Emotional Well-Being

The key to a happy and healthy life

The years of adolescence and young adulthood are ones of upheaval, change, and growth. How you meet the challenges of these years will to some extent determine your future life. Learning the skills needed to handle emotional problems will give you a foundation of mental and emotional health.

Emotional health has many aspects. Put simply, it is based on self-esteem-how you feel about yourself-and behavior that is appropriate and healthy. Someone who is emotionally healthy:

Everyone, including people who are emotionally healthy, has problems. Emotionally healthy people are able to adjust to and solve problems, and in doing so they help others as well as themselves to get satisfaction out of life.

Joanne was having more headaches as the semester progressed. She had had occasional headaches before but now was having them almost every other day. They got worse whenever she had a run-in with her roommate or a deadline in class. Aspirin didn't help. Over the holiday break at home, her headaches disappeared. When she got back to college and the headaches resumed, she went to the medical center.

She thought she might be allergic to something at college or that she needed to have her eyes checked. The medical test results were normal, although the doctor found some spasm and tightness in her neck muscles. He suggested that she might be under stress and advised a program of muscle relaxation and time management. He also suggested ways she could work out some of the problems with her roommate. After applying some of the techniques she learned over the next few weeks, Joanne had fewer headaches and thought she was studying better.

This section focuses on common problems - stress, time management, anxiety, depression, anger, and thoughts of suicide - and ways to approach and solve these problems.

What is stress?

Stress is a mental, emotional, physical, and often behavioral response to a wide variety of stimulants. Contrary to popular belief, stress is not necessarily caused by an acutely upsetting event. The term actually refers to demands placed on you by everyday experiences that result in your body's arousing itself physiologically to meet those demands.

Stress is not innately negative or positive. What determines whether an event (stressor) is negative or positive is your interpretation. Facing three term paper deadlines in one week, for example, is not negative unless you interpret it that way. The significance of this point is that you can control your view of events, though not necessarily the events themselves, and thereby control stress. Stress demands, whatever their value, initiate an arousal of the mind and body. That arousal, if prolonged, can fatigue and harm an individual to the point of distress, dysfunction, and disease.

Take an analogy from physics and engineering. Stress in these fields means strain or pressure placed on a system. With some stress the system adapts or changes slightly, sometimes becoming stronger. With more stress, the system reaches the point where it will break. Human beings respond similarly.

Stress is an unavoidable part of living. To be alive is to experience the joys and frustrations of stress. Some stress is good for us, the so-called spice of life. Other stress, such as a poor grade on an exam, can be either harmful, if you interpret it in a strictly negative way, or useful, if it serves as an incentive for you to develop better study habits. Since stress is unavoidable, it's important to learn to live with it and make it work for you.

Many people mistakenly believe it is a sign of weakness or failure to admit that they experience stress. Problems develop when we don't recognize that stress is causing common difficulties and that it can successfully be managed.

Does everyone react to stress the same way?

There are great individual variations in how people perceive and respond to stress. Some people seem to thrive on deadlines; others get anxious. For instance, a deadline for a class assignment may help you organize a schedule to get the paper done. It may cause someone else to become upset, procrastinate, lose sleep worrying, and finally stay up all night trying to finish the project.

How the body and mind react to a given stressor is different for each person. Too much stress, however, clearly results in too much arousal and eventual dysfunction.

Stress is more than an isolated incident. It is the product of many aspects of your lifestyle and environment. To reduce or manage stress and its potentially detrimental effects, you can change many aspects of your lifestyle. You can do this by learning techniques to reduce external stress, to manage your own internal causes of stress, and to handle acute stress.

What are the dangers of not controlling stress?

Continued stress puts a burden on the body and the mind that can result in your not performing your best. If the stress goes unrecognized and unresolved, it can wear you out and cause various physical and emotional symptoms that you may blame on other sources. It can result in your becoming physically ill or even having an emotional breakdown.

Hans Selye, a Canadian scientist who is the father of stress research, theorized in the 1930s that the body adapts to stress in three stages:

  1. Alarm as the body is aroused
  2. Resistance as the body tries to adapt to continued stress
  3. Exhaustion as, with continuing stress, the body reaches the end of its abilities to handle stress

Because your body's ability to live with stress is not unlimited, there is a point at which you reach exhaustion. If your body cannot eliminate stress or manage it in a positive way, the system is overloaded and exhaustion is inevitable.

Whenever you experience a stressor, whether it is the physical stress of being caught in a blizzard or the emotional stress of breaking up with a close friend, your body unconsciously initiates an intricate set of physiological responses called the fight-or-flight reaction.

Our physiology hasn't changed much since prehistoric times, so the body's nervous system and hormones automatically gear up to fight or flee the approaching danger, although fighting or fleeing is not a useful response to most types of stress encountered today. If the body is not able to discharge the energy built up by this activation, or if stress continues past the initial alarm stage, you enter the resistance stage. Your mind and body remain aroused by stress.

At this stage you may recognize stress and its resultant emotional and physical arousal, but you may not connect it to physical illness or emotional changes. We adapt and get used to the state of arousal to the extent that it no longer feels unusual. Because our minds and bodies are so adaptable, hyperarousal is not recognized as a potential problem. We have lost the ability to recognize imbalance and restore balance until there is some recognized problem at the exhaustion stage, when the body sends a message of distress that our minds have been trying to deny or to cope with.

What makes college so stressful?

College is a unique environment that has its own built-in joys and stresses. It may be helpful to realize that there are new and more complex demands in college. Being aware of them can help you learn strategies to reduce them.

One prime stressor in college is the lack of time to accomplish everything you would like to do. Each professor seems to expect you to devote all your time to his or her class alone. You also have commitments to personal life, social events, and clubs or organizations to which you belong. Learning time-management skills can help you balance all your roles.

In college, competition is more intense than in high school. It seems to exist in all areas-for space in a popular course, for grades, for getting a desirable dorm room and a parking place, for getting dates-leaving you feeling overwhelmed. This generalized stress can make it difficult for you to perform effectively in your academic or social life. Look at your college or university and try to determine which competitive stressors are acting on you.

The living situation in many colleges creates a lot of stress. The housing is often crowded, noisy, with an inherent lack of privacy and uncomfortable chairs, desks, and beds. There are the expectations of friends, family, and hometown high school teachers and counselors to live up to. There may be the stress of being separated from family, home, and close friends you grew up with. There is usually a fair amount of financial pressure for college students, with limited economic resources for entertainment, transportation, and even food and books.

To meet academic demands, many students may start living a life of all work and no play. You may spend all your free time in the library, studying until later hours but not getting any better grades than do your friends who seem to party all the time. The fact is that without some breaks for relaxation and recreation, you do not study so effectively. Study breaks, whether they are fun distractions like going to a movie, a party, or a football game or going for a jog, are needed to get balance in your life. They will renew your enthusiasm for studying.

Social stressors are common in college. There is a natural desire to be accepted and liked by a new peer group. There may be pressure to conform in dress, attitudes, and activities. Concerns about rejection, failure, and inadequacy in a highly competitive environment are huge stressors.

