“Maybe you are depressed.” That was the last thing I expected to hear from a doctor my senior year of college. Depressed? I was doing well academically, was surrounded by a good group of friends and was a student leader for Athletes in Action. Why would I be depressed? But the symptoms were there. I was staying up most nights and sleeping during the day. I found myself getting tired without much physical activity. There were also small panic attacks combined with shortness of breath that would strike at random times. My self-diagnosis was a relapse of mononucleosis. After a series of negative tests, the campus physician suggested depression.

My story is not unique, of course. For the past decade, student mental health issues have increased at an alarming rate, leaving many college counseling centers strained. In 2004, Harvard University psychiatrist Richard Kadison’s groundbreaking book, College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It (Jossey-Bass) became a rallying cry for campuses to be equipped with better mental health services. A recent book by psychiatrist David Leibow, What to Do When College is Not the Best Time of Your Life (Columbia University Press) reminds those who care about college students that mental health issues are not going away.

I think college ministers have a role to play in helping the college community navigate these challenges. What follows are five things college ministers should know about the mental health of college students along with a few suggestions of how to respond:

1. A high percentage of college students battle anxiety and depression.

According to a recent survey by the American College Health Association, within the last 12 months, 30 percent of students reported feeling so depressed that it was difficult to function and 49 percent felt overwhelming anxiety. An additional 10 percent of students also reported being diagnosed or treated for depression and more than six percent seriously considered suicide. Statistics like these should open our eyes to the deeper needs of many of the students in our fellowship groups and bible studies.

2. Many students battling depression feel ashamed and alone.

My own response to my depression surprised me. I didn’t know who to talk to. I was apprehensive about telling my parents and closest friends. What’s more, as a Christian, I wasn’t sure you were allowed to be depressed! After all, Jesus was in my heart, wasn’t he? It turns out that my response was quite common. In an interview for Inside Higher Ed, Dr. Leibow explains that the majority of the patients he has seen “were capable, motivated students, with loving, appropriately involved parents.” So why were these kids floundering and keeping their parents in the dark? The answer, he realized, was shame. “They were ashamed because they believed—wrongly—that they were the only one of their peers having problems.” It’s important for college ministers to create safe places for students to discuss mental health. Let students in your fellowships know that depression is a reality for many students. Be aware of the symptoms. And be honest about the culture of the Christian community on campus. What do students think about depression as it relates to faith? Ask them.

3. Some students think they are a failure if they use medication for anxiety or depression.

As a culture, there may be an increasing tendency to turn to medication too quickly. We need to be careful and discerning. When it comes to anxiety and depression, however, many students have a misguided understanding of antidepressants. Often they are simply used to correct imbalances in the levels of chemicals in the brain. According to the American Psychiatric Association, these “medications are not sedatives, ‘uppers’ or tranquilizers. Neither are they habit-forming. Generally antidepressants have no stimulating effect on those not experiencing depression.” College ministers have a role to play in the way they support students who have chosen to use medication. Let them know that God can work through medication to bring about positive change.

4. The number one cause of stress and depression among college students is academic floundering.

There are many issues that students face that can lead to stress and depression (homesickness, relational disappointments, financial worries, body-image problems), but according to a survey conducted by the American College Health Association-National College Health Assessment, academics was at the top. I remember Brea offering this prayer request at a weekly bible study (her story is recounted in The Outrageous Idea of Academic Faithfulness): “Please pray for me. I’m feeling a lot of stress, and I’m not sure why. It’s not like I have more work this semester than normal. I just don’t know why I am learning what I am learning. I feel like if there was a reason for what I am learning, any reason beyond to get a grade, then I could work hard again. But in all of my classes, I can’t honestly tell you why I need to learn this stuff. I have no idea why this matters.” Here’s how college ministers can help relieve some of the academic stress students have when facing an incoherent curriculum: remind students why they study. Point them to Jesus, the Lord of learning, the One who holds all things together (Colossians 1:15-20). Teach students the centrality of learning within the biblical story and cast a vision for how college learning is preparing them to be used by God in their communities. To be a disciple literally means to be a student, a life long learner. Do students in your ministry love God with their minds? Are students able to articulate how their faith relates to their major? I echo Brea’s frustration: much of the stress around academics is because students don’t have good reasons for learning!

5. Students are surprised by the extra stress created by college breaks.

One of the most well attended bible studies I’ve had with college students was around the theme “honoring your mother and father during the college years.” I invited an older couple to share with the group what they had learned from parenting college students. Students were eager to ask questions and enter the conversation. Here’s what we learned: communication is key. Encourage your students to honor their parents by having a conversation about parental expectations during breaks.

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