Student Anxiety and Its Impact: A Recent American History

Abstract

This article traces the rise of anxiety among American high school and college students since the late 1950s, with particular focus on the decades before 2000. Evidence for rates of change comes from anxiety tests administered during the period, as well as a variety of psychological studies. The article also takes up the issue of causation, highlighting the extension of counseling services and psychological vocabulary that affected evaluations of nervousness; the impact of negative developments like crime rates and growing family instability; and the results both of changes in educational patterns—such as more frequent examinations—and significant shifts in student goals and expectations. Finally, the article touches on efforts to mitigate anxiety, such as expanding student services, and also their limited impact.

A contemporary self-styled parenting expert claims that virtually all American teenagers are now anxious, and most are quite aware of their condition: they are “anxious about everything we are anxious about, and more.”¹ At the college level specifically, counseling center directors in 2002 were reporting an 83 percent increase in psychiatric disorders over the previous five years, with anxiety heading the list and an even more rapid surge in traffic at mental health centers. There was an even steeper increase in the years that followed, even before the challenge of the COVID-19 epidemic. In 2019 one report insisted that 66 percent of the student population was manifesting “overwhelming anxiety.”²

The sense of crisis is obvious, and deeply troubling, and has been increasingly grasped even beyond the campus setting, particularly as the COVID-19 pandemic has pushed anxiety beyond the tipping point for many young people.³ The problem is all the more confounding because, at least before the epidemic, a number of aspects of student life were arguably improving, from rising grades to more elaborate student services to greater sensitivity to sexual identities, without there being a clear dent in the rise in anxiety—an obvious challenge to careful analysis.

The crisis has been examined from a variety of angles. Psychologists and psychiatrists have taken the lead, focusing particularly on plausible therapies, though usually commenting at least in passing on the phenomenon itself and on some possible causes. Almost uniformly, and for several decades, studies have also suggested a sense of change, highlighting the data on increases in psychological disturbance but also a larger conviction that young people's lives have become very different today from times past. Student anxiety, in other words, far from being a fixed phenomenon, has been rapidly accelerating. Admittedly, a few studies note some legitimate uncertainty about whether anxiety is really going up, or whether there is simply a growing willingness to report and to seek help—and this would be a significant change in its own right⁴

The focus on change means that the issue of student anxiety is also a historical topic, though it has not been explored extensively from that vantage point. It requires the same effort to assess origins, timing, and causation that should be applied to any significant shift in culture and experience. To be sure, as an effort at contemporary history the assessment of anxiety has certain perils, including the nature of available evidence. It must be noted at the outset that what one might wish for—a rich sequence of comments from afflicted students over the past several decades—is simply not available. The evidence in this article derives mainly from observers, along with data on relevant changes in context.⁵ This is important in itself, since observers—and particularly, psychological counselors—play a role in the larger phenomenon, but it does have limitations in terms of the experience of anxiety-sufferers themselves.

What is possible, and what this article explores, is the emergence of anxiety as a concern on American college campuses and among students themselves from the 1960s onward, and the factors that propelled the concern. Prior to this point, and even as student mental health began to attract more explicit attention after World War II, there was substantial professional agreement that the student population could be divided into three groups: a troubled but fairly small minority (10 percent was the common figure); a slightly larger healthy minority; and a majority that presented some problems but not fundamental distress.⁶ Over time, clearly, this evaluation changed, and growing recognition of anxiety played a major role in the evolution. Tracing the growth of anxiety as a student problem, and the increasingly explicit institutional response, offers a crucial historical dimension on a vital current issue, and an opportunity as well to explore the factors that contributed to change even before the challenges of student debt, school shootings, and pandemic disruption arose. The fact is that student anxiety has been intensifying far longer than is commonly realized, which means that the causation involved is more complex, and arguably even more troubling, than is commonly assumed as well.

Extending the chronological framework for the rise of student anxiety, and venturing a more comprehensive approach to the causes involved and to initial institutional efforts to recognize and address the problem, admittedly counters some common impulses in the field. The undeniable recent surge in anxiety that calls attention to the problems of the past few years, plus the widespread delight in identifying successive generations—as demonstrated by the current “iGen” label—and differentiating them from their predecessors, has distracted from a fuller perspective and more complex diagnosis.⁷ In fact, the first tentative signs of growing student anxiety stretch back decades before Snapchat or Instagram or the Omicron variant or even soaring costs reared their heads. The initial trend was not a crisis, but it led to a context in which crisis could occur and in which professional responses, often led by university researchers and fledgling counseling centers, would play a growing role. In the process, the initial assumptions about campus mental health—emphasizing a mixture of student “problems” with a minority of the seriously troubled—would progressively shift toward the more pessimistic, even alarmist, assumptions that are common today.

Exploring the gradual but seemingly inexorable rise of student anxiety over several decades involves assessing a number of complex connections. The relationship between campus anxieties and the problems of younger students is one: anxiety did not start with college orientation rituals. At the same time, connections with major changes in educational systems and in college students themselves prove surprisingly important in assessing the anxiety surge, in contrast to some earlier diagnoses that highlighted external factors—like the threat of nuclear war, or changes in family life—without much attention to dramatic shifts in the institutional context. Above all, assessment of any major aspect of student mental health inevitably brushes up against the steady medicalization of anxiety and other phenomena over the past several decades, with a host of well-meaning experts offering diagnoses and treatment on and around the campus setting, contributing to new perceptions in the process.⁸ The result unquestionably complicates historical evaluation.

What follows is, first, a summary of historical approaches to anxiety in general, followed by a comment on conditions in the early 1950s, before student anxiety began to surge. The surge itself comes next, with the initial burst through the 1960s followed by a steady but more moderate increase. Discussion of causation regarding anxiety builds out from impressions of observers at the time, with strong emphasis on the combination of growing therapeutic concern and changes in student experience and expectation. A final section deals more briefly with developments in our own century, including efforts at institutional response.

Anxiety and History

Anxiety is a vague term. Even from a medical standpoint, anxiety is often hard to distinguish from other issues such as depression and simple nervousness (both of which are important in dealing with student anxiety).⁹ A certain amount of anxiety is, arguably, part of the human condition, a reality that is neither particularly noteworthy nor, from a historical standpoint, has necessarily changed over time. Many people, from experts to sufferers, have trouble distinguishing among degrees of anxiety, from seeing it as motivation, or nuisance, or disorder.

