Learning While Undocumented: Psychological Impacts of a Student’s Immigration Status

Who is considered undocumented?

Many people relocate to another country in search of better economic opportunities and superior education. In particular, undocumented students often have high academic aspirations to break cycles of poverty and seek to do something truly meaningful with their lives.[1] People may be considered undocumented if they are in the process of gaining legal status, have Deferred Action Childhood Arrival (DACA), have entered the United States without inspection, used fraudulent documents, or entered legally but stayed without authorization.[2] Some have arrived in the country as children with their parents, while others have decided to immigrate as young adults. In many cases, undocumented students were brought to the US as young children and this is the only country they really know and can call “home.” The absence of a clear path to legality can generate stress, anxiety, and frustration - all of which can be harmful to mental health.  

The Undocumented Students Mental Health Crisis 

Mental health is a significant public health issue in the United States, especially for young adults.  The Substance Abuse and Mental Health Association’s national data shows that in the past year, 30.6% of young adults aged 18-25 experienced a mental, behavioral, or emotional disorder, and 17% had a major depressive episode.[3] 

In addition to the mental health challenges of being a young adult, there are also the challenges associated with being a student, which is even more difficult for those with an uncertain immigration status. As there is no federal law prohibiting undocumented students from attending college or university, many institutions review all prospective students under the same admissions criteria regardless of status.[4] Thus, over 427,000 undocumented college students are enrolled in U.S. colleges and universities, and research confirms that their immigration status negatively impacts their well-being due to psychosocial challenges.[5] 

Enriquez (2019) notes that undocumented students' well-being is often impacted by the additional stressors of limited financial resources due to restricted job opportunities, fear of deportation for self and others, uncertainty about the future, and stigmatization.[6] Torres (2022) found that undocumented students have significantly higher stress levels than students who are U.S. citizens or protected under DACA, likely due to immigration fears.[7] Additionally, Cadenas (2022) explored the impacts of insecure immigration status on college students and found that precarious immigration status was linked to lower perceptions of welcoming campus climate, lower positive mental health, and higher anxiety.[8] Another challenge that undocumented students face is whether to disclose their immigration status due to the potentially negative consequences they feel they may incur.[9]

Age of Arrival

The pursuit of education while undocumented is not the same for every undocumented student, as several factors create a unique learning experience or hurdle. Cha (2019) found significant disadvantages faced by students arriving at a later age than those who have had the majority of their K-12 schooling completed in the United States. Notably, those arriving in their late teens to early twenties often had below-level course placement, less time to learn the US education system, and often a lack of access to ethnically-similar peers outside of ESL courses.[10] Furthermore, forming positive relationships with school agents did not enable them to surmount the aforementioned structural barriers.[11]

The DACA Impact

Established in 2012, the Deferred Action Childhood Arrival (DACA) program provides renewable two-year access to work permits and protection from deportation to approximately 653,000 immigrants in the United States.[12,13] If an individual meets the eligibility requirements they can apply for the DACA program by submitting the application through the U.S. Citizenship and Immigration Services website.[14] The eligibility requirements for the DACA program are as follows:[15]

• Were under the age of 31 as of June 15, 2012

• Have entered the U.S. before turning 16 years old

• Have continuously resided in the U.S. since June 15, 2007 up to the present time

• Have been physically present in the U.S. on June 15, 2012 and at the time of application for DACA

• Have had no lawful immigration status on June 15, 2012

• Currently enrolled in school (or have returned to school), graduated, obtained certificate of completion (e.g., GED) OR be an honorably discharged U.S. veteran

• Have not been convicted of a felony offense, a significant misdemeanor offense, multiple misdemeanor offenses, or otherwise pose a threat to national security or public safety

Thus, an undocumented person can apply to the DACA program and gain temporary legal status by being an active or graduate student in the U.S., by obtaining a GED, or being honorably discharged from the military. Being a DACA recipient helps to overcome some of the structural barriers created by illegal status. According to a study by Cha (2019), DACA recipients report improved high school and college completion rates, higher-paying jobs with better working conditions, eligibility to obtain bank accounts and driver's licenses, and better overall psychological well-being.[16] Further research by Torres (2022) found that undocumented students reported significantly greater stress than citizens, while DACA recipients' stress levels did not differ from those of United States citizens.[17] 

Protection under DACA allowed recipients to spend less time in "survival mode," as found by a review conducted by Siemons (2017), thus enabling them to devote more time and energy to meeting higher-level needs such as fulfilling higher education goals.[18] Even though DACA does not grant permanent legal status, it is renewable every two years. DACA aims to provide a safe environment for these individuals to pursue higher education and better-paying jobs which could lead to sponsorship opportunities for permanent legal status or longer-term work visas.

