Student loans have been increasingly common in young households. In 1989, one of every six had student loans. In 2001, the number was nearly one of four. And by 2010, the number of households with student loans was more than one of three. Among consumer debt, only mortgages exceed the amount of student loan debt.

In today’s economy where stagnant wages and zooming tuition costs are causing student loan debt to skyrocket, the mental health stresses brought on by student loan debt — often amplified by credit card and car loan debt — are more powerful than ever.

A recent study found that finances are ranked as the second largest stressor among college students. More than one-third of the respondents report that finances are traumatic or very difficult to handle.

This guide will help the growing number of people dealing with the issues that may result from overwhelming debt, including:

Financial Pressure Creates an Environment for Mental Health Issues

Two factors conspire to create financial and emotional stress on young adults. First, many young people have a poor understanding of the long-term repercussions of financial decisions like a student loan and, as a consequence, tend to take greater risks in their financesthan any other age group.

Second, three out of five college freshman arrive at school suffering from at least one medically treated mental health problem.

A recent college student facing student loan payments, in addition to the responsibilities of job and family, faces an emotional and psychological avalanche. Financial satisfaction is an integral component of life satisfaction, and it is closely related to one’s overall psychological well-being.


Anxiety is a natural reaction to stressful situations. Our bodies “rev up” to provide higher levels of focus to meet a challenge, whether it be a college test, job interview, or first date.

However, an abnormal level of anxiety, or anxiety that persists long after the immediate challenge has passed, is an unhealthy state and constitutes a mental health issue. Sustained anxiety is a major cause for social phobias and panic disorders. For some people, anxiety becomes the norm, in what is known clinically as generalized anxiety disorder (GAD).

Nearly one in three U.S. households currently live with student loan debt.

Financial stress is often a contributing factor to anxiety. When an individual has a recurring anxiety related to finances —often the case with student loans — it can lead to an emotional and mental environment that leads to depression and other health issues.

Stress and anxiety rank highest among mental health complaints of college students. A study by the American College Health Association (ACHA) of 97,000 college students found that stress and anxiety were the top non-academic factors determining a student’s academic success. Students in the study reported periods of feeling overwhelmed and exhaustion, both of which are linked to anxiety. Students described their symptoms as impaired memory and an inability to order one’s thoughts. On the emotional side, students reported a range from mild — the inability to relax and have a good time and a tendency to procrastinate — to more serious emotional problems like depression. Physical symptoms associated with anxiety include rapid heartbeat, nausea, and dizziness.

College grads and adults attending career schools report lower rates of anxiety than very young adults in college. However, adult anxieties are more complex in their causes, and finances are often part of the mix. For adults, anxiety has a more dramatic impact than on youths. Anxiety can affect a person’s career, family life, and ability to function successfully in the modern world.

Although anxiety is generally associated with personal, social or financial triggers, factors in one’s environment can also play a part. Lack of sleep or disturbed sleep patterns, diet, neurochemical imbalances, and chemical pollutants in the atmosphere can also factor as triggers or accelerators of anxiety.

Online Resources to Better Understand Anxiety


AThe National Institute of Mental Health (NIMH) points to 11 behaviors that are warning signs for depression:

  • Difficulty concentrating, remembering details, and making decisions
  • Fatigue and decreased energy
  • Feelings of guilt and worthlessness
  • Feelings of hopelessness or pessimism
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Irritability and restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Overeating or appetite loss
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease with treatment
  • Persistent sad, anxious, or empty feelings
  • Thoughts of suicide or suicide attempts

These conditions can occur as a transitory phenomenon when a student faces a term paper or exam; or for a graduate, a job interview or big client meeting. However, these behaviors are warning signs of actual depression when they persist.

Types of Depression

The NIMH describes several kinds of depressive disorders, as well as major depressions. These conditions refer to true depression, not the “blues” or a reaction to an uncomfortable state of being. These are disabling in that they interfere with everyday activities such as studying, eating, and sleeping.

In delineating these conditions, the NIMH also notes that for many people, a depressive disorder may only occur once in a lifetime, but for others, depression comes back repeatedly.

Mild Depressions
  • Dysthymia

    The NIMH list of depressions starts with the mildest disorder: dysthymia. The condition, which was once known as neurotic depression, is less severe than a major depression, but the symptoms can last for two years or more. These patients are mostly characterized by the inability to act and a habit of being overly critical. Such a condition leads to low self-esteem and an overall feeling of inadequacy. Dysthymia can trip up a person in the ability to take on new challenges.