Scholars—and particularly philosophers—even dispute anxiety's role in mental health. Thus Rollo May, while noting that anxiety was a “pervasive and profound phenomenon in the twentieth century,” argued that it promotes focus and intelligence, not necessarily a problem at all. This obviously also raises the question of who gets to determine when anxiety has shifted to harmful levels: the individual in question or some outside expert.¹⁰

The plasticity of anxiety certainly applies to the common assumption, at least over the past century, that one's own historical time is a particularly anxious one—another impulse that impinges on any attempt to assess the rise of student anxiety. “Ages of anxiety” have been identified fairly regularly from the interwar period onward.¹¹ W. H. Auden's post-World War II poem to this effect helped him win a Pulitzer Prize for literature, but the concept has persisted in a variety of fields, including psychology. Considerable precedence exists for explaining anxiety outcroppings in one's own time at least in part in terms of a kind of modern inevitability. It is of course possible that the modern age is more anxious than the premodern, or that the twenty-first century is surpassing the twentieth. Proof is elusive, however, and the concept may have dubious value as an explanatory device. The assumption is another challenge to contend with, however, in dealing with the surge in student anxiety.

This in turn links with a further complication, explored by sociologist Allan Horwitz, who has offered the most ambitious overall history of anxiety to date (focused mainly on the medical aspect): surges in anxiety may not correspond clearly to an increase in actual problems.¹² Horwitz notes that the inescapable rise in attention to claims of adult anxiety during the 1950s occurred at a time of growing prosperity and increasing health and longevity, arguing that it was professional attention—including the new interests of pharmaceutical companies—that really supported the change. The possible disjuncture between modern rates of anxiety and “reality” may mirror the same kind of gap that has been discovered concerning the experience of fear; and it will be important at least to raise the possible applicability of this skeptical approach to some aspects of student anxiety over the past half century, linked to the general issue of medicalization but also ranging more broadly. For example, college admissions anxiety now runs high among many secondary school students, but the number of college slots has actually expanded more rapidly than the applicant pool—not just recently, but for several decades.¹³ This does not mean that the anxiety is artificial, but it clearly involves factors beyond an objective response to a problem.¹⁴ Establishing a history of “real” anxiety is challenging in many ways.

The 1950s as Point of Departure

While the surge of student anxiety fairly clearly begins, if gradually, in the late 1950s and 1960s, several features of the prior decade provide context. One was the sheer acceleration of interest in anxiety as a phenomenon. Debates over the somatic and psychological balance in anxiety had advanced from the end of the nineteenth century, from the preoccupation with neurasthenia onward through Freud and others. There was abundant precedent for a further intensification of professional interest after World War I and for the increasing claim that the phenomenon was primarily a medical matter. And while most of the work had focused rather generally on adults, some of the turn-of-the-century commentary on neurasthenia and modern mental fatigue had included concern for students. Heated debates about the burdens of homework on student physical and mental health in the early part of the twentieth century, while not referencing anxiety explicitly, also provided a potential context later on for receptivity to claims of deteriorating mental health.¹⁵

The primary focus during the 1950s centered on anxiety generally, as it gained a growing place in the standard psychiatric manuals from the 1950s onward. The initial Diagnostic and Statistical Manual of Mental Disorders (DSM; 1952), which summarized and guided work in psychiatry, termed anxiety a “psychoneurotic disorder” with a number of manifestations including phobias. DSM-II amplified the importance of the category, with more attention to panic attacks and other physical symptoms. The growing list of anxiety types helped persuade a wider public that anxiety was not simply a normal reaction to uncertainty, but a problematic condition. To be sure, DSM-III in 1980 estimated that only 2-4 percent of the population suffered from an anxiety disorder at any given time, suggesting still a rather tentative concern.¹⁶ However, some individual experts were claiming that the majority of patients that sought medical help were suffering from anxiety owing to an “overabundance of tensions, fears, worries and anxiety that confront mankind today.”¹⁷ Picking up on the growing concern, but also fanning it, several professionals would form the Anxiety Disorder Association of America, in 1980. Equally important, the basic psychiatric literature also began to extend the situations in which excessive anxiety could be experienced, including “work or school performance.”¹⁸ The growing effort to anchor anxiety in real-life settings replaced earlier emphasis on problems within the individual—displacing the notion that anxiety, while serious, was “without cause,” which in turn encouraged people to use the label more freely in dealing with a variety of stresses. Finally, while there was some attention to how long a sense of anxiety had to be present to qualify as a problem, there was no real definition of “excessive”: people were invited to use the label if they felt it was applicable.

This evolution was intimately connected to the simultaneous surge of pharmaceutical attention, where the 1950s provided a particularly clear turning point. When the first anxiety drug—Miltown—emerged in 1955, manufacturers actually worried that there might not be a market. They were quickly disabused. Miltown's success was followed by a procession of FDA-approved anxiety-relevant medicines, including Valium, Prozac, and Xanax, with wide sales only slightly dented by critiques from feminists (who resented the disproportionate attention to women) and others. (By 1973, 20 percent of all adult women and 8 percent of men were using Valium or some equivalent.) The drugs drew huge attention in the popular press, as well as company-sponsored advertising campaigns. As the maker of Paxil once claimed, in a burst of imprudent sincerity, “Every marketer's dream is to find an unidentified or unknown market and develop it. That's what we were able to do with social anxiety disorder.”¹⁹

Not surprisingly, professional, pharmaceutical, and media interest generated growing references to anxiety in general. The Google Ngram Viewer, though at best suggestive of public interest, shows a clear trend in the occurrence of the word anxiety in a large corpus of books: rather low levels of the word use during the first four decades of the twentieth century, followed by a clear uptick in the 1940s and 1950s and the steep and steady ascent thereafter, as shown in Figure 1.²⁰

Chart 1. Anxiety in American English Usage, 1900- early 21st Century: A Google Ngram

To be sure, the rise of medical and popular attention did not initially apply specifically to young people or students, though the drug Librium was discussed as a possibility for disorderly children while the manufacturer, Roche, tried to market it for students with learning disabilities. Growing interest in using Ritalin for ADHD was a related development in the same period. However, DSM manuals would only begin to note children as anxiety-sufferers from DSM-III onward. Unquestionably, a larger concern about identifying a specific student anxiety problem emerged more slowly and later than the professional and public fascination with anxiety more generally.²¹

Indeed, without falling into misplaced nostalgia, the mid-1950s provide a clear contrast to later student patterns in a number of respects, which may help explain why attention focused elsewhere and why students themselves relatively rarely used the term anxiety, more commonly referring to what experts noted as “nervous problems,” if they commented at all. The percentage of students seeking to go to college was still relatively small. Those who did usually applied to only one institution, close to home, and since only 145 colleges were requiring SAT (Standard Aptitude Test) scores at this point, entry procedures may have occasioned relatively little stress. With few colleges boasting dedicated admissions offices, the competitive atmosphere that would become vivid later on was largely absent. Once in college, the continued acceptability of the “gentleman's C” grade may have continued to cushion student concerns to some extent. Claiming a lack of widespread student anxiety is admittedly in one sense an unprovable proposition: the clearest evidence is the absence of frequent reference to the term. However, there were features of higher education at the time that were consistent with the relative calm among the students involved, compared with trends that would begin to take hold by the end of the decade.²²