Seeking Help

Undocumented students often face obstacles when trying to access the support they need to overcome structural barriers. According to Cha (2019), these students are less-likely to use their college mental health services due to various reasons such as: low perceived need (as mental strain is often normalized within immigrant communities); a sense of futility (as they may believe that treatment would not address the underlying immigration issues); or fear of being stigmatized for mental health issues or immigration status.[19] 

Ayon's (2022) research found that greater perceptions of social exclusion due to the immigration policy context predicted lower use of on-campus mental health services by undocumented students.[20] However, when students encountered greater levels of mental health symptoms, perceived mental health needs, and campus-wide resources were available, undocumented students then had a greater likelihood of using on-campus mental health resources.[21] Further, a review by Butt in 2023 found that creating student organizations or support groups for undocumented students can help create a more welcoming and inclusive campus environment, thus making them more likely to seek help through on-campus services.[22] These changes can be especially important and impactful as it’s crucial to address one’s mental health struggles before they reach peak levels of distress. 

Undocumented students face numerous challenges while pursuing higher education, but continue to work towards their education since it can lead to significant benefits. A higher degree can lead to better-paying job opportunities and possible sponsorship for a long-term visa or permanent legal status. While a degree from a U.S. institution is recognized in many foreign countries, many undocumented immigrants who seek higher education in the U.S. have lived there for most of their lives and consider it their home. Therefore, as a society, it is beneficial to promote and foster good mental health resources for undocumented students as they often aspire to stay within the U.S. post-graduation to continue to improve their lives in the country they grew up in and feel a part of, while also “giving back” to the community they live in. 

Contributed by: Maria Karla Bermudez

Editor: Jennifer (Ghahari) Smith, Ph.D.

References

1 Butt, M., & Brehm, C. (2023). Seeking Access: Role Strain, Undocumented Students, and the Pursuit of College. The International Journal of Educational Organization and Leadership, 30(2), 67-86. https://doi.org/10.18848/2329-1656/CGP/v30i02/67-86

2 Who are undocumented students? - immigrants rising. Immigrants Rising. (2023, October). https://immigrantsrising.org/wp-content/uploads/Immigrants-Rising_Overview-of-Undocumented-Students.pdf 

3 Substance Abuse and Mental Health Services Administration. 2020. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health.” https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf.

4 Undocumented student frequently asked questions: Applying to the UW. Admissions. (n.d.). https://www.washington.edu/admissions/undocumented/undocumented-faq/#:~:text=There%20is%20no%20federal%20or,admissions%20criteria%20regardless%20of%20status 

5 Nienhusser, H. K., & Romandia, O. (2022). Undocumented college students' psychosocial well-being: A systematic review. Current opinion in psychology, 47, 101412. https://doi.org/10.1016/j.copsyc.2022.101412

6 Enriquez, Laura E. 2019. “Border Hopping Mexicans, Law-Abiding Asians, and Racialized Illegality: Analyzing Undocumented College Students’ Experiences through a Relational Lens.” Relational Formations of Race: Theory, Method and Practice. Edited by Natalia Molina, Daniel Martinez HoSang, and Ramón A. Gutiérrez. University of California Press.

7 Torres, A., Kenemore, J., & Benham, G. (2022). A Comparison of Psychological Stress and Sleep Problems in Undocumented Students, DACA Recipients, and U.S. Citizens. Journal of Immigrant and Minority Health, 24(4), 928-936. https://doi.org/10.1007/s10903-021-01315-3

8 Cadenas, G. A., Nienhusser, K., Sosa, R., & Moreno, O. (2022). Immigrant students' mental health and intent to persist in college: The role of undocufriendly campus climate. Cultural diversity & ethnic minority psychology, 10.1037/cdp0000564. Advance online publication. https://doi.org/10.1037/cdp0000564

9 Butt & Brehm (2023)

10 Cha BS, Enriquez LE, Ro A. Beyond access: Psychosocial barriers to undocumented students' use of mental health services. Soc Sci Med. 2019 Jul;233:193-200. doi: 10.1016/j.socscimed.2019.06.003. Epub 2019 Jun 5. PMID: 31212126.