  • Minor Depression

    A minor depression is similar in symptoms to dysthymia, as well as to a major depression. Common symptoms include an inability to function in a normal manner, fatigue, loss of interest in things that once mattered, overeating, or a sharp reduction in food intake. Minor depression symptoms are less severe and last a shorter period of time than a major depression.

    The primary distinguishing characteristic of a depression is that its symptoms cripple an individual’s ability function normally. They are symptoms independent of factors like substance abuse or trauma, such as the loss of a loved one. Those who suffer from minor depression have no history of major depressive disorder or manic episodes. However, the NIMH cautions that people with a minor depression are candidates for developing a major depressive disorder.

Online Resources to Better Understand Depression

Seasonal Affective Disorder

Seasonal affective disorder (SAD) has symptoms similar to other forms of depression: lack of energy, irritability, sleep disorders, and loss of interest in once-favored activities. SAD differs from these other forms of depression in that it has a visible cause and a conclusion.

SAD is called “seasonal” in that it often begins during the dark months of winter and lifts with the rising sun during spring and summer.

Acute Depressions
  • Depressive Psychosis

    Psychotic depression or depressive psychosis is a severe depression accompanied by psychosis. People with psychotic depression have the symptoms of depression plus psychosis, which is a loss of contact with reality. Psychosis can include delusions about what is taking place in an individual’s environment; identity problems, in which a person does not know who he is; or hallucinations, in which a person sees and hears things that are not present. The pattern of these delusions is often negative, including criticisms and feelings of inadequacy that reinforce the environment and symptoms of depression.

  • Manic-Depressive Illness

    Manic-depressive illness, sometimes referred to as a bipolar disorder, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. It is a mental health condition that commonly develops in a person’s late teens or early adult years.

    Symptoms of manic-depressive illness are severe and are significantly different from the normal emotional ups and downs most people experience. Symptoms can result in damaged relationships, poor job or school performance, and even suicide.

Manic-depressive illness can be treated, and people with it can lead full and productive lives.

Online Resources to Better Understand Bipolar Disorder

  • PTSD

    Post-traumatic stress disorder (PTSD) is a mental health issue that stems from a traumatic experience. The salient factor with PTSD is that the fear and sense of impending doom continue after the danger has subsided.

    Some symptoms of PTSD resemble other depressions: feelings of guilt, a sense of isolation, the inability to sleep, or a desire to sleep all the time. However, PTSD also includes highly disturbed mental and emotional states: uncontrollable recurrence of mental images, flashbacks, nightmares, extreme edginess, explosive anger, thoughts of doing harm to oneself or to others.

    PTSD was originally called “shell shock” as a term for physical and emotional trauma experienced by soldiers in war zones. The mental health issue of PTSD affects a number of U.S. veterans, especially of wars in Afghanistan and Iraq. Since its impact on a person’s psyche is often long-term, it can be an issue for older vets as well.

    Once the psychiatric community came to better understand PTSD , they extended the diagnosis beyond war combatants to include individuals who have experienced many traumatic conditions. These include surviving a plane crash, a natural disaster, or sustained physical abuse, such as child or spousal abuse. PTSD can occur for witnesses of incidents that involve serious harm or fatalities, from car accidents to murder.

Online Resources to Better Understand PTSD

Treatments for Anxiety and Depression

The first step in regaining a healthy mental state is to recognize that there is a problem and seek professional help. The impetus to do so can come from the individual or from friends and family. Even if the affected persons thinks he can go it alone, the right course of action is to start with a professional assessment. With that assessment, an individual has an informed opinion of the scope of the problem and potential activities or treatments to alleviate its negative impact.

Student loan debt has ballooned in the past 10 years. In 2000, the total of outstanding student loan balances was less than $500 billion. Today, the number is $1.2 trillion, second only to mortgages.

Psychologists also tout the value of peer groups for learning techniques to relieve anxiety and depression. Health service centers at colleges and community services in a number of cities and towns organize regular drop-in sessions.

PTSD is a special case because many with PTSD are U.S. military war veterans. Some colleges, and in particular career colleges, have designed campus programs and curricula to accommodate the needs of those with PTSD. Most of these colleges also strongly advocate participation in group meetings, where those with PTSD can find commonality with others in their struggles to cope with the stresses of college and daily life.

For current or recent students who wish to work on their issues alone, information is available in local libraries and online, including mental health self-assessment programs.

However, the advice from the NIMH is to “give treatment a chance” and have at least a preliminary diagnostic appointment with a mental health professional. The NIMH points out that early treatment can relieve symptoms quicker and reduce the length of time treatment is needed.

