Wellness is a concept that includes the care of your mind, body, and spirit. It includes reducing stress in positive ways, keeping fit, fostering your spirituality, deepening your self-knowledge, maintaining good sexual health, and taking a safe approach to alcohol—assuming that you are of legal age to consume it.

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Take this short quiz. As you consider each question, rate yourself on a scale of 1–5, with 1 being “never” and 5 being “always.”

As you read the preview of the many components of wellness described in this chapter, pay special attention to the areas that you scored as 1 or 2 so that you can get yourself on track.

Managing Stress to Maintain Wellness

Everyone experiences stress at one time or another—it’s a normal part of being a human being—but the level of stress affecting college students can decrease their academic success. Consider the level of stress you feel today. Rate your current level of stress on a scale of 1–5: 1 is “little or no stress” and 5 is “extremely stressed.”

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When you are stressed, your body undergoes physiological changes. Your breathing becomes rapid and shallow; your heart rate increases; the muscles in your shoulders, forehead, neck, and chest tighten; your hands become cold or sweaty; your stomach becomes upset; your hands and knees may shake; your mouth goes dry; and your voice may sound strained. Over time, stress can develop into chronic health issues such as irritable bowel syndrome, common colds, migraines, and fatigue.

A number of psychological changes also occur when you are under stress. You might experience a sense of confusion, trouble concentrating, memory lapses, and poor problem solving. As a result of stress, you may also make decisions that you regret later. High stress levels can lead to emotions such as anger, anxiety, depression, fear, frustration, and irritability, which might cause you to be unable to go to sleep at night or to wake up frequently. These stress-related changes can turn into more serious psychological problems such as anxiety disorder, depression, or panic attacks.

Stress has many sources, but two seem to be prominent: life events and daily hassles. Life events are those that represent major adversity, such as the death of a parent, spouse, partner, or friend. Researchers believe that an accumulation of stress from life events, especially if many events occur over a short period of time, can cause physical and mental health problems. Daily hassles are the minor irritants that we experience every day, such as losing your keys, having three tests on the same day, arguing with your roommate, or worrying about money. The best starting point for handling stress is to be in good physical and mental shape. If you pay attention to your body and mind, you will be able to recognize the signs of stress before they become uncontrollable.

Modifying your lifestyle is the best overall approach to stress management. You have the power to change your life so that it is less stressful. This power rests on an important, but simple, concept known as locus of control. Locus of control suggests that all of us are able to control some elements of our daily lives. When you identify the parts of your life that do not serve you well, make plans for change, and then carry out those plans, you are using your locus of control. One example of your locus of control includes deciding when to get up in the morning: if being late for class stresses you out, get up 10 or 15 minutes earlier. Another example is how you prepare for tests: If you have a lot of test anxiety, learn and practice test-taking skills. Many daily stresses result from decisions that you make yourself using your locus of control, and they all have a cumulative impact on what happens to you, either positive or negative, over a lifetime. As you learn from mistakes, you learn to believe in yourself and you develop greater resilience.

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Another way students can take control of their lifestyle is by knowing their boundaries and making priority lists. This might mean saying “no” to friends or family members who distract you from your tasks and obligations—for instance, telling a friend that you have to stay in to study instead of giving him or her a ride. It is OK to say “no,” and you don’t have to feel guilty about doing so. Students have many obligations (classes, work, their family, and peers), and they have to work hard to manage all their obligations and still maintain good grades.

Check your college website, counseling center, health center, student newspaper, or fitness center for workshops that teach stress management and relaxation techniques. You’ll also find apps, websites, books, and other resources that guide you through many options.

The Importance of Good Nutrition

There is also a clear connection between what you eat and drink, your overall health and well-being, and stress. Eating a lot of junk food will add pounds to your body and reduce your energy level, and with less energy you are less likely to want to exercise. When you can’t keep up with your work because you’re slow or tired, you will experience more stress.

Many of us find that gaining weight is really easy; a few days of donuts, pizza, and soft drinks can pack on unexpected pounds. Losing weight, even a small amount, is far more difficult. Let’s face it—food is one of life’s greatest pleasures, and having the self-discipline to say “no” to a giant piece of birthday cake is difficult. Weight gain also will reduce your energy and interest in exercise.

