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Principles and Practice of College Health pp 57–76 Cite as

Depression and Anxiety in College Students

  • Ayesha K. Chaudhary 3 , 4  
  • First Online: 05 December 2020

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College health clinicians are often first line in detecting the presence of, and providing intervention for, depressive and anxiety disorders in young adult students. Caring for mental health conditions in the primary care setting can be complex, requiring a nuanced and comprehensive approach. The importance of diagnostic accuracy and differentiation of clinical pathology from developmental, nonpathological states, along with carefully defining any underlying comorbidities, are determinants of intervention options and the successful resolution of symptoms. While symptom remission is in itself a primary outcome, other important outcomes include suicide risk reduction, treatment adherence, sustained remission, improved quality of life, and development of positive attitudes toward mental health care. This chapter provides a review of the epidemiology of depression and anxiety in college students, guidance for providers regarding the clinical diagnostic process, strategies to engage students in treatment planning, and an overview of pharmacologic and nonpharmacologic interventions.

  • Student health
  • Mental health care
  • Suicide risk
  • Symptom mapping
  • Pharmacologic
  • Nonpharmacologic

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Statistics NC for E. College navigator. National Center for Education Statistics, U.S. Department of Education. 2008.

Google Scholar  

National Center for Education Statistics. College enrollment rates. Cond Educ 2018. 2017.

Redford J, Mulvaney Hoyer K. First-generation and continuing-generation college students: a comparison of high school and postsecondary experiences. National Center for Education Statistics; 2017.

Beiter R, Nash R, McCrady M, Rhoades D, Linscomb M, Clarahan M, et al. The prevalence and correlates of depression, anxiety, and stress in a sample of college students. J Affect Disord. 2015.

Turner JC, Leno EV, Keller A. Causes of mortality among American college students: a pilot study. J Coll Stud Psychother. 2013;27(1):31–42.

Article   Google Scholar  

Bernstein L. U.S. life expectancy declines again, a dismal trend not seen since World War I – The Washington Post. The Washington Post; 2018.

Eisenberg D, Speer N, Hunt JB. Attitudes and beliefs about treatment among college students with untreated mental health problems. Psychiatr Serv. 2012.

Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000.

Arnett JJ. Emerging adulthood: understanding the new way of coming of age. In: Emerging adults in America: coming of age in the 21st century; American Psychologica Assoc. 2007.

Zald DH, Cowan RL, Riccardi P, Baldwin RM, Ansari MS, Li R, et al. Midbrain dopamine receptor availability is inversely associated with novelty-seeking traits in humans. J Neurosci. 2008.

Kessler RC, Angermeyer M, Anthony JC, de Graaf R, Demyttenaere K, Gasquet I, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry. 2007.

Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of. Arch Gen Psychiatry. 2005.

Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College students: mental health problems and treatment considerations. Acad Psychiatry. 2015.

Lipson SK, Kern A, Eisenberg D, Breland-Noble AM. Mental health disparities among college students of color. J Adolesc Health. 2018.

Viruell-Fuentes EA, Miranda PY, Abdulrahim S. More than culture: structural racism, intersectionality theory, and immigrant health. Soc Sci Med. 2012.

Heyman JC, Kelly PL, Reback GM, Blumenstock KH. Social determinants of health. In: Health and social work: practice, policy, and research; Springer Publ. 2018.

Hunt JB, Eisenberg D, Lu L, Gathright M. Racial/ethnic disparities in mental health care utilization among U.S. college students: applying the institution of medicine definition of health care disparities. Acad Psychiatry. 2015.

Sturdy S. William Osler: a life in medicine. BMJ. 2000;321(7268):1087.

Downey MM, Jackson K, Fernandez T. Free, brief, and validated: Standardized instruments for low-resources mental health settings. Resour Ment Health Settings. 2016;22(1):5–19.

Hirschfeld RM. Differential diagnosis of bipolar disorder and major depressive disorder. J Affect Disord. 2014.

Bowden CL. A different depression: clinical distinctions between bipolar and unipolar depression. J Affect Disord. 2005;84(2–3):117–25.

Hirschfeld RMA, Williams JBW, Spitzer RL, Calabrese JR, Flynn L, Keck J, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the mood disorder questionnaire. Am J Psychiatry. 2000.

