Firstyear Psychology student Nina (22) has been struggling with depression and a mild anxiety disorder. “It makes me feel hollow, empty and on edge all the time. I’ve experienced a great deal of stress for most of my life. At school, this was mostly because of the people around me, deadlines and exams. I don’t think I knew how to cope with it, which is probably why I fell into a depression in the first place.”

Rather than being reduced, heavy workloads and mental health issues appear to be on the rise, for staff and students alike.In a series of articles, EM is looking for causes and solutions. This is part 3: what are the causes for psychological problems among students?

In today’s society, more and more students seem to be dealing with mental health issues, including depression, anxiety or burnout. In the midst of this mental battle, students might feel alone and misunderstood, like Nina. What is mental health? What causes mental health problems? And are there any solutions?

Mental health is difficult to grasp. Is it a matter of not wanting to talk about mental health problems or not knowing how to talk about them? Students find it hard to admit that they aren’t okay. Since that could be interpreted as a sign of weakness or simply because time doesn’t allow them to break down. “I don’t really discuss it because it’s a bit of a taboo, right?” Nina says that others wouldn’t really understand what it’s like. “The conversation just wouldn’t work.”

Impulses and choices

Bert van den Bergh, psychologist-philosopher, recently published De schaduw van de zwarte hond. This book discusses depression in present-day society from a cultural-philosophical perspective. He claims that students are facing increasing amounts of pressure. “Our society has become individualist-centred, focusing on performance. Students are confronted with so many impulses and choices. They’re expected to know what they want when they’re just 17 or 18 years old, which is rubbish.”

Walter van den Broek, psychiatrist and lecturer at the Erasmus Medical Centre, emphasises that depression is a disease and affects many people in this generation. “We may compare it to previous decades and feel that it’s drastically increased, but it’s always been around. However, having depression may have been a more sensitive topic back then than it is now, and people have become more open and transparent than they ever used to be.” That’s a good thing, according to Van den Broek, not only to raise more awareness about the issue, but also to let people know that it’s okaynot to be okay.

All sorts of depression

In contrast to Van den Bergh’s proposition that it’s the culture that pushes individuals to feel pressured due to today’s norms, Van den Broek doesn’t agree. Although he does argue that it may have something to do with burnouts or work overload. “There are all sorts of depression and if a person is more prone to it, stress doesn’t help,” he explains. “That’s why it’s important to first identify the triggers causing someone to become depressed so that experts know how to prevent an episode.”

A person may acquire depression through genetics, psychological factors or social factors, and it can be classified as light, moderate, or severe. If someone has a light to moderate depression, they can be treated as outpatients along with medication. Patients diagnosed with severe depression, however, need to be admitted to hospital so that they can be carefully monitored.


When asked how her depression makes her feel, Nina says: “It makes me feel empty. It’s not really a feeling; it’s a state of being. My anxiety disorder makes me feel constantly on edge. As if you’re on a rollercoaster and you’re unable to control it.”

She continues: “Objectively speaking, I don’t experience more stress than any other human being. Because of my depression and anxiety, however, I deal with it less healthily than most of my peers. For example, I’d love to be able to give a presentation to a class, but I can’t, because it causes me too much anxiety.”


Van den Bergh states that most students feel insecure. “They’re insecure about how and what to choose, which affects their mental state. Nowadays, students are presented with so many possibilities. They need to make choices about which degree to pursue, what extracurricular activities to take on and which friends to hang out with. When this becomes too much, it leads to stress and a fear of missing out.”

“The main feeling of depression is not so much sadness or inhibition but isolation”, says Van den Bergh. When students face problems in their personal or academic lives, they easily tend to feel alone. It’s about fighting our own battles and solving things by ourselves. It would be rude to burden others with personal problems. “I don’t really talk about my mental health, because it’s a hard thing to admit. I don’t know how to tell others without feeling that I’m letting them down,” says Nina.

By adopting this attitude, students often disregard the fact that there are others who are willing to help. Nina: “What can be done to help students who are struggling with mental health problems? The most important thing is compassion. Universities should factor in mental health as a variable that can influence course work.”

Seeking support

Students might recognise Nina’s feelings, whether it concerns mild forms of anxiety and stress, the feeling of being burned out or depressed. Mental health problems are very much here these days, but is there a way to prevent them?

Van den Bergh: “The key solution is to provide support, especially in the first year of higher education where students feel lost. People find it hard to seek assistance, but we shouldn’t blame them for that. Rather, we should perhaps create a system that makes it easier for them to take this step.”

From the medical perspective, however, social factors are mostly evident but not entirely the cause of mental health problems. “Depression, for instance, is a disease which needs to be treated, but we’ll never know its root cause,” Van den Broek emphasises. “When students suspect that they have mental health issues, they should seek support. If you start early, you can prevent future complications. Also, antidepressants could help, even if they aren’t the core solution to depression.”

Sense of community

Image credit: Elzeline Kooy

Therapy might not always be the key to everything, but it can help you get yourself back on your feet. Nina: “Seek help if necessary. If you can’t function because of your mental health then you should try therapy or at least talk to your doctor or parents about what you can do about it. One therapist told me to analyse my feelings whenever I feel depressed again, which helps me a lot.”

Van den Bergh: “Of course, educational institutions have their support systems. However, this only touches on the periphery. We need to work on a sense of community within classrooms, make students feel included. Students are constantly pushed in a certain direction of having to make it in life. Once they get pushed too far, they become lost and start experiencing mental health issues. Medication can help, but that’s generally only a first step.”

Educational institutions have become more aware of mental health among students. In the past, Erasmus University has organised different events to raise awareness. Van den Broek supports this initiative: “A while ago, Erasmus MC organised a symposium for students. We talked about burnout, what to do about it and where to go if you’re struggling. Various psychologists, psychiatrists and student advisors were present to answer questions. I think it’s very important to share this information with students.”

Romanticising mental illness

“Events that revolve around raising awareness for mental health are quite interesting. The problem with these events is that they often talk about addressing the so-called taboo. However, we’ve been talking about this taboo for such a long time. We should move past this, start addressing the issues openly and think about ways to actually prevent it from happening,” says van den Bergh in a thoughtful manner.

Nina thinks that universities should provide help. “It’s really difficult, though. Teachers should take mental health problems into account, but they can’t really give you a higher grade or an automatic pass just because you’re experiencing problems. At the same time, they should, because the fact that you’re experiencing mental health problems is often beyond your control.”

She adds: “I think it’s good to raise awareness of mental health but people should be careful about romanticising mental illness. It’s presented as something that’s very relatable, as if everyone feels bad sometimes. In doing so, we risk creating a situation where the more extreme versions of mental health problems suddenly don’t seem so bad anymore.”

About this article

This article was initially written for the IBCoM course New Media Production. Students were instructed to write an in-depth story about a topic of their choice and present it to a jury. The best story would be published in Erasmus Magazine.

Nina didn’t want her real name mentioned in this article for privacy reasons. Her real name is known to the editors.