147. What Every College Student Should Know: Mental Health Do’s and Don’ts feat. The College Psychiatrist

May 13

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Today's guest is Dr. Bianca Busch— a board-certified adult and board-eligible child & adolescent psychiatrist who specializes in helping college students flourish. In this episode, we discuss why exactly college students experience so many mental health challenges, signs your mental health may be at a breaking point in college and when/where to reach out for support, ways to boost your mental health while transitioning to college and key mental health skills to use while you’re in college, and what she wishes student health services could do differently to support students’ mental health.

Dr. Busch's Instagram: https://www.instagram.com/collegepsychiatrist/

Mentioned In The Episode…

+ Dr. Busch's Website

+ Dr. Busch's TikTok

+ Dr. Busch's Facebook

+ Schedule a Consultation with Dr. Busch

+ Parent Salon Series

+ Mood Meter App

SHOP GUEST RECOMMENDATIONS: https://amzn.to/3A69GOC

Episode Sponsors

🛋This week's episode is sponsored by Teen Counseling. Teen Counseling is an online therapy program with over 14,000 licensed therapists in their network offering support with depression, anxiety, relationships, trauma, and more via text, talk, and video counseling. Head to teencounseling.com/shepersisted to find a therapist today!

About She Persisted (formerly Nevertheless, She Persisted)

After a year and a half of intensive treatment for severe depression and anxiety, 18-year-old Sadie recounts her journey by interviewing family members, professionals, and fellow teens to offer self-improvement tips, DBT education, and personal experiences. She Persisted is the reminder that someone else has been there too and your inspiration to live your life worth living.

a note: this is an automated transcription so please ignore any accidental misspellings!

[00:00:00] Sadie: Welcome to She Persisted. I'm your host, Sadie Sutton, a 19 year old from the Bay Area studying psychology at the University of Penn. She Persisted is the Teen Mental Health Podcast made for teenagers by a teen. In each episode, I'll bring you authentic, accessible, and relatable conversations about every aspect of mental wellness.

[00:00:19] You can expect evidence-based, teen approved resources, coping skills, including lots of D B T insights and education in. Each piece of content you consume, she persisted, Offers you a safe space to feel validated and understood in your struggle, while encouraging you to take ownership of your journey and build your life worth living.

[00:00:37] So let's dive in this week on She persisted.

[00:00:42] Bianca: this may be an unpopular opinion, but the thing that can go, the thing that can sacrifice, I think you mentioned sort of the academic demands and how serious things are. At the end of the day, I feel like your physical health, your mental health is the most important thing. And so, okay, you don't get an A on that paper, but you get a B that's okay. There are lots of ways that you can do the things that you want to do and flourish in this world. And so I think if something can give it's, the high academic achievement that we're expecting of ourselves.

[00:01:14] Sadie: Hello, hello and welcome back to She Persisted. I'm so excited you're here today. We have a super exciting episode and actually a series all about college navigating that transition. I was originally going to do this as like a back to school series, but most of you're probably finding out. Where you're going to college, starting to think about navigating that or planning to work on your college applications this summer.

[00:01:38] So I thought, why not share these conversations, resources with you now so that you have all of the information going into this experience a little bit in advance rather than right before it happens. To kick off this series, we have Dr. Bianca Bush on the podcast. She's a board certified adult and adolescent psychiatrist, and she specializes in college students, so she works with tons of individuals on the transition to college, navigating college once you are a student, getting resources, getting support, mental health challenges that college students navigate, et cetera.

[00:02:12] I absolutely adored this conversation. We talked about so many different aspects of mental health and questions that I know so many of my peers had going into college, questions I had that I wish I would've had answered before freshman year. So we cover a ton of topics including. Why mental health struggles are so common in college students and in that age demographic.

[00:02:33] We talk about when to ask for help and when to know that you're struggling and you need more support. We talk about how to reach out for that support and the best ways to improve your mental health and give yourself the best chance of success. We also talk about mental health resources and mental health systems at colleges and what she'd like to see differently so that we can better support college students in this really important period of life.

[00:03:01] And before we dive into this, I have to give a disclaimer that I had tech issues, so I totally accidentally was not recording when I did my little intro kicking off the episode said, thank you so much for being here. So we're just gonna jump right into it.

[00:03:14] Pretend I've said hello, pretend I've said thanks for being on. She persisted and we'll dive right into Bianca's side of the convo.