Nevertheless, the growing professional and popular interest in general anxiety during the 1950s inevitably impinged on some students. Most obviously, a growing number of students had parents, particularly mothers, who were worried about their own anxiety. More specifically, it was also in the 1950s that psychological and psychiatric researchers and some fledgling college counseling offices began looking for anxiety and related signs of mental distress in the student population. Starting in the late 1940s, a host of studies of what was called test anxiety brought anxiety concerns onto college campuses directly.²³ The need seemed clear enough: a substantial minority of students were unable to translate their basic abilities into academic success thanks to problems with test-taking. Experts were eager to identify the problem and experiment with a variety of remedies, and it was certainly true that a distressingly large percentage of college students were dropping out, at least in some cases because of this barrier.²⁴ But the decision to apply the anxiety label to what many students themselves had called nervousness was itself revealing. Further, it was consistent with a larger movement in the 1950s to begin testing students at various levels, grade school as well as college, for their anxiety potential. A host of ambitious anxiety-measurement schemes were generated precisely for this purpose.²⁵ The questionnaires would provide vital longitudinal data about anxiety rates, but they also encouraged experts and potentially some students themselves to look for problems or interpret older issues in new ways. The result, though hardly reason to dismiss student anxiety as a manufactured problem, inevitably raises the same questions that researchers like Allan Horwitz have applied to the rise of adult anxiety in that same 1950s period. The balance between “real” changes in student mentalities and the impact of the larger, increasingly medicalized cultural climate is hard to determine. For there is no question that by the 1960s a growing number of researchers and agencies were not only looking for campus anxieties, but finding them in growing abundance.

Signs of Change: The 1960s as a Starting Point

In an ambitious article published over two decades ago, psychologist Jean Twenge argued that evidence points to a steady increase in youth anxiety from the end of the 1950s to the 1990s, both among college students and grade schoolers (average age: eleven).²⁶ Her data derived from accumulating the results of anxiety tests (150 in all for college students, 99 for grade schoolers) administered during the same four-decade period, and charting the fairly steady increase in the percentage of examinees reflecting problems. It can be argued that the sample size was fairly small, though Twenge was careful to eliminate students who were in some kind of therapy; her subjects were apparently “normal.” To be sure, comparable evidence from decades prior to the 1950s is absent: anxiety tests were a new phenomenon after midcentury—as in the widely used Taylor Manifest Anxiety Scale, introduced in 1953 with a version for children following in 1956. But the change from an early 1950s baseline was striking.²⁷

And it seems to have been fairly steady, though the rate of increase may have slowed after the late ’60s until it surged again early in the twenty-first century. Twenge's data suggest a 23 percent increase in male student anxiety between 1952 and 1967, and 27 percent for females, then another 12 percent surge (and 22 percent for females) between 1968 and 1993—by which time the average American child or college student was considerably more anxious than those counterparts in the 1950s who had actually been under psychiatric care.²⁸

Not surprisingly, even as studies of anxiety—and particularly examination anxiety—multiplied from the 1950s onward, most researchers and counseling professionals did not initially emphasize any particular increase While estimates varied, it continued to be widely believed that anxiety and other psychological issues among students were fairly constant—though experts were eager to point out that they were far more common than most people realized and that a large number of students who needed help were not seeking it.²⁹

When a handful of colleges first began to set up mental health services—Princeton established its own by 1910—very few students reported mental illness. A 1920 Harvard study suggested that about 16 percent had some neurotic condition. Data from Michigan and Minnesota in the same period revealed 10-15 percent of students with serious psychological problems, though only 50 percent (Minnesota) or 15 percent (Michigan) were deemed “really well.” Other 1920s studies similarly pinpointed about 10-16 percent with serious problems, though at that point there was no specificity on the types of ailment involved.³⁰

Doubts about the decisiveness of these new trends persisted even as interest in student anxiety increased. An unusually skeptical 1963 epidemiological study noted that use of mental health services was growing simply because of greater student awareness—by this point about 14 percent of all colleges had some psychiatric or psychological services—but not because of greater need. About 16 percent of all students (particularly women) were using services when available, but many were not in fact ill. The authors noted a widespread belief that about 10 percent of all students had mental health needs, but insisted the actual figure was nearer to 6.5 percent, adding that the more students were examined, the more likely some problem would seem to emerge.³¹

This particular estimate was decidedly on the low side, for findings of anxiety and other signs of mental distress were beginning to accelerate. The discovery that at least a quarter of all students suffered from test anxiety already began to move the needle. For students in general, by the early 1960s most estimates insisted on a figure of at least 10 percent or even a bit higher, even as some intensification was probably already underway. A Yale study noted that about 10 percent of the student body was using the mental health clinic, particularly during the first year, but nearly half of these simply had adjustment problems, not real illness; on the other hand, many students who could use help stayed away, for 75 percent of students who tested positively for mental illness had never visited a clinic. Revealingly, the biggest student complaint continued to be “nervousness,” suggesting that anxiety was not yet a particularly relevant term for students, followed by “loneliness.” Another account cited 25 percent of all students suffering from some level of disturbance. But the experts themselves increasingly saw anxiety as a major culprit, with about 80 percent of clinically disturbed students and 30 percent of those more mildly troubled suffering from the disorder. A Harvard report in the early 1960s stayed away from “anxiety” but noted a common “apathy” that interfered with study and led the affected students to try to bypass the increasingly competitive atmosphere in the classroom; here again, one wonders if the kind of problem that would later be called anxiety was more pervasive than realized. A Vassar estimate cited a figure of 15-20 percent who could use help, though only half sought it. A small religious college (unnamed) cited a figure of 12 percent, with another 30 percent more mildly troubled. During the 1950s and 1960s the growing focus on test anxiety, often “extreme anxiety,” produced even higher numbers of 20 percent or more; 24 percent of students at a Christian college reported this problem, while figures at Southern Illinois University were also high. Another inquiry pointed to 20 percent of students in general suffering from examination anxiety, rising to 25 percent in the college population.³²

In other words, evidence past midcentury suggests a considerable incidence of issues that might later more uniformly fall under an anxiety heading—such as “nervousness” or “apathy”—plus some indications of a clear increase beyond the conventional 10 percent of the student body. This complements, if loosely, the trends suggested by the anxiety test results.

