Mental wellbeing of students: Conquering your fears

31 Oct 2022

We live in tough, stressful times. Feeling some trepidation ahead of the new semester is therefore perfectly normal. Professor Thomas Ehring from the Division of Clinical Psychology and Psychological Treatment explains how to deal with anxiety.

© MaltexMueller/imago-images

First the pandemic, now war and inflation: times are tough. And this is affecting the mental wellbeing of many students. In a survey conducted by the German Centre for Higher Education Research and Science Studies (DZHW) in the first year of the pandemic (2020), 10 percent of students indicated that they were suffering from mental stress. This was up from 7 percent in 2016 and 3 percent in 2012. According to the German Federal Ministry of Education and Research, depression is the most common mental health problem among students (80 percent), followed by anxiety disorders (39 percent).

A striking feature of the data is the skew toward certain faculties, with mental health problems most prevalent for linguistics and cultural studies students. International studies show, moreover, that symptoms of anxiety among students have increased during the pandemic.

And now there are fresh problems for students to worry about. Will a strong Covid wave come along and jeopardize in-person university life again? Will inflation leave them with enough money to cover food and rent? Will the winter really be as harsh as everybody is predicting? And if so, what does it mean for their lives? It is hardly surprising that all these uncertainties would make people apprehensive. And intrinsically, there is nothing wrong with this response. Fear is actually much more positive than its reputation would have it. “Many fears are perfectly normal!” says Professor Thomas Ehring, psychotherapist and Chair of Clinical Psychology and Psychological Treatment at LMU. “Fear is a natural, useful, and important alarm system in the body, which has ensured and continues to ensure our survival.”

Fear versus anxiety

Science has distinguished two different systems that have evolved in the human psyche: fear and anxiety. In fear, the physical response is usually massive. “This makes sense,” explains Ehring. “Fear arises in a very specific threat situation. It is meant to prompt a fight-or-flight response.” The body freezes or gets ready to fight or flee the threat. This accelerates heart rate and respiration. It can also induce sweating, shivering, and nausea. “Anxiety, by contrast, is less specific and milder,” says Ehring. “It alerts us to possible danger. When a person feels anxiety, they are anticipating a threat in their minds. So the excitement tends to be moderate.” However, even an imagined threat can feel very real. “This is due to the power of our imagination,” says Ehring. Unfortunately, this comes at a high price, as anxieties can get out of hand and make our everyday lives unbearable.

As Ehring is primarily interested in anomalous mental phenomena in his capacity as a clinical psychologist, he carries out research into “false alarms” – that is to say, fear and anxiety that arise too often, too powerfully, and at the wrong moment. This can happen, for example, as a result of traumatic experiences such as violence and war.

People who have suffered sexual or physical violence come to the trauma outpatient clinic he leads at LMU, as well as patients who have had traumatic accidents or lived through natural catastrophes. Syrian refugees come here for support, as do increasing numbers of war refugees from Ukraine.

“Very often, people with post-traumatic disorders have huge problems with anxiety,” says Ehring. “They get flashbacks, nightmares, panic attacks.” Patients do not even feel safe when there is no threat, because they have not been able to adequately process their stressful experiences.

“Normally, an experience is stored away in the memory and embedded in one’s own biography, where it fades over time,” explains Ehring. In the case of traumatization, things are different: The memory does not become less vivid, rather it is preserved with such clarity that environmental stimuli can trigger it at any moment. “When this happens, the person feels as if they were exposed to the threat right there and then.”

This is a mechanism, incidentally, that also applies to positive memories. We feel as if highly emotional moments such as the birth of a child, or a personal triumph, or our first kiss, have special resonance and intensity in our memory. “This is a normal process, which has the function of keeping important events in our conscious awareness.” Ehring and his colleagues offer traumatized patients practical help. “In a controlled, safe setting, we elicit and discuss the patient’s experiences. In this way, their brain learns something it had previously been unable to grasp, namely that the threat has passed.” The patient comes to understand the extent to which the trauma has shattered their conception of the world and affected their relationships. And they practice avoiding unhelpful behaviors. If the therapy is successful, the traumatic experiences are processed and filed away.

A major technique is exposure therapy, which can be successfully applied to most types of fear and anxiety. It works on phobias such as the fear of spiders, and also on the fear of exams and presentations that grips many students. “In the case of pathological anxiety, exposure is one of the most effective forms of therapy,” says Ehring and recommends exposing oneself as frequently as possible to the feared situation, indeed to simulate it. In the course of the habituation process initiated by this exposure, fears and anxieties lose their potency.

Ehring also researches the worried thoughts that frequently accompany anxiety. “Worrying often serves the cause of avoidance. Instead of sitting down and studying when we’re nervous about an exam, we fret about whether we’re going to pass. It would be better to think the matter through to its conclusion: What exactly will happen if I fail the exam? What will I do then?” He encourages people who are given to brooding to train themselves to stop the worrying process. Relaxation, mindfulness, and breathing exercises can also be helpful tools. For Ehring, the major problem still to be resolved in anxiety research resides less in treating anxiety than in prevention. “We’re very good at treating problems, but relatively poor at preventing them from occurring in the first place.”

Acknowledging negative feelings

Sophie Appl from the Intercultural Counseling Center at LMU is also interested in low-barrier methods of alleviating people’s fears and anxieties. The qualified psychologist looks after many foreign students who are suffering from anxiety. For all the adventure of studying abroad, it is not easy to find one’s feet in an unfamiliar land among strangers who speak a different language. “There are the anxieties ahead of the move, and then the culture shock and the fear of not making friends and of not understanding the university system. There is the pressure of parental expectations back home and the fear of not being good enough.”

The pandemic brought additional anxieties, such as the fear of misinterpreting the Covid rules. Or in the case of students from Asia, the fear of hostility and discrimination. Then there is the worry about not finding a job to support oneself, not to mention the all-encompassing feeling of loneliness.

At the moment, Appl is meeting lots of students who are anxious about the coming winter. Sometimes she refers students to clinics that can offer more intensive treatment. But to provide low-barrier assistance to people suffering from anxieties, she has published a blog over the past couple of years with tips about anxiety and the coronavirus.

“It’s very important to acknowledge negative feelings in the first place,” she explains. “When you suppress things, they get stronger. This is the case for all negative feelings.”

She recommends breathing exercises as an effective way of soothing anxiety. After all, when somebody is afraid or anxious, their breathing becomes shallower. “But if you breathe out for longer than you breathe in, it actually forces the body to relax.”

She recommends the following technique: “Breathe in for four seconds, hold your breath for four seconds, breathe out for eight seconds, then hold your breath again for four seconds.” The handy thing about this little intervention: “It can be done in a way that nobody will notice – you can do it in a seminar, say, or on the bus.”

In her blog posts, she describes many other ways of relaxing and shedding anxiety. She is convinced that “people can overcome their fears and anxieties, leading to personal growth and making them incredibly strong!”

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