Signs of Distress
Signs of Distress
Students of concern are students with social, emotional, behavioral or medical difficulties, or life stressors that are affecting their ability to fully participate in the academic community. General signs of distress can include any of the below.
- Psychological: Self-disclosure of personal distress such as family problems, financial difficulties, depression, grief, or thoughts of suicide; Excessive worry, tearfulness, panic reactions, irritability, or unusual apathy; Unusual/disproportional emotional response to events; Delusions and paranoia; verbal abuse (e.g., taunting, badgering, intimidation); Expressions of concern about the student by his/her peers
- Academic Signs: Sudden decline in quality of work and grades; repeated absences; continuous classroom disruptions; multiple requests for extensions; disturbing content in writing or presentations (e.g. violence, death themes); overly demanding of faculty and staff time and attention; you find yourself focusing more on personal topics, rather than academic, during office hours
- Physical/Behavioral Signs: Marked changes in physical appearance including deterioration in grooming, hygiene, or weight loss/gain; excessive fatigue/severe sleep disturbance; abandonment of previously enjoyed activities, social withdrawal; intoxication, hangovers, or smelling of alcohol; drug use or abuse; inappropriate or complete lack of emotion; disoriented or appearing “out of it”
- Safety Risk Signs: Suicidal thoughts, unprovoked anger or hostility; physical violence; making implied or direct threats to harm self or others; academic assignments dominated by themes of extreme hopelessness, rage, worthlessness, isolation, despair, acting out, suicidal ideations/violent behaviors—a “cry for help”; stalking or harassing behavior; communicating threats via email, social media, texting, phone calls, or other correspondence
Additional Information
Aggressive/Potentially Violent Behavior
Facts About Aggression
- Behavior falls along the continuum from threats to verbal abuse to physical abuse and violence.
- It is very difficult to predict aggression and violence.
- Possible indicators of potential violence may include:
- Paranoia and mistrust
- An unstable academic or employment history
- A history of juvenile violence or substance abuse
- Prior history of violence or abuse
- Fascination with weapons
- History of cruelty to animals as a child
- Impulse control problem
- Fire-starting behavior
What You Can Do
- Assess your level of safety. If you feel that you or others may be in danger, remove yourself from the situation and call Public Safety at 401.865.2222.
- If you feel it is appropriate to stay with the student, remain in an open area with a visible means of escape (sit closest to the door).
- Enlist the help of a co-worker or another student.
- Stay calm and set limits; describe to the student behaviors that are unacceptable.
- If the student refuses to cooperate and remains aggressive or agitated, ask the student to reschedule a meeting with you once he/she has calmed down.
- Consult with professionals at Personal Counseling 401.865.2343 or the Dean of Students Office 401.865.1782.
What You Should Avoid Doing
- Remaining in a situation in which you feel unsafe.
- Meeting alone or in a secluded space with the student.
- Engaging in a screaming match or behaving in other ways that escalate anxiety and aggression.
- Ignoring signs that a student’s anger is escalating.
- Touching the student or crowding his or her sense of personal space.
- Ignoring your intuition that tells you that you or others are in danger.
Anxiety
Facts About Anxiety
- Anxiety can be generalized across a range of situations, or it may be situation-specific (e.g., test anxiety, social anxiety, public speaking anxiety).
- Symptoms of anxiety include:
- Stress
- Panic
- Avoidance
- Irrational fears
- Fear of losing control
- Ruminations
- Excessive worry
- Sleep or eating problems
What You Can Do
- Talk to the student privately.
- Remain calm and take the lead by focusing on relevant information.
- Help the student develop an action plan that addresses his or her main concern.
- Refer the student to Personal Counseling 401.865.2343.
What You Should Avoid Doing
- Overwhelming the student with information or complicated solutions.
- Arguing with the student’s irrational thoughts.
- Devaluing the information presented.
- Assuming the anxiety the student is experiencing will end or lessen without treatment.
Bizarre/Psychotic Behavior
Facts about Psychotic Thinking:
- The main feature of psychotic thinking is “being out of touch with reality.”
- Bipolar disorder involves periods of serious depression combined with periods of extreme euphoria and frenzied thinking/behavior, the latter of which can reflect a poor reality. A person with bipolar disorder can become psychotic.
- Psychological illness that involve psychotic features often have an onset between the late teens and early 30s.
- Symptoms include:
- Speech that makes no sense
- Extremely odd or eccentric behavior
- Inappropriate or complete lack of emotion
- Bizarre behavior that could indicate hallucinations
- Strange beliefs that involve a serious misinterpretation of reality
- Social withdrawal
- Inability to connect with or track normal communication
- Extreme or unwarranted suspicion
What You Can Do
- Consult with a professional at Personal Counseling 401.865.2343.
- Speak to the student in a direct and concrete manner regarding your plan for getting him/her to a safe environment.
- Accompany the student to Personal Counseling 401.865.2343 or call Public Safety at 401.865.2222 if the student is highly impaired.