[00:03:21] Bianca: I'm so glad to be here. Thank you for having me. And I also wanted to say thank you for being so brave and sharing your story and also for promoting all of the greatness of D B T. I think it's a fantastic treatment.

[00:03:32] Sadie: Yes. Love it. It's literally amazing. It's anytime I'm like, guys, D B T skills, use that.

[00:03:39] That's so funny. Okay. Well I'd love to start with your background and how you started working with teens and really offering expertise on this transition. Because as a teen who's looked for a psychiatrist at many points, sometimes it can be hard to find provider that specializes in that demographic.

[00:03:56] And then once you get to that very challenging transitional period, finding a mental health provider who has tips and tricks that are relevant specifically to that time period can be really challenging. And I hear that from a lot of college students that the resources they use before maybe aren't as effective, or people don't know how to support them.

[00:04:14] They don't have the skills themselves. So how did you get to the point of really working with teens and college students and supporting them throughout that life change?

[00:04:24] Bianca: Right, so I'm an adult child and adolescent psychiatrist, which means I can work with patients from zero to 100. I love this age because it's a time where you're exploring independence, who you are.

[00:04:36] It's really a fun time, but can also be a challenging time. It's also a time where your parents might be still involved in your life in some ways, and as a child psychiatrist, I'm used to working with parents and helping them along in this developmental transition, right? They're, they're getting used to.

[00:04:52] You, your baby, becoming an adult. So that's sort of my professional training and how I'm prepared to take care of college students and help with their parents. But I have my own experience. As a college student, I really struggled. I, of course, you know, like many students did very well in high school and got to college and just.

[00:05:12] I was very challenged. Didn't know why I was working really hard. And so it was a rough, a rough go. I went to student counseling and they said, okay, we think you're depressed. Here is an antidepressant. And I said, okay. I don't know that that's the whole part of the story and so I continued on years past.

[00:05:31] I didn't get diagnosed with the learning difference until I got to medical school, and so I wish I had known sooner because I probably could have had a different outcome as an undergraduate, but I would like to be there for other students and sort of really see them holistically, see what's going on.

[00:05:49] Is it primarily mental health? Is it academic? Is it a combination? But really providing nuanced evaluation so that people can flourish. Yeah. And do the things they wanna

[00:05:59] Sadie: do. I'd love to get your professional perspective on why this specific period of time is so challenging. I'm hearing it constantly students.

[00:06:09] I don't know if you're aware it, but Penn is the most depressed school statistic. That's a fun little statistic. So. Internally in the community, people are very aware that people are struggling with mental health. It's a question I always am getting submitted. Mm-hmm. Why are teens struggling in college?

[00:06:25] I've never struggled before. Now I'm having a really tough time. What do you think it is? Do you think it's the academic pressure? Is it the distance from family? Is it being so in charge of your routine and wellness? Is it a perfect storm of all of those? , what's your perspective both from what you see with teens and then also what you know from your own experience? Mm-hmm.

[00:06:47] Bianca: You hit the nail on the head with a lot of things, so, you know well, one, I'll start from the biological perspective. The brain does not finish developing the frontal woes, which are the, the area of the brain that helps you make decisions until like, 22, 23.

[00:07:04] And so you're thrust into this world having to make all these decisions, whereas when you're at home for, for a lot of students, Their families or parents are helping them make decisions, organize their day, organize their meals, that kind of thing. And so here you are, you've got to make all of these decisions yourself.

[00:07:20] And so that can be really challenging. Not only that, but you have all of the emotional ups and downs with friends, partners. You may have someone that you're dating in high school and now you're transitioning, maybe you're staying together, maybe. Broken up. So there is so much that's going on. All the academic demands, you know, I have a colleague who is, is much older and he always likes to say the academic demands, the pressures, what's expected of students now is much greater than it was 20 years ago, 30 years ago, 40 years ago.

[00:07:52] So I think that's a key factor. We cannot ignore the impact of the pandemic. So a lot of students who are in school now, the pandemic was underway for a part of their schooling high school where you might be developing some of these skills, but you were at home. Yeah. And so it's a tough transition.

[00:08:09] Some of my students were in college for parts of the pandemic, and so they missed out on their sophomore year or their freshman year, something like that. So it's multifactorial. The other thing that I'll say is that there's just much more awareness. I think that these struggles probably have been going on, but now people are talking about it and they feel comfortable talking about it in ways that people hadn't been before.