The people staffing campus counseling centers are aware of these pressures and often have discussion groups or seminars on techniques to cope with the problems. They may target a certain group-for example, students with weak academic backgrounds. Sometimes summer programs are offered to bring them up to the expected academic levels.

The social stressors are more subtle and may best be managed by finding your own niche in college. Try not to pressure yourself by matching yourself against others' popularity, trendy clothes, and cars. These superficial measures tend to shift from one semester to another.

Another common source of stress is career anxiety. With competition in the workplace and in graduate schools, you may think that you don't have much time or flexibility to explore interests and get a broad education. If you're feeling pressured about choosing a major or career direction before you're ready, talking the matter over with your academic adviser or a peer counselor may help to relieve that stress.

Getting used to living in a new area, adjusting to a different climate, and learning your way around can be stressful as well as exciting. Going to college is an adventure and a challenge. Don't let the experience overwhelm you. Keep your priorities straight-staying healthy and getting a sound education are your primary goals.

How does my body react physically to stress?

Stress activates the nervous system and the endocrine, or hormonal, system for fight or flight. Its intended result is some form of physical action after which the body returns to balance. If a physical response does not occur or the cause of the stress is not removed, the nervous system will continue to be aroused. The nervous system releases adrenalin, which causes increased heart rate and blood pressure and a shift of the circulation away from the skin and the digestive system. The endocrine system is also activated and discharges hormones of stress, principally ACTH and corticosteroids. These hormones increase metabolic activity, protein mobilization from muscle, glucose formation, and fat mobilization.

How do stress reactions affect specific parts of my body?

If stimulation is prolonged, these high levels of stress-induced hormones and nervous system arousal induce changes in the following body systems:

The body's complex responses to meet the demands of stress are useful when a short-term physical reaction (such as dodging a speeding car) is needed. Our bodies are well adapted to handle stress if we then return to balance after mobilizing these physical reactions. After the stressful situation passes, we need to allow our body to return to its normal state of equilibrium-a condition known as homeostasis.

Does stress cause disease?

Although acute stress may not cause disease, it can increase your susceptibility to disease by decreasing your immune resistance. The trouble comes when arousal continues and your body does not return to its original state of balance. Diseases or symptoms associated with chronic unrelieved stress include hypertension, irritable bowel, eczema, coronary artery disease, headaches, ulcers, allergies, and asthma.

How can I tell if I am under stress?

You body or your emotions will very likely give you warning signs. If any of the following apply, you are experiencing stress.

  1. You are always rushed and cannot take enough time to do things well or to get everything done.
  2. You can't slow down and relax, even during vacations.
  3. You're irritable or moody, get angry, or cry for no obvious acute reason.
  4. You find it hard to concentrate or to pay attention.
  5. You don't follow through on what you would not have forgotten a few months before-remembering the deadline for a research paper or sending a birthday card to your best friend.
  6. You cannot seem to find time to do something you enjoy or to just relax.
  7. Your mind is usually racing or talking to itself. You are up to your neck in details and are constantly thinking of more things to do, which makes it hard to focus attention on the problems in front of you. You're not fully "there" when people talk to you.
  8. You have difficulty sleeping even when you're exhausted. Your mind is racing when you should be resting.
  9. You feel pressure and an urgency to be active and accomplish something almost all the time.
  10. You become irritated at the minor inconveniences of life, such as standing in line at the cafeteria, waiting for an elevator, or getting caught in traffic.

If these feelings are familiar, you are not alone. They are very common reactions that result when stress has not been resolved. They indicate that you may be suffering from stress and need to reconsider your attitudes and priorities.

I'm healthy, have good grades, and am getting along well with my parents and my friends. But I still experience the symptoms of stress. Why should I feel the effects of stress even though nothing bad is happening to me?

Stress can be subtle and unrecognized because most of us think of it in terms of something bad happening to us or a "failure" on our part to deal with some event. Remember, stress is not necessarily either good or bad. It just means that there are a great many demands on you and that your body is aroused to meet them. If there is no break or return to balance after an extended period of stress, the effects of the hyperaroused state are felt. Good things, just as easily as bad things, can trigger arousal.

Can I suffer from the stress of too many good things happening to me?

Yes. Say you just started college. Your first-quarter grades were excellent. You met someone new and have fallen madly in love. Your boss at your part-time job has praised your work, given you a raise, and asked you to work an extra day each week. The basketball coach is expecting to start you-the first time he has ever started a freshman.

It is no wonder that by the end of your second quarter your grades have slipped, you can't sleep at night, the coach has benched you because you're not playing well, your boss is ready to fire you because you are chronically late, and your girlfriend is mad at you because you don't pay enough attention to her.

Researchers have devised rating scales to help people recognize when accumulated stress is likely to reach the point of overload. The key factor seems to be the total number of demands (either good, bad, or neutral) that are occurring simultaneously, although serious problems or changes have higher stress rankings.

What are the major causes of stress?

There are a multitude of different causes of stress. Some are external factors that stem from our society, some are physiological, and some are based on individual personality.

What are some typical external stress factors?

External stress arises from the interaction between social factors and the way we react (or don't react) to them. Different individuals react differently to the sources of stress that are inherent in our environment. The obvious external stressors are urban crowding, noise and air pollution, the threat of nuclear war, and the high rate of social change. Because we very often believe we can do nothing about these stressors, we tend to disregard them or think they are not really affecting us when they are.

Social problems that produce stress and frustration are discrimination, economic conditions, and bureaucracy. Traffic jams, waiting in lines, competition for jobs, and anxieties on the job are all examples of social stressors.

What physiological stresses are most common?

Physiological causes of stress include diet, posture, ergonomics, heat or cold, noise, light, and pollution. A stress-prone diet is high in caffeine and sugar and low in vitamins. This can lead to jitteriness and difficulty in dealing with situations that would not normally be upsetting.

A room that is too cold or too hot, a jarring noise, a foul-smelling atmosphere-all lead to anxiety if the conditions persist.

Incorrect body posture can lead to chronically stiff muscles. Ergonomics is the science that is concerned with the physical relationship between your body and the machines or tools you use on a regular basis. Some examples are a typewriter or a computer, your desk and chair combination, and the seat in your automobile. Improper positioning of any of these can contribute to physical and mental stress.

Another physiological stress stems from the interaction of the environment with our own built-in biological rhythms-the times of day when we feel most awake and alert. Modern technology and classroom schedules may be imposed to create an artificial time and rhythm that may not synchronize with your own periods of alertness.

What's the link between personality and stress?

Much of the stress you experience is caused by your thought patterns and perceptions, which interpret and give meaning to events. The ways in which you think, your values, and your self-perception can increase or decrease your reaction to stressors. How you interpret events, and therefore experience them, is often determined by your personality. If you become aware of these thought patterns, you can work to reduce negative thought patterns and stress responses.

Sam's experience is an example of how internal thought patterns can create stress. Sam had just started dating a classmate and arranged to pick her up for a movie on Friday. Earlier in the week his roommate had agreed to lend him his car for the date. On Thursday his roommate reneged, saying that he needed the car on Friday night.

