The new stresses students face when they enter university can trigger anything from mild stress to serious mental-health issues. But there are ways to cope.
The first year of postsecondary education can prove challenging for any student.
In addition to likely being away from home for the first time, they suddenly need to juggle studying with no one looking over their shoulder, exam pressure and managing relationships with new friends and professors.
For James Lao, those factors were just the tip of the iceberg.
Currently a part-time student taking a university access course at Wilfrid Laurier University in Waterloo, Ont. Mr. Lao is 10 years removed from a life-changing diagnosis.
As a 19-year-old in his first semester at Conestoga College in his hometown of Kitchener, Ont., he was juggling a part-time job and six courses at school, in addition to his personal hobbies of boxing, martial arts and running. Then a curveball was thrown into the mix – his first episode of schizophrenia.
"It was just like a nervous breakdown," Mr. Lao says now. "I had too much stress in school and I had too much to do."
His mother took him to the local hospital, where he ultimately ended up spending a total of six months between two facilities undergoing treatment and counselling. "It's like your life unravelling," he says of a mental disorder for which the average age of onset is 18 in men and 25 in women.
Mr. Lao also relied on the resources provided by the Canadian Mental Health Association, and after three years of using its services, he signed on as a peer mentor, where he now helps out three times a week as a volunteer. He also speaks on mental health in local high schools and runs a monthly art workshop for people with mental-health issues.
He has also returned part-time to postsecondary education, taking such classes as a humanities course at the University of Waterloo and an arts course at Wilfrid Laurier.
He says it took him two or three years to get a sense of health "that wasn't miserable," and which finally allowed him to return to school. Living at his family home, Mr. Lao is taking his studies one course at a time at local schools in the area, and he dreams of being an English professor one day.
His struggles have also taught him a few things about the postsecondary education experience.
"The first year of university is probably a very different situation because it's different from high school," he says. "You're trying to independently learn, just trying to manage, and then once you've got the gist in the next semester or the second year, you're good from there."
He advises students to improve their study and mental-health habits before coming to university. His own personal recipe is to study for 45 minutes at a time before taking a 15-minute break to recharge before going at it again.
"There's a concept I do called self-care," he says. "When you feel too stressed, just go for a walk or just stop doing homework or stop doing your activities and have a little bit of stress relief."
For many students, university can represent a life-changing period of their lives, not only from an educational standpoint, but from a health standpoint, too.
"The period between 13 years and 25 years is the period in the lifespan when most of the mental illnesses can be diagnosed," says Stanley Kutcher, a psychiatry professor at Dalhousie University in Halifax and the Sun Life Financial Chair in Adolescent Mental Health.
"So 70 per cent of all mental illnesses can be diagnosed by age 25 and the big ones – schizophrenia, major depression, anxiety disorders, eating disorders, substance abuse – they all come on mostly between 12 and 25."
But Dr. Kutcher cautions that people can overreact.
"Sadness is a normal part of life; crying is not a mental illness," he says. "Being anxious about an exam is a good thing, not a bad thing."
Dr. Kutcher says a lot of students would do well simply to follow the four cornerstones of good health: sleep, exercise, good nutrition and surrounding oneself with good friends.
"We know that what's good for mental health is good for physical health and viceversa," he says.
To provide for students' mental and physical needs, Dalhousie University has its own health services clinic on-site, with 10 physicians on hand to attend to students.
They offer psychiatric services and last year brought in a social worker as part of the team.
The university also offers an online app, Welltrack, which offers 24/7 support to students in the form of a self-help program that targets depression, anxiety, stress and some phobias.
"It just offers another alternative for students to be able to reach out for help and engage with our services without physically having to come into our offices," says Verity Turpin, the assistant vice-provost of student affairs at Dalhousie.
Another thing that Ms. Turpin says the students are asking for is more peer support – being able to go to their peers and discuss their challenges – so the university is looking at launching a new peer-support coaching model this year.
It is an approach that is endorsed by Natalie C, a recent graduate of the University of Waterloo, who preferred not to use her full name because of the stigma still associated with mental-health issues.
Ms. C entered school in the fall of 2010, but left after a month and a half because she was battling an eating disorder, returning to resume her studies in the spring of 2011.
While she acknowledges in hindsight that she probably should not have started school at the time, she says her stubbornness took over.
"Keep in mind that I wasn't really thinking straight at that point," the 23-year-old says. "The thought was 'I will go to Waterloo and everything will magically get better.' In hindsight, it definitely wasn't a good idea."
She says the change in environments from school to university, with its large classes and many strangers, was especially challenging for her, a self-confessed introvert.
And despite improvements in the way society views mental health, she says mental illness is still not an easy thing to acknowledge.
"There's still a large amount of stigma against saying 'I'm not doing well' or 'I'm having some problems' and I think that staff and faculty and parents need to be open about the fact that stuff might be going on during this transition," she says.
Ms. C says she relied on counsellors and doctors at the university health services in her third and fourth years, but one of the things that really helped her was volunteering for an initiative called Burst Your Bubble, a peer-education team that was started at Wilfrid Laurier University.
"I found it was good because I was able to interact with other students on campus and have that platform to talk about stigma and mental illness and misconceptions and everything," she says.
Tay yab Rash id, a psychologist and researcher at the University of Toronto Scarborough, says that the mental health of students should be a prime concern for universities looking to bring out the best in them. His solution is a simple one, though.
"Mental health should be a mandatory course in the first year," Dr. Rashid says.
"There is no way out other than that. You don't need to call it mental health; you can call it life skills."