Insurance May Cover Anxiety & Depression Treatment

For the college student, seeking professional help is relatively easy. Most colleges and universities have mental health services, counseling, and student health centers. A college counselor can do an initial assessment and provide short-term psychotherapy, or may refer the person to a local professional mental healthcare provider.

Services at these organizations may be provided under a health insurance plan included in the registration fee structure. If not, the college typically subsidizes mental health services so fees are much less than typical rates.

In current mental health treatments, most forms of anxiety and depression are treated in part with pharmaceuticals. These drugs may or may not be covered by your insurance policy.

Common-Sense Advice for Anxiety and Depression

Anxiety and many forms of depression include feelings of being overwhelmed, isolated, and believing one is inadequate to meet daily challenges. To offset these anxieties, mental health care professionals have some common-sense advice:

  • Break up large tasks into smaller ones

  • Do what you can, when you can

  • Spend time with friends or relatives whom you trust, and with whom you can share your feelings

  • Try not to make important decisions until your disposition has improved

  • If you must make important decisions, review those decisions with someone you trust

A healthy body makes a healthy mind. The brain, small as it is, uses 25 percent of the body’s energy each day. Brains need three things to perform its best: Exercise, sleep, and fuel.


Exercise increases blood flow to the brain and triggers the release of chemicals in the brain that reduce anxiety and promote feelings of well-being. Exercise will also release muscles taut with anxiety-related tension, and the heartbeat tends to slow after exercise, another factor that promotes a sense of ease.


The old dictum about getting eight hours of sleep is often ignored in today’s fast-paced and busy life. However, science is finding considerable evidence of a direct link between a full night’s sleep and good mental health. The common perception that a person can “catch up” on sleep by adding additional hours on another night or the weekend is incorrect.

During sleep, a person’s body repairs and replenishes chemicals in the brain and throughout one’s body. This repair-and-replenish sequence only occurs after the body has been at rest for some time, and the processes often take hours before a proper balance is achieved.

For people who suffer from anxiety or depression, a lack of sleep and the consequent lack of balance in the body’s essential functioning mechanisms will exacerbate physical and emotional symptoms.

Eat Right

Diet is another a factor that can improve or worsen a person’s anxiety and depression. The functions of the brain and a person’s blood flow and blood pressure are directly affected by the intake of nutrients.

Among important nutrients, research shows that foods that contain antioxidants are helpful. “Antioxidants clearly prevent or delay oxidative damage,” according to Aron Troen, neuroscientist at the Jean Mayer USDA Human Nutrition Research Center at Tufts University. “That may be especially important for brain health,” Troen said. “Since the brain is the most metabolically active organ in the body, it is exposed to the most oxidative stress. The brain also contains high levels of lipids, or fats, which are especially prone to oxidative damage.”

More than one in 10 student loan borrowers default on their loans.

Research has shown that a nutrient-rich flow of blood to the brain can reduce the symptoms of depression. As a result, one’s mood and outlook on life improves.

Health, wellness, and nutrition are popular subjects, and there is a wealth of information available at the library, bookstores, and online.

Most colleges offer nutritional counseling that support emotional and mental wellness. For grads and adults, most communities have certified nutritionists who can help design a personalized diet strategy. The cost of nutritional counseling may or may not be covered under a medical insurance plan.

Emergency Care: Suicide Hotlines

Not all people who suffer from anxiety and depression, even in its more acute forms, consider suicide. However, a number of studies have determined that there is a direct link among debt, depression, and suicide.

A Law and Psychology Review study titled “A Certainty of Hopelessness: Debt, Depression, and the Discharge of Student Loans Under the Bankruptcy Code” found that difficulties in repaying debts were found to be independently associated with suicidal ideation. “The clinical implication of these findings is that individuals experiencing difficulties in repaying their debts may require psychiatric evaluation as well as socio-economic counseling.”

In a study of debt and its relation to suicidal behavior among the population in Finland, the findings were dramatic evidence of the links among debt, mental disorders, and suicidal tendencies.

A study titled “Debt and suicidal behaviour in the Finnish general population” found that “of those with a mental disorder, 23 percent were in debt (compared with 8 percent of those without disorder), and 10 percent had had a utility disconnected (compared with 3 percent without). The more debts people had, the more likely they were to have some form of mental disorder, even after adjustment for income and other socio-demographic variables.” The study also found that “people with six or more separate debts had a six-fold increase in mental disorder after adjustment for income.”

Online Resources for Depression

Other Mental Health Issues

Although anxiety and depression in its various forms are the mental health issues for those struggling with student loan debt, there are several other issues that can make coping much more difficult, including ADHD, OCD, alcohol and drug abuse, and eating disorders. What follows is a look at these conditions, and resources for information and treatment.