Sam began to think the evening would be a failure. He was trying to impress this woman, and now he had no transportation. He decided that therefore she would not like him. He called a few other friends, but no one could lend him a car. He was angry at his roommate and started thinking of ways to get back at him. He couldn't sleep Thursday night and on Friday afternoon was still trying to make arrangements for a car. By the time he arrived, without a car, to pick up his date, he was anxious, nervous, and convinced the evening would be unsuccessful.

Sam's negative self-talk created a great deal of stress for him over the relatively minor problem of not having a car. If Sam had a better self-image, he could have assumed the evening would be a success, with or without a car. He could have used a positive coping technique and gotten a better result by saying to himself, "It's not the end of the world that I can't borrow a car. We can leave a little early and walk to a nearby theater or go to a movie on campus, or we could go out to dinner near her house. I could take the bus over and back. I'll call her up and explain what happened and we'll make other plans together."

A positive self-perception gives you the feeling of being in control of yourself and the stressors that come along in everyday life. Developing a positive attitude toward yourself will help you manage stress.

Your personality type affects your reactions to stress. Researchers in the field of psychology have identified several personality types in American culture. The Type B personality tends to be relaxed, contemplative, and laid-back, while the Type A personality is likely to be rushed, aggressive, highly motivated, and involved in doing several things at once (see Chart 8.3).

Type A people react and behave in ways that probably are learned and can be unlearned to some degree. They tend to rush through life, sometimes in an aggressive manner that disregards and antagonizes other people. Some researchers have found that people with this personality type are more prone to heart attacks.

Another personality style is called anxious-reactive. People who are anxious-reactive, like Sam in the foregoing example, tend to think the worst in any situation no matter how trivial. Their reaction to a stressor is to worry, which creates more anxiety, leading to a chronic, persistent state of stress resulting from always anticipating, and preparing for, the worst. Their rationale is that they are ready for any calamity and then can relax when the catastrophe doesn't happen. The problem is that they are always under a heavy burden of stress, usually for trivial stressors.

Some people are prone to stress from the cumulative demands of home, college, and social commitments. Other people feel stress from being underinvolved, lonely, and bored. Clearly, both types of stressors can be controlled or even eliminated through recognition and effort on the part of the individual, although some students may need outside help to do that.

How can I tell Type A from Type B behavior?

Here are descriptions fo Type A and Type B behavior:


  1. Sharp, aggressive speech style
  2. Easily bored
  3. Eats, talks, and walks quickly
  4. Impatient with those who dawdle
  5. Does many things (for example, eats, shaves, and reads) at the same time
  6. Selfish; interested only in things that relate to him or her
  7. Feels guilty when relaxing
  8. Not observant of details
  9. Aims for things worth having, not things worth being
  10. Feels challenged by other Type A's
  11. Assertive, tense; leans forward in chairs
  12. Believes success comes from a fast pace
  13. Measures success mainly by numbers


  1. Not characterized by Type A traits
  2. Seldom feels time urgency but can be as ambitious as a Type A person
  3. Easygoing, not hostile
  4. Plays a game for fun, not just to win
  5. Can relax without guilt; can get as much work done as a Type A
  6. Often more efficient and succeeds because of steadiness and economy of movement

If I'm one of those Type A personalities, what can I do to reduce stress?

Much of the behavior that causes undue stress in Type A personalities can be changed to healthier behavior. A sense of urgency is one of the most common traits of a Type A personality and one of the most easily changed. Try the following techniques to help you relax and get your life under control:

  1. Decrease the pressure of always being in a rush by learning to organize your time. Allow more than enough time to get where you're going or to accomplish a particular goal, and enjoy the resulting relaxed confidence.
  2. Learn assertive instead of aggressive behavior.
  3. Recognize when you are doing two things at once. Type A people think this is efficient, but it is usually less efficient and often causes accidents and errors. Concentrate on one action at a time and do it well.
  4. Get up earlier in the morning. Your body and your mind will appreciate having enough time to do everything calmly.
  5. Don't waste time and energy by getting angry at things or people you have no control over and cannot change-such as a late plane or someone dawdling in front of you in line.
  6. Avoid confrontation with other Type A personalities. It can only serve to increase aggressiveness and competition. Spend more time with Type B people.
  7. Do something each day that slows you down and lets you relax-for example, listening to music for a half hour, reading a book purely for pleasure, or taking a leisurely walk away from crowds and traffic.

Is it normal to get nervous about taking tests?

Yes, taking a test makes almost everybody nervous. Some people are less anxious than others. The nervousness may be felt in a variety of ways, ranging from being unable to sleep or having an upset stomach the night before a test to having sweaty palms or being unable to concentrate on each question during a test.

If you are very nervous about taking tests and tend not to do well on tasks that involve memory and judgment, training your memory by using flashcards and other techniques can help you. If anxiety makes you procrastinate so that you have to cram for a test, see the section on tips for better time management. You are more likely to have test anxiety if you expect the worst and consider that single test a predictor of your entire college career. Try not to go through a negative mental scenario of failing the test, flunking the class, and being kicked out of college.

What can I do about test anxiety?

First, try not to think "catastrophe." It is more advantageous to use your energy to think positively and get your studying done. Many books are available on developing study skills. If you are having trouble organizing your time and studying effectively, we urge you to consult one of these books (see For Further Reading). If your major problem is nervousness about taking tests, here are several things you can do:

  1. Practice taking tests. There is an art to knowing how to take a test, whether it is multiple choice, essay, or open book. Many campuses offer classes in test-taking skills or have library sections with back tests available. Take advantage of these to test yourself on similar material in a nonstressful environment.
  2. Minimize distractions during a test. Wear comfortable clothing. Bring adequate pens and pencils. Focus your attention on the test instead of the random noise of students around you. If you feel the need for a break, close your eyes and practice a relaxation technique like deep breathing. Massage your closed eyes briefly before returning to the test.
  3. Avoid staying up the night before the test drinking coffee and taking No-Doz to do last-minute cramming. The extra caffeine will add to your stress and may make it more difficult to concentrate during the test.
  4. Go into the test expecting to do your best, and keep the consequences of not doing well on that one test in perspective. A single test score is not going to determine whether you succeed or fail in college.
  5. Train your memory with flashcards, word associations, and recall techniques.
  6. Prepare for the test throughout the natural course of the class. Mastering the content step by step assures you of a passing grade and gives you a good foundation for achieving a higher grade.
  7. Don't eat for an hour or two before the test. Food can make you feel sluggish by directing blood away from your brain to your digestive system. The added stress may give you indigestion, ruining both the meal and your test-taking abilities. Instead, take a brisk walk to increase circulation and alertness as you review the material in your mind.
  8. Relax.

If some stress is good for me, what is the right amount?

The goal is not to eliminate stress but rather to manage it at a level that allows you to function most effectively-to control stress instead of having it control you. Since there are positive aspects, you want to be able to use stress as a motivating force and avoid stress levels that interfere with your abilities. There is no precise recipe for the right amount of stress in your emotional diet. The stress that creates discomfort for one person may be the ideal motivator for another. What's important is to recognize your own needs and learn to manage stress in ways that benefit you.

