t shut off your brain?

What to Do if You Recognize the Signs

• Create a bedtime routine. Stick to the same approximate bedtime each night, complete the same tasks before bed, and wake up at about the same time each morning.
• Use your bed for sleep and intimacy only. Don’t study, watch TV, or scroll on your phone in bed.
• Try to avoid long naps.
• Engage in physical activity to wear yourself out.
• Consider natural sleep aids, like warm milk, chamomile, lavender, and other herbal remedies. Utilize an essential oil diffuser near your bed to help you relax.
• Make sure your bed is appealing; choose linens that you like in a space that you find calming. Keep your bedroom cool but have plenty of blankets.
• Sleep in a room that is as dark and free of stimulation as possible. Discontinue screen use 30-60 minutes before bed.
• Consult with a sleep medicine doctor and consider having a sleep study to gain insight into improving your sleep.

“Work hard, play harder” is a common mantra among students in challenging disciplines. Graduate students typically have more control over their finances and are old enough to drink alcohol. And, of course, it’s natural to want to unwind with your peers or friends.

According to the National Institute on Alcohol and Alcoholism, one in four college students reported experiencing academic difficulties from drinking, including falling behind with work or missing class. A survey concluded that 6.7% of graduate students engaged in high-risk alcohol consumption, 20.3% used marijuana, and 7.1% used prescription drugs for nonmedical uses.

If you’re concerned for yourself or a friend, read on to learn more about how substance use disorders look for grad students.

Check Your Symptoms

• Do you need more time to recover from a night of drinking or drugging than your schedule allows?
• Do you use alcohol or drugs more days than you did previously? When you do, are you using more than before? Does it take more to achieve the desired effect?
• Do you spend less time with friends, loved ones, or on your studies because you use that time for drinking or substances?
• Has anyone noticed your drinking or substance use and commented to you about it? Do your friends, peers, or loved ones seem concerned?
• Do you use alcohol or substances to cope with how overwhelmed you feel?
• Are you falling behind on your coursework or other responsibilities?
• Are you having financial trouble because you spend money on alcohol or substances?
• Do you find you need a drink or to use drugs first thing in the morning to take the edge off?
• Do you crave alcohol or other substances when you aren’t drinking or using, or are in a situation where you aren’t able to use them?

What to Do if You Recognize the Signs

If you notice that a friend shows some of these signs, try the following:

• Have a compassionate, empathetic conversation. Their reaction—positive, negative, or neutral—shouldn’t change the message that you are concerned.
• If you have a relationship with another loved one in your friend’s life, approach that person to share your concerns. Perhaps the two of you can address the situation together. Don’t hesitate to get professionals involved.
• If you have immediate concerns about your friend’s safety, take action by contacting emergency services or confiscating their keys.
• If you remain concerned and without further resources, consider reaching out to a trusted faculty member for advice.

Suicide is a devastating loss. With the mounting pressures of the world, the stress of academic settings, and mental health challenges, students sometimes feel trapped in their problems without a way forward.

According to the American College Health Association, suicide is the second leading cause of death among college students, with about 1,100 suicides on campuses each year. About 25% of students know someone who has died by suicide, and 40% know someone who has attempted suicide.

If you are having thoughts of suicide, seek help immediately.

Check Your Symptoms

• Are you experiencing feelings of worthlessness, helplessness, or hopelessness?
• Do you feel life isn’t worth living?
• Do you have frequent thoughts about suicide, including formulating a plan or gathering the means to execute your plan?
• Do you feel like a burden to your friends and loved ones?
• Do you feel overwhelmed, like there’s no way out of your problems?

What to Do if You Recognize the Signs

• If you are concerned for yourself or a friend, go to your local crisis response center for an evaluation immediately. You can also call the Suicide Prevention Lifeline (1-800-273-8255) for assistance and support.
• If you have suicidal thoughts, seek counseling from your school’s student counseling center.
• Engage in safety planning with your counselor; come up with a plan for what you might do if you have suicidal thoughts during the weekend or overnight and how you can find support.
• If you are concerned for a friend, don’t relent in trying to talk to them because you worry they may get angry at you.

Emergency Services: Call 911 immediately if you are concerned for yourself or a loved one.

If you are struggling with mental health issues, under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973, it is within your rights to seek accommodations to help you be successful in grad school. Your school will have a student accessibility services office with whom you can discuss your situation and the accommodations you may require to complete your studies successfully. For mental health needs, accommodations may include extended deadlines, private/lower stimulation areas to take exams, having a peer as a note-taker, making audio recordings of the class, or using technology (like a laptop or calculator) for exams.

During the pandemic, online learning became more robust and is viewed as equivalent in quality and rigor to in-person learning. Many colleges and universities now offer hybrid or online-only courses to complement their on-campus classes. Students have more choices on how and when to continue their education to meet their needs.

If you have mental health issues, online learning may be an accommodation that would be helpful, especially if in-person classroom learning causes distress to your health. While your goal may be reintegration with your peers, online learning keeps your studies on track while providing valuable time and space for healing.

Q: In your experience, what are some unexpected challenges that graduate students face?

A: Unexpected challenges I’ve observed in graduate students include family struggles, peer and romantic relationship issues, grief and loss, academic pressures, troubles with concentration, financial hardship, gender dysphoria, sexual identity struggles, and physical and mental health difficulties. These challenges may be extensions of what this student struggled with as an undergraduate or newer issues that arise as life continues for them.

Q: What aspects of graduate education are inherently different from one’s time as an undergraduate student?

A: Graduate education typically involves more reading, writing, studying, and research than undergraduate education. Graduate studies are usually at a higher level academically than undergraduate studies, and thus students may need to work harder to keep up with their cohorts. Additionally, there tends to be less day-to-day social support, such as events or structured resources like a meal plan in the dining hall, for graduate students. 

Q: What should a prospective graduate student know before enrolling in a graduate degree program?

A: Be prepared to work hard with less handholding than in previous educational endeavors. In my experience, if a graduate student enjoys the subject matter they’re studying and is motivated to learn, it’s easier to manage the intensive workload. Something else to keep in mind is that if a graduate student is struggling, they may need to seek out support (on-campus and/or off-campus) independently. 

Q: Are there aspects of life as a graduate student that increase isolation or other mental health challenges?

A: Graduate students frequently have different schedules than their peers who are employed full-time. Additionally, graduate students often don’t have the opportunity to find employment and earn an income. Lack of adequate funds and a busy schedule that conflicts with friends outside of school can make it more difficult to socialize.

Q: If a graduate student notices that one of their peers is struggling but is not engaged in any help or support, how can that individual share their concern to help their peer?

A: I would encourage the graduate student to check in directly with their peer, express concern, and ask how they can be supportive. If there are significant issues at play, the concerned graduate student may need to consult with a staff member on campus who can evaluate the situation and offer additional support or problem solving. Examples may be a dean, professor, adviser, or counselor. Each of them can listen to a student’s concern about a peer without violating the privacy of the student in question.

Q: What are some outside-of-school activities/self-care practices that you’ve seen help support graduate students’ mental health and wellness?

A: Important self-care practices that students can incorporate into their routine include proper nutrition, sleep hygiene, fitness activities, support groups, study groups, social support from friends and family, meditation practices, and hobbies. If a student is engaging in these activities regularly and is still struggling, a referral to a mental health provider may be warranted.