When Beau Braden arrived at Washington State University to begin his freshman year, he wasn't prepared for the pressures he would face.

Braden’s transition was particularly abrupt. Recruited to play football, he arrived at the Pullman campus just three days after graduating from high school. He went from a low-key high school agenda to a rigorous college schedule that had him up at 6 a.m. and juggling football practice, strength workouts, classes and homework well into the night.

“It was all football and all school, all the time,” the defensive lineman says. “It wears you down. It’s not healthy.”

While most of the students went home for the holidays, Braden and the rest of the team stayed on campus for practice. The grinding schedule, which left no room for other activities that once brought him joy, became overwhelming. The depression he’d been managing since his sophomore year in high school resurfaced.

“There’s a real pressure to bury your feelings and not talk about” your depression, says Braden, now a junior at Washington State. “I had to come to the realization that I needed help, that I wasn't dealing real well with this on my own.”

Braden eventually decided he had to create time for the activities he missed: drawing, listening to music, spending time alone and sometimes just “zoning out.” He found help at WSU’s counseling center, where therapists are on hand to help students dealing with anxiety, depression and the general stressors of college life.

“A lot of us see strength as being able to manage our problems on our own,” Braden says. “But the real strength comes from being able to say, ‘I need help.’”

‘It’s a normal thing to have a hard time’

Even without a pandemic, college students face extraordinary pressures. Most are living away from home for the first time, separated from the care and support of their family and community. Preparing meals, managing schedules – even just doing laundry – are chores new to many students. A demanding academic schedule, combined with social activities and sports commitments, can easily become unmanageable.

Now student athletes face uncertainty about when and how they will compete, throwing off years of planning and disrupting training routines. They may be at home or live alone when they would usually have roommates and other students around to socialize.

“In this 18-, 19-, 20-year-old time, it’s a big transition,” says Kate Geiger, a clinical psychologist in WSU’s athletics department. “Folks will have feelings of guilt, worthlessness, difficulty with sleep. Sometimes people will think it’s a character flaw, that they’re not tough enough, that they’re not strong enough.”

In fact, these are common feelings for anyone.

“It’s really a very normal thing to have a hard time,” Geiger says. “Every human goes through periods of times in their lives when they’re struggling.”

A little time and a little help goes a long way

Even though depression and anxiety are common among college students, the stigma associated with mental health struggles keeps many from reaching out for professional help, or even sharing their issues with friends or family. WSU graduate Josie Williams experienced an assault her freshman year which sent her into a spiral of depression and anxiety. She lost weight, withdrew from friends and considered dropping out of school. Yet at the height of it all, she received the “Miss Sunshine” award from her coworkers at the student recreation center, where she worked at the front desk.

“To everyone else, I was completely fine, when internally I was the exact opposite,” says Williams, who eventually met with a therapist at the student health center. “We don’t ask for help because we don’t think we need it, or we think someone else needs it more.”

Sunday Henry is the director of athletic medicine at WSU and supervises all medical care for student athletes. She says she’s begun to see a realization among young people that talking about mental health is healthy, particularly during the COVID-19 pandemic.

A mental health concern “is a treatable thing, like a sore throat or a headache,” Henry says. “It doesn’t mean that you’re weak.”

When Henry works with students, she offers them strategies to deal with the stressors they’re facing. She encourages them to find time to connect with friends, listen to music and carve out time in their days just for themselves.

“Take an hour a day and make that yours,” Henry says. “Do whatever you want with that hour and never give it back.”

If an hour seems impossible, Henry suggests 30 minutes. What’s most important is that students take the time to step away from the pressures of school, sports, peers and electronics.

“I ask them a lot, ‘When is the last time you sat on a park bench?’” Henry says. “It can be really grounding. There’s a connection we have with being outside, and we don’t do it enough.”

Supporting student mental health

In addition to the services of campus therapists, WSU recently established the Coug Health Fund, a student-run, student-led initiative offering educational resources to students on all WSU campuses in the areas of mental health and sexual violence prevention. Premera Blue Cross supported the fund in April 2019 by matching the proceeds from ticket sales for WSU’s spring football game that year, resulting in a donation of $25,000.

The university also collaborated with Premera to launch mental health outreach campaigns using social media and videos featuring student athletes to raise awareness about the prevalence of mental health conditions and encourage students to reach out for support.

“Mental health is an issue we all need to address together by reducing the stigma around the conditions and providing access to care,” says Jim Havens, a senior vice president at Premera Blue Cross who oversees marketing and government programs.

Havens, who is also the father of two WSU students, says Premera is trying to encourage everyone to ask for help while ensuring those who do receive it.

Beyond those efforts to support treatment of depression and other mental health issues, Premera offers its members a number of behavioral health options that include online therapy through video and text messaging. Other virtual care solutions include as home-based care for opioid use disorder and alcohol use disorder.

‘Just open the door’

In his journey with the pressures of college and football life, Braden found that meeting with his on-campus therapist helped keep his depression and anxiety in check. While the tips from his counselor help, he’s found the most value in just being able to talk to someone, even when societal pressures dictate otherwise.

“It’s important to shed that ‘football image,’” Braden says. “People can see us as football players but we’re real people first. And we need help like anyone else.”

Dr. Susanne Quistgaard, a Premera medical director, emphasizes that mental health issues like depression are both treatable and common.

“If untreated, mental health conditions can get worse and lead to other problems,” Quistgaard says. “It's important to seek care when symptoms start."

It took Williams time to seek help for the depression after she was assaulted. It was more than a year before she shared her trauma with her family and friends. When she decided to seek counseling, she walked out of the health center twice before sitting down with her counselor. Once she did, she learned her depression was normal, that many students struggle with anxiety, and, most importantly, that she was not alone.

Her advice to other students with depression?

“Just say, ‘Hey, I need a little help,’” Williams says. “Just open the door. And someone will walk through.”