There are various ways to deal with stress and make it work for you. While there is no single most effective method, some techniques work better than others. Definitely avoid quick-fix "solutions" such as overeating or using alcohol, sleeping pills, or tranquilizers. Any one of those may temporarily alleviate or mask stress, but they don't help you get to the root of the problem and usually create even more problems.

Caution: If you are having severe problems with stress or have had a recent major life change, we urge you to seek outside help. See a physician or a counselor. Don't wait to ask for help until you are desperate. Seeking professional counseling is a sign of your inner strength and motivation to make changes for the better.

Many people make the mistake of not asking for help until they are overwhelmed, saying they are too busy to do stress management and that it takes too much time. Stress management techniques do require time, but if you incorporate them into your day-to-day life, they can help you avoid crises. If you use stress management only during times of crisis, you may be missing many opportunities to subtly change elements in your personality that may be contributing greatly to your stress.

How can I manage general stress?

First, you must acquire an understanding of your own particular stressors and stress reactions. Once you recognize what causes your stress, you can develop coping strategies for situations you cannot avoid.

This section offers basic guidelines for handling common causes of stress on your own. Look at the external, physiological, and personality causes of stress described above to see which ones are particularly important to you. Also note what bodily symptoms or diseases you may have had in the past or have currently, as a gauge of how your body is affected by stress. Keeping a stress diary for a few days, in which you note when you felt stress, and what the symptoms were, will sometimes help you become more aware of your personal stressors and stress reactions, which, in turn, can help you decrease those factors and manage your own response to stress.

How can I reduce stress from my everyday life?

To reduce social stress from overload, frustration, and high rates of change, establish and maintain a daily routine. This can insulate you from, and minimize, some of this subtle, day-in-and-day-out stress. Set a regular schedule for getting up, studying, relaxing, working at a job, doing chores, eating, and sleeping. Before you go to bed, put out the clothes you want to wear the next day and place the books and materials you need for class near the door so that you won't be dashing around in the morning, rushed and anxious about forgetting something. Knowing you're prepared for the coming day will help you relax and sleep better.

A student's single most important responsibility is keeping up with course work. Set aside a part of each day for studying and completing assignments. Make it a reasonable amount of time-at least an hour or two that you never interrupt or change.

Establish set times for the chores that have to be done on a regular basis. For example, do your laundry every Saturday morning, if you know the laundry machines will be free. Then you won't be trying to get something washed at the last minute only to find all the machines are in use.

When parts of your routine become automatic, you will find that you use less energy and are less frustrated. This strategy will assure that needed studying and chores get done and will also reduce the anxiety and stress associated with trying to find time to do things or procrastinating until the last minute.

Use some part of your week as "stress reduction" or "mental health" time. Give yourself a morning, an afternoon, or an evening each week to do something you especially enjoy. This is a time to feel no pressure, to take a breather from the demands on you, to unwind and recharge. Use it for whatever relaxes and renews you.

The stress of overcommitment is epidemic among college students. You can sacrifice health, sleep, and social life and still end up doing a poor job because you are overextended. To avoid taking on more activities and duties than you can reasonably handle, try saying no to some of the demands on your time. Not every academic, extracurricular, social, or work activity is essential. You have the right to make responsible choices without apologies or excuses.

If you have trouble refusing requests or demands from others, you may want to look at books on assertiveness training. Many colleges offer classes in assertiveness training, which are designed to teach you ways to say no without making yourself uncomfortable or antagonizing others.

When you are on committees or involved in large-scale projects, delegate some of the work to others or divide a major project into manageable tasks and tackle them one at a time. In most cases this approach will also benefit the people working with you, as evidenced in the following example.

Elaine is an energetic, resourceful young woman, which is why she was elected chairwoman of her sorority's rush committee. But under the pressures of a heavy academic program and a part-time job, she began to feel overwhelmed by all the work she had taken on and would, it seemed, have to accomplish by herself. She was pretty resentful by the time she let the committee know what needed to be done and how overloaded she was. The committee members themselves had been feeling left out and were beginning to resent what they saw as Elaine's overbearing approach to her responsibilities. Once she acknowledged her need for help, the situation was defused. Elaine devised an overall schedule, and the committee members pitched in to handle individual tasks and duties. What had seemed an enormous burden for one person became a cooperative effort to which everyone on the committee was willing to contribute.

What can I do to manage other sources of stress in my everyday life?

To reduce physiological stress, be aware of your own biorhythms-for example, what time of day you are most alert, interested, and active. Most of us know instinctively whether we are night people or morning people. Try to schedule your classes around your biorhythm. Avoid a demanding early-morning class if you function best later in the day. Assign your most difficult tasks to your high-energy times and your repetitive chores or relaxation to your low-energy times.

Be aware that you, like most people, have a cyclic attention span that ranges from 90 to 120 minutes. When you sense your attention is decreasing during a study period, take a break-get up and stretch, walk around, drink water or fruit juice. Then return to studying when you are physiologically ready to pay attention. To use study time most productively, do your most difficult studying during the first part of the cycle.

When you are studying, be sure to use a chair that has support for your lower back and legs. Put your reading and writing materials at a comfortable level to avoid the muscle tension and headaches that can result from sitting hunched over for long periods. Poor posture creates unnecessary physical stress.

You may not have realized that there are substances in what you regularly eat and drink that produce dietary stress. Caffeine, a stimulant, mimics the effects of adrenaline, the principal neurotransmitter of the stress response. No-Doz and other stimulants like decongestants and diet pills stimulate the nervous system and add cumulatively to arousal.

There is also some evidence that a high sugar intake may increase stress, putting you on a blood sugar roller coaster-a quick surge of energy followed by an equally sudden drop in energy and a jittery, overstimulated sensation. Chronic dieting and fasting can also add to dietary stress by placing extra demands on your hormonal system to maintain body fuel levels in the face of inadequate food intake.

Some researchers believe that you need extra vitamins, particularly B vitamins, if you are experiencing increased stress-therefore the plethora of "stress" vitamins currently on the market. It is unlikely that with a healthy normal diet including breads, cereals, fruits, and vegetables, you would become deficient in vitamins. However, as insurance against vitamin deficiency, you may want to take a vitamin supplement - one that doesn't exceed 100 percent of the recommended daily allowance (RDA), information on the label of the vitamin preparation.

Can noise and traffic be a source of stress?

Noise is a source of subtle but very real stress. Exposure to high levels of acute or chronic noise is directly linked to learning and hearing problems, irritability, fatigue, and insomnia. Noise can stimulate the sympathetic nervous system, annoy, and disrupt concentration. Noise is capable of stimulating all the physiological changes of a generalized stress response. (For more information on noise and stress, see Environmental Health.)

You can easily reduce the noise level of your environment. You can study in the library. If you study in your dorm room, keep the radio, stereo, or TV turned off or at very low volume while you work. Use earplugs to reduce outside noise that you can't eliminate entirely. Work out a schedule with your roommates to have quiet times for studying and reading.

If you are going to a rock concert or a disco, take along earplugs to reduce the loudest noise. Many cases of permanent hearing loss have resulted from a few minutes of highly amplified music. Keep that in mind, too, when you play your radio or stereo.