[00:08:34] You know parents, generation of college students, a lot of the times. They're like, well, we just kind of sucked it up and, and made it through. And so, you know, I have to do a lot of education about like, okay, well that was the mentality then, but that's actually not the mentality. This now we're really trying to tackle things head on.

[00:08:50] Yeah. So it's multifactorial.

[00:08:52] Sadie: I think that's such an amazing perspective, and I think that's something that a lot of students struggle with that they want to pinpoint one reason. They're like, oh, it's the academic stress, or, I missed my friends, or, I don't know what I want to do with my life. But it really is a mix of all of those things, and that's why it's so important to take a holistic approach to addressing your mental health and addressing that transition.

[00:09:17] So, What are, what are your thoughts there? Obviously, huge question. I'm sure this will take up most of our thing. I'll ask lots of follow up questions. Yeah. But when you're supporting students through this transition mm-hmm. What is the process from start to finish? How are they setting themselves up for success in high school?

[00:09:33] What are the things they're dealing with right before move in, in that transition? And then once they're there, the, the skills that they're using, the challenges they're navigating, et cetera. Mm-hmm.

[00:09:43] Bianca: Yeah, I like that sort of before as they're getting there and after. What are they doing? So, you know, when I think about before we can talk about this, you know, Like you said, we could talk about this for a while, but you're really thinking about old friendships, maintaining old friendships.

[00:09:59] You mentioned missing your friends, so is there a way that you can set yourself up to sort of maintain some of those friendships or connection to close family members while you're away? Yeah, I think that's important to think about to be very thoughtful about. I mentioned are you going to stay with a person that you're with or not, and how are you gonna remain connected?

[00:10:16] I think that can be really important before, if you are a person. That has had like an I E P or a 5 0 4 or something like that, accommodations in high school. It's really important to think about continuing those into college. And this requires some forethought because you get there, you're a freshman, you're like excited to be on campus.

[00:10:38] There's all this fun stuff going on, but you have to apply for accommodations, right? And so this is where state you talked about, okay, now we have to be responsible for all these things. Your parents could help you do it, but it's, it's going to be on you. They don't automatically roll over and

[00:10:52] Sadie: you have to do them every year and apply them Yes.

[00:10:54] To every specific test. Every specific class. Yes. It's a process. It's

[00:11:00] Bianca: a process. And sometimes you end up having to advocate for yourself, cuz sometimes professors are like, Yeah, yeah, yeah, yeah. Whatever. You need extra time for your test. So does everybody else, you know, and so you end up sometimes having to advocate for yourself or getting someone from the Office of Student Services to help you advocate.

[00:11:16] Yeah. And so the, the needs that you have in high school don't go away just because you're in college. In fact, you might have more needs because most students find that the demands, the academic demands are often greater So thinking about friends, Thinking about preparing yourself if you have had accommodations, and then if you are a person who has had an existing relationship with a therapist or psychiatrist, making sure that's set up or that you have somewhere to go once you get to college.

[00:11:44] So these are all things that you've gotta think about before

[00:11:47] Sadie: you get there, because your provider might not be licensed in the state that you're going to school, which is a whole other thing to deal

[00:11:54] Bianca: with. Absolutely. And this is a as much of a pain for us as it is for you because we wanna keep caring for you.

[00:12:01] But the way that the laws are, you know, some of this was suspended during the pandemic, but the public health emergency is ending soon. And so there really are restrictions about who can see who where. it depends on your type of license, if you're a medical doctor versus a social worker versus a psychologist.

[00:12:19] So it can be tricky, so you gotta get started on it early. You know, in the summer. It's not something that you can wait until September and try to find someone because you'll probably won't get connected until October, November. Yeah.

[00:12:32] Sadie: What are some of the most common things that student gets get to college with?

[00:12:37] They are struggling with a lot and they're feeling the need to reach out, whether it's going to student services, trying to reconnect with an old care provider. Really just reaching out for resources when they're not sure where to go. What are those common? Pain points mm-hmm. Or challenges that really are almost the breaking point.

[00:12:56] Like there's some amount of stress where they're like, this is a lot, I'm adjusting socially. This is a new experience, but what is really pushing students over the edge where they're like, this is impacting my wellbeing and my ability to show up and mm-hmm. In these areas of life.

[00:13:10] Bianca: I'll tell you sort of what it looks like because mm-hmm.

[00:13:13] The cause can be a number of different things, and I'll talk about potential causes, but what it will look like is, You know failing assignments you know, you're trying to do the homework and it's not working, or you're just not doing the homework. And so then the, the outcome is that you end up failing tests.