11 Ibid.

12 Ibid.

13 Torres et al. (2022)

14 Steps to apply for DACA for the first time. IMMIGRANTS RISING. (2022, December 2). https://immigrantsrising.org/resource/steps-to-apply-for-daca-for-the-first-time/ 

15 Ibid.

16 Cha et al. (2019)

17 Torres et al. (2022)

18 Siemons R, et al. Coming of age on the margins: Mental health and wellbeing among Latino immigrant young adults eligible for Deferred Action for Childhood Arrivals (DACA). J Immigr Minor Health. 2017;19(3):543–51.

19 Cha et al. (2019)

20 Ayón C, Ellis BD, Hagan MJ, Enriquez LE, Offidani-Bertrand C. Mental health help-seeking among Latina/o/x undocumented college students. Cultur Divers Ethnic Minor Psychol. 2022 Dec 15. doi: 10.1037/cdp0000573. Epub ahead of print. PMID: 36521136.

21 Ibid.

22 Butt & Brehm (2023)

"I Don’t Remember Last Semester" - Examining the Normalcy of Blacking Out On College Campuses

A Truth of College Life

College life is often associated with memorable experiences and substance experimentation. However, an alarming phenomenon has taken root on college campuses: "blacking out." Miller et al. (2018) note that 49% of college students who drink experience alcohol-induced blackouts.[1] In a society where excessive alcohol consumption has become commonplace among college students, it is crucial to explore the associated underlying influences and mental health issues, in addition to spreading support to those affected.

Understanding Blacking Out

Blacking out refers to a state of temporary amnesia triggered by excessive alcohol consumption, in which memories from experiences of heavy alcohol consumption cannot be recovered. Binge drinking (i.e., excessive drinking in short periods of time) is as prevalent as alcohol-induced blackout experiences among college students.[2] This indicates the link between college cultures of normalized, excessive drinking and frequent blackout experiences. In her memoir, “Blackout: Remembering the Things I Drank to Forget,” University of Texas alumni Sarah Hepola shares that through her research and interactions with current college students, she discovered that blacking out is now considered more casual than it once was 40 years ago, when she was attending UT.[3] In many college cultures, blacking out is often perceived as an inevitable rite of passage, trivializing its potential dangers as it is employed through peer pressure or initiations, particularly in fraternities and sororities.[4]

The National Institute on Alcohol Abuse and Alcoholism (NIAA) notes that blackouts can be separated into two categories:[5]

1. Fragmentary Blackouts - Fragmented memories from events during alcohol consumption exist, but without the ability to connect them.

2. Complete Amnesia - Memories from events during alcohol consumption cannot be recovered.

It is crucial to differentiate between occasional alcohol-related memory lapses and chronic blackouts, which might indicate underlying alcohol use disorder (AUD). Identifying these distinctions early-on can significantly impact an individual's mental well-being and prevent future difficulties with alcohol addiction. It is also important to distinguish blacking out from passing out following alcohol consumption. While “passing out” is the loss of consciousness or falling asleep from excessive drinking, “blacking out” refers to the loss of memories and the inability to create new memories while in a state of excessive alcohol consumption.[6] While a person can blackout and subsequently pass out, it’s also possible to blackout while still remaining completely awake (but unaware).

Your Brain When You Blackout

The amount of alcohol that one's body can withstand depends on blood alcohol concentrations (BACs). The NIAA reports that BACs of about 0.16 percent (about twice the legal driving limit) and above can induce blackouts.[7] However, this value can vary and become lower among:[8]

• Those who consume anti-anxiety medications 

• Those who consume common anti-inflammatories (e.g., Advil/ibuprofen)

• Those who consume alcohol more frequently (indicative of a tolerance)

Many other substances like opioids and antidepressants, in combination with alcohol, can lessen the BAC threshold as well, increasing risks related to these drugs or medications (e.g., overdose or liver failure).[9]

This excessive amount of alcohol results in the temporary block of the transfer of memories, or memory consolidation, from short-term to long-term memory storage via brain structures including the hippocampus.[10,11] Specifically, blackouts lead to anterograde amnesia: the prevention of the formation or storage of new memories.[12] Banerjee (2014) notes that alcohol’s interaction with neurons in the brain leads to the enhancement of inhibitory neurotransmitters and pathways like GABA while lowering the function of excitatory neurotransmitters like glutamate.[13] Such processes lead to heavy intoxication symptoms of poor motor function, altered reward systems, slurred speech, impulsive behavior and poor memory.