Another source of stress is traffic. If you commute, heavy traffic and the demands of driving may be daily environmental stressors. To avoid the frustration and anxiety of traffic delays, allow more than enough time to get to the campus or your job. Try to beat rush-hour traffic by leaving home a little early. You can use the extra time on campus to study before class rather than after, exercise at the fitness center, do research at the library, or just relax.

My roommate always leaves our room a mess and I get stuck with cleaning it. Can I get her to do her share without starting a fight?

Definitely! Assertive behavior techniques will help you get what you want and need, without guilt or anger. Basically, assertiveness skills allow you to stand up for your own rights, to express your feelings honestly, and to avoid overcommitting yourself.

Assertive behavior is different from aggressive behavior, which often attacks and alienates others. Assertive behavior is also different from passive behavior, which allows others to take advantage of you and leads to your feeling resentful. You can use assertive behavior to ask for a change in your roommate's behavior. The following five steps can be applied to many situations:

1.         Summarize the situation and describe the behavior you want changed in specific, neutral terms. If you share a kitchen, say, "You've been leaving your dirty dishes around after meals. In particular, you didn't clean up after dinner last night." Don't use subjective or loaded statements like "You're such a slob, I don't know why I ever agreed to live with you." Limit your comments to the behavior you want changed, and you will have better luck than if you attack someone's personality.

2.         Explain how the person's behavior affects you. State your feelings as factually and honestly as possible. Use "I" statements. Don't overdramatize them or expand them to other areas of the relationship. You could say, "I like to have a clean house and it makes me angry to have dirty dishes around" or "It embarrasses me to come home with my date and have the kitchen full of dirty dishes." It is important to use an "I" statement as a way of acknowledging responsibility for your own feelings and avoiding an attack on the other person.

3.         Ask for a change in the behavior you're focusing on. "I'd like you to wash your dishes after every meal. I'll do the same." Keep the request straightforward and fair. Don't become global in your request and ask for changes that are peripheral to the one you want. For example, don't say to your roommate, "I expect to have the kitchen spotless after a meal and that you'll mop the floor every other week."

4.         Ask if the person is willing to do what you've asked. If not, move to step 5.

5.         If your roommate refuses to make a reasonable change, or agrees but doesn't actually do it, you will have to let the person know the consequences of that behavior. Remember, you are asking only for a behavior change, not attacking the person's character or personality. It would be legitimate to say something like "If you don't clean up your dishes, the next time I'm going to put them in a bag and leave them on your bed."

Once you start asserting yourself you will find that you are getting what you have a right to request. Assertive behavior can increase your self-confidence and eliminate the resentment you may feel at being taken advantage of.

How can I refuse other people's demands without making enemies?

A basic premise of assertiveness training is that you have a right to say no and not feel guilty. You do not have to meet everybody's needs or agree to help everyone who asks for your help. Saying no can be a great stress reducer by preventing your becoming overcommitted. Here, too, there are five points to remember:

  1. Saying no does not reject or put down the other person. It simply means you are refusing a specific request. You can keep the relationship with the other person and may say yes to requests in the future.
  2. When saying no, be brief and direct.
  3. Do not diminish your refusal with elaborate explanations or apologies. You can give a brief reason, such as "I'm really too busy this semester. Maybe next time." Excuses only provide the other person with ammunition for trying to make you change your mind.
  4. If you really mean to say no, stick to it. Don't be swayed or coerced by the other person, who may plead, compliment you, or make you feel guilty, particularly if you have been manipulated into saying yes in the past. Remember, although the other person has needs and wants, so do you. And you have a right not to meet all the needs of others. Your first obligation is to yourself.
  5. When saying no, use assertive body language. Make direct eye contact, speak clearly and distinctly, have good posture, and use appropriate gestures for emphasis. Avoid whining, slumping, and looking away.

Assertive behavior is a skill you can learn to help you get what you want and reduce stress. Assertive behavior is useful in other areas of your life (see chapters 7 and 10) and will improve communication and self-esteem. For further information, get in touch with your counseling center or health center to find out if there are classes on assertiveness training. Several books on the subject that you may find helpful are listed in For Further Reading.

What's the best way to avoid getting stressed over trivial things?

What may be as important as the stressors themselves are the ways in which you perceive them and how often your body calls physiological responses into play. If you get upset frequently about the common inconveniences of life - traffic on the way to the campus, long lines in the cafeteria, computer errors in registration - you are generating strong physiological reactions to relatively minor stimuli.

One way to deal with stress is to learn to recognize and change the way you think about certain things that cause you stress. The process has been called cognitive restructuring and personality engineering. The underlying premise of these techniques is that the way you think determines the way you feel. Thus, it is not the event itself that makes you tense but rather the way you perceive the event. If you can change the perception, you may experience less stress.

Take the example of giving a talk in front of class. For John, a theater major, it's an easy, enjoyable assignment. However, it is very stressful for Greg, who is a computer major with a slight stutter. John relishes the opportunity to talk in front of an audience. He has always been rewarded by his entertaining presentations and has learned to speak and perform effectively. Greg has given very few talks in class. In the past he did not prepare well, stumbled over notes, and stuttered. He thought he was a failure, and even the anticipation of speaking to an audience made him anxious and a little sick to his stomach. If Greg could change his perception about giving a talk, he could better control the situation and make it less stressful.

Taking the advice below would help him achieve that goal:

  1. Think positively by making a list of your good qualities and forgetting what you imagine are your bad qualities.
  2. To improve your confidence, remember all the times you did a good job.
  3. Visualize yourself in the stressful situation-acting calm, then feeling calm, then doing well. Rehearse the situation several times in your mind or in front of a mirror.
  4. Practice, practice, practice.
  5. Learn relaxation techniques to perform before giving the talk.

Another way to use cognitive restructuring is to listen to the self-talk you generate during a stressful encounter in order to determine how it produces stress. Once you recognize the negative self-talk, you can consciously change the way you have been defining the situation to yourself, so that it becomes less stressful.

For example, if you do not answer all the questions on a test, you might react by saying to yourself: "I'm really worried about not finishing the test. Now I'll probably flunk the test, then I'll get an F in the class, then I'll probably get kicked out of college." The test was a stressor, but your exaggerated negative self-talk magnified the stress and produced more. A better alternative is to think more positively and realistically and avoid seeing the situation as a catastrophe.

Try the following scenario: "Since even the best students make mistakes and do not always answer every question on a test, I probably did not do any worse than most of my classmates. I did as well as I could on the part of the test that I finished, and I think I did a very good job. Even if I didn't do great on this test, I'm fairly certain I passed it and will get a good grade in the course. I'm relieved that the final is over. I did a decent job and now I can relax before preparing for the next round of exams.

Is there anything I can do to feel less stress in social situations?

Negative self-talk is also common in social situations. For example, you are walking on campus and see someone you're interested in dating coming toward you, but the person is with someone else and pays no attention to you as they walk by. Do you think: "She (or he) really cut me, didn't even notice I exist, and probably wouldn't want to go out with me. I just don't have what it takes to be popular; no one wants to go out with me; I'll never have any dates."

