Stress, Depression, and Sleep Among College Students

There has been a rise in the prevalence of mental health disorders among western industrialized populations.1 By 2020, depression will be second to heart disease in its contribution to the global burden of disease as measured by disability-adjusted life years.2 Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States ages 18 and older, or 18.1% of the U.S population every year.3
Mental disorders are prevalent in young adults and frequently present between 12-24 years of age.4 The top five sources of stress reported by college students were changes in sleeping routines, changes in eating habits, increased amount of work, new responsibilities, and breaks/vacations.5 Overall, a total of 73% of college students report occasional difficulties sleeping, and 48% of students suffer from sleep deprivation, as self-reported.6,7
Lifestyle factors such as diet, exercise and sleep may influence symptoms related to stress and depression.8 Symptoms of depression include but are not limited to, persistent anxious or sad moods, feeling guilty or helpless, loss of interest in hobbies, irritability, and other behaviors that may interrupt daily living.9 Inadequate intake of folic acid from fruits and vegetables, and essential fatty acids in fish, may increase symptoms of depression.10 Unhealthy eating habits may be associated with increases in depression-like symptoms in women, supporting the notion that healthier eating habits may decrease major depression.11 Diet is only one component of how lifestyle may influence depression and stress in adults. Exercise may be another important component in decreasing depression-related symptoms due to the release of endorphins.12 It has been found that participating in regular physical activity may decrease tension levels, increase and stabilize mood, improve self-esteem, and lead to better sleeping patterns.13 It has been concluded that individuals who consume a healthy diet are less likely to experience depression whereas people eating unhealthy and processed diets are more likely to be depressed.14
Poor sleep quality as well as unstable sleeping patterns may lead to poor psychological and physical health.15 Poor sleep includes longer duration of sleep onset latency, which is defined as the amount of time it takes to fall asleep, waking up multiple times throughout the night, and not getting a restful sleep because of tossing and turning.16 In healthy adults, the short-term consequences of sleep disruption consist of somatic pain, emotional destress and mood disorders, reduced quality of life, and increased stress responsivity.17 Irregular sleep-wake patterns, defined as taking numerous naps within a 24 hour span and not having a main nighttime sleep experience, are present at alarming levels (more than a quarter) among college students.18 A study done with 2,000 college students concluded that more than a quarter of the students were at risk of a sleeping disorder.19 Therefore, college students who were classified as poor-quality sleepers, reported experiencing more psychological and physical health problems compared to their healthy counterparts. Perceived stress was also found to be a factor in lower sleep quality of young adults.20
The link between depression-like symptoms and sleep remains poorly understood. It is mentioned that there are risk factors of poor sleep, depression and anxiety among college students but this topic has not yet been heavily studied within this population.