From a long-term lens, Nunes et al. (2019) found that frequent blackouts and binge drinking can lead to degenerative and functional deficit trends in the brain through hippocampal and frontal brain damage.[14] Additionally, going to sleep intoxicated shortens the REM (Rapid Eye Movement) phase of sleep [15] which Peever & Fuller (2016) found is responsible for consolidating memories and information in the brain from that day.[16] Exacerbating the issue, this loss of REM sleep may contribute to both short-term and long-term memory/cognitive issues.[17]

Mental Health Consequences 

In addition to impacting cognitive functioning, blackouts inflict significant effects on one’s emotional well-being. Miller et al. (2020) found that in heavy-drinking college students, blackouts were related to increased symptoms of depression.[18] Further, students who experience blackouts may already struggle with anxiety and depression, and abuse alcohol as a coping tool. For example, alcohol can often be employed as a social anxiety “buffer”, as alcohol alleviates behavioral inhibitions.[19] In a survey of 772 college students by White et al. (2002), increased frequencies of blackouts were associated with lower grades, increased heavy drinking and increased frequencies of high-risk behaviors like vandalism.[20] College student blackouts can also impact many aspects of a young person's life including academics, physical health, depression and anxiety risk, memory and cognition, sexual assault risk, and even suicide.[21] 

Pertaining to the college cultures that promote the normalization of blackouts, Greek Life subpopulations are of particular interest. Turrisi et al. (2006) note that these organizations are linked to heavier alcohol consumption.[22] Further, Estaban et al. (2018) found that male fraternity engagement predicted high levels of binge drinking and other drug use in young adulthood as 45% of participants experienced alcohol use disorder (AUD) by age 35.[23] These rates were significantly higher when compared to non-fraternity-associated adults.[24] Additionally, as Cara Rosenbloom in The Washington Post (2019) remarks, eating disorder rates are increased for these college subgroups, and the term “drunkorexia” (purging before excessive alcohol consumption) has arisen on campuses.[25] This phenomenon has created tendencies of heavy and high-risk drinking to replace normal eating, particularly among women struggling with body image.[26] The lack of food in one’s system when consuming alcohol makes binge drinking even more dangerous, as it increases the rate of intoxication.

Shedding the Light on Blacking Out

Due to societal stigmas surrounding mental health, many students hesitate to seek help or support. Wombacher et al. (2019) add that most college students rationalize frequently blacking out while completely acknowledging that the habits are unhealthy.[27] It is crucial to normalize help-seeking behavior and offer accessible resources to those facing alcohol-related issues and potential mental health concerns. By promoting responsible drinking and educating students about the risks, universities can foster a safer environment conducive to positive mental health, both relevant to long and short-term life. Integrating mental health support into college curricula and readily available campus resources empowers students to address their concerns proactively.

Harm reduction approaches may target the engrained social norms on college campuses. In this way, resources may be provided to reduce high rates of negative consequences such as emergency room visits due to alcohol poisoning, anxiety and depression and dangerous behavior. Such educational approaches may spread information about:

• Substances to avoid combining with alcohol

• Ways to be mindful when partaking in alcohol consumption

• Safe sexual practices like consent

• Awareness to avoid situations of peer pressure

• Accessibility to counseling and medical care

• Bystander awareness training 

Additionally, student accessibility to forms of psychotherapy would lead to beneficial effects for students struggling with alcohol use. For example, Ehman & Gross (2019) found that Acceptance and Commitment Therapy (ACT), a modality used to focus on awareness of mental states and thoughts, in addition to Motivational Interviewing (MI), lead to reductions in alcohol consumption and less heavy drinking in college students.[28]

Blacking out might be perceived by many as an “ordinary part of college life”, but its implications on physical, mental and cognitive health require urgent attention. By raising awareness about the normalcy and consequences of blacking out, it is possible to dismantle the harmful aspects of social cultures that perpetuate this behavior. 

If one is experiencing excessive alcohol use, binge drinking, addiction, or blackouts that impair well-being and/or daily life, please reach out to a licensed mental health professional (e.g., a psychotherapist, psychologist or psychiatrist) for guidance and support.

Contributed by: Phoebe Elliott

Editor: Jennifer (Ghahari) Smith, Ph.D.