[00:13:31] Classes you end up on academic probation. Another thing that it can look like is just staying in your room and not going anywhere. Mm-hmm. Sleeping a lot. Another thing that it can look like is not eating or eating too much. Mm-hmm. And so those are some of the things that, like if you're starting to see those things in yourself or someone else would be assigned to get some help.

[00:13:54] Now what could be causing that? Could be anxiety. It could be depression, could be that you have a learning difference that needs some accommodation and you just can't keep up. It could be that you have a history of eating disorder or disorder of eating, and that is sort of rearing its head.

[00:14:10] Could be social anxiety. Sometimes I have students that get to school and you know, everyone is wanting to go out and they have some form of anxiety that's. Making them cautious and not want to go out and not want to participate with the other things that people are doing. Yeah, so that's kind of what you would see, what might be going on and when you might think about getting some help.

[00:14:31] Sadie: If you were to give listeners almost like an order of operations of what's most important to maintain, to be a successful student, and that doesn't just mean academically, but in all areas of life, whether you mentioned sleep, diet relationships. There's academics, there's. Access to resources, what is it most important to maintain as a foundation, and where is there a little bit of leeway when things get more stressful?

[00:15:00] Mm-hmm. And you're not able to keep up with everything. Well, that's a,

[00:15:03] Bianca: that's a great question. That's a great question. You know I think the two most important things are probably sleep and nutrition, honestly. Yeah. And that's hard because you have so many demands. Not only academic demands, but social demands.

[00:15:19] Yeah. You wanna go out, you wanna have a good time. But sleep is really important. And can you know? Mean you being able to cope with stresses versus not if you, if you're tired, it just makes it more difficult. So,

[00:15:32] Sadie: or even just showing up to class, like if you're not sleeping, you're not gonna be able to get to class or stay awake during that class.

[00:15:37] Yes,

[00:15:38] Bianca: Absolutely. So as best you can getting sleep, Wearing an eye mask using earplugs. If your roommate is noisy. , there's a lot that we can do with sleep hygiene. So sleep, nutrition. You know, one of the things I always joke about is like when you're in college, you get to manage what you're eating.

[00:15:54] Like I can remember having an all cookie dinner at one time was fantastic, but not the best. For your brain, right? So you're, you know, want to get some nutritious foods or have snacks in your room if you're not making it to the dining hall, or they don't have what you like to eat there. So those are probably the two things.

[00:16:11] And then, you know, this may be an unpopular opinion, but the thing that can go, the thing that can sacrifice, I think you mentioned sort of the academic demands and how serious things are. At the end of the day, I feel like your physical health, your mental health is the most important thing. And so, okay, you don't get an A on that paper, but you get a B that's okay.

[00:16:34] I work a lot with students on sort of being okay with not getting all A's and thinking about, okay, how is this really going to impact your life and your career? And it could be so scary because you have your advisors. People in pre-professional organizations saying you have to have this GPA to get into this graduate school.

[00:16:53] And that is so hard because you end up putting a lot of pressure on yourself, but you know, it can just be so detrimental. So I try to work with students To say like, okay, well what's, what's reasonable? Yeah, okay. If you get a B on this paper, how's that gonna impact the whole semester? How about your entire gpa?

[00:17:11] And really thinking like, well, what are the paths to this career? And, and just really being on the other side of things and having had a circuitous path to medicine, I think informs my perspective. But, There are lots of ways that you can do the things that you want to do and flourish in this world.

[00:17:28] And so I think if something can give it's, it's sort of the, the high academic achievement that we're expecting of ourselves.

[00:17:35] Sadie: I think it's also worth mentioning almost adjusting expectations and really understanding how GPAs and performances shift in college. Yes. Because like you mentioned, the academic requirements and just like the, the level that you're working at are different and so, Like you said, in your own experience, and I hear this from the Penn community all the time, like people that were straight A students in high school, that's not always the case in college, especially depending on your major.

[00:18:02] Mm-hmm. And it's a really hard thing to mentally adjust to. Mm-hmm. And understand that you're working just as hard. Mm-hmm. And maybe you're doing just as well, but even when you just logic through it of like, okay. At Penn, all of these students here had an insane GPA in high school. Mm-hmm. If you put them all, all them in a class together, you have to maintain a certain average.