- Recognize that psychotic states can involve extreme emotion or lack of emotion and intense fear to the point of paranoia.
- Recognize that a student in this state may be dangerous to self or others.
What You Should Avoid Doing
- Assuming the student will be able to care for him/herself.
- Agitating the student with questions, pressure to take specific actions, etc.
- Arguing with the students unrealistic or irrational thoughts.
- Assuming the student understands you.
- Allowing friends/roommates to care for that student without getting professional advice as to whether or not that plan is appropriate.
- Getting locked into one way of dealing with the student, be prepared to adapt to the specific situation.
- Assuming the family knows about the student’s condition.
Depression
Facts About Depression:
- Depression is a common mental health problem that varies in severity and duration.
- In its less serious form, depression is a temporary reaction to loss, stress, or life challenges. It can be alleviated through the passage of time and/or the natural healing effects of social strategies like finding personal purpose and meaning through regular exercise, a healthy diet, hobbies, and social engagement.
- Severe or chronic depression usually requires professional help.
- Research shows that depression can be highly responsive to both therapy and medication.
- Symptoms of depression can include:
- Feelings of emptiness, hopelessness, helplessness, and worthlessness
- A deep sense of sadness
- An inability to experience pleasure
- Irregular eating and sleeping
- Difficulties with concentration, memory, and decision-making
- Fatigue and social withdrawal
- Sometimes depression includes irritation, anxiety, and anger.
- In its most serious form, depression can be accompanied by self-destructive thoughts and intentions as a way to escape from the emotional pain.
What You Can Do
- Talk to the student in private.
- Listen carefully and validate the student’s feelings and experiences.
- Be supportive and express your concern about the situation.
- Discuss clearly and concisely an action plan such as having the student immediately call for a counseling appointment.
- Refer the student to Personal Counseling 401.865.2343.
- Be willing to consider or offer flexible arrangements to alleviate the student’s stress and instill hope.
- Ask student if he/she has thoughts of suicide. If so, do not leave student alone. Walk him/her over to Personal Counseling. If it is after 4:30pm, or on the weekend, access emergency services by calling 401.865.2222.
- Call the Office of Public Safety for assistance at 401.865.2222, 24/7.
What You Should Avoid Doing
- Downplaying the situation.
- Arguing with the student or disputing that the student is feeling depressed.
- Providing too much information for the student to process.
- Expecting the student to stop feeling depressed without intervention.
- Assuming the family knows about the student’s depression.
Eating Disorders
Facts About Eating Disorders:
- Eating disorders are not necessarily about food, but food is the substance that people with eating disorders abuse. Eating disorders have both physical and psychological symptoms. They are characterized by problematic attitudes and feelings about food, insecurity regarding weight and body image, a disruption in eating behaviors and weight management, and intense anxiety about body weight and size.
- Eating disorders usually refer to Anorexia Nervosa, Bulimia Nervosa and/or Binge Eating Behavior.
- Anorexia Nervosa is characterized by restricted eating, self-starvation and excessive weight loss.
- Bulimia Nervosa is characterized by recurrent episodes of overeating large amounts of food in a short period of time (the binge) followed by some form of purging.
- Binge Eating Disorder is characterized by recurrent episodes of binge eating that are not followed by inappropriate compensatory behaviors (purging/use of laxatives) to prevent weight gain.
What You Can Do
- Select a time to talk to the student when you are not rushed and won’t be interrupted.
- In a direct and non-punitive manner, indicate to the student all the specific observations that have aroused your concern.
- Your responsibility is not to diagnose or provide therapy; it is the development of a compassionate and forthright conversation that ultimately helps the student find understanding, support, and the proper therapeutic resources.
- If the information you receive is compelling, communicate to the student your concern as well as your conviction that the matter clearly needs to be evaluated.
- Contact the Student Health Center for advice or information at 401.865.2422
What You Should Avoid Doing
- Avoid conflicts or a battle of the wills with the student.
- Avoid placing shame, blame, or guilt on the student regarding her/his actions or attitudes.
- Avoid giving simple solutions. For example, “If you’d just stop, then everything would be fine!”
Overly Persistent Demands
Facts About Students Who are Demanding to an Unreasonable Degree:
- Students who are demanding can be intrusive and persistent and may require excessive time and attention.
- Demanding traits can be associated with anxiety; depression, personality problems and/or thought disorders, mania, and drug use/abuse.
- Possible characteristics of students who are unreasonably demanding include:
- A sense of entitlement
- An inability to empathize
- A need to control
- Difficulty in dealing with ambiguity
- Perfectionism
- Difficulty with structure and limits
- Dependency
- Fears about handling life
- Elevated mood
- Drug use or abuse
What You Can Do
- Talk to the student privately in a place that is safe and comfortable.
- Remain calm and take the lead by making clear that it is a discussion, not an argument.