References

1 Miller, M. B., Merrill, J. E., DiBello, A. M., & Carey, K. B. (2018). Distinctions in Alcohol-Induced Memory Impairment: A Mixed Methods Study of En Bloc Versus Fragmentary Blackouts. Alcoholism, clinical and experimental research, 42(10), 2000–2010. https://doi.org/10.1111/acer.13850 

2 Juergens, J. (2023, April 17). Binge Drinking. AddictionCenter. https://www.addictioncenter.com/alcohol/binge-drinking/ 

3 Walsh, K. (2015, November 25). UT Unspoken: Students Reflect on Blackout Drinking Culture. The Daily Texan. https://thedailytexan.com/2015/11/25/ut-unspoken-students-reflect-on-blackout-drinking-culture/

4 Ibid. 

5 National Institute on Alcohol Abuse and Alcoholism. (2023 February). Alcohol’s Effects on Health: Research-Based Information on Drinking and its Impact. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/interrupted-memories-alcohol-induced-blackouts

6 Ibid.

7 Ibid. 

8 Ibid.

9 National Institute on Alcohol Abuse and Alcoholism. (2022, May 6). The Healthcare Professional’s Core Resource on Alcohol: Alcohol-Medication Interactions. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-medication-interactions-potentially-dangerous-mixes#:~:text=Nonsteroidal%20anti%2Dinflammatory%20drugs%20(NSAIDs,alcohol%20significantly%20increases%20the%20risk. 

10 Wetherill, R. R., & Fromme, K. (2016). Alcohol-Induced Blackouts: A Review of Recent Clinical Research with Practical Implications and Recommendations for Future Studies. Alcoholism, clinical and experimental research, 40(5), 922–935. https://doi.org/10.1111/acer.13051 

11 National Institute on Alcohol Abuse and Alcoholism

12 American Addiction Centers. (2023, July 12). Blackout Drunk: Signs, Causes, and Dangers of Blackout Drinking. https://americanaddictioncenters.org/alcoholism-treatment/blackout 

13 Banerjee N. (2014). Neurotransmitters in alcoholism: A review of neurobiological and genetic studies. Indian journal of human genetics, 20(1), 20–31. https://doi.org/10.4103/0971-6866.132750

14 Nunes, P. T., Kipp, B. T., Reitz, N. L., & Savage, L. M. (2019). Aging with alcohol-related brain damage: Critical brain circuits associated with cognitive dysfunction. International review of neurobiology, 148, 101–168. https://doi.org/10.1016/bs.irn.2019.09.002

15 Brower K. J. (2001). Alcohol's effects on sleep in alcoholics. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 25(2), 110–125.

16 Peever, J., & Fuller, P. M. (2016). Neuroscience: A Distributed Neural Network Controls REM Sleep. Current biology : CB, 26(1), R34–R35. https://doi.org/10.1016/j.cub.2015.11.011

17 Brower (2001)

18 Miller, M. B., DiBello, A. M., Merrill, J. E., Neighbors, C., & Carey, K. B. (2020). The role of alcohol-induced blackouts in symptoms of depression among young adults. Drug and alcohol dependence, 211, 108027. https://doi.org/10.1016/j.drugalcdep.2020.108027 

19 Locco, A. (2021, March 15). Alcohol and Blacking Out. Resurgence Behavioral Health. https://resurgencebehavioralhealth.com/blog/alcohol-blacking-out/ 

20 White, A. M., Jamieson-Drake, D. W., & Swartzwelder, H. S. (2002). Prevalence and correlates of alcohol-induced blackouts among college students: results of an e-mail survey. Journal of American college health : J of ACH, 51(3), 117–131. https://doi.org/10.1080/07448480209596339 

21 Juergens (2023)

22 Turrisi, R., Mallett, K. A., Mastroleo, N. R., & Larimer, M. E. (2006). Heavy Drinking in College Students: Who Is at Risk and What Is Being Done About It? The Journal of general psychology, 133(4), 401. https://doi.org/10.3200/GENP.133.4.401-420 

23 Esteban, S., Veliz, P., & Schulenberg, J. E. (2018). How collegiate fraternity and sorority involvement relates to substance use during young adulthood and substance use disorders in early midlife: A national longitudinal study. The Journal of adolescent health : Official publication of the Society for Adolescent Medicine, 62(3 Suppl), S35. https://doi.org/10.1016/j.jadohealth.2017.09.029

24 Ibid. 

25 Rosenbloom, C. (2019, March 11). New Concern on College Campuses: ‘Drunkorexia,’ a Combination Drinking and Eating Disorder. The Washington Post. https://www.washingtonpost.com/lifestyle/wellness/new-concern-on-college-campuses-drunkorexia-a-combination-drinking-and-eating-disorder/2019/03/08/093cf47c-4028-11e9-9361-301ffb5bd5e6_story.html 

