Emotional/Mental Health

Adjusting to College Life

For most freshmen, college life is unlike anything they have experienced before. No matter how comfortable a student may be moving away from home, transitioning to a new environment will undoubtedly cause stress. New independence comes with great responsibilities, such as learning to manage your time, taking care of your health, and meeting academic goals and financial needs. Among other things, students arriving at Princeton must usually cope with roommates, large and impersonal lectures, and exclusion from selective teams and clubs. It’s important to stay in touch with your emotions and know where to go for help if you feel overwhelmed. Counselors at University Health Services (UHS) are available for all students and provide support in helping you handle various emotions. Don’t hesitate to seek their help, even if you just want someone to talk to. First year students who have not developed close relationships with peers or other members of the community may find Counseling and Psychological Services especially helpful.

What can I do to ease my transition to college life?

Homesickness is common, but here are some tips to reduce the stress and anxiety accompanied with adjusting to a new environment:

  • Schedule time each week to talk with friends and family from home. This will give you an opportunity to share new experiences and concerns, and to learn what’s happening at home.
  • Have someone from home visit. Thinking about what you want to share with your visitor will help you understand what you like about college life.
  • Post pictures of home and people you care about around your room and share these memories with visitors. This is a good way to get to know people at school and possibly hear them voice their own concerns about living away from home.
  • Get a care package from home with food that reminds you of home.
  • Join a club or group with similar values and experiences. However, remember that interacting with students from diverse backgrounds is an important part of the college experience, too. 

Attention Deficit/Hyperactivity Disorder (ADHD)

ADHD is a mental health disorder that can cause difficulty focusing and sustaining attention, as well as hyperactive and impulsive behaviors.  These deficits cause substantial impairment in school or work, and can also impact interpersonal relationships.  A diagnosis of ADHD requires the presence of symptoms before the age of 12. If you suspect that you might have ADHD, you can complete a screening at CPS, pursue an evaluation with an outside mental health practitioner, or complete formal neuropsychological testing. Treatment for ADHD can include medication, therapy, or a referral to a learning specialist for executive functioning coaching. CPS can assist with referrals to all of these modalities. 


Everyone experiences anxiety now and again. Challenging situations naturally trigger fight-or-flight responses, such as rapid heartbeat, sweaty hands, cool extremities, and increased alertness. However, anxiety disorders cause more intense emotional and psychological discomfort. Sufferers feel helpless, and instead of coping and resolving tension naturally, they feel overwhelmed and think the worst possible things will happen. Anxiety is the largest mental health problem in the US.

What are the symptoms of anxiety disorder?

  • Headaches or muscle tension
  • Fatigue, trouble sleeping
  • Upset stomach
  • High blood pressure
  • Rapid heartbeat
  • Shortness of breath
  • Frustration
  • Depression, feelings of emptiness, low self-esteem
  • Irritability
  • Edginess
  • Difficulty concentrating
  • Racing thoughts or obsessions
  • Biting fingernails and scratching
  • Increased use of drugs or alcohol (unfortunately this may increase frequency and severity of panic attacks)
  • Accident-prone
  • Avoiding situations associated with panic attacks, leading to an increasingly restricted life
  • Feelings of bitterness
  • Nagging
  • Conflict
  • Avoidance

What causes anxiety disorder?

Anxiety disorder is frequently triggered by a sudden crisis or troubling event. Otherwise, the disorder may be caused by a more permanent aspect of life, such as:

  • Stress, especially long-term.
  • Pressure you place on yourself to reach personal goals.
  • Changes at home, school, or in your family.
  • Genetics or biological predisposition. People who have relatives with an anxiety disorder are more likely to develop one themselves. Studies suggest that those who suffer have a chemical imbalance in the brain, causing the fight-or-flight response to be out of order.
  • Personality traits. Certain qualities, such as low self-esteem and poor coping skills contribute to the development of anxiety problems.
  • Long-term abuse, violence, or poverty.
  • Drug use. Some people experience panic attacks after using caffeine or marijuana. Drastically reducing caffeine intake can have the same effect.

What’s the difference between everyday nerves and anxiety disorder?