Attention-Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is a term for a spectrum of symptomatic behaviors that include difficulty focusing and organizing one’s thoughts, mood swings, hyperactivity, and excessively compulsive tendencies.

For households with a head of household under age 40, the average net worth is $8,700 while those with exactly the same salary but no student debt have an average net worth of $64,700. Households without student loans are 7.4 times richer than those with student loans.

Also known as Attention Deficit Disorder (ADD), ADHD is a condition that on its own makes coping difficult, and can be greatly exacerbated by substance abuse and sleep problems. Clinically, ADHD is both a cause and a result: the coping issues it creates can lead to anxiety and depression; those with anxiety and depression can exhibit their mental state with ADHD behaviors.

Research indicates that ADHD is a large and growing problem, particularly among young people. Among the general adult population, approximately 11 percent have ADHD; among college students, ADHD diagnoses are close to 20 percent.

People with ADHD can have a tough time with depression and anxiety. Most treatment protocols require repetition of new, more positive behaviors as a way to break the depression pattern. In some cases, the treatment includes medications, which must be taken at specific times and intervals. For those with ADHD, finding the right medication and maintaining a set schedule or protocol is a formidable challenge.

ADHD Treatment

As the ADHD problem on campuses has grown, colleges are responding with increased counseling resources. In some cases, colleges have developed a hybrid freshman year in which a student takes courses that increase coping skills, such as time management, studying and testing skills, and money management. Other responses include a college course curriculum designed specifically for students with ADHD, particularly for those with other learning disabilities, or providing a tutor to help students navigate coursework and social activities.

Online Resources for ADHD

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is characterized by an overwhelming urge to perform the same routines with daily tasks and other interactions.

While most people are prone to habits, the OCD person is compulsive about it and may engage in repeating a routine even when such behavior is contrary to his best interests. A commonplace example would be a person who cleans the dishes, makes the bed, sorts the trash, and is then late for an appointment.

OCD can also exhibit itself in behaviors less routine and banal than daily chores. For a person with OCD, the urge to maintain a routine is strong, regardless of whether the consequences are positive or negative. A person with OCD is more likely to exhibit social behavior that is unpleasant or socially unacceptable and, in its more extreme forms, can even be dangerous.

The onset of OCD is more likely to occur in late adolescence or early adulthood. The NIMH estimates that about 2.2 million adults in the United States have OCD.

OCD is often linked with anxiety and depression. Someone with the urge to maintain a routine even when circumstances strongly suggest a more positive response is much more likely to encounter conflicts and over time, a discouraging view of their social and personal identity. OCD, with its emphasis on repeated behavior, is also strongly linked to eating orders and drug and alcohol abuse.

OCD Treatment

Breaking the chain of obsessive-compulsive behavior is difficult, but modifying the behavior into acceptable limits is possible through informed therapy. Much of the treatment is designed to help identify the mental and physical environment that leads to OCD behavior, so that he can make adjustments before the urge takes over. Other aspects of treatment are focused on reducing anxiety and depression or eliminating eating disorders and drug and alcohol abuse.

Counseling centers at colleges and career schools are well-versed in diagnosing and treating OCD and its common corollary problems of anxiety and depression. As with other mental health issues, OCD counseling at colleges and in the community may or may not be covered by health insurance. More likely, insurance plans cover depression and anxiety and the therapist or counselor includes OCD behavior in the treatment plan.

Online Resources for OCD

Substance Abuse

Substance abuse is not a mental health disorder in and of itself. However, alcohol and drug abuse are behaviors that can lead to a number of problems in coping with stress, and can lead to an acceleration of the onset of anxiety and depression.

About one in three former students who borrowed for college are dissatisfied with their finances. Of those who did not borrow, one in seven are dissatisfied financially.

Alcohol and prescription medication abuse is common in society and sometimes seen as a rite of passage for college students. In recent years, prescription drug abuse has soared. The CDC reports that pharmaceutical drug overdoses now surpass motor vehicle accidents and firearms as the leading cause for death. Substance abuse is also strongly linked to serious anti-social behavior, sexual assault, and self-damaging behaviors, including suicide.

Clinical studies indicate that some people are far more likely to move from social use of drugs and alcohol to dangerous levels of abuse and addiction. One’s genetic makeup, family experiences, and maturity are all factors.

A particularly negative aspect of substance abuse is that those who are suffering from anxiety and depression make things far worse by the overuse of alcohol or drugs. Whether one’s anxieties spring from schoolwork, professional and social pressures, or financial problems like looming student loan debt, “escape” into substance abuse will derail any possible alleviative treatment.