[00:18:22] All of them are not gonna get a hundred percent. That's right. It's just a completely different ballgame. And that can be difficult to navigate, especially Yes. If parts of your identity have been tied to that academic

[00:18:33] Bianca: performance. Yes. So I really try to work with students to create an identity outside.

[00:18:38] Side of their academics, right? Yes. Explore, try new things, you know that is something that is preserving for students. If you feel successful in something, maybe you're not successful in your classes 100% of the time. But you just really are able to do this Asana, this pose in yoga that you've been working on for a while or, you know, I tried all sorts of things.

[00:19:03] When I was in college. I did cheerleading. I never had done cheerleading. I played basketball in high school, whatever. I tried out University of Chicago D three. Nobody really cares. So, you know, trying something new that can really preserve you while you're having these academic challenges.

[00:19:18] Sadie: Yeah, I obviously am not a college or graduate school admissions counselor, but whenever I get asked that question or am thinking about it with my siblings or anyone from home or any of these different, Areas that people are like, how do you navigate this process?

[00:19:33] I'm always like, anyone can deliver with the grades and the S a T score and likely someone identical to you will deliver with those things just like you are. And so if you can supplement with those other passions and interests and projects, That is what's going to differentiate you mm-hmm. And have a positive impact on your mental health.

[00:19:49] Mm-hmm. Then there's this TikTok trend right now where it's like, this is the thing that no one can ever take away from me. And so if people talking like they're fitness or they're, they're a side project, or their passion or mm-hmm. Whatever it is. Mm-hmm. Mm-hmm. And. That is very true. Like you mentioned, if academics aren't going the way you want them to, and if that's your whole identity, it's gonna have a really negative impact on your mental health.

[00:20:11] But if you have these other areas that are boosting your mood and allowing you to maintain that mental stability, you're really setting yourself up for success. Mm-hmm. Oh,

[00:20:20] Bianca: absolutely. Absolutely.

[00:20:23] Sadie: Today's episode is brought to you by Teen Counseling. You guys know whenever I have mental health professionals on the podcast. I like to mention teen counseling to give you guys a direct resource that you can utilize to find a mental health care provider if you are looking for a support.

[00:20:37] So if you haven't heard of teen counseling, it is better Helps branch of online therapy specifically for teenagers. They have over 14,000 licensed therapists in their network and they offer support on everything like depression, anxiety, relationships. Navigating college, so many different things. And what's great about teen counseling is that they offer talk, text and video counseling.

[00:20:57] So depending on what kind of support you're looking for, what level of resources they meet you, where you're at, and give you the support that you were looking for. So, If you would like to check out teen counseling, you can go to teen counseling.com/she persisted. Again, that is teen counseling.com/she persisted.

[00:21:13] This is a great option for college students. I had to switch therapists when I went to college because a lot of clinicians are only licensed in certain states. So if you're moving away to college and don't know where you're gonna find a therapist, this is a great place to check out some providers, see if you can find a good fit, and it's amazing because you don't have to deal with wait lists or referrals and all of those things that can be really challenging.

[00:21:34] To get support when you need it. So check out teen counseling. The link is in the show notes. Or you can go to teen counseling.com/she persisted.

[00:21:42] How do listeners know or parents know when it might be time for a student to get support?

[00:21:48] Like when are you kind of crossing over that line of mm-hmm. Okay. This is tough and I can get through this. Mm-hmm. And it'll be fine and like professional support. Is necessary. Mm-hmm. And could be really beneficial because it's so scary to ask for help, especially because so many college students, like we'd mentioned, hadn't struggled in this way before.

[00:22:06] Mm-hmm. And in a lot of ways, I felt really lucky that I had my terrible mental health experiences in high school, because then once I was completely independent, I was like, I've got this, I've done this before. Yeah. I've been depressed, I've been anxious. I've asked for help. I've utilized resources and I'm very aware that so many teens and freshmen and sophomores mm-hmm.

[00:22:25] Haven't had that experience. So for the first time, their mental health is struggling for the first time. They don't have a support system. So do clients come to you and when do you wish they would come to you for support?

[00:22:37] Bianca: Mm-hmm. Oh, this is such a good question. I think so. You know, I go back to sort of what would you see in yourself or someone else.

[00:22:45] I think if you're having like a low mood and feeling down. For like more than two weeks and it just, it stays and you don't feel happy at all during that period. And, and you're sleeping more or you're sleeping less, or you're eating a whole lot more or eating a whole lot less, or even having thoughts of suicide.