If you are gaining weight and losing energy, what can you do about your eating habits? It might not be easy at first, but if you start making small positive changes, you can build toward a new way of eating. You will not only feel better but also be healthier and probably happier. Here are some commonsense suggestions:

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Risky Eating Habits. Although we advise you to think about what you eat from day to day, we also advise you not to overthink your diet. Remember that the key to good health is achieving balance, and an obsession with food intake may be a sign that things are out of balance. Over the last few decades, an increasing number of both male and female college students have been developing eating disorders such as anorexia nervosa (an extreme fear of gaining weight), bulimia (overeating followed by self-induced vomiting or laxative use), or binge eating disorder (compulsive overeating long past the feeling of being full).

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Anyone who is struggling with an eating disorder should seek immediate medical attention. Eating disorders can be life-threatening if they are not treated by a health care professional. Contact the National Eating Disorder Association (nationaleatingdisorders.org) to find a professional in your area who specializes in the treatment of eating disorders. For help on campus with possible eating disorders, check out your counseling and/or health centers. This is a common phenomenon with stressed-out college students.

Caffeine. Caffeine is probably the best example of a commonly ingested substance that is linked to high stress levels. College students, like many adults, use caffeine to help with productivity. Caffeine increases alertness and reduces feelings of fatigue if used moderately. Up to 400 milligrams (mg) of caffeine a day appears to be safe for most healthy adults. That’s roughly the amount of caffeine in four cups of brewed coffee, ten cans of cola, or two “energy shot” drinks. However, too much caffeine can cause nervousness, headaches, irritability, upset stomach, and sleeplessness—all symptoms of stress. It is important to monitor your daily use of caffeine. Many students consume energy drinks, which can contain more than the recommended amount of caffeine. Be careful to limit your caffeine intake. Using coffee or energy drinks when you’re studying for exams, or even to get through the day, can become a crutch. Find other sources of energy, especially low-cost sources, like jogging or power napping.

The Effect of Alcohol and Other Substances on Wellness

In this section, our purpose is not to make judgments, but to warn you about the ways in which irresponsible use of legal and illegal substances can cause serious harm to your health and well-being and have a major negative impact on your college experience and success, not to mention your overall life. For college students, tobacco, alcohol, and marijuana are the substances most commonly used and abused. It is important to observe the laws that pertain to such use to avoid legal consequences. In the United States, the age at which you can legally consume alcohol is 21; and recreational marijuana use is legal only in a few states. The minimum legal age to purchase tobacco products has increased to 21 in California and Hawaii as well as dozens of localities in eight states across the United States.

Alcohol Use. Because 65 percent of college students drink alcohol in a given month, with a large percentage drinking too much,¹ it is important that all students learn about the effects of alcohol consumption. Alcohol can turn even people who don’t drink into victims, such as people who are killed by drunk drivers or family members who suffer as a result of the destructive behavior of an alcoholic relative. You might have heard news reports about college students who died or were seriously or permanently injured as a result of excessive drinking. Just one occasion of heavy or high-risk drinking can lead to serious problems.

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People experience the pleasurable effects of alcoholic beverages as the alcohol begins to affect several areas in the brain. How fast you drink makes a difference. Your body gets rid of alcohol at a rate of about one drink—defined as one 12-ounce beer, one 5-ounce glass of wine, or 1.5 ounces of hard liquor—per hour. Drinking more than one drink an hour may cause a rise in blood alcohol content (BAC) because the body is absorbing alcohol faster than it can eliminate it. We should also note here that popular home remedies for sobering up, like drinking coffee or water or taking a cold shower, don’t work.

At BAC levels of .025 to .05, a drinker tends to feel animated and energized. At a BAC level of around .05, a drinker may feel rowdy or boisterous. This is where most people report feeling a buzz from alcohol. At a BAC level between .05 and .08, alcohol starts to act as a depressant, so as soon as you feel that buzz, remember that you are on the brink of losing coordination, clear thinking, and judgment.