Alcohol and Drug Abuse Treatment

Since Americans have a long history of dealing with alcohol and drug abuse, there is much information available to better understand it and more therapies to successfully treat it.

Colleges and career schools are well aware of substance abuse problems. Most colleges have alcohol policies, and those in violation are required to see the campus health center for screenings and intervention. On most campuses, a student can also self-refer and get treatment. Campus health center staff members are trained to spot indicators of anxiety and depression as well, and will design a treatment plan appropriate for the mix of symptoms exhibited.

In post-college adult life, some businesses require screenings for alcohol and drug abuse, particularly those in which employees have a role with sensitive information or in providing security for others.

However, most adults do not have a third-party requirement to undergo screenings and treatment for substance abuse. It is up to the individual to seek help — or more likely, for those who care about the individual to provide an intervention. In either case, the mental health community of therapists and counselors has field-tested treatment plans to reduce a person’s reliance on drugs and alcohol, relieve anxiety and depression, and find a path back to a productive life.

Online Resources for Substance Abuse

Eating Disorders

In 2012, two out of three graduates from public colleges had student loans, three of four graduates from private non-profits had student loans, and nine of 10 grads from for-profit schools had loans.

Americans have a confused relationship to their food intake. On the one hand, there is a remarkable amount of information on nutrition and healthy eating available online, at libraries, and on newsstands. Despite all this attention to healthy eating, the number of obese Americans is at an all-time high.

Overeating that leads to obesity is a common symptom of depression and anxiety. Therapists say that depressed people can turn to food as a source of pleasure that they are otherwise not finding in their daily lives. As a related pattern, people who are overweight often develop anxiety as they face a negative turn in their self-image and in the responses of others to their physical condition.

Under-eating is likewise a common symptom linked to depression and anxiety. People who feel overwhelmed financially or other causatives may seek to gain control of the one thing within their power: they own bodies. The two most common under-eating disorders are anorexia nervosa and bulimia nervosa. The difference between the two is that anorexia is characterized by extreme weight loss and an obsessive preoccupation with what foods one eats and with portion control. Bulimia is similar, but is characterized by binge eating followed by purging and rapid weight loss.

Similar to obesity, individuals with anorexia or bulimia are often in a state of heightened anxiety most of the time, which can develop into depression. Likewise, depressed people may seek greater control of their circumstances by extreme dieting.

Eating Disorders Treatments

The obese need look no further than daytime TV to find advice on weight loss. Most socially popular diets, it should be noted, often result in weight loss followed a return of the lost pounds.

For people seeking more permanent control of their weight, a combination of professional nutrition advice and therapy are the ticket. In most cases, conditions of high weight gain or loss have psychological roots. A trained therapist can help an individual gain a greater understanding of the circumstances that led to one’s food disorder and, by addressing the causal triggers, recommend diet adjustments that are do-able within the pattern of one’s daily life.

A therapist can also help when obesity or weight loss disorders like anorexia or bulimia are tied to anxiety and depression. Many colleges and career schools already have counseling to address eating disorders. In some cases, they can also tap into the school’s nutrition department to provide dietary counseling.

Adults seeking treatment will find that eating disorders like obesity, anorexia, and bulimia are covered by most insurance plans.

Online Resources for Eating Disorders

Additional Resources

Where to find online and local help for mental health and substance abuse issues.

Online resource providing access to U.S. government mental health information. provides a range of information from facts and myths to helpful articles to how and where to get help to local organizations with mental health expertise.

Mental Health America

Find local support groups for a variety of issues, including addiction, Alzheimer’s, grief, brain injury, gambling, debt, eating disorders, and many others.

Substance Abuse and Mental Health Services Administration (SAMHSA)

Online search engine for people seeking treatment facilities in the United States or U.S. territories for substance abuse or addiction and mental health problems.

Center for Parent Information and Resources (CPIR)

Find information organizations that focus on specific disorders, where to find mental health services, and how to find mental health services in schools. Also has links to quick facts on mental health.

Find a Psychologist

Produced by the National Register of Health Service Psychologists, this site will help you find a local therapist by area of expertise, ages of patients served, the therapist’s theoretical orientation, and other credentials.

Find a Therapist

Produced by the Anxiety and Depression Association of America, this site will help you find a local therapist that specializes in anxiety disorders, depression, OCD, PTSD, and related disorders.

National Suicide Prevention Lifeline

Talk to someone immediately and learn how to find a local support group or therapist. Learn how to become involved, including volunteering at your local support center.

U.S. Department of Veterans Affairs Veterans Crisis Line

A searchable database to help veterans and their families find local mental and behavioral resources.