[00:23:02] That is certainly a time yeah, to reach out. But really you're just feeling kind of slothful down sad for for two weeks consistently. You should definitely be reaching out. I think it's important. Anxiety, I feel like is something that flies under the radar a lot of the time. Like people just think like, oh, this is just the way I am.

[00:23:19] But you know, it is, it is normal to want to engage socially with people, and that doesn't mean just going out to parties that can be playing board games. In your, in your dorm or your house, getting with them,

[00:23:30] Sadie: studying with people, sitting with them in

[00:23:32] Bianca: class? Absolutely. Yeah, absolutely. But if you are finding that that's just too overwhelming and you feel like you need to stay in your room and not be around anyone, that is a time to reach out for help.

[00:23:42] For sure. If you're having a lot of panic attacks and that's, feeling like your palms are sweaty, you're losing your breath. You know, I have some students who feel that way and can't even get to class. They start to walk to class and start to feel like that and then just go back home.

[00:23:55] Mm-hmm. So these are are times where you should reach out. Certainly if you're having thoughts of suicide or death or feeling like life is over living. If you're feeling like you're, you again, have a history of eating disorders and you're going back to some of your old ways, that's a time to reach out.

[00:24:11] And then I would say that times that I wish people would have reached out. I've seen this when Even with some patients that I've had where maybe I'm only prescribing their medicine and I may only see them every three months or, yeah, as you mentioned, it's a challenge to see them where when they're at school or I'm not licensed there, so I might only see them on summer break and winter break, and then I find out that they've like failed classes or things like that.

[00:24:32] I'm like, oh no, like I wish. Even though I couldn't see you in, I wish you would've, called me or reached out so that we could get you the help that you, you needed. So it's when the student has failed and I feel like, well, there's something that we could have done whether it's advocating for incompletes or extensions or anything like that, so you could finish.

[00:24:52] So, yeah.

[00:24:54] Sadie: Yeah, it's, it's a really tough position to be in, and it definitely speaks to how much your previous support system can do, even if they're not there, and even if they can't offer that daily support, whether it's an old therapist or your pediatrician mm-hmm. Or family members, they can still be there to text and check in.

[00:25:12] Mm-hmm. Or mm-hmm. Call on a weekly basis. Mm-hmm. Or give recommendations mm-hmm. Of how to find a therapist, how to find a local psychiatrist, leaning into their own networks and being like, okay, I sent an email and I found these three providers used should check out Yes.

[00:25:26] That are in my community. So there's a lot that people can do and I think that students really underestimate. How much people will help even mm-hmm. From a distance. Mm-hmm. Like, you're like, well, my, my friends from home aren't at college with me. They don't get it. And every single time I hear that, I'm like, every college is the same.

[00:25:44] The difference is if you are at a bar schoolers or a frat school, the difference is if you have like actual seasons or if it's sunny all the time and. Like maybe how good the food is. Everything else is the same. Yes. Everyone is stressed over pre-med. Everyone's engineer program is crazy. Everyone's tired all the time.

[00:26:05] Like it's the same. Your friends are definitely, definitely. So it's these like little things that make a difference, but you guys can still support each other and I think that gets

[00:26:14] Bianca: lost. Ab Absolutely. Absolutely. You're right. Everyone just think their, their school in New York, they're like, well, at this school, such I'm you football

[00:26:22] Sadie: games?

[00:26:23] Oh, do you?

[00:26:25] Bianca: Definitely,

[00:26:26] Sadie: definitely. It's very, very similar. Mm-hmm. And that means that you guys can support each other and share funny stories. And if anything, it's almost great because you have someone that you can just be a hundred percent honest with. Mm-hmm. You're like, I'm having trouble with this friend, or I want to try and be more social, and they can support you from a distance.

[00:26:44] Mm-hmm. And they're not in your everyday life, so you're not like, It, it sometimes gets awkward when you not awkward isn't the right term, but if you go to a close friend at college and you're like, I'm really struggling, and then every time you see them they're like, are you depressed today? Yeah.

[00:26:57] Because it

[00:26:57] Bianca: works. You can't get awkward.

[00:26:59] Sadie: Yeah. Yeah. So if you can have those support systems that are there for you no matter what, when it's not those newly developed friendships where you still kind of feeling each other out, that can be pretty effective. That's great. Yeah. Yeah. Yeah. What do you wish student health services did differently to support students with their mental health?

[00:27:18] Hmm.

[00:27:18] Bianca: Oh gosh. Yeah. So, you know, student health services have just such a big challenge.