26 Ibid.

27 Wombacher, K., Matig, J. J., Sheff, S. E., & Scott, A. M. (2019). "It Just Kind of Happens": College Students' Rationalizations for Blackout Drinking. Health communication, 34(1), 1–10. https://doi.org/10.1080/10410236.2017.1384351 

28 Ehman, A. C., & Gross, A. M. (2019). Acceptance and Commitment Therapy and Motivational Interviewing in the Treatment of Alcohol Use Disorder in a College Woman: A Case Study. Clinical Case Studies, 18(1), 36–53. https://doi.org/10.1177/1534650118804886

Stress Management for Students: Unveiling Coping Strategies & Creative Outlets

Adverse Effects of Stress

Stress is a feeling that most people experience at some point in their life. Students are especially prone to experiencing the negative effects of stress when they feel overworked, sleep deprived and overwhelmed. Symptoms of stress are demonstrated in our bodies, mental state, mood and behavior and have a prominent effect on our day-to-day lives. 

The Mayo Clinic notes that symptoms of stress can manifest in a variety of ways, such as:[1]

• Body - headache, fatigue, sleep problems

• Mood - anxiety, irritability, lack of focus/motivation, depression

• Behavior - over/undereating, angry outbursts, drug/alcohol misuse, social withdrawal 

It is important to be able to recognize the symptoms of stress in order to effectively manage the cause.[2] 

Common Stressors

Students encounter a number of ongoing stressors, which involve the typical day-to-day challenges they face. Both high school and college students commonly report experiencing continuous stress related to their education, specifically academic-related stress. Pascoe and Parker (2020) found that this stress stems from factors such as the pressure to achieve high grades and concerns about receiving poor marks.[3] A 2017 survey conducted by the Organisation for Economic Co-operation and Development (OECD) across 72 countries involving 540,000 student respondents aged 15-16 revealed that, on average, 66% of students feel stressed about receiving low grades and 59% worry that tests will be difficult. Additionally, the survey found that 55% of students experience high levels of anxiety regarding school testing, even when adequately prepared. Furthermore, 37% of students reported feeling “highly tense” while studying.[4] 

With the prominence of social media in the lives of today’s students, news and world events are more readily available, thus providing additional stress in the lives of students. Information about politics, school shootings, and war are readily available, adding additional stress in their lives as they perceive the world they live in as “unsafe.”[5] Additionally, media can push unhealthy and unrealistic body images as well as idealistic lifestyle expectations on young minds, warping their sense of reality and leaving them feeling inadequate in comparison. While it is important for students to be informed, today’s teens have much more information at their fingertips than ever before, thereby exacerbating their stress. Since the many pressures and events that incite feelings of stress often cannot be avoided, people engage in utilizing coping mechanisms; however, not all coping mechanisms are healthy.[6] 

Unhealthy Coping Methods

As stress levels continue to rise in student populations, a number of unhealthy coping mechanisms have become increasingly popular. Harvard Health (2012) notes that some common methods of dealing with stress involve doing activities that help one put aside their worries for some time (e.g., constantly sleeping, binge-watching television, alcohol consumption and taking illegal drugs.[7] New York University (2015) found that alcohol and marijuana were common relaxers utilized by students for temporary relief from the daily pressures in their lives.[8] Additionally, temporary relief tends to be found through over- or under-eating, smoking, and engaging in a whirlwind of social activities in an attempt to avoid facing their problems. Unfortunately, a buildup of stress can lead to a person lashing out at others and increased violent behavior. On the surface, these coping mechanisms may seem to offer relief; however, many of these actions are not effective at relieving pressure and can actually exacerbate the stress one already feels to a higher degree. Fortunately, there are a number of creative methods of coping with stress that have a positive effect on students.[9]

Effective and Creative Outlets

Art

Art can be used to mitigate feelings of stress and anxiety. Specifically, art therapy is a type of psychological intervention that utilizes various artistic mediums and the individual's creative expression to facilitate the therapeutic exploration and comprehension of emotions – ultimately resulting in the creation of artwork. It is both a natural and enjoyable way for students to manage their stress.[10] Research conducted by Zaidel (2014) on the influence of art and active creativity on the brain indicates that patients who engage in newly discovered creative outlets often experience elevated dopamine levels. Dopamine, a neurotransmitter frequently depleted in individuals suffering from anxiety, depression, and excessive stress, tends to increase through the practice of art therapy. As a result, art therapy emerges as a beneficial option for individuals dealing with high stress levels, as it can effectively raise dopamine levels and promote a sense of happiness and well-being in patients.[11]

