The College Pressure Cooker: High Achieving Students, High Mental Health Risks

This story is part two of our four-part series, "Stressed And Depressed On Campus." Read part one here, part three here and part four here.

Growing up in Medfield just outside Boston, Ali Gold was a star student-athlete, playing soccer, lacrosse and basketball, winning four state championships at Medfield High.

Her senior year, WCVB-TV featured Gold and her beaming soccer teammates after they went undefeated. A reporter asked her what life was like being a state champion once again.

“It is pretty unbelievable!” Gold responded, smiling. “Walking through the hallways at school, and people are clapping and cheering for you. It's unreal."

That unreal feeling, though, didn't last long. Overwhelmed and exhausted, Gold would cry without knowing why. She was diagnosed with anxiety, obsessive compulsive and bi-polar disorders. The idea of killing herself popped into her head at times. She began cutting herself secretly.

After graduating in 2013, Gold enrolled at Trinity College in Hartford, where her mental health issues continued.

Across the country, young people are experiencing unprecedented rates of anxiety and depression. One group of students who experience mental illness are high achievers from prosperous suburbs like Gold.

Just over half of students served at college counseling centers around the country have severe psychological problems, a 2014 survey conducted by the Association for University and College Counseling Center Directors found. Suicides are at their highest levels in a century. Researchers warn this psychic stress is widespread on college campuses.

"If this is a mental health crisis, if we want to qualify it as such, it's a crisis of young people's mental health," said Sarah Lipson, a psychology professor at the Boston University School of Public Health, where she helps conduct an annual survey of college student mental health.

Lipson blames high admissions standards at selective schools for creating high-pressure academic and athletic environments filled with over-achievers. She also points to technology.

"We're just spending so much time looking down at a screen and not looking at one another,” Lipson said. “Then even within the world that we're looking at on our phone, there's every little bit of comparison, and people's perfect lives being displayed on social media."

All of that undermines well-being, Lipson and other mental health experts say.

Away from home at Trinity, Gold found the freedom of college life was not good for her mental health at first.

"The beginning of the semester was a bit rocky. I think I got my staying-out-late college experience out of the way,” she said. “Sleep is something that is very important to me for my stability and my mood and making sure I'm taking care of myself."

Also that first semester, Gold decided not to continue playing sports, a choice that left her feeling isolated.

“It was a very small school, and I felt like it was really hard for me to connect socially with people if I wasn’t playing a sport because it was a really big student-athlete population,” she recalled.

On campus, studying and going to the gym to work out alone took up a large chunk of her time. She developed an eating disorder. Her obsessive tendencies returned.

"I literally had gotten a 100 on an exam because I had studied a lot, and I still didn't feel good about it,” she said.

Gold was trying to control every aspect of her life.

"If my room wasn’t spotless and color-coded and labeled and if I hadn’t studied and didn’t have my flash cards — each chapter according to a specific color — that would amplify the anxiety,” she said. “I think not having that social connection, or feeling like I couldn't access that social connection, really led to more mental health challenges."

Isolated and depressed, Gold dropped out of Trinity in 2015.

BU’s Lipson said many students like Gold are now heading to college already stressed and depressed, and their increased rates of anxiety come with larger consequences.

"We know that depression is associated with a two-fold increase in the likelihood of dropping out or stopping out of college,” Lipson said. “We know how much every year of college education translates to economic earnings at an individual level, productivity at a societal level."

On campuses across the country, eight in 10 college presidents say student mental health has become more of a priority than it was three years ago, according to a survey the American Council on Education conducted earlier this year. Seventy-two percent of the college presidents surveyed also said they're spending more money now on mental health initiatives than they did three years ago.

With students increasingly isolated and anxious, many four-year colleges are responding by adding more mental health counselors. But 40 percent of students with mental health issues never seek help, according to the National Alliance on Mental Health.

A BU spokesperson said the university has added counselors and trained more than 1,000 members of the campus community in identifying and helping students in distress.

But Lipson said that this approach alone will not sufficiently solve the problem.

“We're never going to be able to meet this demand by continuing to just increase the number of counselors that we have in our counseling centers,” Lipson said. “That's going to be a very inefficient and ineffective approach."

Andrew Martin, chancellor of Washington University in St. Louis, has suggested group therapy sessions as way to serve more students.

“You can’t just treat them with one-on-one therapy,” Martin said. “It doesn’t scale.”

Another approach being taken at some colleges like Wellesley, Georgetown and the University of Vermont is having professors take on mental health in their courses, meeting students where they are required to be: inside the classroom.

David Rivera, a counseling psychologist at Queens College in New York, said faculty should talk about mental health more openly, baking it into their curriculum, "having it on a syllabus, encouraging people to discuss their mental health needs — their mental health stories."

Stephanie Pinder-Amaker, founding director of McLean Hospital’s College Mental Health Program, agrees. She said one of the most effective ways of reducing the stigma surrounding mental health on campus is to have students hear directly from other students.

"Any student who might be experiencing a level of distress that's persisted or that's so significant that they're having difficulty functioning — if they're feeling persistent feelings of hopelessness — it's important to know that you may very well have a common mental illness," Pinder-Amaker said.

Because these ailments are treatable, psychologists recommend students seek support, as Gold did.

After dropping out of Trinity, Gold transferred to Boston University in the fall of 2017. Closer to home, she has been studying health science and psychology.

She said through ongoing therapy, her mental health has improved. She's now interning as a counselor at the same psychiatric facility at Franciscan Children’s Hospital in Brighton where she was twice a patient.

Walking the halls on a recent afternoon, Gold said she never imagined she'd be working there.

“I didn't know what my future held when I was here as a patient," she said, noting that she sees herself in a lot of the teenagers she works with.

“Just remembering that I was in that place, too, and people take time,” Gold added. “And I took time."

After she graduates in May, Gold hopes to launch a career in mental health.

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.