[00:27:26] Sadie: And at all schools.

[00:27:27] Bianca: Again, this is Univers School. At all schools. At all schools. So I'm on the National Network of Depression Centers Committee for task Force or College Mental Health. And so there are a lot of people from across the country who are in student mental health centers set an honor committee.

[00:27:41] And the, the, it's the same. They need more people and more resources and so if I could help them to do something better, it would be to advocate. For more resources to have enough services and have enough people to see students. I mean, the demand is just so great. And that they would also be able to provide longitudinal care.

[00:28:03] You know, some campuses can, and have the resources where you have a therapist and they're gonna be with you for all four years, who, what a gift. Mm-hmm. But for the most part, it's, they're going to be able to see you for six to eight weeks to sort of. Help you stabilize if you're in a crisis and then refer you to someone in the community.

[00:28:21] And so, you know, that is what they can do. But it would be lovely if they were able to provide this more long-term treatment and care.

[00:28:31] Sadie: Yeah. If a student is struggling, do you typically refer them to a psychiatrist or a therapist? Like what is their best place to,

[00:28:42] Bianca: to start? It depends. So I, I always think that people should start with therapy unless they have very severe symptoms where again, you know, they can't get out of bed.

[00:28:51] They really just can't do anything to engage in the therapy. Mm-hmm. But I really would recommend that people have a good course of therapy, six to eight weeks. The modality that's best for their condition. CBT is great for depression and anxiety. D B T is great really for everything, for coping with interpersonal difficulties if there is self harm, if there's a suicidal ideation.

[00:29:12] So getting a good work of C B T or D B T, even talk therapy so doing that, and then if symptoms aren't getting better, it could be time to consider a medication and then that's when they would see a psychiatrist.

[00:29:25] Sadie: Mm-hmm. I think that's huge, and I think it's something that if you've never struggled with mental health before and you're trying to do this independently, like I remember when I navigated this, my mom was making the appointments.

[00:29:35] She was like, today's the psychiatrist, today's the therapist, like, Parents when you were younger and in high school, they're more hands on. Mm-hmm. They're the ones asking the questions. The pediatrician or the school counselor. Mm-hmm. And so when you are now in the position to advocate for yourself mm-hmm.

[00:29:50] You're the one that's going to student health and saying, mm-hmm. Do I need a psychiatrist or do I need a therapist? And you're the one that's on like Psychology Today looking up, therapist near me, being like, what does this mean? And so, yes. Just being even aware of, this is where I start and then this will be the next step.

[00:30:05] And I truly have so much faith in the mental health community that if you do that first step of getting into therapy for that six weeks, like you said, they're gonna be the one to be like, okay, I'm not seeing a shift here, five psychiatrists to check out, or let's continue, or, I'm so happy with your progress.

[00:30:21] Let's check in in a month. Yes, yes. And so it's just really looping someone in. Yeah. And having that professional that's keeping tabs. Because it's so much to ask of friends or community members or family members to be solely responsible for checking in on someone's mental health. Yeah. It's different from having a healthy relationship with them, so, mm-hmm.

[00:30:41] It's huge. If you can have a mental health provider that's in your corner and on your side and looking out for you. Mm-hmm. Mm-hmm.

[00:30:49] Bianca: Yeah, that's a good point. I think you, you said you have faith in the mental health community. I, I, I do too. I mean, when people come to me that are like, I don't even know what I mean, we can help you figure that out.

[00:31:01] Yes. We can help you.

[00:31:02] Sadie: and making sure that we are giving ourselves the best possible evidence, based care possible. Yes. Yeah, that's so true. If you could give one skill to listeners that you wish all college students were equipped with, whether it's a way to tolerate stress or have healthy relationships mm-hmm.

[00:31:20] Or advocate, just one thing that you think mm-hmm. , is absolutely essential that most students aren't aware of.

[00:31:25] Bianca: That's a good question. The thing that I think is most powerful is, Emotional regulation. Yes. And that it takes a little bit of learning, but like, if you can check in with your body and your mind to know where you are, like that's half the battle.

[00:31:47] You know, you can develop the skills, but you have to take the moment to check in and know that you need to use some skills. So that's, that's a hundred

[00:31:58] Sadie: percent.

[00:31:58] Bianca: Yeah. You know, I don't know how accessible that is. And sometimes I have to check myself because being in, you know, embedded in the mental health community, it's like an automatic, but if I could, if I could teach someone, is to get in tune with themselves and how they are feeling.