From the late 1960s onward, experts of various stripes increasingly agreed that mental health problems, including anxiety, were surging, possibly rapidly, though the old 10 percent stereotype lingered in some cases.³³ A Boston University report suggested that a full 78 percent of the student body had real emotional problems, with 7 percent suffering from psychosis. Dartmouth found that only 7 percent of its students in the class of 1962 were “mentally impaired,” but that figure soared to 16 percent just five years later. The University of Missouri saw a 300 percent rise in mental health complaints in the same period, though many involved “transient situational issues.” Fifty-five percent of students reported “personal problems” at Brooklyn College that interfered with study, with a large minority considering counseling, though only 5 percent actually following through. By the late 1960s, 35 percent of those seeking counseling at Harvard emphasized considerable “anxious agitation,” with anxiety causing serious problems in their studying.³⁴

College freshmen themselves ultimately confirmed the trend, as suggested by large annual national polls. In 1966, 60 percent of them believed they enjoyed above-average emotional health, and this would actually rise to 70 percent by 1980. But by 2001 the figure was dropping rapidly, to 56 percent, as growing numbers of students grew concerned about their own anxieties and about anxious peers (as reflected by several studies noting growing beliefs that others were being affected by mental health problems).³⁵

Granting both considerable campus-to-campus variation and some imprecision amid a variety of definitions of mental ailments, the claim that some fundamental mental health deterioration began to occur from the late 1950s onward—or at least that both experts and students began to be more aware of relevant problems—seems highly probable. Though the phenomena involved obviously varied greatly in severity, this was also the period in which youth suicide rates began to rise rapidly, though in this case—in contrast to the anxiety trends—they would later decline, thanks in part to the urgent efforts to expand campus counseling centers, before a renewed surge after 2000.³⁶

The Challenge of Causation

If the 1950s-1970s were the seedbed of the contemporary American problem of youth and student anxiety, the obvious question is why—what was changing at this point to induce both greater consciousness of mental health problems and an expansion of the problems themselves? Further, what has sustained the trends?

Causation is a tricky issue in history, since there is no opportunity for confirmatory experiment. With a development as recent and as diffuse as mental health changes, the challenge is even more substantial. Observers at the time suggested several possible components that can help launch a discussion and can also contribute to an understanding of how colleges began to respond to the problem, while additional correlations can be suggested as well. Not surprisingly, college agencies such as counseling centers have usually emphasized factors in the larger environment, now including the deterioration of the natural environment itself, plus shifts in the nature of the student body. They have been less open to the role of well-meaning agencies and researchers or alterations in educational structures that colleges themselves have helped to create, though the latter have been gaining some attention. Compounding the challenge is the inability to assign proportions to the main factors involved.³⁷

At the same time, analysis is not impossibly open-ended. Some possible issues, such as economic fluctuations, do not seem relevant; student concerns about jobs and the economy, and even finances, bounced around in the final half of the twentieth century, but there was no consistent trend until well after 2000. Indeed, attention to these factors was at a low point in the 1990s, while anxiety continued to increase, albeit more slowly than before. It is both possible and desirable to be somewhat selective concerning causes and correlations.³⁸

Indeed, despite unavoidable imprecisions about their relative importance. three major clusters of factors have been primarily responsible for generating the changes in student mental health: the growing awareness and acceptance of therapy; external factors, both on the big stage and at the family level; and the mixture of shifts in educational structure and in student expectations. Many of these factors have persisted into the twenty-first century, to be joined by more familiar developments such as the advent of social media, debt, and pandemic disruptions. Analyzing the causes of a transformation over a half century ago, in other words, feeds directly into the analysis of today's dilemmas, as the transformation has persisted and expanded.

The Role of Experts and Services

Not surprisingly, given the growing role of psychological research and service by the 1950s, the impact of well-meaning experts on student anxiety would only expand. In the 1970s, two new terms became popular among students themselves and those who counseled them: math anxiety and writing anxiety. The phrases had not been widely used before (though the idea of math anxiety built on a claim of “mathemaphobia” had been introduced in the early 1950s), but they would have a healthy existence from that point onward, complete with new measurement procedures.³⁹ (The notion of public speaking anxiety also added to the mix around the same time, though it had a clientele well beyond student ranks.) The neologisms focus some of the obvious questions about student anxiety more generally. Were the new terms simply fairly harmless replacements for older notions, such as the nervousness in anticipating tests reported by Yale students and others in the 1950s? Did they reflect growing levels of mental tension, among other things, as college populations expanded and the importance of educational results increased—specific symptoms, in other words, of the broader changes in anxiety levels? Or were they, at least in part, the product of well-meaning researchers and counselors who had been highlighting the prevalence, and resultant damage, of examination anxieties for over two decades, spreading a new vocabulary in the process? The answer to each question is yes, in all probability, but sorting out the balance between changes in psychological experience and the results of professional input is no easy matter. The role of input, however, at least provides a causal starting point, for anxiety in general as well as for the neologisms in writing and math.⁴⁰

As a few mental health authorities themselves noted, the gradual growth of psychological and counseling services, and the even more rapid increase of research interest in the area, undoubtedly played a role in greater student awareness of vulnerabilities—including their own—in a society becoming increasingly comfortable with psychological language, therapy, and even medication. The expansion of campus research projects continued, maintaining but moving beyond the earlier interest in test anxiety. Many projects were informed not only by specific concerns about academic performance, but by the wider belief in the threatening nature of modern life.⁴¹ Experts were also increasingly concerned about impaired students who were not seeking counseling on their own, and the view that in fact most of the students in greatest need of therapy were least likely to admit it helped motivate the ongoing fascination with questionnaires to get at problems the students involved were not openly admitting. Specific groups also won attention. In one study, for example, a hypothesis that primary and secondary students in special education programs were unusually likely to be anxious was confirmed through questionnaires, potentially motivating corrective action. Some interest also attached to the issue of transitions from high school to college and the rate of college dropouts. Several studies exclusively probed dropouts, who reported “a feeling of anxiety concerning self in relation to the new environments,” with their impressions of college being “impersonal, frightening, fraught with pitfalls”—and who were badly in need of counseling.⁴¹

These were also the decades when doctors and researchers began paying increased attention to the problem of Attention Deficit Disorder. To be sure, the first DSM did not recognize this category, in 1952. But Ritalin was introduced in 1955, and the DSM acknowledged an issue in 1968, with the 1980 edition exploring the ADHD label. There was also growing concern from parents and teachers, leading to unusually high rates of medication in the United States and a steady increase in diagnoses. Here was another contribution to increasing concern about the psychological fragility of students—at various ages. By the 1990s the attendant surge of students on some kind of psychiatric medication would add another relevant complication to college life.⁴²

Finally, what can be seen as a “psychological turn” in American education helped generate a steady reorientation of student services toward greater sensitivity to mental health problems, including anxiety. The school counseling profession had been born in the 1920s, sometimes initially just involving an interested faculty member offering parttime service. For several decades attention focused primarily on what is now called career counseling (though West Point had a psychiatrist on staff as early as 1921), at both the school and college level; however, as a more specialized profession emerged, some leaders began calling for attention to student mental health issues as early as the 1930s. E. G. Williamson, for example, claimed that almost all students had personal issues that colleges should help them address, involving both the “basic psychological needs of all young people” and issues specifically attached to academic life.⁴³ But the real move occurred, not surprisingly, from the 1950s onward. The trend was gradual: in the 1950s only about 10 percent of all colleges, a significant number of them private institutions, had any service specifically available for psychological issues. But growth was steady, as was the expansion of reports stressing the need for mental health counseling. As early as 1986, 16 percent of college psychological counselors were reporting that they were “frequently overwhelmed” by student demand—obviously, that figure would only increase (to 27 percent in 2002).⁴⁴

These developments bring us back to this aspect of the causation puzzle. The rise of therapeutic student services clearly reflected growing student need, or at least awareness. But, running parallel with the other varieties of anxiety research and therapy, it could also promote a sense of need, encouraging—with every good intention—a growing number of students to wonder if their nervousness was anxiety, if they needed to think about professional help. Here was one key measurable component of a larger package.