Music

Another effective outlet for stress is music. Listening to music offers a stress-reducing effect by influencing both the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. A study published by the Cambridge University Press (2021) indicates that music demonstrated a decrease in cortisol levels (a well-known biomarker of stress) and a reduction in sympathetic activity (reflected in lower heart rate and blood pressure).[12] 

Different compositional elements of music (e.g., melody, rhythm, tonality and frequency) seem to influence individual relaxation responses. While most studies have used classical music, these effects have been observed across various music genres. High-frequency music, particularly at 528 Hz, appears to play a significant role in stress relief. Lata and Kourtesis (2021) note that music with this frequency can lower cortisol levels and increase oxytocin levels, regulating stress response and social bonding.[13] 

Meditation

Meditative practices can also relieve stress experienced by students. The Mayo Clinic describes meditation as a simple and inexpensive method of relaxation that doesn’t involve any materials or equipment to participate. Meditation is classified as a form of complementary medicine that involves the connection between the mind and body. By engaging in meditation, individuals can achieve a profound sense of relaxation and cultivate a calm state of mind.[14] During meditation, one directs their attention to clearing away the influx of chaotic thoughts that often clutter the mind and contribute to stress. This practice has the potential to improve both physical and emotional well-being, fostering a sense of overall balance and tranquility. Meditation can serve as a tool for relaxation and stress management by redirecting one’s focus towards calming elements. Through meditation, one can develop the ability to maintain inner peace and a centered state of mind.[15] 

Furthermore, the benefits of meditation extend beyond the duration of the practice, itself. It can help individuals navigate their daily lives with a greater sense of composure. Yoga is a well known form of meditation utilized to cultivate both physical flexibility and mental tranquility through a sequence of poses and controlled breathing exercises. By engaging in specific postures that demand balance and concentration, attention is redirected away from the demands of a stressful day and towards the present moment.[16]

Exercise

Medical professionals consistently encourage maintaining an active lifestyle as the positive effects of physical exercise have been widely recognized (e.g., improving physical health and combating illness). Exercise is also regarded as essential for preserving mental well-being and can alleviate stress. The Anxiety and Depression Association of America (2022) notes that exercise has significant efficacy in reducing fatigue, enhancing alertness and focus, and improving overall cognitive function.[17] This research is supported by a 2015 study conducted van der Zwan et al., which compared a number of stress intervention methods and indicated physical activity was effective in reducing stress in the sample group.[18] This can be particularly beneficial when stress has depleted one's energy or ability to concentrate. When stress impacts the brain, affecting its numerous neural connections, the rest of the body experiences the repercussions as well. Exercise and other forms of physical activity stimulate the production of endorphins(a natural pain-relieving chemical in the brain) and also contribute to improved sleep, subsequently reducing stress levels.[19]

Psychotherapy

If creative outlets for stress reduction are not enough to mitigate the extreme levels of stress one is experiencing, psychotherapy can be used alongside or in place of creative outlets for stress reduction. Psychotherapy, also known as talk therapy, encompasses a range of therapeutic approaches designed to assist individuals in recognizing and modifying distressing emotions, thoughts and behaviors.[20] People often turn to psychotherapy when coping with intense or prolonged stress caused by work or family circumstances, the bereavement of a loved one, or challenges within relationships or family dynamics. Various forms of psychotherapy and interventions have demonstrated efficacy in addressing mental health disorders. Frequently, the treatment approach is customized to suit the particular case someone is experiencing. This involves identifying techniques for managing stress and formulating targeted problem-solving strategies.[21] 

There are a number of evidence-based approaches in psychotherapy that aid in dealing with stress:

• Cognitive Behavioral Therapy (CBT)

• Acceptance and Commitment Therapy (ACT)

• Mindfulness-Based Stress Reduction (MBSR) 

Both CBT and ACT are evidence-based psychotherapies utilized to help people manage symptoms of stress. CBT places greater emphasis on modifying or rectifying one's negative thoughts in order to relieve distress while ACT focuses more on transforming the way our personal experiences (e.g. thoughts, emotions, memories, and physical reactions) function and increasing our psychological flexibility, so that they no longer have a hold on us.[22,23] MBSR utilizes meditation principles to assist individuals in developing a heightened awareness of the influence negative thoughts have on their physical sensations.[24]

While beneficial for students, any of the afore-mentioned creative outlets and therapies can be useful for the general population experiencing stress, as well.

