74 Chapter 4: Stress Management and Sleep Anxiety, Depression, Suicide, and Hope Chronic stress, if left unchecked, can lead to severe anxiety and/or depression. According to a 2018 American College Health Association survey tailored to college students, they reported feeling: • Very sad (68.7%) • Overwhelming anxiety (63.4%) • Overwhelming anger (4.12%) • So depressed that it was difficult to function (41.9%) Similarly, according to the 2020 Healthy Minds Study, 37% of college students experienced depression and an additional 31% experienced generalized anxiety disorder (Eisenberg & Lipson, 2020). Anxiety is a state characterized by a feeling of worry, nervousness or unease as a result of an event that is either imminent or uncertain. Some of the different categories of anxiety include social anxiety disorder, post-traumatic stress disorder, generalized anxiety disorder, panic disorders, and various phobias. Physiological symptoms of these disorders include increased heart rate, sweating, nausea, panic attacks, nightmares or flashbacks, fatigue, and headaches (Walters & Byl, 2021). These disorders are usually treated through counseling and medications. Depression is a mental illness characterized by a state of extreme sadness and/or low spirits. Depression is not a character flaw or a sign of weakness. Researchers believe that depression results from a combination of physiological, psychological and social factors such as genetics, chemical imbalance, stress, inadequate social support, and/or negative and/or irrational thoughts. Some of the more common symptoms of depression, assuming they persist for two weeks or more, include (American Psychiatric Association, 2000): • Feeling sad or depressed • Loss of interest in activities once enjoyed • Trouble concentrating, remembering and/or making decisions • Persistent fatigue • Feelings of guilt, worthlessness and/or hopelessness • Inability to sleep or sleeping too much • Irritability • Restlessness • Binge eating or loss of appetite
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