Mental Health Struggles Persist Among College Students in The Post Pandemic Era
by Graham Harrington
Saying the Coronavirus pandemic had an adverse effect on mental health worldwide would indeed an understatement, but as we hurtle into an uncertain post-Covid landscape, we need to examine the scars it has left. Current and recently graduated college students were hit especially hard, with many feeling that the pandemic snatched away the capstone to their youth.
Maturation Robbed
The instability caused by Covid was scarring to the psyche of college students who watched burgeoning careers, friendships, and even living situations wash away in the spring of 2020. Many saw their financial situation thrown into disarray and even now, after many have recovered or at least started their recovery from the pandemic’s setbacks, students are still anxious that the other shoe will drop and throw them right back to square one.
Online classwork was a pale imitation of the real college experience, leading to many college students to struggle with grades and motivation. Students whiled away the days in their lonely dorms, staring at screens full of tiny faces who looked just as defeated and bored as they felt. It’s no wonder that depression would creep its way in. Students felt cheated, robbed of what should have been some of the best and most enriching years of their lives.
A Lack of Friends, Sleep, and Purpose
Studies have found that depression, insomnia, and anxiety are common problems among college students and recent graduates even in the post pandemic era, and I’m not surprised. Simply existing on campus during the heights of COVID created a mental toll, the fear of infection creeping into everyday life at any opportunity.
Students were forced to choose between extreme isolation or risking infection by participating in campus life. The ‘safe’ choice only heightened feelings of loneliness and depression, made even worse by online classes and the near total cancellation of extracurriculars. Students spent hours upon hours locked alone in their dark dorms with day and night bleeding together with little distinction.
This seemingly ‘time-blindness’ heavily impacted the sleep patterns of college students, leading many students (including myself) to report issues with insomnia during and after the pandemic. To make matters worse, insomnia and anxiety may be mutually causative. Anxious thoughts prevent students from getting enough sleep, which makes them more anxious, which keeps them from sleeping; repeating the pattern ad-infinitum in a vicious cycle.
Where do we go from here?
Despite momentary flare ups on a region by region basis, Covid seems to be on the backfoot; so why does it still feel like a cloud hanging over my generation? Despite the apparent booming job market, pessimism runs high among nearly graduating students. There’s an overarching feeling that another crisis might swoop in and wipe the slate clean once again. As the world grows seemingly more and more unstable, it’s a very real worry. Still, there is hope. While studies have shown an increase in mental health struggles among young people around the globe, they’ve also found higher levels of resiliency and a willingness to seek help. It’s going slowly, but we will be able to move past this one step at a time.
Graham Harrington is a Senior at Denison University with a Creative Writing Major and Communications Minor. After winning an award in the annual Denison Pod-A-Thon podcast competition, Graham found his passion for journalistic writing and uses it to advocate for mental health awareness, body positivity, and transparency for patients and consumers.
April's Featured Videos
April is National Parkinson's Awareness Month. In this video interview for Perspectives with Charlotte Grinnell, Dr. Ray Dorsey talks about the latest advancements in caring for patients with Parkinson's Disease.
April is National Donate Life Awareness Month. This interview was conducted several years at the Gift of Life in Philadelphia featuring John Green, who is Director of Community Relations. It was hosted by media personality Karima Williams. It discusses organ donation and why it is something to consider.
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The Importance of the Social Determinants of Health in Diagnosing
Patients
by Dima Bischoff-Hashem
According to the CDC, the social determinants of health are the “conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.” They fall into the following categories: health care access and quality, education, social and community contexts, built environments, and economic stability. Healthcare access and quality are somewhat self-explanatory; access can be impacted by time, location, and financial restraints, and quality describes the effectiveness of care. Education, both formal and informal, can impact people’s health through knowledge of healthy lifestyle choices. Social and community context refers to the influence that health decisions of an individual’s friends, family, and community members have on their own health choices. Built environments describe a person or community’s water and air quality, neighborhood safety, availability of healthy food, and access to housing and transportation. And economic stability culminates in all of the proceeding categories as it affects access to health care, living location, and everything in between. Because social determinants of health can make individuals more prone to certain illnesses, they should be considered when diagnosing patients.