If you or someone you know is experiencing extreme stress and/or anxiety, please reach out to a licensed mental health professional (e.g., a psychotherapist, psychologist or psychiatrist) for guidance and support.

Contributed by: Ananya Kumar

Editor: Jennifer (Ghahari) Smith, Ph.D.

References

1 Mayo Foundation for Medical Education and Research. (2021). How Stress Affects Your Body and Behavior. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987  

2 Ibid.

3 Michaela C. Pascoe, Sarah E. Hetrick & Alexandra G. Parker (2020) The impact of stress on students in secondary school and higher education, International Journal of Adolescence and Youth, 25:1, 104-112, DOI: 10.1080/02673843.2019.1596823

4 Ibid.

5 Simmons, A. (2019). As Teen Stress Increases, Teachers Look for Answers. Edutopia. https://www.edutopia.org/article/teen-stress-increases-teachers-look-answers/ 

6 Columbia University. (2021). Is social media threatening teens’ mental health and well-being? Columbia University Irving Medical Center. https://www.cuimc.columbia.edu/news/social-media-threatening-teens-mental-health-and-well-being 

7 The President and Fellows of Harvard College. (2012, August 4). Watch Out for Unhealthy Responses to Stress. Harvard Health. https://www.health.harvard.edu/healthbeat/watch-out-for-unhealthy-responses-to-stress 

8 New York University. (2015). NYU study examines top high school students’ stress and coping mechanisms. NYU. https://www.nyu.edu/about/news-publications/news/2015/august/nyu-study-examines-top-high-school-students-stress-and-coping-mechanisms.html

9 Harvard Health

10 Sage Neuroscience Center. (2021, July 27). How Art Can Help Relieve Stress. Sage Neuroscience Center. https://sageclinic.org/blog/art-relieve-stress/#:~:text=How%20Can%20Drawing%20and%20Painting,%2C%20depression%2C%20and%20excessive%20stress  

11 Zaidel DW. Creativity, brain, and art: biological and neurological considerations. Front Hum Neurosci. 2014 Jun 2;8:389. doi: 10.3389/fnhum.2014.00389. PMID: 24917807; PMCID: PMC4041074.

12 Lata, F., & Kourtesis, I. (2021). Listening to music as a stress management tool. European Psychiatry, 64(S1), S609-S609. doi:10.1192/j.eurpsy.2021.1621

13 Ibid.

14 Mayo Clinic. (2022). Meditation: A simple, fast way to reduce stress. Mayo Foundation for Medical Education and Research (MFMER). 

https://www.mayoclinic.org/tests-procedures/meditation/in-depth/meditation/art-20045858

15 Ibid.

16 Ibid.

17 Anxiety and Depression Association of America. (2022). Physical Activity Reduces Stress. ADAA. https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/physical-activity-reduces-st#:~:text=Exercise%20and%20other%20physical%20activity,your%20body%20to%20produce%20endorphins.

18 van der Zwan, J.E., de Vente, W., Huizink, A.C. et al. Physical Activity, Mindfulness Meditation, or Heart Rate Variability Biofeedback for Stress Reduction: A Randomized Controlled Trial. Appl Psychophysiol Biofeedback 40, 257–268 (2015). https://doi.org/10.1007/s10484-015-9293-x

19 Anxiety and Depression Association of America

20 U.S. Department of Health and Human Services. (2023). Psychotherapies. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/psychotherapies  

21 Ibid.

22 Guarna, J. (n.d.). Comparing ACT and CBT. Association for Contextual Behavioral Science. https://contextualscience.org/comparing_act_and_cbt#

23 Wersebe H, Lieb R, Meyer AH, Hofer P, Gloster AT. The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention. Int J Clin Health Psychol. 2018 Jan-Apr;18(1):60-68. doi: 10.1016/j.ijchp.2017.09.002. Epub 2017 Oct 17. PMID: 30487911; PMCID: PMC6220909.

24 Johns Hopkins Medicine. (2023) Stress Busters: 4 Integrative Treatments. The Johns Hopkins University. https://www.hopkinsmedicine.org/health/wellness-and-prevention/stress-busters-4-integrative-treatments