Or do you think: "Too bad Jane (or Joe) was so engrossed in conversation that I didn't get a chance to say hello. Well, we'll see each other later this week. Maybe we can get together to study or go out."

Negative self-talk can become an automatic habitual response that often arises from a negative self-concept and reinforces it through repetition, causing more stress. Listen to your self-talk during a stressful social event. Do you pep yourself up and encourage yourself, or do you put yourself down? Rewrite your internal scripts to be positive. The next time you walk into a party and have that moment of panic when you can't find a familiar face in the crowd, try not to say to yourself: "What a disaster! I don't know anyone and no one is going to come over and talk to me." Instead, rewrite that internal script in a positive tone-for example: "I didn't realize there were so many interesting-looking people on campus I've not met. This is a great chance to get to know some of them. I'll start by introducing myself to the two people standing near the food table. One of them looks familiar, maybe from choral tryouts."

Maintaining what is commonly referred to as a positive mental attitude (PMA) can greatly reduce stress and build self-confidence. Try to focus on the positive aspects of every situation.

Is physical exercise a good stress reducer?

Yes! Your body is made for physical activity. The fight-or-flight response to stress, which was mentioned earlier in the chapter, prepares you for motion. Exercising is an effective way of releasing the energy generated by stress, which is far healthier than letting it build up inside and create uncomfortable pressure. Exercise of any type releases the excess adrenalin generated by the stress response. Exercise also generates endorphins, natural pain relievers and euphoric chemicals that help you feel relaxed and energized after a workout.

Many people use exercise as their primary stress reducer. Aerobic exercise for 20 or more minutes a day seems to be the most helpful in discharging the stress response. Dancing, weight lifting, and walking can also work if you enjoy them.

What other stress-reducing relaxation techniques do you recommend?

The following stress-reducing techniques will help you feel better by inducing a state of relaxation. They work best when practiced daily and in conjunction with the strategies, mentioned in the preceding pages, to decrease the cause of stress. The exercises can be done independently, with a counselor trained in using them, or with a group of people in an organized class. The more you use them, the better they will work for you.

Controlled breathing. Breathing techniques and exercises have been used for centuries to calm and center the body. When you are under stress, your breathing tends to become shallow and your muscles tighten. At such times you often use only the upper third of the chest muscles and some neck muscles to breathe with. By breathing deeply from your diaphragm, you lessen muscle tension and reduce body arousal.

To do diaphragmatic breathing, sit or lie down and make yourself comfortable. Wear loose clothing. Place one hand on your abdomen around the area of your belly button. Feel your hand rise and fall as you breathe in and out. Try different ways of breathing until you get the sensation of your hand rising as you breathe in. Don't force it or you will tighten up.

Breathing deeply will slow down your breathing and relax the neck and chest muscles. Identify one area of your body that feels tense. When you inhale, mentally send the breath to the tense area. Imagine the tight muscle in the area relaxing and being massaged by the breath. Imagine that muscle being warmed and loosened. This isn't the heat generated by physical activity but rather the internal warmth that comes from letting a taut muscle relax.

Practice this type of breathing several times a day. It will remind you to relax and slow down. After practicing it for a while, you will automatically use diaphragmatic breathing as a response to a stressful situation, and instead of tensing your chest and neck muscles, you will be more relaxed.

Progressive muscle relaxation. This technique involves first tightening muscles that are stiff and then relaxing them. It is useful for people who have headaches, neck strain, and backache and tense their muscles as a reflex response to stressful situations.

Lie or sit comfortably and close your eyes. First, pull up your toes and tighten the anterior (front) leg muscles for 5 to 10 seconds; then let go and relax for 10 to 20 seconds. Take a deep breath, feeling the tension and tightness leave your body. Notice the difference between the sensation of tightening and relaxing. You can apply this procedure to all your muscle groups or use it just for those that are tight. This is a good technique to use if your neck muscles tighten while you are studying.

Other relaxation techniques.Some other relaxation techniques you may want to investigate are yoga, self-hypnosis, biofeedback, and meditation. There are a number of books available that describe those disciplines in detail. Many colleges and communities offer classes in these techniques.

I never seem to have enough time to complete even the regular projects I am assigned, let alone take on extracurricular activities. What do you recommend I do?

Since we can't give you more hours in the day, how about some tips on ways to manage the time you have? Learning to manage your time will result in less wasted time, less anxiety, and more productive use of your time. Simple time-management skills are easy to recognize but sometimes hard to put into practice. Old habits of wasting time and procrastinating die hard. Managing time effectively means putting aside unnecessary tasks and focusing on the important ones.

Most of us spend the highest percentage of our time on the small, everyday jobs that take a lot of energy and time but do not accomplish much. If we could learn how to get the big jobs done and then use leftover time for the small, nagging chores of daily life, we would be better managers of our time. The problem is that the big jobs often seem overwhelming, so we are likely to do the easily accomplished tasks first.

For example, Sue's term paper for her political science course was assigned at the beginning of the semester. She had due dates for submitting an outline, listing references, interviewing subjects, and editing the interviews and then a final due date for the paper.

As each deadline approached, she stayed up late to complete the assignment. She felt anxious and rushed and dreaded the whole process. And she had other deadlines creeping up, such as finding a job for the summer and getting work done for her other courses. After one particularly hectic week, she compared what she needed to accomplish with what she had actually done all week. Although she had been incredibly busy, she really hadn't accomplished much toward her big goals.

One way of handling time better is to set priorities and devote 80 percent of your waking time to completing the tasks you've identified as most important. You can start the process by making a daily To Do list and assigning each item on your list a priority ranking-A for what must be started immediately and accomplished as soon as possible, B for less essential tasks, and C for anything that can be done in the future or, perhaps, not at all. Then block out most of your time to work on the A items.

Be realistic when assigning priorities. You should have only 1 to 4 A items, 1 to 6 B items, and no more than 12 or so C items. Over the course of time you'll find that some of your B and C items will move into the A category, and others will be dropped for lack of time, interest, or urgency.

Sue's priority list would look like this:

A Start writing poly sci paper
A Get in touch with placement center about summer job
B Get notes for class missed last week
B Study for quiz in history
B Pay bills
B Return sweater to Joan
C Do laundry
C Check with Angela about ride to game on Saturday
C Clean apartment
C Call Cindy about her new boyfriend

Try making your own priority list, but beware of making it too long and all-inclusive. And don't let list making become an excuse for time wasting. Remember, the goal is to spend about 80 percent of your time on A items and the rest of the time on Bs and as many of the Cs as you can get to. You may find that a lot of the C items tend to take care of themselves. Either they no longer need to be done, or they get done in the course of a normal day. Don't let yourself be lured into taking care of C items first just because they're usually the easiest to tackle.

Because A tasks often seem so big and overwhelming, it's tempting to delay starting them. One trick for handling them is to break them down into smaller parts that can be more easily accomplished. For Sue that might mean dividing the poly sci paper assignment as follows:

By breaking down the big A task into small, manageable jobs, Sue can set a schedule and meet her deadlines with a sense of accomplishment. Now the paper does not seem so overwhelming.

