• Marked changes in academic performance or behavior, poor performance or lack of preparation.
• Absences or tardiness.
• Unusual or changed pattern of interaction.
• Avoiding participation.
• Domination of discussions.
• Excessive anxiety when called upon.
• Disruptive behavior.
• Exaggerated emotional responses obviously inappropriate to the situation.
• Unusual behavior or appearance.
• Depressed or lethargic mood.
• Hyperactivity or very rapid speech.
• Unexplained crying.
• Irritability or angry outbursts.
• Swollen or red eyes.
• Change in personal hygiene or dress.
• Dramatic weight loss or gain.
• Strange or bizarre behavior indicating loss of contact with reality.
• References to suicide, homicide or death.
• Expressed thoughts of helplessness or hopelessness.
• Isolation from friends.

If you choose to approach a student you’re concerned about or if a student reaches out to you for help with personal problems, here are some recommendations.

• Talk to the student in private when both of you have the time and are not rushed or preoccupied.
• Give the student your undivided attention. It is possible that just a few minutes of patient listening may be enough to help the student feel cared about as an individual and more confident about what to do.
• Listen to thoughts and feelings in a sensitive, non-threatening way. If you have initiated the contact, express your concern in behavioral, non-judgmental terms.
  • For example, “I’ve noticed you’ve been absent from class lately and I’m concerned,” rather than, “Where have you been lately? You should be more concerned about your grades.”
• Communicate understanding by repeating back the essence of what the student has told you. Try to include both content and feelings.
  • For example, “It sounds like you’re not accustomed to such a big campus and you’re feeling out of it.”
• Let the student talk.
• Assure the student that things will get better.
• Help the student realize that there are options and that things will not always seem hopeless.
• Ask the student what resources have been helpful in the past to manage stress/emotional distress.
• Suggest resources (e.g., family, friends, counselors or professional help on campus).
• Maintain clear and consistent boundaries and expectations.
• Refer to other resources if:
  • The student states intention to harm themself or others.
  • The problem is more serious than you feel comfortable handling.
  • You are extremely busy, stressed and cannot find the time to deal with the student.
  • You have helped as much as you can and further assistance is needed.
  • You think your personal feelings about the student will interfere with your objectivity.
  • The student admits that there is a problem but doesn’t want to talk to you about it.
  • The student asks for information or assistance you are unable to provide.

Refer to the related emergency procedures as necessary.

For general stress and anxiety, the active listening skills detailed above are appropriate. Some additional considerations for helping someone cope with stress and anxiety include:

• Learn some of the signs more specific to anxiety.
  • Physical symptoms: light headedness, sweating, nausea, restlessness, shortness of breath, GI distress, easily fatigued
  • Anxious thoughts: believing the worst will happen (catastrophizing), persistent worry, overgeneralization
  • Anxious behaviors: avoidance of feared situations, seeking out reassurance, irritability and frustration in feared situation
• Provide validation for the person’s concerns. You may not see their concerns in the same way they do, but you can always validate their experience.
• Express concern. Be open, direct and non-judgmental in your communication.
• Avoid minimizing or dismissing their concerns.
• Don’t enable avoidance behaviors. Even though avoidance helps to reduce in-the-moment distress, over-reliance on avoidance-based coping can reinforce symptoms of anxiety.
• Don’t force confrontation. Help the student gain mastery over their own experience by finding small, manageable ways to challenge themselves.

A panic attack is an acute episode of distress characterized by a sudden rush of intense fear or discomfort accompanied by four of more of the following:

• Palpitations, pounding heart or accelerated heart rate.
• Sweating.
• Trembling or shaking.
• Shortness of breath or sensation of smothering.
• Feelings of choking.
• Chest pain or discomfort.
• Nausea or abdominal distress.
• Feeling dizzy, lightheaded or faint.
• Chills or heat sensations.
• Numbness or tingling sensations.
• Derealization (feelings or unreality) or depersonalization (being detached from oneself).
• Fear of losing control or “going crazy.”
• Fear of dying.

For someone who may be experiencing a panic attack, here are some helpful steps to consider:

• Name it gently — “you may be having a panic attack and it will pass.”
  • This helps to provide context for the experience and may help to relieve some fear of the unknown.
  • Remember that panic is temporary — symptoms usually peak around 10 minutes, but may last 20–30 minutes.
• Stay calm.
  • You may be feeling uneasy yourself in this situation. Take some deep breaths and model calming behaviors.
  • If you start to feel overwhelmed, reach out for support.
• Give them space.
  • During panic, the person may be easily overstimulated by touch, noise, bright lights, etc.
  • If possible, move to a quiet, calm location.
  • It’s OK to stay nearby if they ask you to, but you want to reinforce their ability to ride out symptoms independently.
• Offer coping statements.
  • Be empathetic, but don’t be overly reassuring or fussy.
  • Avoid reinforcing ideas that panic is dangerous, harmful or needs to be “escaped from.” Rushing to fix emotions often makes symptoms more intense and prolongs intense emotional episodes.
  • Try saying things like:
    • “You can handle these symptoms.”
    • “This will pass.”
    • “These feelings aren’t comfortable, but you can work through them.”
    • “These symptoms will roll over you, like a wave coming in and going back out.”