Kline E, Wilson C, Ereshefsky S, Denenny D, Thompson E, Pitts SC, et al. Psychosis risk screening in youth: a validation study of three self-report measures of attenuated psychosis symptoms. Schizophr Res. 2012.

Cranford JA, Eisenberg D, Serras AM. Substance use behaviors, mental health problems, and use of mental health services in a probability sample of college students. Addict Behav. 2009.

Massey SH, Lieberman DZ, Reiss D, Leve LD, Shaw DS, Neiderhiser JM. Association of clinical characteristics and cessation of tobacco, alcohol, and illicit drug use during pregnancy. Am J Addict. 2011.

Köhler S, Gaus S, Bschor T. The challenge of treatment in bipolar depression: evidence from clinical guidelines, treatment recommendations and complex treatment situations. Pharmacopsychiatry. 2014;47(2):53–9.

Fela-Thomas AL, Olotu OS, Esan O. Risk of manic switch with antidepressants use in patients with bipolar disorder in a Nigerian neuropsychiatric hospital. South Afr J Psychiatry. 2018;24:1–6.

Lamis DA, Ballard ED, May AM, Dvorak RD. Depressive symptoms and suicidal ideation in college students: the mediating and moderating roles of hopelessness, alcohol problems, and social support. J Clin Psychol. 2016;72(9):919–32.

Beesdo-Baum K, Knappe S. Developmental epidemiology of anxiety disorders. Child Adolesc Psychiatr Clin N Am. 2012.

Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci. 2015.

Kizilbash AH, Vanderploeg RD, Curtiss G. The effects of depression and anxiety on memory performance. Arch Clin Neuropsychol. 2002.

Singh RL, Schommer JC, Worley MM, Peden-McAlpine C. Antidepressant use amongst college students: findings of a phenomenological study. Inov Pharm. 2012;3(2):1–13.

McGorry PD, Hickie IB, Yung AR, Pantelis C, Jackson HJ. Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry. 2006.

Lynch D, Tamburrino M, Nagel R, Smith MK. Telephone-based treatment for family practice patients with mild depression. Psychol Rep. 2004;94(3 I):785–92.

Khan A, Faucett J, Lichtenberg P, Kirsch I, Brown WA. A systematic review of comparative efficacy of treatments and controls for depression. PLoS One. 2012.

Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm. 2009;116(6):777–84.

Nasrin F. A randomized controlled trial of mindfulness versus yoga [Internet]. J Am Psychiatric Nurses Assoc. 2016;22:483–97. Available from

Cuijpers P, van Straten A, Warmerdam L. Behavioral activation treatments of depression: a meta-analysis. Clin Psychol Rev. 2007.

Bersani FS, Iannitelli A, Pacitti F, Bersani G. Sleep and biorhythm disturbances in schizophrenia, mood and anxiety disorders: a review. Riv Psichiatr. 2012.

Shephard RJ. Sleep, biorhythms and human performance. Sports Med Int J Appl Med Sci Sport Exerc. 1984.

Tuma JM, Pratt JM. Clinical child psychology practice and training: a survey. J Clin Child Adolesc Psychol. 1982;137:37–41. , Gobry F. {T}his is a title. {M}y Journal. 1999;1:120–30., Osment SE (1980). TA of R 1250–1550. … and RH of LM and R…. R from, Caprara G, Fida R. Longitudinal analysis of the role of perceived self-efficacy for self-regulated learning in academic continuance and achievement. … of Educational …, 2008;100(3):525–34. , Shanker S. Philosophy of science logic and mathematics in the twentieth century. … PL and NYR. 2003. ., Marenbon J. RH of PI… PL and NYR. 1998. ., et al. Sleep disturbance in heavy marijuana users. Sleep. 2008.

Deykin EY, Levy JC, Wells V. Adolescent depression, alcohol and drug abuse. Am J Public Health. 1987.

Benjamin AB, Dooley TP. Anxiolytic benefits of compounded Atenolol–Scopolamine in eight patients in psychiatry. Pers Med Psychiatry [Internet]. 2020;19–20:100051. Available from

Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. J Consult Clin Psychol. 2010.

Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. Int J Psychiatry Med. 2011.

Cooney G, Dwan K, Mead G. Exercise for depression. JAMA J Am Med Assoc. 2014.

