Amy Ebeling struggled with anxiety and depression throughout college, as her moods swung from high to low, but she resisted help until all came crashing down senior year.
“At my high points I was working several jobs and internships — I could take on the world,” said Ebeling, 24, who graduated from Ramapo College of New Jersey last December.
“But then I would have extreme downs and want to do nothing,” she told NBC News. “All I wanted to do was sleep. I screwed up in school and at work, I was crying and feeling suicidal.”
More than 75 percent of all mental health conditions begin before the age of 24, according to the National Alliance on Mental Illness, which is why college is such a critical time.
Ebeling resisted getting therapy, but eventually got a diagnosis of bipolar II disorder from a psychiatrist associated with Ramapo’s counseling office.
“Then everything fell into place,” said Ebeling, who is doing well on medication today.
College counselors are seeing a record number of students like Ebeling, who are dealing with a variety of mental health problems, from depression and anxiety, to more serious psychiatric disorders.
“What has increased over the past five years is threat-to-self characteristics, including serious suicidal thoughts and self-injurious behaviors,” said Ashley Stauffer, project manager for the Center for Collegiate Mental Health at Penn State University.
According to its data, collected from 139 institutions, 26 percent of students who sought help said they had intentionally hurt themselves; 33.2 percent had considered suicide, numbers higher than the previous year.
And according to the 2016 UCLA Higher Education Research Institute survey of freshmen, nearly 12 percent say they are "frequently" depressed.
At Ramapo College, counselors are seeing everything from transition adjustment to more serious psychiatric disorders, according to Judith Green, director of the campus' Center for Health & Counseling Services.
Being away from home for the first time, access to alcohol and drugs and the rigorous demands of academic life can all lead to anxiety and depression.
Millennials, in particular, have been more vulnerable to the stressors of college life, Green told NBC News.
"This generation has grown up with instant access via the internet to everything,” she said. “This has led to challenges with frustration tolerance and delaying gratification."
Millennials tend to hold on to negative emotions, which can lead to self-injury, she said. It’s also the first generation that will not likely do as well financially as their parents.
"Students are working so much more to contribute and pay for college,” said Green. “Seniors don’t have jobs lined up yet.”
'I dragged myself to the counseling center'
Like Ebeling, many students often experience mental illness breaks in college.
She had been in grief counseling after the death of her father at age 8, and even had therapy — but refused medication — during her teen years.
“I thought that it was weakness — 'why can’t I just snap out of it?'" she said. “It became apparent it just wasn’t that easy."
She hit a deep low her senior year.
“I was a crazy over-achiever,” she said. “I got involved in all the clubs and extracurricular activities.” But when her mood dropped, she said, “I couldn’t do anything, but had all those responsibilities.”
“In one class I panicked so much, I freaked out,” said Ebeling. “I dragged myself to the counseling center.”
The resources are available, according to Green, who first counseled Ebeling.
Ramapo reaches out to freshman and their parents at orientation and reinforces the availability of mental health resources throughout the year. The college also maintains an online anonymous psychological screening tool so students can see if therapy might be helpful.
“Students are electronically savvy, so we meet them where they are,” said Green.
They also sponsor wellness fairs so students learn about nutrition, exercise and even financial well-being — “the whole gamut to keep themselves well,” she said.
As for Ebeling, she took her experience and devoted her senior capstone project to learn more about mental illness. “It was therapeutic.”
“Kids going to college need to realize it’s not a weakness,” she said. “They shouldn’t be afraid to get help. ”
“I try to be open and talk about it with friends and family,” said Ebeling. “Don’t shy away from it. It needs to be addressed. Let go of the stigma.”
Ebeling had good communication with her mother regarding her mental health diagnosis, but said other students should consider sharing their medical information if they “feel they have a good support system.”
"I have friends who tried to discuss mental health issues with family members and completely got brushed off, which can be crushing and damaging,” she said.
"I think both students and parents need to keep an open mind, but at the end the of the day, those who are seeking help need to realize that they are doing this for themselves and no one else, and they need to put themselves first and foremost no matter what."
Tips for Parents from the National Association of Mental Illness:
- Let your child know that mental health conditions are common — one in five college students — so they don’t feel alone.
- Emphasize the importance of exercise, sleep and diet.
- Know the warning signs of mental stress and when and how to seek help. Check out the college’s resources.
- And because of privacy laws, come up with a plan in advance for which information about mental health can be shared with the parent.