Driving is seriously impaired at BAC levels lower than the legal limit of .08. In fact, an accurate safe level for most people may be half the legal limit, or .04. As BAC levels climb past .08, people become progressively less coordinated and less able to make good decisions. Most people become severely uncoordinated with BAC levels higher than .08 and may begin falling asleep, falling down, or slurring their speech.

Most people pass out or fall asleep when their BAC level is above .25. Unfortunately, even after you pass out and stop drinking, your BAC level can continue to rise as alcohol in your stomach is released to the intestine and absorbed into the bloodstream. Your body may try to get rid of alcohol by vomiting, but you can choke on your vomit if you are unconscious, semiconscious, or severely uncoordinated. Worse yet, at BAC levels higher than .30, most people will show signs of severe alcohol poisoning, such as an inability to wake up, slowed breathing, a fast but weak pulse, cool or damp skin, and pale or bluish skin. Anyone exhibiting these symptoms needs medical assistance immediately.

Now that we have discussed the dangers of excessive drinking, here are some simple harm-reduction approaches to consuming alcohol:

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Tobacco and Marijuana. Tobacco is a legal drug that contains nicotine, a highly addictive substance, and is the cause of many serious medical conditions, including heart and lung diseases and some forms of cancer. One concern that particularly relates to college students is social smoking—smoking when hanging out with friends, drinking, or partying. Becoming addicted to cigarettes often derails plans to stop social smoking after graduation.

You may have noticed advertisements for electronic cigarettes (e-cigarettes or e-cigs) or seen them in stores. According to the U.S. Food and Drug Administration, e-cigarettes are battery-operated products designed to deliver nicotine, flavors, and other chemicals in the form of vapor. “Vaping,” or using e-cigarettes, has not been fully studied, so consumers currently don’t know the potential risks.

Although only a small percentage of college students use smokeless tobacco, the habit is no less addicting than smoking is. One dip delivers the same amount of nicotine as three or four cigarettes. Smokeless tobacco contains 28 known cancer-causing substances and is associated with many of the same health risks as cigarette smoking.

A final reason for smokers to quit, or for others never to start, is the cost (see Table 11.1). If you are a smoker, contact your campus health or counseling centers for more information about quitting.

Recently, Colorado, Washington, Oregon, Alaska, and Washington, D.C., became the first places in the United States to legalize recreational marijuana use for individuals 21 years or older. It is still not legal in other states or federally, however. As with tobacco, there are health risks associated with smoking it. Some impacts of marijuana use include an increase in anxiety, paranoia, short-term memory loss, and depression. In addition, marijuana smoke increases your risk for lung cancer, much like tobacco. It is important to know the risks and acknowledge your state and federal laws.

Exercising to Maintain Wellness

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Exercise is an excellent stress-management technique, the best way to stay fit, and an important element in effective weight management. Whether it’s walking to class, going to the campus recreation center, or going for a bike ride, it is important to get outside and be active every day. Any kind of exercise benefits your body and spirit and is a great choice for stress and weight management. Choose activities that you enjoy so that you look forward to your exercise time, and make it a regular part of your routine. People who exercise report higher energy levels, less stress, better sleep, healthier weight, and an improved self-image compared with people who do not exercise.

Besides doing wonders for your body, aerobic exercise keeps your mind healthy. When you do aerobic exercise, your body produces hormones called beta-endorphins. These natural narcotics cause feelings of contentment and happiness and help manage anxiety and depression. Your mood and general sense of competence improve with regular aerobic exercise.

Think about ways to combine activities and use your time efficiently. Maybe you can leave your car at home and walk or ride a bike to class. If you must drive, then park at the far end of the parking lot to get in extra steps. Try going to the gym with a friend and asking each other study questions while on the treadmill. Take the stairs whenever possible. Wear a pedometer or a tracker like Fitbit, or use pedometer apps such as S Health or Stepz on your phone, and aim for a certain number of steps each day. If you’re a parent, run around with your kids. Many campuses have fitness centers that offer exercise equipment and organized sports. The most important thing about exercise is that you stay active and make it part of your day-to-day life.