Everyone experiences a little anxiety in stressful situations, like a first date, class presentation, or job interview. Such nerve-racking situations can cause sweaty palms, butterflies in the stomach, rapid heartbeat, and blushing. However, there is good reason for this nervousness which passes without serious physical or psychological consequences. Anxiety disorder, on the other hand, is a medical disorder that strikes without warning and can hinder daily activities. People who suffer anxiety disorder feel inexplicably overwhelmed by fear and physical distress. Efforts to reduce these symptoms often disrupt daily routines, and personal and business relationships.

What are the different types of anxiety disorders?

  • Generalized Anxiety Disorder: chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience. People with GAD constantly worry about all sorts of things and usually expect the worst.
  • Panic Disorder: frequent panic attacks characterized by a flood of physical and emotional sensations of fright, without apparent cause. You’re likely to suffer rapid heartbeat, chest pain, trouble breathing, and fear of going crazy or dying. Sensations can be so real you feel like you’re having a heart attack or some other medical emergency.
  • Obsessive-Compulsive Disorder: recurring irrational thoughts that cannot be controlled through reasoning. To make these unwanted thoughts go away, people with OCD engage in repetitive behavior, such as washing hands or counting. These actions can take up significant amounts of time and energy, disrupting daily life.
  • Post-Traumatic Stress Disorder: occurs in individuals who have survived extremely taxing and disturbing situations, such as warfare or abuse. They suffer recurrent memories of their ordeals through nightmares and flashbacks. When reminded of their traumas, patients experience extreme psychological and physical symptoms of anxiety. Other symptoms include a sense of numbness and detachment from the world.
  • Phobias: uncontrollable and irrational fears of certain objects, situations, or activities. Examples include fear of snakes, water, spiders, heights, or social events. These phobias can greatly restrict life as patients go to extreme lengths to avoid the situations that cause them fear.

How is anxiety treated?

  • Psychotherapy: along with medication, psychotherapy is the most common and effective treatment for anxiety disorder. Therapists provide clients an opportunity to talk about uncomfortable feelings, stay in touch with emotions, and learn how to reduce anxiety. By investigating the cause of anxiety, a client is better able to overcome his/her disorder.
  • Medication: Depending on the severity of the anxiety, medication is used in combination with psychotherapy. Drugs can offer effective, yet short-term relief from anxiety. The prescription depends on the type of anxiety.
  • Self-help: Most effective when accompanied by therapy, self-help techniques enable individuals to cope with anxiety problems through relaxing activities. Therapists will often suggest clients take up art, keep a journal, breathe deeply to relax, exercise regularly, or practice yoga.

What should I do if I have a panic attack?

  • Remember you’re not in danger.
  • Change your breathing patterns. You are probably breathing shallowly and fast, so slow down by taking long, deep breaths to get more oxygen in your blood.
  • Relax all your muscles. A good technique to accomplish this involves starting with the feet, tensing the muscles there and relaxing them, doing the same for each muscle all the way up to the face.
  • Imagine a peaceful setting, such as the beach or park.
  • Give yourself a simple task, like counting backwards from 100 by 3’s, to give your mind something else to focus on until the attack subsides.

Will anxiety disorders get worse if left untreated?

Unfortunately, yes. People who suffer from anxiety disorders often begin to fear panic attacks themselves, resulting in agoraphobia. Agoraphobics avoid situations they believe trigger panic attacks and from which escape would be difficult or embarrassing. This leads to an increasingly restricted life. For example, a person may refuse to go grocery shopping because she had a panic attack in the supermarket. Without treatment patients may enter a vicious cycle of increasing fear.


Grief is the normal response of sorrow, emotion and confusion that comes from losing someone or something important to you. It is a natural part of life.

Grief is a typical reaction to death, relationship break-up, failure to get into a coveted graduate school, job loss, a move away from friends and family, or loss of good health due to illness. The more significant the loss, and the more sudden, the more intense the grief. However, even subtle losses can lead to grief. For example, you might experience grief after moving away from home, graduating from college, changing jobs, selling your family home, having your best friends graduate and move away, an athlete who is injured and can’t play their sport.

How does grief feel?

Just after a death or loss, you may feel empty and numb, as if you are in shock. You may notice physical changes such as trembling, nausea, trouble breathing, muscle weakness, dry mouth, or trouble sleeping and eating. You may become angry — at a situation, a particular person, or just angry in general. Almost everyone in grief also experiences guilt. Guilt is often expressed as "I could have, I should have and I wish I would have" statements. People in grief may have strange dreams or nightmares, be absent-minded, withdraw socially, or lack the desire to return to classes or work. While these feelings and behaviors are normal during grief, they will pass. However, contact CPS at 609-258-3141 to speak with a counselor if your grief is interfering with your functioning.

How long does grief last?

There is no prescribed timeframe for the grieving process. For some people, grief lasts a few months. For others, grieving may take even longer. The length of time spent grieving is different for each person. There are many reasons for the differences, including personality, health, coping style, culture, family background, and life experiences — including past losses. The time spent grieving also depends on your relationship with the person lost and how prepared you were for the loss.

There is no right or wrong way to grieve.

Common symptoms of grief

While loss affects people in different ways, many people experience the following symptoms when they’re grieving. Just remember that almost anything that you experience in the first weeks and months following a death is normal — including feeling like you’re going crazy, feeling like you’re in a bad dream, reexamining your values and priorities, or questioning your religious beliefs.

  • Shock and disbelief — Right after a loss, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened or even deny the truth. If someone you love has died, you may keep expecting them to show up, even though you know they’re gone. Examples include: “But I just saw them.” “No, it could have happened to them.”
  • Sadness — Profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning or deep loneliness. You may also cry a lot or feel emotionally unstable.
  • Guilt — You may regret or feel guilty about things you did or didn’t say or do. You may also feel guilty about certain feelings (e.g., feeling relieved when the person died after a long, difficult illness). After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done.
  • Anger — Even if the loss was nobody’s fault, you may feel angry and resentful. This is very common if the death was by suicide. If you lost a loved one, you may be angry at yourself, God, the doctors or even the person who died for abandoning you. You may feel the need to blame someone for the injustice that was done to you. You may also feel angry at the deceased.
  • Fear — A significant loss can trigger a host of worries and fears. You may feel anxious, helpless or insecure. You may even have panic attacks. The death of a loved one can trigger fears about your own mortality, of facing life without that person, or the responsibilities you now face alone.
  • Physical symptoms — We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.

Coping with grief and loss, tip #1: Reach out to others

The most important factors in healing from loss are acknowledging your feelings and having the support of other people. Even if you aren’t comfortable talking about your feelings under normal circumstances, it’s important to express them when you’re grieving and this can include writing them out, which many people find very helpful. Sharing your loss with someone else makes the burden of grief easier to carry. Wherever the support comes from, accept it and do not grieve alone. Connecting to others will help you heal.

Finding support after a loss

  • Turn to friends and family members — Now is the time to lean on the people who care about you, even if you take pride in being strong and self-sufficient. Draw loved ones close, rather than avoiding them, and accept the assistance that’s offered. Oftentimes, people want to help but don’t know how, so tell them what you need — whether it’s a shoulder to cry on or help with funeral arrangements. Don’t worry about “making others feel sad” — sharing your thoughts and feelings is the #1 way to heal.
  • Draw comfort from your spiritual beliefs – If you are a person of faith, embrace the comfort its mourning rituals can provide. Spiritual activities that are meaningful to you can offer solace. The Office of Religious Life is a great resource.
  • Join a support group — Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can help. If you are interested in a grief support group, contact CPS at 609-258-3141 for information about on and off-campus groups.
  • Talk to a counselor – If your grief feels like too much to bear, contact CPS and speak with a counselor who can help you work through intense emotions and overcome obstacles to your grieving.

Coping with grief and loss tip #2: Take care of yourself

When you’re grieving, it’s more important than ever to take care of yourself. The stress of a major loss can quickly deplete your energy and emotional reserves. Looking after your physical and emotional needs will help you get through this difficult time.

