How to Spot Psychological Distress in the Students You TA
(and What to Do About It)

Doris Iarovici, M.D.
Psychologist

You’ve heard the statistics: according to the National Mental Health Association, college students report feeling more stressed and overwhelmed than fifteen years ago, and suicide is the second leading cause of death in the college population. With one in ten college students diagnosed with depression, one in fourteen with an anxiety disorder, and eating disorders peaking in the college years, chances are some of the students you teach will be dealing with mental health issues. As a TA, you are sometimes in a unique position to notice undergraduates in distress, and to guide them toward help.

What warning signs might alert you to a psychological problem in a student?

  • Sudden changes in behavior or school performance.
  • Dramatic changes in appetite, weight, or sleep.
  • Loss of interest in friends, or withdrawal from contact with friends or social activities. (The student who sets up appointments with you to discuss academic problems, but then doesn’t keep them, or skirts contact with you, may be feeling worthless, hopeless, and helpless; these are also signs of depression.)
  • Change in personal hygiene or appearance.
  • Agitation or an inability to sit still.
  • Sudden suspiciousness.
  • Feeling indifferent to very important situations.
  • A rigid insistence on perfection, symmetry, or having things “just so.” (The student who color-codes their class notes and then feels the need to copy and re-copy them to look “right” may not be “nerdy,” but may need help with an anxiety disorder.)
  • Talking about death or dying. In college students, this may also occur through academic papers; the student who has a preoccupation with well-known writers who have committed suicide, for example, may also be personally preoccupied with dying.

Be aware of the enormous pressure to succeed on our campus. According to Alan Lipschitz, M.D., suicidal college students are not usually rebellious and aggressive, as high school students at risk for suicide might be. Instead, college students tend to be quiet and withdrawn, often plagued by hopelessness and pressure for success. They feel out of synch with their surroundings. Be on the lookout for the student whose daily schedule is markedly different than everyone else’s, or whose sleep/wake schedule has become reversed.

What can you do?

  • Be a good listener: trustworthy and non-judgmental. A student who feels he or she has your respect and acceptance is more likely to take your suggestions seriously.
  • Remind students that getting help with emotional problems often significantly improves their academic performance.
  • Assure students that they are not alone. Often, the problem is an adjustment to college life, but talking about it with others and getting professional help can make the transition go much more smoothly. I sometimes tell students that many of our former CAPS clients are now leading lives as physicians, lawyers, entrepreneurs, artists, etc., in our community.
  • Offer hope. Many treatments for various emotional problems are available on campus, and they are very effective.
  • Suggest they seek help through CAPS, Student Health, or even their family doctor, if they have a good relationship with that person.
  • For students with eating or body image problems, make a suggestion to see a nutritionist. Franca Alphin at the Duke Student Health Center may be a good starting point.
  • Call CAPS for a consultation with one of our clinicians if you are unsure about what to do.

Resources on campus

Helpful Web sites

Remember too that graduate students, like the rest of us, are not immune from these problems. So if you notice warning signs in a grad school colleague or in yourself, take them just as seriously.

(This article originally appeared in the Spring 2003 issue of The GRIND.)

Last updated: 08/04/2005