Smits JAJ, Berry AC, Rosenfield D, Powers MB, Behar E, Otto MW. Reducing anxiety sensitivity with exercise. Depress Anxiety. 2008.

Vital-Lopez FG, Ramakrishnan S, Doty TJ, Balkin TJ, Reifman J. Caffeine dosing strategies to optimize alertness during sleep loss. J Sleep Res. 2018.

Furukawa TA, Cipriani A, Cowen PJ, Leucht S, Egger M, Salanti G. Optimal dose of selective serotonin reuptake inhibitors, venlafaxine, and mirtazapine in major depression: a systematic review and dose-response meta-analysis. Lancet Psychiatry [Internet]. 2019;6(7):601–9. Available from

Parris M, Marver J, Chaudhury S, Ellis S, Metts K, Allison, Burke A, Oquendo M, Mann J, Grunebaum M. Effects of anxiety on suicidal ideation: exploratory analysis of paroxetine versus bupropion randomized trial. Int Clin Psychopharmacol. 2018;33(1):139–48.

Duhoux A, Fournier L, Menear M. Quality indicators for depression treatment in primary care: a systematic literature review. Curr Psychiatr Rev. 2011.

Gaynes BN, Rush AJ, Trivedi MH, Wisniewski SR, Balasubramani GK, McGrath PJ, et al. Primary versus specialty care outcomes for depressed outpatients managed with measurement-based care: results from STAR*D. J Gen Intern Med. 2008.

Eisenberg D, Chung H. Adequacy of depression treatment among college students in the United States. Gen Hosp Psychiatry. 2012.

Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the food and drug administration. PLoS Med. 2008.

Kovich H, Dejong A. Common questions about the pharmacologic management of depression in adults. Am Fam Physician. 2015;92(2):94–100.

PubMed   Google Scholar  

Warden D, Rush AJ, Trivedi MH, Fava M, Wisniewski SR. The STAR*D project results: a comprehensive review of findings. Curr Psychiatry Rep. 2007.

Paykel ES. Partial remission, residual symptoms, and relapse in depression. Dialogues Clin Neurosci. 2008.

Abraham G, Milev R, Stuart Lawson J. T3 augmentation of SSRI resistant depression. J Affect Disord. 2006.

Cipriani A, Hawton K, Stockton S, Geddes JR. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ. 2013.

Ketter TA, Wang PW, Chandler RA, Alarcon AM, Becker OV, Nowakowska C, et al. Dermatology precautions and slower titration yield low incidence of lamotrigine treatment-emergent rash. J Clin Psychiatry. 2005.

Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet [Internet]. 2018;391(10128):1357–66. Available from

Article   CAS   Google Scholar  

Faquih AE, Memon RI, Hafeez H, Zeshan M, Naveed S. A review of novel antidepressants: a guide for clinicians. Cureus. 2019;11(3):e4185.

PubMed   PubMed Central   Google Scholar  

Thase ME, Greenhouse JB, Frank E, Reynolds CF 3rd, Pilkonis PA, Hurley K, et al. Treatment of major depression with psychotherapy or psychotherapy-pharmacotherapy combinations. Arch Gen Psychiatry. 1997;54(11):1009–15.

Burlingame GM, Fuhriman A, Mosier J. The differential effectiveness of group psychotherapy: a meta-analytic perspective. Group Dyn. 2003.

Bamber MD, Kraenzle Schneider J. Mindfulness-based meditation to decrease stress and anxiety in college students: a narrative synthesis of the research. Educ Res Rev. 2016.

Li AW, Goldsmith CAW. The effects of yoga on anxiety and stress. Altern Med Rev. 2012.

Swiecicki L. Seasonal affective disorder and phototherapy. Psychiatr Pol. 1990.

Kasper S, Rogers SLB, Yancey A, Schulz PM, Skwerer RG, Rosenthal NE. Phototherapy in individuals with and without subsyndromal seasonal affective disorder. Arch Gen Psychiatry. 1989.

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Department of Psychiatry, Duke University, Durham, NC, USA

Ayesha K. Chaudhary

Womens Health Center, Durham Veterans Affairs Medical Center, Durham, NC, USA

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Anthony J. Viera

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Chaudhary, A.K. (2021). Depression and Anxiety in College Students. In: Vaughn, J.A., Viera, A.J. (eds) Principles and Practice of College Health. Springer, Cham.

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