The Issues in Diagnosing Patients
A medical diagnosis is often a first step in addressing a medical condition. In order to effectively treat an illness, it is crucial to characterize it and understand its causes. The general procedure for
diagnosing is as follows: an individual experiences a health concern and goes to a doctor to seek information and treatment. The doctor asks the individual about their symptoms, looks at their medical history, conducts exams, perhaps orders lab work, and then comes to a diagnosis. Every patient has a unique set of genetic and social health factors, and as much as there are efforts to standardize the diagnosing process, doctors’ perspectives and biases factor into it. The types of questions doctors ask, the direction they pursue, and the tests they order are all at their own discretion, so their lived experiences and schooling can greatly influence the final diagnosis.
Low-income populations are more commonly at risk for misdiagnosis as doctors sometimes neglect to consider the social determinants of health when diagnosing patients. For example, low-income and previously redlined neighborhoods are more likely to be polluted, a significant contributor to asthma, lung cancer, and other respiratory issues. While doctors may correctly diagnose these conditions, they may not attribute factors in a patient’s environment to their onset or worsening. Therefore, doctors must look into secondary diagnoses - additional conditions that a patient may have beyond the primary diagnosis. The secondary diagnoses may be contributing factors to the primary health concern.
A Doctor’s Anecdote
Physician Renee N. Salas recounts an experience examining a girl who had been diagnosed with asthma. The patient’s mother took her to Dr. Salas after diagnoses and treatment recommendations from other doctors failed to improve her condition, and her asthma worsened. Salas notes that despite being ineffective, these doctors’ diagnoses and treatments followed the standard of care. In looking up her patient’s home address, Salas found that she lived in a highly polluted, previously redlined area. Familiar with the connection between asthma and air pollution, Salas immediately recognized that her patient’s condition was likely connected to her living environment. Citing this experience, Salas stresses the importance of using secondary diagnoses, in this case suspected exposure to air pollution, to contextualize and shed light on the root causes of the primary diagnosis.
Solutions for Making More Comprehensive Diagnoses
Besides pollution, medical professionals need to assess for all social determinants of health. Dr. Salas’ experience provides doctors with a few broad pointers to achieve this– investigating living situations and accounting for patients’ environments. These are certainly important starting points, but more systemic solutions are required to address misdiagnoses large-scale. First, training on health disparities must be integrated more strongly into medical school curriculums. Currently, the standard curriculum involves courses on body and brain function, on behavior, and on laboratory procedures, as well as clinical practice, but no substantial course work examining the impact of the natural and built environment on health. Second, as continuing education courses are designed to educate professionals on new research and emerging treatment methods, they must be updated to emphasize the impacts of social determinants of health, as well as methods for addressing them. Other remedies include providing on-the-job training and educational materials for medical professionals that make them familiar with the health issues of the communities they serve.
Additionally, adequately addressing patients’ health issues means spending enough time with them to listen to their concerns and questions and to look into their past diagnoses and living environments. Therefore, as opposed to just financial incentives for seeing a certain number of patients, healthcare systems should be modified to include incentives for patients getting well.
In addition to training for healthcare professionals, community education is critical. No matter how comprehensive, caring and committed doctors are, they no longer make house calls. Patients know the details and changes in their lives intimately. They must also take charge of their own health. With community education, patients can make more educated connections between their health and illnesses and their environments. Armed with that information, they can better advocate for themselves in medical systems. Persistent, pervasive problems in diagnosing need multi-level solutions, from individual doctors, to hospitals, to health insurers, to larger societal responses.
Dima Bischoff-Hashem is an undergraduate at Rutgers University pursuing a double major in Public Health and Biomathematics. She aims to incorporate health-related participatory action research into her career and is currently a member of the Young People’s Campaign whose goal is to improve access to healthcare in the United States. She aspires to be a part of policymaking that improves the health of low-income communities. In her spare time, she enjoys hanging out with her pet rabbit and crocheting keychains, bookmarks, and stuffed animals for her business on Etsy.
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