External Sources: The Wider World

Those involved with student mental health and aware of a growing problem sometimes went beyond platitudes about a modern “age of anxiety” to look for linkages with new events and patterns beyond student life. This was particularly true for those concerned with signs of trouble in young people generally, and not just college students. The category is a tough one. It is at best correlational. It calls for difficult judgments about whether one kind of threat is more troubling than another. But some attention is unavoidable.

As Jean Twenge later noted, two candidates seemed particularly plausible for the anxiety surge from 1960 onward: crime rates and the threat of war.⁴⁵ Crime rates did rise rather rapidly in the United States from the 1960s to the early 1990s, and the change was even more widely publicized. Politicians, particularly from the Republican side, played on the trend. Changes in newscasting, and especially the rise of dramatic local news segments from the 1970s onward, complete with out-of-studio coverage, promoted even wider attention. Included in this flurry were growing, though statistically unwarranted, concerns about rates of stranger abduction of children.⁴⁶ By the early 1980s, if not before, this atmosphere was beginning to produce greater parental caution about children's behavior, ranging from new efforts to supervise trick-or-treating at Halloween to new restrictions on unsupervised play in parks or use of urban transportation. Surveys of college students over time suggested relevant awareness: though decidedly liberal on most subjects, students between the 1960s and 1990s became increasingly favorable to capital punishment, and increasingly critical of the “coddling” of criminals. Whether this directly promoted anxiety is impossible to prove, and heightened parental caution arguably had a greater impact on young people by the 1990s than in times previous. But it is worth considering what role the crime factor played in previous decades.⁴⁷

Nuclear anxiety may be an even more obvious candidate, as it has a suggestive correlational chronology. The year 1951 saw the introduction of “duck and cover” films and related instruction in many schools, aimed at protecting students against atomic bomb attack, a campaign that would continue into the late 1960s. While teachers were urged to present the material with a smile, to minimize fear, the effect could be profound. Mothers wrote of children “waking up in terror” after one of the drills, which included teachers unexpectedly shouting “Drop!” in the middle of a regular lesson. Many school districts also distributed dog tags so children might be identified after an attack. The Los Angeles school district explained: “What is the atom bomb? It is a bomb that blows up houses and makes the earth wiggle. Children have to be ready when it drops.”⁴⁸ While overall psychological impact was not thoroughly studied, many individuals noted an enduring sense of insecurity. As one student told Greg Diamond and Jerald Bachman, “We could never quite take it for granted that the world we were born into was destined to remain.”⁴⁹ And there were reports of a wide belief among teenagers that they were unlikely to live past thirty.

Compounding the general fears, for high school and college males by the 1960s, was the growing concern about the draft and the Vietnam War, another contribution to a sense of fragile mortality. This, too, connected to schools. From 1951 onward draft boards began to take academic performance, including SAT scores, into account in deciding on military deferments, enhancing stress over grades and creating an annual pressure point as grades and class standings were reported and students awaited local draft board reactions. Some have suggested that the resultant tension contributed to the beginnings of the pattern of grade inflation that would have its own complex impact on student anxieties.⁵⁰

The rise in crime, nuclear fears, and the draft were not permanent, of course. All three had receded by the end of the twentieth century, but while this may help explain the slower acceleration rates of student anxiety in the final decades of the century, anxiety (and expert interest therein) continued to mount. (Of course, by the twenty-first century environmental concerns and school shooter drills may have offered uncannily analogous replacements for the initial triggers.) Claiming causation, rather than correlation, may be a stretch. But as one factor among several, the tensions added by perceptions of crime rates and the concern about conscription and war may well contribute to an understanding of why new levels of student anxiety kicked into gear.

Twenge and some other observers added further connections to the wider national climate. Impressed with Robert Putnam's work, Twenge speculated about the impact of growing loneliness, a theme that would later expand with the subsequent impact of social media. The famous decline of interpersonal trust also reached students: in 1975, 35 percent of high school seniors believed that most people could be trusted, but by 1992 the figure had plummeted to 15 percent. A few commentators also cited the misleading effects of the American obsession with happiness, leading some students to expect more than they found in this stage of life. The expectations theme would play out more clearly in more specific aspects of the changing student culture, discussed below.⁵¹

External Sources: Family Life and Childhood

The 1950s and 1960s saw significant changes in several aspects of family life, some of which proved quite durable. A few were frequently mentioned by those concerned about student anxiety, but several other less-discussed changes might be relevant as well. Jean Twenge, in her retrospective, in fact emphasized the combination of new kinds of family instability together with crime and nuclear fears as the primary components of children's overall anxiety. Again, the focus is on correlations, but in some cases, the connections to growing psychological distress seem rather compelling.⁵²

The divorce rate has attracted particular comment. In 1972, 86 percent of college freshmen reported coming from two-parent households, but by 2001 this had dropped to 72 percent. Some of these households were themselves the result of multiple marriages. In 1966 only 20 percent of freshmen had divorced or separated parents, but by 2001 this had soared to 49 percent. The same decades saw a considerable transition from optimistic beliefs that children were “better off” if feuding parents split, to a growing conviction that divorce was psychologically damaging. Debate here continues: several recent studies suggest that while most children suffer an initial surge of anxiety, only a minority are affected long-term.⁵³

The rise of mothers in the workforce was an equally fundamental trend. Data varied, but in the 1970s up to half of all college freshmen reported “homemaker” as their mother's occupation, while by 2001 this had dropped to at most 28 percent and possibly below. The shift here was not necessarily disruptive, but in the United States, with an absence of widely accepted childcare alternatives, it could affect children's equilibrium Further, the growing guilt and anxiety that working mothers themselves reported could affect children as well, particularly in the initial decades of transition.⁵⁴