Knowing your BMI is a good way to understand your optimum size. According to the U.S. Centers for Disease Control and Prevention (CDC), BMI is calculated by weight and height, and provides an effective way to screen for health issues. You can use an automatic BMI calculator such as that available at nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm, or you can do the calculation yourself. For an adult, calculate BMI by dividing weight in pounds (lbs.) by height in inches (in.) squared and multiplying by 703.

Example: Weight = 150 lbs., Height = 5'5" (65")

Calculation: [150 ÷ (65)²] × 703 = 24.96

Per cdc.gov, a BMI of under 18.5 indicates “underweight,” 18.5 to 24.9 is “normal,” 25 to 29.9 is “overweight,” and 30 or higher is “obese.”

The Importance of Sleep

Getting adequate sleep is another way to protect yourself from stress. According to a 2013 Gallup poll, almost 50 percent of individuals aged eighteen to twenty-nine get less than the recommended seven hours of sleep per night.²

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Lack of sleep can lead to anxiety, depression, and academic problems. Researchers found that students who studied all week but then stayed up late partying on the weekends forgot as much as 30 percent of the material they had learned during the prior week. Try the following suggestions to establish better sleep habits:

Managing Your Emotional Health to Maintain Wellness

Your emotional or mental health is an important component of your overall health. Particularly in the first year of college, some students have difficulty establishing positive relationships with others, dealing with pressure, or making wise decisions. Other students are optimistic and happy, and seem to believe in their own abilities to address problems successfully. Your ability to deal with life’s challenges is based on your emotional intelligence (EI). Emotional intelligence is part of your personality; if you take a psychology course in college, you will learn more about it.

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Taking care of your emotional health is a big part of maintaining wellness. When one’s emotional health declines, the consequences can be very serious.

Depression. According to the National Institute of Mental Health, an estimated 17 million adult Americans suffer from depression during any one-year period.³ College students are at especially high risk for both depression and suicide because of the major life changes and high stress levels some of them experience during the college years.

Depression is not a weakness; it is an illness that needs medical attention. Many college students suffer from some form of depression. The feelings are often temporary and may be situational. A romantic breakup, a disappointing grade, or an ongoing problem with another person can create feelings of despair. Although most depression goes away on its own, if you or a friend has any of the following symptoms for more than two weeks, it is important to talk to a health care provider:

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One trigger for depression is simply the process of starting college. As you begin, you may not know enough about this new way of life to know what to expect. This may trigger short-term depression and anxiety. You can receive free and confidential assistance on many campuses either through a counseling or health center.

Suicide. The CDC reports that students aged 15 to 24 are more likely than any other group to attempt suicide.⁴ Most people who commit suicide give a warning of their intentions. The following are common indicators of someone’s intent to commit suicide:

If someone you know threatens suicide or displays any of these signs, here are some ways you can help:

Finally, remember no shame is attached to having high levels of stress, depression, anxiety, or suicidal tendencies. Unavoidable life events or physiological imbalances can cause such feelings and behaviors. Proper counseling, medical attention, and in some cases prescription medication can help students cope with depression and suicidal thoughts.

Cyberbullying. In recent years, cyberbullying has been on the rise, not just in grade school and high school, but on college campuses as well. Experts define cyberbullying as “any behavior performed through electronic or digital media by individuals or groups who repeatedly communicate hostile or aggressive messages intended to inflict harm or discomfort on others.”⁵ According to a recent study, the prevalence of cyberbullying among college populations ranges from 10 to 28.7 percent.⁶ These may seem like low numbers, but cyberbullying can go unreported because of embarrassment or privacy concerns. Tragic cyberbullying stories that have resulted in the victim’s clinical depression or suicide have been reported in recent years.

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Cyberbullying is a serious issue that harms individuals in many ways. It is a crime that should be dealt with immediately. If someone you know has experienced cyberbullying, or if you have been a cyberbullying victim, you should report it as soon as possible. Several foundations and resources are available to help students report cyberbullying: