APA Expert Opinion
An APA expert answers common questions about college mental health

This month's expert: Rachel Glick, M.D., clinical associate professor, Department of Psychiatry, University of Michigan Medical School and co-chair, APA Presidential Task Force on Mental Health on College Campuses

A couple girls in my dorm never seem to eat. Do they have an eating disorder?

People with eating disorders need a comprehensive evaluation by a mental health professional with specific training and expertise in this area. The good news is that with proper medical care, those suffering from eating disorders can resume more normal eating habits, and return to better emotional and physical health

Eating disorders affect some several million people at any given time, most often women between the ages of 12 and 35, and can begin during college. They can interfere with self-esteem, social interactions and performance at school.

Eating disorders are illnesses in which the victims suffer severe disturbances in their eating behaviors and related thoughts and emotions. Those suffering from eating disorders typically become obsessed with food and their body weight as well. Although eating disorders are more common in women, they also occur in men.

There are two main types of eating disorders, anorexia nervosa and bulimia nervosa. People with anorexia nervosa and bulimia nervosa tend to be perfectionists who suffer from low self-esteem and are extremely critical of themselves and their bodies. They usually "feel fat" and see themselves as overweight, sometimes even despite life-threatening semi-starvation (or malnutrition). In early stages of these disorders, patients often deny that they have a problem.

For more information about eating disorders, see: http://www.healthyminds.org/collegeeatingdisorders.cfm.

Almost every night I go out drinking with guys in my fraternity and am starting to wonder if I have a problem with alcohol.

For students over 21, going out with friends and drinking in moderation is a normal part of college life. However, college is also time when many young adults start abusing alcohol. In fact, young adults aged 18 to 22 who attend college drink more than those who don't continue their education. Tragically, approximately 50 college students die each year from excessive alcohol consumption.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines alcoholism (or alcohol dependence) as a chronic disease with four symptoms:

• a strong need to drink (craving);
• an inability to limit the number of drinks (loss of control);
• signs of withdrawal, such as sweating, shaking, and nausea, once drinking has stopped (physical dependence); and
• a need to drink greater amounts of alcohol to get "high" (tolerance).

People who crave alcohol have an uncontrollable need to drink that is stronger than their desire to stop drinking. These cravings for alcohol last for a lifetime and can be as strong as the need for food or water. The risk for developing alcoholism is influenced by a person's genes and lifestyle.

If you are concerned about your drinking, please talk with your family physician, college health service, school counselor or a mental health professional.

For more information about alcohol abuse, see: http://www.healthyminds.org/multimedia/ltfcollegealcohol.pdf.

I didn't realize college would be so hard. I feel depressed all the time.

Starting college for the first time or returning can be a difficult adjustment for some students. They may feel anxious, stressed and possibly depressed. Depression significantly affects a person's appetite, sleep, energy, thinking, self-esteem and physical well-being. The symptoms are persistent and not the same as a temporary blue mood or normal emotional experiences such as sadness or grief.

A person may recognize the symptoms of depression themselves or others may notice persistent symptoms that cause distress and interfere with day-to-day functioning in school and other personal areas. Making an appointment for evaluation and treatment by a student health/counseling service professional or other mental health care provider is an important step towards feeling better.

If you are in a suicidal crisis, get help immediately by contacting an on-campus mental health professional or health care clinician, emergency room or call the National Suicide and Crisis Hotline (800-SUICIDE /800-784-2433).

For more information on depression, see: http://www.healthyminds.org/cmhdepression.cfm.

My university doesn't have a psychiatrist on staff at the health center. How can I get help?

You can begin by talking to your family doctor or the physician at your school's health center. Tell the doctor what you're thinking and how you're feeling. They will probably do a physical exam to check whether any other medical illnesses may be contributing to your symptoms. If the doctor recommends a psychiatric consultation or treatment, ask for the names of two or three psychiatrists. You should also request a copy of your medical records for the psychiatrist to review.

Your local medical or psychiatric society, community mental health center, and medical school are also good sources for referrals to psychiatrists. You can also seek advice from friends and family members.

Information on locating a psychiatrist near you can be found right here on this Web site.