Demographic change came in for less comment, but it merits attention. The rapid decline of the birth rate by the 1960s increased the percentage of children who were firstborn or who had no siblings at all. Several disputed studies argue that firstborns are disproportionately anxious, and data for only children suggest a connection as well. And there was more: from the 1970s onward the average age of puberty began to drop three months every decade, particularly for girls, which definitely correlated with rising depression and anxiety.⁵⁵

As with the larger political and social context, it is impossible to claim great precision regarding the effects of familial and demographic shifts. It is revealing that while some trends eased over time—the divorce rate was declining by the 1990s—anxiety still mounted (if for a time at a slower rate of change). On the other hand, familial and demographic shifts are prime candidates in explaining rising childhood anxieties generally, beyond the college-bound population alone. Furthermore, some newer trends might add to pressures. It was by the 1990s and early 2000s that the effects of helicopter parenting began to intensify, involving increasing levels of supervision and intervention—here, disproportionately among the college aspirants. Counseling centers reported growing numbers of students who had been so carefully sheltered that their coping skills were poorly developed. And helicopter parenting—not a uniform style, but affecting up to 40 percent of American offspring—itself resulted from a combination of efforts to compensate for maternal employment and growing adult fears about the dangers of the external environment—fears that easily translated to children themselves, helping to push anxiety levels up even further, beyond what the initial causation had generated.⁵⁶

School and Students: New Structures and Growing Competitive Pressure

Contemporary explanations for rising anxiety often sidestepped changes in the school and university experience itself, though some connections were offered. Twenge, most notably, did little with this factor in favor of the external developments. And it is important to remember that youth anxiety extended well beyond aspirant college ranks. Still, important changes occurred in higher education systems, and some measurably contributed to anxiety at least regarding certain aspects of the student experience.

The big news was the sheer expansion of education and its importance—societally and to individuals and families—at the secondary levels and beyond. This was also accompanied by new structures and requirements, including far more significant admissions examinations, that could have their own impact, creating a range of new pressures—some of which were quite real, others arguably imagined but often vivid.

The enrollment surge was massive. In the 1950s, the U.S. college population increased by 49 percent; then, in the next decade, it surged a further 120 percent. This meant a rise in the share of the relevant age group in college from under 15 percent to approximately 40 percent by the early 1970s. The growth was even more overwhelming as baby boomers reached college age—reaching about 300 percent in the 1970s and 1980s. Even more young people were affected by the growing pressure to complete high school, as the “drop out” phenomenon received national attention in the same period. The National Defense Education Act of 1958 heightened the importance of higher education at the societal level, while a growing number of individuals or parents began to recalculate the role of schooling in their own plans.⁵⁷

Expansion, in turn, had several effects relevant to anxiety. Most obviously, young people who did not particularly like school faced new pressures, at least through high school; early exit became increasingly difficult. Groups that were disproportionately anxious in any event, or at least disproportionately willing to voice their anxiety, now found themselves heading to college in growing numbers. Women, particularly, made up a rising percentage of new college goers, rising to 50 percent of the total by the later 1970s.⁵⁸

More generally, this kind of growth generated a growing segment of students whose parents had no college experience—in other words, a growth of “first gens.” By the mid-1960s, 42 percent of college freshmen had fathers with no college record of any sort, and there was an outright majority whose fathers had not completed a college degree. This proportion would hold roughly steady through the 1970s when, thanks to the preceding years of growth, the parental picture changed (for fathers and mothers alike): by 2001 the first-gen figure was down considerably. These trends suggest that during the decades when reported student anxiety rose most rapidly, a lack of relevant parental precedent and guidance may have played a growing role. Further, in contrast to the twenty-first century, when first gens surged anew, colleges were ill-prepared to deal with the concerns involved, with no special programs, scant orientation, and in some cases administrative greetings that continued to include stark warnings about potential failure.⁵⁹

Perhaps the most important result, though one resistant to a statistically precise analysis, is that the surge of the 1950s and 1960s, combined with baby-boom crowding in school classrooms, created a rising sense of competition and a heightened concern about getting into college. The concern was not entirely justified: the expansion in college slots and the sheer increase in the number of colleges soon kept pace with demand. But the impression had been created, and resultant admissions anxieties would linger, even intensify, beyond the primary growth period itself—enhanced by the extent to which colleges began to realize that they had some incentive to make applicants a bit anxious.⁶⁰

There was one other change during the decades after 1950s, though its importance should not be exaggerated. A growing (though still small) minority of the college bound redefined their ambitions, thanks in part to improved transportation facilities. The percentage of people seeking a college located at some distance from home, usually motivated by an interest in greater prestige, began to rise modestly but steadily. This added to the sense of heightened competition, particularly for the ambitious students themselves but potentially more widely.⁶¹

A few discussions of student anxiety began to pick up on the implications of some of these new trends as early as the 1960s. Thus a Harvard counselor (himself a Harvard grad) noted that some of the university's new national recruits displayed a painfully stubborn belief in the importance of top grades, even though they were told to relax—an example of the growing number of “anxiety neurosis” cases that student health personnel were seeing. In some cases a certain amount of old-school snobbery crept into their observations: as Harvard and other places admitted more of the types of students who previously would not have attempted to apply at such schools, much less to any college at all, some counselors found the students lonely and ill-prepared, without the academic (read: prep school) attributes that would lead to real success.⁶²

For college applicants more generally, other new patterns suggested heightened anxieties around the admissions process itself. A surge in the rate of multiple applications to college reflected the growing sense of competition and challenge—and further added to it. By 1967, only 43 percent of college applicants were confining themselves to a single, usually local target—the norm just a decade before—whereas 26 percent were already venturing four or more. And these trends continued steadily, aided by the introduction of the common application in the 1970s: by 2006, only 18 percent were completing only one application, while 57 percent were sending out more than four. Here was a clear sign of growing concern, along with heightened ambitions in some cases.⁶³

The new competitive picture was exacerbated, from the late 1960s onward, by increasingly elaborate procedures required for getting into many colleges, and growing admissions rivalries among colleges themselves. Even after the most rapid spurt in enrollment subsided, other changes, some initially in response to the growth itself, maintained a sense of tension. It continued to be increasingly easy to believe that it was getting harder to get into college, though the facts were more complicated.