- Set clear limits at the outset and hold the student to the allotted time for the discussion. Emphasize behaviors that are and aren’t acceptable.
- Respond quickly and with clear limits to behavior that disrupts class, study sessions, or consultations.
- Be prepared for likely manipulative requests and behaviors.
- Call the Dean of Students Office 401.865.1782 for help with identifying strategies for dealing with disruptive behaviors.
- Refer the student to Personal Counseling 401.865.2343 for counseling.
What You Should Avoid Doing
- Arguing with the student.
- Giving in to inappropriate requests.
- Unreasonably adjusting your schedule or policies to accommodate the student.
- Ignoring inappropriate behavior that has a negative impact on you or other students.
- Feeling obligated to take care of the student or feeling guilty for not doing more.
- Allowing the student to pressure or intimidate you to not deal with or to excuse the problematic behavior.
Substance Abuse
Signs That a Student May Have an Alcohol Problem:
- Failure to fulfill major work, school, or home responsibilities.
- School-specific problems such as poor attendance, low grades, and/or recent disciplinary action.
- Drinking in situations that are physically dangerous, such as driving a car.
- Recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or physically hurting someone while drunk.
- Continued drinking despite having ongoing relationship problems that are caused or worsened by drinking.
- Mood changes such as temper flare-ups, irritability, and defensiveness.
- Physical or mental health problems such as memory lapses, poor concentration, bloodshot eyes, lack of coordination, or slurred speech.
Signs That a Student May Have a Drug Problem:
- Experiencing withdrawal symptoms (e.g., nausea, restlessness, insomnia, concentration problems, sweating, tremors, anxiety).
- After reducing or stopping chronic drug use, taking a drug in order to avoid withdrawal symptoms.
- Spending a lot of time getting, using, and recovering from the effects of a drug.
- Abandoning previously-enjoyed activities, such as hobbies, sports, and socializing, in order to use drugs.
- Neglecting school, work, or family responsibilities.
- Taking risks while high, such as starting a fight or engaging in unprotected sex.
- Continuing to use despite physical problems (e.g., blackouts, flashbacks, infection, injuries) or psychological problems (e.g., mood swings, depression, anxiety, delusions, paranoia) the drug has caused.
- Legal troubles such as arrest for disorderly conduct, driving under the influence, or stealing to support a drug habit.
What You Can Do
- Treat the situation as a serious problem.
- Share your concern and encourage the student to seek help.
- Recognize that denial is a powerful aspect of substance abuse problems and that it can involve conscious or unconscious lying and distortion of the truth.
- Refer the student to Personal Counseling 401.865.2343 or the Student Health Center 401.865.2422.
- If an overdose, needing immediate response call 911 or the Office of Public Safety 401.865.2222.
Suicidal Risk
Facts About Suicide:
- Although suicide is a rare event, it is the second leading cause of death among college students.
- Suicidal states are often associated with major depression, a combination of acute anxiety and depression, post-traumatic stress disorder, and bipolar disorder.
- People who are suicidal often tell people about their thought or give clues to others about their feelings.
- Students who are at high risk usually have a specific plan, have a means that is lethal (e.g., medication, knife, gun), and tend to be or feel isolated.
- Some factors associated with suicide risk are:
- Suicidal thoughts
- Pessimistic view of the future
- Intense feelings of hopelessness, especially when combined with anxiety/feelings of alienation and isolation
- Viewing death as a means of escape from distress
- Previous suicide attempts
- Personal or family history of suicide attempts
- Substance abuse
- History of self-mutilation
- A student who is suicidal and who confides in someone is often ambivalent about suicide and open to discussion.
What You Can Do
- Call 911 if the student is behaving in a way that poses an immediate danger to him/herself.
- Talk to the student in private.
- Remain calm and take the lead by asking the student directly about feelings and plans.
- Do not be afraid to ask about suicide. Asking a student if he/she is suicidal will not put the idea in his/her head if it isn’t there already.
- Take a student’s disclosure as a serious plea for help.
- Express care and concern, and assure the student that you will help him or her reach a professional.
- If the incident occurs during business hours, call or escort the student to Personal Counseling located in lower Bedford Hall next to Student Health Services.
- Call the Office of Public Safety at 401.865.2222 for assistance 24/7.
What You Should Avoid Doing
- Minimizing the situation. All threats must be considered potentially lethal.
- Arguing with the student about merits of living.
- Allowing friends to assume responsibility for the student without getting input from a professional.
- Assuming the family knows that the student has suicidal thoughts.
The Dean of Students Office
Office Hours: Monday – Friday: 8:30am-4:30pm
Office Location: Slavin 201 (the stairs/elevator to the 2nd floor of Slavin are around the corner from ’64 Hall)
401.865.1782
deanofstudents@providence.edu
The Office of Public Safety
Office Hours: Open 24 hours a day, 7 days a week
Huxley Avenue Gate
401.865.2391 (General); 401.865.2222 (Emergency)