Procrastination - putting off tasks until the last moment - is, paradoxically, a problem that often affects people who expect themselves to be perfect. They delay because of the fear of failing and therefore of being imperfect. Perfectionists are often poor managers of time. They have a great deal of self-induced pressure to succeed, and their expectations are unrealistically high. Putting things off until the last moment is a way of explaining or rationalizing doing something less than perfectly.

If you could use time-management skills (and who couldn't?), start with the following suggestions:

  1. Set aside 10 minutes - no more - each day to organize your time: make your daily list and set priorities.
  2.   Recognize your peak productive times and schedule your difficult tasks for those periods.
  3. Have all your materials ready in a clean, well-organized study area. (But don't spend a half hour each day straightening things; that is a time waster.)
  4. Do only one thing at a time, concentrate on it, and stay with it until you have finished it.
  5. Reduce time wasters as soon as you identify them. For example, limit telephone calls to 5 minutes when you are working and avoid socializing in the library.
  6. Take reasonable breaks to reenergize yourself and refocus. your concentration. If you find your mind wandering, spend a few minutes doing something related to another A priority item.
  7. Reward yourself when you do accomplish all or part of the A items. Enjoy crossing the items off your list. Have a frozen yogurt or go out for a pizza.
  8. Lump together as many activities as possible. For example, Sue could get the tapes she needed at the same time she bought a book for her American lit course, instead of making a separate trip.
  9. Learn to say no to inappropriate requests and time-consuming errands.

There are many resources for learning time-management skills. Perhaps your campus offers a seminar. There are several books on the subject (see For Further Reading).

Managing stress and making the best use of time are only some of the skills needed for happiness and emotional health. In the following section interpersonal problems commonly faced in college and the development of skills for dealing with them are discussed.

My boyfriend has bouts of uncontrollable anger that frighten me. What can he do, and is there anything I can do to help him?

Anger is a difficult emotion to deal with because it is hard to express, can be overwhelming, and has serious consequences. If there is a history in his family of abuse or violence, or if he has ever physically assaulted someone, he probably needs professional counseling to help him handle the anger. The problem may be more than even a very caring friend can help him overcome. And if there is any chance of danger to you, your first responsibility is to protect yourself. It would be a good idea to get in touch with the campus counseling center for advice.

If there are no obvious danger signs in his anger, it may be something you can talk about with him when he is not angry. In a nonjudgmental way, tell him what you've noticed and the effect it is having on you. Encourage him to talk about what is making him so angry.

Anger is a common emotion that we have all felt at times, particularly when we are frustrated or hurt. It may be a form of self-defense or a symptom of self-destructive behavior.

If alcohol or other drugs are involved in his fits of anger, it makes sense to point out the correlation and urge him to stop the use or get help. But remember, you can't solve the problem for your friend. He has to acknowledge the source of the problem and make a commitment to overcome it.

If the source of his anger seems to be frustration, encouraging him to examine the frustration and reassess his goals may be helpful. Is the frustration realistic? Is it worth getting angry about? Is he asking for something that he can't get? Is there a better way to have his needs met? If he is a highly competitive person, he may find an effective physical outlet in noncombative situations such as sports.

Disagreements and arguments are part of the give and take in most relationships. It's natural to feel anger under certain circumstances, and there are appropriate ways to express that anger (see the discussion of assertive behavior above). It is important not to let anger build up over time.

Let your boyfriend or girlfriend know it is all right with you if he or she tells you what is upsetting at the time it first occurs. Don't bring up the past; just stick to the current disagreement. Deal with the upset, and try to view it as a problem to be solved. Don't attack each other.

I get depressed sometimes, usually because of a bad grade or because someone I like doesn't like me. How can I handle this?

Nearly everyone gets depressed sometimes. Part of being human is experiencing times when not everything is going your way. It does not mean that you are mentally ill or that you necessarily need to see a counselor or a physician. It may help to talk to a close friend and to give yourself a special treat. It's important to take care of yourself physically during these times. Get plenty of rest and eat properly. When you are depressed, your immune systems seem to be depressed as well, and you may find yourself more susceptible to colds and the flu.

Keep in mind that your depression is a temporary state. Spend some time at your favorite activity or hobby to see if that helps. Maintain your appearance and enhance it by wearing your favorite clothes. Some people find exercise beneficial in dealing with mild depression.

Isolation and withdrawing from friends is often part of depression. Because you don't feel good about yourself, you assume that others don't like you either. The isolation worsens the depression and you lose the positive feedback you get from friends and family.

Stay in touch with friends and get involved in activities even though you're feeling low. Try not to dwell on the problem that is causing you to be depressed, and move on with your life. You always feel as if depression will go on forever, so you may have to keep reminding yourself that you'll feel better soon. And you will!

My roommate is very depressed about her parents' divorce but won't talk to anyone about it. How can I help?

It is important to get someone who is severely depressed to see a counselor or physician. Sometimes depression is overwhelming and immobilizing. This usually happens when there is an extreme reaction to a specific emotional blow, such as a divorce, the death of a loved one, or a severe financial loss.

One of the characteristics of depression is that it can intensify and result in a depressive cycle. The sadness, hopelessness, loss of interest, or grief leads the depressed person to withdraw and become socially isolated. These persons may stop doing the things that would normally distract them, keep them busy, or provide them pleasure. They may lose touch with their usual coping skills and develop even deeper feelings of worthlessness and hopelessness. Outside help may be needed to break the cycle, but often these victims of depression believe themselves to be unworthy of help or friendship.

Physical symptoms often associated with depression include loss of appetite, weight loss, constipation, difficulty in sleeping, fatigue, headache, and loss of interest in sex. Sometimes depressed persons recognize only the physical symptoms and not their underlying depression.

Depression can be a factor in eating disorders and drug abuse. Psychologists say that people use food or drugs to self-treat the underlying depression.

Severe depression can also be the result of a medical problem - a hormonal imbalance or thyroid disease. Medications such as sleeping pills, antihypertensives, and oral contraceptives can cause depression, as can withdrawal from drugs like alcohol, cocaine, barbiturates, and stimulants. Once a medical problem is ruled out, counseling and possibly medication will probably be recommended. This treatment is usually successful.

Occasionally I've thought of committing suicide. What should I do when I feel like that?

Many people have thought about committing suicide at one time or another. If you have any inclination to carry out this idea, or if your thoughts are more than just passing, you should immediately seek help from a physician or a mental health crisis center. Most campuses and hospitals have 24-hour help-lines for crisis intervention.

People trained in suicide prevention are available to talk to you, help you through the rough times, and plan for your getting further help. The number of the local helpline should be listed in the directory of emergency telephone numbers.

If you are contemplating suicide to get back at someone, remember that you are not going to be around to enjoy your revenge. Virtually all problems are temporary, but suicide is permanent-an irrevocable action. It is not a solution.

Does thinking about suicide mean I'm crazy?

No. Thoughts of "ending it all" or "wishing I were dead" are not uncommon. Many of us at one time or another joke or think about suicide. When the crisis or depression passes, or we've gotten help for the problem, we realize that suicide is not the answer.