The big change was the spread of required tests: the College Board's SAT and the new ACT exam, introduced in 1959. By 1965 the number of schools with test requirements had quintupled as colleges (including state schools like the University of California, starting in 1958) sought new sorting procedures to help with the soaring applicant numbers. By 1990, that total had doubled yet again, with 1,839 colleges now on the list. In 1955 only 23 percent of college freshmen had taken this kind of test, but by the mid-1960s that share was 80 percent. Many now would take the test twice or more—another development that arguably both reflected increased anxiety and in turn contributed to it. Ironically, around the same time that many studies of test anxiety were concluding, aptitude tests were producing much greater angst than were achievement tests, because of students’ uncertainties about exam preparation. Such tests now seized the spotlight.⁶⁴ Training courses, such as the Princeton Review, launched in 1981, reflected some of the pressures. Further, testing and preparation began to be pushed onto students, particularly the most ambitious ones, earlier in high school and even in the middle school years. The National Merit Qualifying exam, introduced in 1956, morphed into the PSAT in 1971, creating in some students as early as sophomore year a sense that “time was running out” for their best college chances. During the 1970s, the College Board began providing information about average test scores to particular colleges, yet another contribution to the sense of pressure. For some students, the advent of the Advanced Placement program in 1955 and its steady expansion created yet another challenge, with rising emphasis on taking a respectable number of AP courses in order to both impress colleges and distinguish oneself from less ambitious peers.⁶⁵

In other words, for a growing number of students, high school—and not just senior year—was increasingly slanted toward preparing for a competitive admissions process with a widening array of hurdles, some with a distinctive American twist compared to the single set of achievement tests typical in many other countries. In another national trend, competitive pressure plus the emphasis colleges themselves claimed to place on the need for well-rounded applicants pushed a growing number of high-school students into a dizzying array of extracurricular and community service activities along with their academic regimen, which not only added pressure in principle but, from the 1980s onward, measurably cut into students’ sleep time.⁶⁶

Colleges themselves got into the game in a big way, particularly by the 1970s and 1980s, with increasingly elaborate and intrusive marketing programs aimed at enticing ambitious students and pressing into sophomore and junior years of high school. It was in 1983 that U.S. News and World Report introduced its college rating system, which emphasized each institution's average SAT scores and also the number of applicants it turned down. Colleges routinely responded by lamenting this new development while eagerly seeking to enhance their profiles, particularly by actively encouraging huge increases in applicant numbers that could be rejected. Thus Harvard dropped to a 16 percent admissions rate by the 1980s, while flagship state schools were not far behind. Tens of thousands of very able students were receiving multiple rejection letters by the end of the twentieth century—a disappointment in itself that was amplified by the informal competitive jostling among seniors, who could not resist sharing good results and quietly gloating over others’ misfortune, as the admissions process became something of a public sport.⁶⁷

It is impossible to quantify the rise in anxiety that unquestionably affected the high school experience, or assess the ongoing impact of the heightened pressures on students once they reached college. It is also important not to exaggerate. The most demanding admissions goals involved about 5 percent of college applicants, who showed the greatest ambition (personal or parental) and generated the highest rate of multiple application to the most selective institutions. In fact, during the late twentieth century only about 10 percent of all colleges actually stiffened their admissions standards. The bulk of college brochures—89 percent by one estimate—were simply thrown away. Even some students who did venture some stretch applications realized that it was, in their terms, a “vanity” effort not likely to pay off.⁶⁸

On the other hand, the intensification of what became known as admissions anxiety was very real for many—the first time, as Jeffrey Selingo has noted, that ambitious teenagers faced such a wide range of choices, hurdles, and setbacks. References to the whole admissions process as “judgment day” or the “moment of truth” became increasingly common—a sense, as one put it, that “the slightest mistake would mean total failure.” Getting into the right school seemed to some the difference between being “destined for greatness” or doomed to an unremarkable “middling” life. The chronology was important as well: while the basic sense of competitive pressure began to emerge by the 1960s, many of the specific hurdles crested later, from the 1970s and 1980s onward.⁶⁹ This may help explain why student anxiety, both before and during college, continued to mount, if more slowly, even after the initial turning point.⁷⁰

One other change in college structure—this one also surfacing in the 1960s and intensifying thereafter—must be noted, which is the steady decline of guidance rules, particularly around sexual behavior. Obviously, the relationship between sexual concerns and psychological tension was not new: counselors were reporting many issues around masturbation and homosexuality fears in the early 1960s. Yet regulations arguably provided some cushion: as late as 1963 the Harvard Crimson, apparently unaware that the sexual revolution was underway, praised college parietal rules for keeping men's dormitories a place for “relaxed socializing.”⁷¹ The steady decline of regulations and chaperonage, along with the rise in student-age sexual activity, increased the number of choices many students had to make, and probably exacerbated problems such as date rape and unwanted pressure to have sex, particularly though not exclusively for women students. In most of the studies explicitly about anxiety, this was not a category that was emphasized compared with academic pressures (which always headed the list) and other issues; but it could figure in, and it contributed to the pace and timing of change.⁷²

Schools and Students: Changing Aspirations

Change, in the final decades of the twentieth century, involved more than new admissions numbers and educational structures. It also involved some striking alterations in student expectations and experiences. Some of these were clearly relevant to rising anxiety, while other connections at least deserve serious consideration today, even if many of them were not widely noted at the time. Between the 1960s and the 2000s, what students wanted out of college and what they thought they brought to the table shifted considerably, and in most cases the new trends began to set in at least by the 1960s—in tandem with the first clear signs of the surge in anxiety.

In the first place, questionnaire responses from college freshmen suggested a major redefinition, from at least the 1960s onward, of what higher education was for. In the mid-1960s, “achieving a meaningful philosophy of life” ranked highest in the list of possible goals, closely followed by a better understanding of political affairs and a capacity to help others and the ability to raise a family. Only the family goal survived in the top category by the 1990s. In stark contrast, making money—a goal ranked sixth in the 1960s—had soared to the top: 74 percent rated “being well off financially” as their primary purpose for going to college. Parallel with this was a corresponding shift in the most popular college majors, with a rapid decline in liberal arts majors and a rise of majors in business (doubling between the 1960s and 1980s, to 24 percent of the total), engineering, and computer science.⁷³

These changes did not necessarily generate new levels of anxiety, though for liberal arts proponents it would be tempting to push the claim. But they did link to a troubling decline in positive expectations for the college experience. In the 1960s, overall 60 percent of all freshmen expected to be satisfied over the coming four years, but by 2001 this had dropped steadily, to 48 percent. At the same time, the anticipation of being bored or periodically missing or coming late to class all rose substantially: by 2000, 41 percent thought they would be bored in class, and doubtless in many cases this anticipation could be readily fulfilled. Arguably, a more instrumental or utilitarian approach to college generated a lower emotional commitment to the process—and at least potentially greater anxiety both in anticipation and result.⁷⁴

At the same time, predictions of personal success soared. The basic change was simple enough. In the 1960s, 27 percent of all freshmen expected to gain a B average in college, but by 2000 that figure had inflated to over 57 percent. And whereas 3.5 percent had anticipated entry to an honors society in the 1960s, 19 percent were confident in that outcome four decades later. Yet there was gap between this striking shift and other indicators. For example, study time in high school dropped noticeably in the same time span—by as much as 20 percent for those planning to enter college. And actual confidence in being above average academically (as opposed to predicting personal college success) remained essentially stable between the 1960s and the 1990s, not rising in tandem with expectations of reward.⁷⁵