  • Face your feelings — You can try to suppress your grief, but you can’t avoid it forever. In order to heal, you have to acknowledge the pain. Trying to avoid feelings of sadness and loss only prolongs the grieving process. Unresolved grief can also lead to complications such as depression, anxiety, substance abuse and health problems.
  • Express your feelings in a tangible or creative way — Write about your loss in a journal. If you’ve lost a loved one, write a letter saying the things you never got to say, make a scrapbook or photo album celebrating the person’s life, or get involved in a cause or organization that was important to them.
  • Look after your physical health — The mind and body are connected. When you feel good physically, you’ll also feel better emotionally. Combat stress and fatigue by getting enough sleep, eating right and exercising.
  • Don’t let anyone tell you how to feel, and don’t tell yourself how to feel, either — Your grief is your own, and no one else can tell you when it’s time to “move on” or “get over it.” Let yourself feel whatever you feel without embarrassment or judgment. It’s okay to be angry, to feel numb, or to cry or not to cry. It’s also okay to laugh, to find moments of joy and to let go when you’re ready.
  • Plan ahead for grief “triggers” — Anniversaries, holidays and milestones can reawaken memories and feelings. Be prepared for a reaction, and know that it’s completely normal. If you’re sharing a holiday or lifecycle event with other relatives, talk to them ahead of time about their expectations and agree on strategies to honor the person you loved.

When grief doesn’t go away

If you aren’t feeling better over time, or your grief is getting worse, it may be a sign that your grief has developed into a more serious problem, such as depression, especially if you are starting to have thoughts of death. Please contact CPS for support.

Adapted from the Hope College Counseling Center.


It’s normal to feel sad at times, but clinical depression is a serious disorder requiring treatment. You can’t just “snap out of” clinical depression – it’s an illness, not a sign of weakness. Depression is associated with reduced levels of the neurotransmitter serotonin, impairing the body’s ability to respond quickly to external situations. In other words, your brain cannot respond appropriately to information from the external world that unceasingly bombards the senses. Fortunately, antidepressant medication can restore chemical balance in the brain by raising the level of serotonin. Tackling the root of depression through medication and counseling is important for the well-being of the whole person. In fact, depression not only causes emotional changes, but also affects behavior, physical health and appearance, academic performance, social activity and the ability to handle everyday situations. Women are twice as likely as men to suffer depression.

What causes depression?

Not all causes of depression are known, but scientists generally agree that certain biological and environmental factors increase the likelihood of depression. Studies have shown that individuals with depressed family members are more likely to develop the disorder. Biological factors include personality traits, chemical imbalances in the brain, and changing hormone levels. You are more likely to suffer depression if you are pessimistic, have poor coping skills, or have low self-esteem.

Elements of your environment that may contribute to depression are difficult life events, such as divorce of your parents or death of a loved one, physical illness, and lack of support from friends and family. Although behavior patterns are usually a result of genetics and environment, they too can be considered causes of depression. Such behavior includes abusing alcohol or drugs and holding unrealistic expectations.

What are the symptoms of depression?

If you experience symptoms of depression for more than two weeks it’s very important to seek help.

  • Sadness or pessimism
  • Feelings of hopelessness or worthlessness
  • Irritability, anger, worry, agitation, anxiety, guilt
  • Recurring thoughts of death or suicide
  • Loss of energy, persistent lethargy
  • Headaches, digestive disorders, and chronic pains that don’t respond to medical treatment
  • Changes in appetite and sleep patterns
  • Impaired ability to concentrate, remember, or make decisions
  • Inability to take pleasure in former interests; social withdrawal
  • Using alcohol or drugs to “feel better”

What is manic-depression?

Also known as bi-polar disorder, manic depression is characterized by extreme changes in mood, thought, energy and behavior. It is more than just mood swings. Severe emotional changes can last for hours to months. Unlike people who suffer clinical depression, manic-depressives experience “highs” distinguished by periods of mania, which are intense bursts of energy or euphoria. In such a manic state, patients usually experience extreme optimism, self-confidence, aggression, and grandiose delusions. Thoughts race through their minds and they feel little need for sleep. They exhibit poor judgment, short attention spans, and risky behavior.

Manic depression usually appears during adolescence, but people of all ages can suffer from the disorder. Research has found that bi-polar disorder affects an equal number of men and women, and it’s found in all races, ethnic groups and social classes. Like clinical depression, bi-polar disorder often runs in families.

What is Seasonal Affective Disorder (SAD)?

Seasonal affective disorder is a form of depression that affects people during part of the year when they aren’t exposed to much daylight. A lack of light disturbs the neurotransmitter systems. Similar to other types of depression, SAD causes changed sleeping and eating patterns, loss of interest in sex, social withdrawal, pessimism, and inability to concentrate. Students who suffer SAD may notice a drop in grades during the winter. Therapy and medication used to treat ordinary depression works for SAD, but the most effective treatment plans address the root of the disorder by exposing the eyes to certain wavelengths of light.

What is the treatment for depression?

The most common and effective means for treatment is a combination of psychotherapy and medication. A good therapist can help you modify behavioral and emotional patterns that contribute to your illness. Medication improves your ability to cope with life’s problems and restores your sense of judgment. Some patients fear that using drugs will change their personality, but most people who take antidepressants find relief and “feel like themselves” again.

What can I do to relieve feelings of depression?

Many find exercise helpful in relieving depression. Others find help through laughter, perhaps from a funny movie, and hanging around people they like. Avoid pessimists who worry excessively. Participate in activities you enjoy, write a journal, and keep pictures of your favorite people with you. Bear in mind that clinical depression requires professional treatment, and these self-help tips may have limited effect on your mood if you suffer a chemical imbalance in the brain.

For tips on recognizing signs of mental health distress in a friend or peer, visit UMatter's website.

Navigating Identity


Romantic Relationships

Romantic relationships often get complicated, especially when young adults are still figuring out what they want from their partners and relationships. Explore and discover what qualities you value in others and don’t settle for a relationship with someone who does not exhibit the characteristics you find important. When you begin a committed relationship, no matter how much you love your partner, don’t let the relationship consume your individuality. The truth remains that relationships come and go. You don’t want to be left without a network of other relationships for support if your romantic life doesn’t go as planned. Don’t sacrifice friendships and interests to focus solely on your relationship with one person.

Romantic relationships don’t necessarily lead to sex. If you and your partner decide that having sex is right for you, make sure you both feel comfortable and that there won’t be any guilt or regret accompanying sexual acts.

Conflict is not necessarily bad. In fact, it provides an opportunity for the relationship to strengthen and deepen. By sharing fully and honestly the emotions that you feel about the relationship, you open yourself up, letting your partner get to know you better. Making yourself vulnerable can increase trust and confidence – qualities that are important foundations for a lasting relationship. If the conflict is resolved, you will have learned more about each other and how to maintain a relationship that suits you both. Unfortunately, not all conflicts can be solved through understanding and negotiation, and may lead to an end in the relationship.

Committed Relationships in College

One of the most important aspects of a college education occurs outside the classroom. The social development that results from interaction with peers and University employees will teach you a great deal about yourself and provide you with important social skills. Exploring and developing new relationships with other students may lead to romance. Having a partner can provide emotional support to help you deal with the stresses of college, but it’s also an added responsibility. Like studying or playing on a sports team, relationships require time and attention. You may experience conflict because you cannot spend as much time with your partner as you would like, especially during exam period. When such conflict arises, relationships may become confusing and frustrating, adding to the stress in your life. 
Obviously the focus of college life should be academic education, but not to the detriment of social connectedness. Students must find an appropriate balance between schoolwork and social life. Communicate what you are feeling to your partner, whether you are happy or upset, or seek change in the relationship. To overcome the obstacle of a busy schedule, set specific times to spend together and learn to say “no” to people who demand time that you have set aside to spend with your partner. You may enjoy doing necessary tasks together, such as studying, but this doesn’t fulfill the intimate time partners need to strengthen and maintain a relationship.

Long-Distance Relationships

Many students arrive at Princeton planning to continue romances from high school. Being away from yourpartner for extended periods of time can be difficult, but as long as you communicate openly with one another, the relationship can provide fulfillment and happiness. Don’t dismiss time spent apart as a meaningless interruption of your time spent together, but consider it an opportunity to learn about your partner from a different perspective. Emails, phone calls, and letters can reveal personal values and characteristics that are not apparent in face-to-face communication.

