I've been helping college students deal with the pressures of young adulthood for twenty-five years. And yet I confess that when I was in college, I did not take the advice that I now give to you. I still regret it. I clearly remember some of the mistakes I made along the way and wish I had the wisdom in my youth to seek help that would have avoided a lot more mistakes, pain, and lost opportunities.
I remember thinking that I was comfortable, confident, and autonomous when I left for college. I had been a strong high school student, a three-sport athlete, and socially very engaged and confident. When I arrived at college, among a group of very bright, accomplished other students, I felt insecure but never admitted this to myself or anyone else. I felt the best way to prove that I could manage was to be sure I didn't need anyone. I drank a lot on many weekends, like many other college students, to bolster my confidence in social situations, but it didn't really work and probably interfered with forming deeper relationships with peers. I threw myself into literature and reading and isolated myself, trying to prove that I was autonomous and didn't need anything from other people.

If you had asked me at the time, I would never have described myself as depressed and would not have seen my drinking and isolation as "coping mechanisms." I frequently pulled all-nighters to study for exams and finish papers, having no idea of the negative effects of sleep deprivation. And I admit that the thought of seeking counseling never entered my mind.

It took me years to learn that the patterns and behaviors practiced in college don't disappear when you graduate. You must address them to develop as a person. I now know that there is no need to suffer long or suffer alone.

Keep that thought in mind. When you start to feel unhappy or anxious, it is a normal reaction to withdraw from friends. You probably figure that they don't want to be around someone who's un happy or struggling, and you don't want them to worry about you. But once you're isolated, you might find out that you feel worse. Then you might think that the feeling will pass; it's just a mood, after all. But it doesn't pass.

Now you've created a vicious cycle. You've withdrawn from your friends, but then you feel worse, and feeling worse makes you less willing to socialize, which makes you feel even lonelier, and the bad feelings just go around and around. Still, you think that eventually you'll get these awful feelings under control. But another day goes by, and then another, and another, and still you can't shake it.

If you suffer any of the symptoms of depression and anxiety listed earlier for more than two weeks, it's going to be very hard, if not impossible, to get over this tough spot without the help of others. We all need each other to feel connected, engaged, and mentally healthy.

The result of reaching out to others when times get tough opens the way to a secure and happy future beyond college. You don't have to take my word for this. Take a look at this e-mail that I received from Kara when I wrote to ask for permission to publish the personal letter about depression she wrote four years ago that opened this chapter:
I wish you the best of luck with the book. And I am delighted to hear that my article has helped so many over the years. I am so grateful for the time that you spent helping me, as well as the countless others. I have learned how to recognize "bad" days, and they never get past "so-so" days anymore. It's wonderful! My spouse and I have been very open about the topic and we have discovered similarities in our pasts"likely due to both being so driven and ambitious. This has helped us grow and also achieve a new focus in life"energy with underlying strength and assuredness. I have enjoyed every moment of it, including the stressful days.
I can never thank you enough for encouraging me to follow the full path of treatment and for giving it time. It has made the world of difference.

If you should ever feel alone and hopeless, remember Kara. There is treatment, there is a life of joy beyond college, and there is hope.
Above all else, I'd like you to remember these five things:
Self-care is not the same as being selfish.
Be honest with yourself about what you're feeling.
Eat, sleep, and exercise.
Stay connected to others.
Think of proactive ways to address problems.

Good grades and impressive jobs don't mean anything if you feel miserable all the time. There are people"family, friends, peers, and counselors who can help you, so reach out when you need to.