This somewhat complex pattern of change in turn created new potential for anxiety in two ways. Most obviously, the commitment to higher grades opened new doors for disappointment, possibly with regard to one's overall results in college, and certainly with regard to some of the bumps that might be encountered in the first year or so. To be sure, college grade inflation closed the gap in many cases, particularly at some of the highest prestige schools, but a potential disjuncture remained. Even for the successful, increased grade consciousness could lead to new pressures before the results were known. The second vulnerability was more subtle: a possible disjunction between the results so widely expected (often by parents as well as students themselves, which was another frequently expressed concern) and a real belief in personal mastery, especially as acceptable workloads declined. A gap opened up, for some students, between hope and confidence, leaving them at least periodically (and anxiously) wondering—as one put it—when the house of cards might fall.⁷⁶

Grade inflation fed both expectation and possible uncertainty, particularly from the 1970s onward. In the early 1970s the average college freshman still brought in a C average from high school, but this changed steadily, and by 2000 a near-majority had As. Further, while grade inflation occurred at collage as well, it not quite keep up with high school levels. More students did not do as well as they expected to, and more students faced challenges for which their prior experience had not prepared them.⁷⁷

The typical student of the late twentieth century was a somewhat different animal from their counterpart a generation or two before. Less eager for college, less committed to a deep educational experience, more attached to high grades but not always to corresponding effort—it is easy to paint a somewhat bleak picture, always recognizing that individual students continued to vary widely. The most important result, from the anxiety standpoint, was the increase in vulnerability. More students expected As and honors than would receive them, particularly in the first year or so of college, and the causes of the shortfall might have been difficult for them to determine. It was not hard to become at least somewhat more anxious in the process. All the studies of student anxiety by the later twentieth century pointed to academic issues as the leading target, even as other concerns such as finances began to figure in, and the focus was, if anything, overdetermined.

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The multiplicity of developments capable of promoting greater student anxiety was potent and mutually reinforcing. Possibly newly concerned about changes in the wider environment—like the threat of nuclear war—and certainly affected by shifts in family structure, college-bound students from the late 1950s onward faced a new set of direct pressures as they prepared for admission, and a challenging mix of expectations and uncertainties once they actually arrived. They were also variously affected by the new therapeutic vocabulary and services that helped some apply anxiety labels even to perturbations that were not necessarily unprecedented. It was a powerful combination and, at least for a growing minority of those involved, it generated measurable psychological change.

The combination also posed a challenge for institutions to mount a fully successful response. Academic agencies most aware of rising student anxiety readily picked up on environmental challenges and family shifts. On the whole they paid less attention to the other factors, including those created by the colleges themselves, though there certainly was some concern about competitive pressures. Over any other reasonable response, the most common diagnoses clearly conduced to a growing emphasis on expanding counseling services and raising student awareness of their availability.

The Twenty-First Century

By 2000, there was ample basis for more anxiety to come.⁷⁸ By this point many students were the children of adults whose own childhoods had featured anxiety, surely one of the reasons for the rise of (anxious) helicopter parenting, which would have its own role in fueling more maladjustment.⁷⁹ A growing number of campus professionals were acutely attuned to look for anxiety, an obvious factor in helping students articulate their own concerns; as a 2019 report suggested, it remained difficult to determine the balance between new problems and the greater readiness to seek help. Indeed, though this would be amplified by later developments, a sense of deep concern was abundantly present as the new century opened, with regular reports from student affairs offices about dramatic increases in demands on counseling services, in which anxiety headed the list of student issues and the words crisis and overwhelming were becoming increasingly common. Subsequent developments, from rising debt to the negative effects of social media to the pandemic, merely added fuel to the fire.

Prior trends also help explain why, even as mental health problems began to increase for many young people throughout the world, anxiety levels ran unusually high among American students. The comparative angle deserves further exploration, but two points seem probable. First, anxiety issues are particularly pronounced in English-speaking countries compared with continental Western Europe. Presumably, unusually high individualism and “performance orientation” contribute here, though parenting styles and acceptance of therapy play a role as well. Comparisons with Germany also highlight differences in higher education systems, including the absence of a clear German aspirational equivalent to Oxbridge or the Ivies. Second, among English-speaking countries, American rates stand out, with anxiety reports running about 40 percent above levels in the UK and Canada by 2019. Rates of increase after about 2000 have been distressingly similar in all three countries, though the American trends started from a much higher base. The earlier history has continued to matter, again calling attention to distinctive causation in the United States.⁸⁰

Moving from historical analysis to the turbulence of post-pandemic America, important challenges remain. The need to combine attention to the older root causes of contemporary anxiety with newer factors persists. Student affairs professionals—justly concerned about the further increase in demand for counseling services—have often emphasized the novelty of the crisis, rather than grasping the longer historical trajectory.⁸¹ Indeed, it was only after the first years of the new century that awareness of rising anxiety passed from the ranks of mental health counselors to student affairs personnel more generally—another reason for the emphasis on recency.⁸² But the previous history remains vital, in establishing the basic causes and characteristics of student anxiety and the depth of the phenomenon in the United States—even as problems deepen. For example, a number of observers continue to report on the strain caused by high levels of grade consciousness and ambitious financial aspirations—trends with deep roots in the later twentieth century.

Historical analysis does not, unfortunately, offer clear remedies for what has been a long-standing problem, but even here it may contribute to constructive policy. Clearly, the main response to increased anxiety has emphasized therapy, both in the twentieth century as counseling centers were becoming established and experts worked on specific problems like test anxiety, and now more generally as the wider trends are recognized. And surely this has helped many individuals, but it is equally obvious that it has not stanched the trend. Some recognition of the limitations has emerged in the twenty-first century. Student affairs offices, even while struggling to keep pace with demands on health facilities, have branched out, giving more general advice to students (and faculty). Specific projects, such as the introduction of pets to help students through pressure periods (a venture which began at Kent State University in 2005 and quickly spread) suggest new efforts at therapeutic prevention.⁸³ For high schoolers, the advent of mental health days (launched first in Utah in 2018) point in the same direction. Other approaches, including the elimination of college entry examination requirements and the growing impulse to reconsider grading and deadlines in college itself, reflect a mounting debate about the variety of factors that generate student anxiety.

But surely more is needed, as the higher education community thinks more deeply about the complex factors prompting what is now a long-standing and stubborn trend. A fuller discussion of the mixture of causes long responsible for student anxiety is arguably overdo. It is even possible that reconsidering older conventions, such as taking greater care in distinguishing between the needs of the seriously ill and those with more diffuse concerns, might usefully reduce the general sense of crisis. Whatever the approach going forward, there is no escaping the need for continued historical evaluation of a phenomenon that has taken shape over a considerable period of time and that has thus far been distressingly resistant to the efforts that have developed in response.