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

This month's expert: David Fassler, M.D., APA Trustee-at-large and child and adolescent psychiatrist.

There are a few girls in my dorm who make themselves sick after some of their meals. Are they bulimic?

Many people don’t know when a friend or family member has bulimia because people almost always hide their binges. Since they usually don’t become drastically thin, their behaviors may go unnoticed even by those closest to them.

People with bulimia binge frequently. They may eat an astounding amount of food in a short period of time, often consuming thousands of calories that are high in sugars, carbohydrates, and fat. They can eat very rapidly, sometimes swallowing food without even tasting it. The binges often end when their stomach hurts from being stretched beyond normal capacity.

During an eating binge, people feel out of control. After a binge, stomach pains and the fear of gaining weight can cause them to purge by throwing up or using a laxative. This cycle is usually repeated at least several times a week or, in serious cases, several times a day.

In early stages of an eating disorder, people often deny that they have a problem. But 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.

For more information about eating disorders, see our Let's Talk Facts brochure on the subject.

Every Friday and Saturday night I have at least five beers with the guys in my fraternity- does that count as binge drinking?

College is a 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.

Binge drinking is defined as consuming five or more drinks in a row for boys and four or more in a row for girls. By the end of college, almost half of all students have had at least one episode of binge drinking.

Alcohol poisoning – a potentially fatal physical reaction to an alcohol overdose – is the most serious consequence of binge drinking. When excessive amounts of alcohol are consumed, the brain is deprived of oxygen. The struggle to deal with an overdose of alcohol and lack of oxygen will eventually cause the brain to shut down the voluntary functions that regulate breathing and heart rate.

Symptoms of alcohol poisoning include:
• Vomiting
• Loss of consciousness
• Cold, clammy, pale, or bluish skin
• Slow or irregular breathing (less than 8 breaths a minute or 10 or more seconds between breaths).

Tragically, approximately 50 college students die each year from excessive alcohol consumption.

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 binge drinking, see the U.S. Department of Health and Human Services and SAMHSA's National Clearinghouse for Alcohol and Drug Information.

I didn’t realize college would be so hard. I feel stressed out all the time.

Stress is a normal part of life. However, sometimes stress can become overwhelming and even dangerous. Stress can cause physical, emotional and behavioral problems which can affect your health, your relationships, and even your grades. Too much stress can cause minor symptoms like insomnia, backaches, or headaches, and can contribute to potentially life-threatening diseases like high blood pressure and heart disease.

Exercise, avoiding alcohol, drugs or excessive caffeine, and sharing your feelings are all good ways to cope with everyday stress. However, if you think that you or someone you know may be under excessive or ongoing stress, it’s important to talk to a mental health professional.

For more information on dealing with stress, see the Mental Health America's (formally NMHA) fact sheet.

I’m feeling depressed but 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. He or she 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.

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