One of the guys in our dorm tried to commit suicide when he didn't get into graduate school. The paramedics saved him. Why would anyone do something like that?

People who consider suicide are overwhelmed by emotional or psychological pain. They often become isolated and consumed by feelings of loss, failure, or hopelessness. Suicide can seem like an option for them to end the pain or escape the situation. They lose sight of their own good points and the ways in which they can help themselves escape pain and depression. They may turn away from friends and family, worsening their sense of isolation and worthlessness. They deny themselves the social contacts that let them know they are valued and loved even when they are having problems. They may use alcohol or other drugs, which worsen depression and lead to further irrational and impulsive thinking. They lose touch with their usual problem-solving skills.

They don't see that the pain and the crisis are often temporary and might end. For a person in a state of withdrawal and hopelessness, suicide may be a last-ditch attempt to get rid of pain, grief, loneliness, or guilt. It may also be a desperate effort to communicate with someone loved or important in the person's life.

What we have given are generalities. The reasons your friend tried to commit suicide may be very complex and even unknown to him, particularly if he is depressed and is not thinking clearly. With professional help he will better understand the reasons and will be able to communicate more directly with those people important in his life, and he will learn other ways to deal with depression.

How do you act toward someone who's recovering from a suicide attempt? No one knows quite what to say.

Most people who attempt suicide do not want to die. They want to be heard and helped through their pain. But often they don't know how to get help or are not thinking rationally. Persons contemplating or acting out suicide are speaking in a different language. Instead of "Hey, I need to talk to someone because I hurt and need help," they say, "I wish I was dead."

Someone recovering from a suicide attempt may be embarrassed and unable to explain his actions to you. The important thing is for you to be honest and express your concern, to be nonjudgmental, and to let him know that people care.

You might say, "I heard you've been having a rough time. I'm sorry I didn't know you were having trouble, but I'm glad you're OK. You have a lot of friends here in the dorm who care about you. Do you feel like talking about things?"

If it is natural and appropriate, invite him to join you in some group activities. Commiserate about the difficulties of getting into graduate school, but put it in perspective with the reminder that there are other graduate schools and that he has a lot going for him even if he didn't get into a particular school. Treat him the way you would want to be treated if you had just had a terrible loss and needed support. After the crisis of the suicide attempt has passed, the person can usually get on with life, particularly if the pain was heard and understood.

Encourage him to talk if he feels like it, and encourage him to stay in touch with professional counselors. Let him know he can call on you if he feels really down again, at any time of the day or night. For your own information, find out your local helpline telephone number in case you come up against a situation you are not able to handle.

My roommate took an overdose of aspirin one night and had to be taken to the emergency room for treatment. When she was released, the doctor said that she hadn't taken enough to kill herself and called it a suicide gesture. What is that?

Suicide attempts, or so-called suicide gestures, are more serious than are passing thoughts of ending it all. Every year 50,000 persons between the ages of 15 and 24 make a recognized attempt to commit suicide. One in ten is successful. Currently, suicide, after accidents and homicide, is the third leading cause of death in the 15-to-24-year-old age bracket.

Many suicides or suicide attempts may go unrecognized as the motive behind car or motorcycle accidents, drownings, and drug overdoses. Any suicide gesture should be taken very seriously and treated as an emergency. There should be follow-up psychiatric care to help the person understand and deal with the feelings that led to her attempted overdose.

Are there warning signs that someone may be at risk for suicide?

Yes! Most suicidal behavior is a desperate cry for help. Recognizing warning signs and getting someone to go for professional help is the key to preventing suicide.

People contemplating suicide may exhibit one or more of the following warning signs:

Some people commit suicide without giving clues. Become aware of the danger signs in friends. Listen with a third ear to hear the clues. Your active listening and willingness to listen may help a friend pass safely through a crisis.

People who have not developed a firm concept of self-worth may be prone to suicide. They may not have worked out their own problem-solving skills or may have poor impulse control. They may be struggling with problems in a relationship with family or friends. A suicide attempt may be their way of communicating the seriousness of their feelings or situation when other avenues of communication are closed. Often they suffer from underlying depression, alcohol or other drug abuse, a serious eating disorder, or psychological problems. They may also have a family history of alcohol abuse, suicide, or both.

Suicide is more common for the person who moves or starts college in a new city. New students may have difficulty finding a support system and can end up feeling isolated and overwhelmed.

Unrealistically high self-expectations or parental expectations can also induce persons to attempt suicide. They may be anxious about their own abilities and pessimistic about the future. Their home lives may be chaotic, without the usual support systems. They may have failed, or thought they failed, at something important to them.

If you recognize any of these warning signs, get help. Suicide is preventable with care and knowledge of coping skills and ways to communicate.

What do I do if a friend says she is thinking of killing herself?

Having a friend talk about suicide is very upsetting and frightening. The best approach is to try to hear her and understand what she is experiencing and then to go with her to get professional help. Do not be afraid to talk about it.

Do not brush her off by saying, "You must be kidding." Avoid statements that deny her feelings, like "I can't believe you, you seem to have it all together" or "It can't be as bad as all that, so cheer up.

Offer sympathy and concern. Then, firmly and patiently, insist that your friend get professional help as soon as possible. If necessary, make the appointment yourself to see a counselor and go with her.

If she is drinking or using drugs, take control of the situation and don't let her have any more. Remove excess pills or anything else you consider dangerous from her room. Don't let her drive. Help her get in touch with friends and family, and communicate with anyone she may be trying to reach.

Many suicides are preventable. Suicidal thinking is temporary. The person thinking of killing herself is in a crisis state, overwhelmed with pain, grief, loneliness, or depression. She is not thinking rationally. Help absorb some of the load by listening. Professional help will lessen the crisis.

The suicidal crisis can be helped by psychological treatment. Remember, never do anything serious or irreversible when you are upset or depressed. Crises can be resolved and will pass. Help is available.

Where can I turn for help?

Help is available through many agencies and services. If you are on a college campus, check with the counseling center or the health center. They will have a list of referrals, usually available at no charge or minimal charge for registered students. Most centers have emergency walk-in appointments available with minimal or no waiting for serious problems.

There are local helpline services, usually run through the campus counseling center, local hospital or mental health agency, or church or synagogue. They are listed in the telephone directory, or you can call a local hospital emergency room for an immediate referral. Suicide is an emergency and a crisis. The sooner someone gets help, the better. With help, suicide is preventable.

Our emotions are a substantial part of what makes us human. It is important to realize that we can control our emotions and direct them in ways that can help us be more sympathetic, kind, and loving.

We can not always be happy. Life is a roller coaster of emotions-from happiness, joy, and love to sadness, pain, and sorrow. Getting through the tough times helps us appreciate the times of love and happiness.

The techniques described in this chapter can help you smooth out the roller coaster ride a little, but don't count on a flat ride. Times will be tough and times will be great. You can use these techniques to take off some of the ragged edges and make the tough times a little easier to get through.

These techniques can also help you create more good feelings, be more productive, and give more satisfaction to both yourself and others.