[00:32:12] Are they angry? Are they sad? What is the way that they're feeling, because that is where you have to start to know where

[00:32:17] Sadie: to go. Yeah. Like if you don't know if you're anxious or angry or guilty or ashamed, the skills you use aren't gonna be effective. That's right. Two things that have been helpful, I think one is the D B T skill, which I don't know if this is actually D B T skill, but they would add it as like a little add-on at residential, which is mindfulness of current emotion.

[00:32:36] Yeah. So you use all the mindfulness skills that you would when you're like, Oh, I'm noticing a breeze on my face, or I'm noticing someone talking around me. But you're doing it for emotions. So what thoughts are you having? What are the physical sensations? What was happening before this emotion arose?

[00:32:51] Mm-hmm. And that can be really effective. And then the other one is an app my therapist gave me this recommendation. You open it and it says, how do you feel? You click, I feel uhhuh. And then you tell it what level of energy you're feeling.

[00:33:07] Oh, nice. Which is like almost a freebie question where you're like, yeah, I don't know what my emotion is, but I know I'm high energy and pleasant, or I'm high energy and unpleasant. Mm-hmm. So you pick whether you're high energy, low energy, pleasant, or unpleasant. Mm-hmm. Or I'm like pretty low energy, pleasant, I would say.

[00:33:22] And then, You have all of the emotion words based on intensity. Oh, interesting. And you can find the exact label. So are you Oh, cool. At ease, easygoing content. Loving, fulfilled, balanced, blessed, restful, chill. Nice. So many different words. Nice. And then you can track it. Nice. So it'll record on a daily basis.

[00:33:42] And if you're in therapy, like therapists would love if you recorded your Absolutely. Absolutely. You're like, please do that. Gimme the data. Yeah, so it's a great song. What F is that? It's called Mood meter. Okay. It's a app store. It's free. Okay. Oh wow. It has like a little grid on it. Okay. That's red, yellow, blue, and green.

[00:34:00] Nice. But emotional words are hard if you haven't been in therapy. They are. They are. Like, my cop out was always I'm fine or I'm tired. Yeah. Those aren't feelings. Yeah. Yeah. So it's. Like we gotta, we gotta supplement however we can. Gen Z loves an app, so add this one to your home screen. Yes. And it can be helpful with that, that first step of identifying what you're experiencing.

[00:34:21] Yes. And then working to problem solve. I

[00:34:24] Bianca: love that. I love that. Yeah.

[00:34:26] Sadie: Where can listeners find you? Follow along? Mm-hmm. If they are local to your area. Mm-hmm. How can they, if you're taking new patients mm-hmm. How can they begin that process? All of the things for people to continue to connect. Yes.

[00:34:39] Bianca: So first follow me on my socials at college psychiatrist.

[00:34:43] So I'm TikTok, IG and Facebook, but TikTok and ig and then Website is college psychiatrist.com. You can find a link to schedule an initial 15 minute visit. I am licensed in Illinois, Massachusetts, New York and Texas. So if you're living in one of those states or attending colleges in one of those states that can see you there.

[00:35:01] I prescribe medicines and a provide therapy for patients and the practice is growing. So we also have a new psychiatrist who's in Austin Texas, who has expertise in eating disorders who is doing the practice and more to come. So that is how to get connected. And bonus, we have stuff for your parents.

[00:35:18] So not only for you, but like how to help your child with depression and anxiety. All of these things We have what I call the parent salon, which is a conversation series for parents tackling a different topics. How many times have they asked you what your major's going to be? That's like super annoying.

[00:35:33] So send them to me and I have some tips for them so they can stop annoying you, but also support you while you're picking your major in various things. So college psychiatrist.com.

[00:35:43] Sadie: Amazing. Well, thank you so much for this phenomenal conversation. I wish that I could just like make this a required listen for every incoming freshman because it's so much value and things that most teens aren't aware of.

[00:35:56] So thank you so much for sharing all of your insight and expertise. Thank you for having me.

[00:36:01] Thank you so much for listening to this week's episode of she persisted. If you enjoyed, make sure to share with a friend or family member, it really helps out the podcast. And if you haven't already leave a review on apple podcasts or Spotify, you can also make sure to follow along at actually persisted podcast on both Instagram and Tik TOK, and check out all the bonus resources, content and information on my website.

[00:36:23] She persisted podcast.com. Thanks for supporting. Keep persisting and I'll see you next week.

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