Although it’s important to schedule time for long distance communication, don’t let the relationship hinder social possibilities at school. Go to parties, study breaks, concerts, plays, movies, etc. Staying in at night to talk on the phone limits social development and you will likely regret not meeting more of your fellow Princetonians. Feel free to talk to others about your relationship. Friends, counselors, and RAs can provide valuable advice and support. Another emotional outlet that can help clear your head to allow you to fall asleep easier is writing letters or keeping a journal. Taking up a new hobby and making new friends can help pass the time until you see your boyfriend or girlfriend again.

Unhealthy Relationships

In order to maintain emotional health, it is important to avoid relationships that burden you with unnecessary stress. Here are some indicators of unhealthy relationships, whether romantic, friendly, or familial:

  • Lack of communication. You don’t listen to each other; you do not feel comfortable expressing emotions.
  • Physical abuse
  • Psychological manipulation
  • Possessiveness. At least one of you is jealous of the other spending time with friends and family.
  • Criticism, ridicule, and name calling
  • Lack of time spent together. The amount of time and attention needed to maintain a healthy relationship depends on the situation and level of commitment. Good communication is necessary to make sure each partner understands the time commitment expected by the other partner.
  • Exploitation. One partner controls the other’s material resources (money, car, etc.).

Living in a Dorm

Civil life in college dorms depends on the behavior of students. It’s a fairly unrestricted environment in which students should be considerate of the wishes and living habits of their neighbors and roommates. Whether you and your roommate get along or not, sharing a room with one of your peers can be a great experience. You have the chance to make a lifetime friend, to learn social skills, and to get to know someone from a different background. It’s natural for people living in close quarters to experience tension now and again. Learning to resolve conflict is an important social skill that will help bring you closer to those with whom you share relationships. Here are some tips to foster a comfortable living environment:

  • Set ground rules for drinking, smoking, bringing friends over, having people sleep in the room, sharing food and clothing, and watching TV. It’s important that you and your roommate understand and respect each other’s expectations for behavior in the room.
  • Be honest about what you do and do not feel comfortable with. Talking behind your roommate’s back can make the situation worse.
  • If you have concerns about the way people treat your living area, like students making noise or leaving messes, you should mention it to your neighbors who may have similar complaints. Discuss the problems with your RA or dorm representative who can post signs in the hallways or organize a dorm meeting.
  • Raise concerns by using “I” statements, instead of accusing your roommate of causing problems. Try to offer solutions, not just complaints.
  • Try to remain tolerant and respectful of different opinions and behaviors. This can make the dorm a comfortable living environment for everyone.
  • Share personal information with your roommate, such as preferences, characteristics, and quirks, so he/she will be able to read your emotional signals. 

Dealing with Problems at Home

Although you have had a chance to leave home and live differently at college, parents generally don't change much, or at all, while you are away. They continue their same old patterns of living and behaving in the same old environment. When you go home, you may find their behavior and the condition of your home more difficult to cope with than before, because you have had an opportunity to be away from it. A person will get very disappointed if he or she expects to get along with everyone in the family that historically doesn’t get along, just because it is the holiday season.

Breaks from college are supposed to be for recharging and relaxing. If visits home make you feel depressed and anxious, reconsider where you spend your time during these periods. Would it help to shorten your visit home and spend the rest of your vacation elsewhere? What would happen if you didn't go home at all for a break but made other plans? Would you feel better upon returning to college? More relaxed? Or, would you be worried about your parents back home? To help you make your decisions, make a list of pros and cons for visiting home. Make your own emotional health a priority. If you have to go home, talk to a counselor about it beforehand to help prepare you for the visit.

Many students make tough choices and choose alternatives to going home during breaks. Since many college residence halls are open through the holidays, staying in campus housing over vacation could be a good alternative. Working, studying abroad, going to summer school or getting an internship are some other ways to keep yourself occupied and away from long stays at home during your college years.

On- and Off-Campus Resources


Counseling & Psychological Services (CPS)

Mind-Body Programs

Sexual Harassment/Assault Resources & Education (SHARE) 


ULifeline: an anonymous, confidential, online resource center where you can find information for yourself or a friend, and use their self-evaluation to screen for common mental health concerns.