“This Beer Should Do the Trick!”: Heading to College with Social Anxiety Disorder

  • Elisabeth M. KressleyEmail author
  • Adele Martel
  • Jennifer Derenne


Social Anxiety Disorder may adversely impact transition to college. Alcohol and cannabis can be misused or abused in an attempt to self-medicate symptoms. Academic underachievement is common due to lack of self-advocacy, fear of public speaking, and avoidance of classes. This chapter describes the case of a young woman diagnosed with Social Anxiety Disorder and Major Depression Disorder prior to college matriculation. While her symptoms were relatively stable prior to starting college, she experiences a relapse of both anxiety and depressive symptoms in the context of disrupted treatment. This contributes to misuse of alcohol as well as declining academic achievement. Discussion focuses on the need to adequately prepare the patient and family for the transition to college through psychoeducation, establishing a treatment team on or near campus, anticipating potential difficulties with academics and social relationships, and developing a plan for accessing campus resources and supports. Other topics discussed include introversion, social maturity, and developmental readiness for college.


Social anxiety disorder in college Alcohol use in anxiety disorders Academic underachievement in anxiety disorders Self-advocacy in social anxiety disorder Introversion vs. anxiety Developmental readiness for college 


  1. 1.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.CrossRefGoogle Scholar
  2. 2.
    Topham P, Russell G. Social anxiety in higher education. Psychologist. 2012;25(4):280–2.Google Scholar
  3. 3.
    Baptista CA, Loureiro SR, de Lima Osorio F, Zuardi AW, Magalhaes PV, Kapczinski F, Filho AS, Freitas-Ferrari MC, Crippa JAS. Social phobia in Brazilian university students: prevalence, under-recognition and academic impairment in women. J Affect Disord. 2007;136(3):857–61.CrossRefGoogle Scholar
  4. 4.
    Terlecki MA, Ecker AH, Buckner JD. College drinking problems and social anxiety: the importance of drinking context. Psychol Addict Behav. 2014;28(2):545–52.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Buckner JD, Heimberg RG, Schneier FR, Liu SM, Wang S, Blanco C. The relationship between cannabis use disorders and social anxiety disorder in the National Epidemiological Study of Alcohol and Related Conditions (NESARC). Drug Alcohol Depend. 2012;124(1–2):128–34.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Baez T. Evidence-based practice for anxiety disorders in college mental health. J College Stud Psychother. 2005;20(1):33–48.CrossRefGoogle Scholar
  7. 7.
    Norton AR, Abbott MJ, Norberg MM, Hunt C. A systematic review of mindfulness and acceptance-based treatments for social anxiety disorder. J Clin Psychol. 2015;71(4):283–301.CrossRefPubMedGoogle Scholar
  8. 8.
    Damer DE, Latimer KM, Porter SH. “Build your social confidence”: a social anxiety group for college students. J Spec Group Work. 2010;35(1):7–22.CrossRefGoogle Scholar
  9. 9.
    Schneier F. Pharmacotherapy of social anxiety disorder. Expert Opin Pharmacother. 2011;12(4):615–25.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Elisabeth M. Kressley
    • 1
    Email author
  • Adele Martel
    • 2
  • Jennifer Derenne
    • 3
  1. 1.Child Study CenterYale School of Medicine, Yale UniversityNew HavenUSA
  2. 2.Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Ann and Robert H. Lurie Children’s Hospital of ChicagoNorthwestern University Feinberg School of MedicineChicagoUSA
  3. 3.Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral SciencesStanford University School of Medicine, Lucile Packard Children’s HospitalStanfordUSA

Personalised recommendations