Generalized Anxiety Disorder in High Functioning College Students and Relief through Meditation

Anxiety is an inherent part of college for most high achieving students. To succeed in college and matriculate to graduate school a student typically must take heavy course loads per semester, maintain a stellar grade point average, and engage in a variety of extra classroom work such as aiding graduate students with research projects. To succeed with such a tough schedule requires excellent time management, the ability to prioritize assignments, and the ability to anticipate the amount of work and study that will be necessary for upcoming papers, projects, and tests.

When one thinks about the notion of “planning,” it essentially involves a focus on the short and longer-term future. You are casting your mind away from the present and pondering what actions you need to take to create a positive future outcome. Unfortunately, for many college students, this focus on the future can slowly transform into unproductive worry and fears of academic catastrophe. When these worries become incessant and impossible to stop then secondary physical symptoms can emerge. This pattern of uncontrolled worry with associated physical symptoms is referred to as Generalized Anxiety Disorder.

Generalized Anxiety Disorder is defined by the DSM-5-TR as a pattern of uncontrollable and unproductive worry about one’s life that is abnormally intense and irrational. This worry can lead to concentration impairments, a sense of foreboding about one’s future, sleeplessness, daytime fatigue, irritability, and physical symptoms such as muscle tension, shakiness, shortness of breath, feelings of lightheadedness, restlessness, and general feelings of discomfort and tension. These symptoms can become so intense that a student cannot focus on homework, falls behind in school, and then worries more because of their faltering performance. At times, these cycles can go unchecked until finally a student stops going to class altogether and may fail a semester’s worth of classes. In many cases, secondary depressive symptoms can ensue.

So, what is a student to do when they begin to develop pathological anxiety? First, students should seek help from their college or university’s student mental health and counseling center. These college affiliated programs are almost always staffed with psychologists and psychiatrists who offer their services to students. In many cases, when one presents with Generalized Anxiety Disorder, they are prescribed a regimen of psychotherapy and medication.

The most common form of therapy recommended for Generalized Anxiety Disorder is cognitive-behavioral therapy (CBT). CBT is a form of therapy based upon the idea that anxiety is generated by negative thought processes that trigger a person’s biological “fight or flight system,” leading to the physical symptoms of anxiety. For instance, an ambitious student may be plagued by the recurring “automatic” thought that they lack the ability to do well in a college calculus class. Thoughts such as “I’m just bad at math,” “I never do well on math tests,” “I’m just not that smart at math” may pervade a student’s thoughts and generate a great degree of performance anxiety during testing situations. Because the person has concluded they are bad at math, during math performance situations they may anticipate that they are “failing” a test, which triggers their internal threat response. When this occurs, the student’s body is flooded with adrenaline, their heart starts to race, they become short of breath, and they lose focus. At this point, the chances they will complete the test in a timely and accurate manner are slim to none. A CBT therapist will try to help a student break this cognitive and physical feedback loop that is at the heart of anxiety.

In modern cognitive-behavioral psychology, a common technique for addressing anxiety is to employ meditation and mindfulness strategies. Meditation is a cognitive-behavioral technique that is rooted in Buddhism. Though people certainly meditate as a part of a Buddhist religious tradition, in psychology, the pragmatic and therapeutic aspects of meditation are borrowed, and the more “spiritual” aspects of the practice are factored out. Essentially, meditation is a practice in which a person sits in a somewhat upright, erect posture and slowly and deeply breathes in through the nose, and out through the mouth.

Below are basic meditation instructions:

• 10 minutes ideally in the morning and before bed.
• Sit in an erect, balanced position with straight back (not laying on a bed).
• Take long, slow breaths in through the nose and out through the mouth.
• Focus on the sensations of the air entering your nose, your lungs, and
  the feeling of your abdomen rising and falling.
• Try to breath in until your lungs are full, pause at the top, and
  slowly blow all your air out. The longer and slower the better.
  Keep your eyes closed.
• As you attempt to focus on your breathing you will notice that your
  mind will run rampant with thoughts and images. Every time you notice
  that you are deliberating on something, such as an image of yourself
  doing something or reciting your plan for the day, picture a “stop
  sign” and then re-focus on the rising and falling of your breath.
  You will likely have to stop your thought processes and re-focus very
  frequently in one session.
• The key is learning to recognize a thought (you can even label a
  thought- such as “worrying about my test tomorrow”), let the thought go,
  and re-focus on your breath.
• Set a timer before you meditate – like 10 minutes- and don’t stop
• Remember that meditation is not easy or even meant to be “relaxing,” it’s a
  method of becoming more aware of your thought processes and learning to
  free yourself from images and thoughts that cause you anxiety.

It is hoped that becoming practiced at the above cognitive-behavioral techniques can translate into greater management of anxiety in a student’s life. For example, let’s recall the discussion from an earlier paragraph concerning test anxiety. When a person has been consistently meditating, as a test approaches, they will recognize and label their self-defeating thoughts: “I’m going to do terrible at this test” – “Ok, I’ve just had a negative thought, that’s all it is, a thought. I’m going to recognize it and watch it float by like a cloud passing through the sky.” At this point, the student will also be practiced at taking long, slow deep breaths that short-circuit the fight or flight response and prevent an adrenaline dump. The student becomes calm, centered, and they are ready for their test. They may even employ a positive mantra, “I will succeed at this test, I will succeed at this test.” Oftentimes, meditation techniques such as those described above are preferable to anti-anxiety medications such as Xanax (alprazolam), which can be sedating and addictive.

If you are a college student, or you know a college student, who may be suffering from Generalized Anxiety Disorder then please encourage them to visit their student mental health center or seek treatment with a local psychologist. Frequently, a psychologist may employ a psychoeducational assessment to determine if it is indeed anxiety that is affecting a student’s academic performance. We administer a wide variety of emotion and personality measures that can identify clinical anxiety, help determine its origin, and provide a clear treatment plan to bring the anxiety disorder into full remission. Anxiety is one of the most treatable mental health conditions and can often be resolved quickly. Alternately, if you are beginning to experience anxiety that has not reached clinical proportions, we encourage you to employ some of the above meditation strategies before your anxiety worsens. If you want more information on meditation, the book: “Meditation for Beginners” by Jack Kornfield is an excellent resource guide.