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January 12, 2023

Coping with Anxious Distress: Going Back to College

by Sarah Brown, LCSW-A, LCAS-A

The start of a new semester in college can bring all kinds of excitement from picking out new pens to seeing your friends again. However, many college students may dread the start of school due to having anxious thoughts. Thoughts like, “will I make friends in my new classes,” “will I wake up in time for my 8 am class,” “can I handle my workload and have a social life,” “do I have the money to stay in college,” can plague college students when going back to school. Even if you may not be diagnosed with an anxiety disorder or are a college student, you can still benefit from learning some techniques to manage your distress and prevent it from becoming overwhelming anxiety.

Dialectical Behavioral Therapy, or DBT, is an evidence-based modality that can be used to address anxiety and other emotional dysregulation. Distress Tolerance is a module from DBT that solely focuses on teaching skills to relieve stress and prevent one from resorting to unhealthy coping mechanisms. Although you may not be able to change the situation that caused the distress, you can change the way you feel. Instead of resorting to skipping class, try using the following DBT skill when overwhelmed with anxiety or other emotions.

The DBT skill of T.I.P.P. utilizes physical sensations to “tip” your body’s chemistry to feeling calmer, which can also help to alleviate anxious feelings. By using T.I.P.P., you can reduce extreme emotions quickly.

T: Temperature- Change your body temperature through splashing your face with cold water, holding an ice cube for 30 seconds, or taking a cold and/or hot shower.

I: Intense Exercise- Match your intense emotion with doing an intense exercise. Dance your heart out, sprint, walk at a fast pace to class, or do jumping jacks.

P: Paced Breathing- Attempt at paced breathing exercises. For example, breathe deeply into your belly, and then breathe out slowly while counting. One method is the “Box Breathing” exercise. Breathe in for 4 seconds, hold for 4 seconds, breathe out for 4 seconds, and hold 4 seconds. Repeat as many or as little as needed until you feel relaxed.

P: Paired Muscle Relaxation- With your paced breathing, try to be aware of what muscle groups are tense. Focus on one muscle group at a time and tighten those muscles as much as possible for 5 seconds. Then, release and relax the muscle group. Try it again with another muscle group. For example, tighten fingers, then release. Tighten forearms, then release. Saying “relax” in your mind may help you to release more fully.

Please consult a physician if you have a medical condition or are unsure how it will affect any physical limitations before trying these methods.

Remember you are not alone if you suffer from anxiety, especially if you are also a college student. One study conducted in 2019 found that the percentage of U.S. adults with the highest rate of reported anxiety symptoms are adults aged 18-29 years old.  It is very important to seek help, especially if it is disrupting your day and preventing you from enjoying this time of your life. If you are curious about attending therapy to help learn other skills to help lower distress, you can check out Avance Care’s Behavioral Health program and our therapists.


Linehan, M. (2014). DBT Skills Training Manual, Second Edition. United Kingdom: Guilford Publications.

Terlizzi EP, Villarroel MA. Symptoms of generalized anxiety disorder among adults: United States, 2019. NCHS Data Brief, no 378. Hyattsville, MD: National Center for Health Statistics. 2020.

Van Dijk, S. (2013). DBT made simple: A step-by-step guide to dialectical behavior therapy. Oakland: New Harbinger Publications.

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