thesis for anxiety research paper

351 Anxiety Research Topics & Essay Titles (Argumentative, Informative, and More)

According to statistics, approximately 40 million people in the United States struggle with anxiety disorders, constituting 19.1% of the population. Generalized anxiety disorder is a condition that is characterized by an excessive and constant feeling of worry about everyday things. Open conversations about anxiety help reduce the stigma associated with mental health issues. Moreover, it is a good way to educate people about the condition, its causes, symptoms, impact, and available treatments.

In this article, we’ll introduce 351 anxiety topics you can use for your essay or research paper ! Keep reading to find out more.

• 🔝 Top 12 Anxiety Essay Topics

📝 Anxiety Essay Prompts

🔍 anxiety research topics, 🤓 anxiety essay titles.

• 📕 Essays on Anxiety: Guide

🔗 References

🔝 top 12 anxiety topics to write about.

• Types of anxiety disorders.
• Anxiety: Causes and treatment.
• How to deal with anxiety?
• Is there a connection between anxiety and depression?
• What are treatments for anxiety?
• Anxiety disorders in children.
• Physical symptoms of anxiety.
• Antidepressants as a way to overcome anxiety.
• Risk factors of anxiety.
• Symptoms of anxiety in teenagers.
• How do you prevent anxiety?
• Social anxiety disorder: My experience.

Have trouble writing a paper about anxiety disorder and related topics? Don’t worry—we’ve prepared some essay prompts to help you get an A for your writing assignment!

Social Anxiety Essay Prompt

Social anxiety disorder, formerly known as social phobia, is characterized by a persistent fear of being in unfamiliar social settings. It usually begins in youth and influences an individual’s adult life. In your essay on social anxiety, you may touch on the following aspects:

• Causes and risks of social anxiety.
• The main symptoms of social anxiety.
• Social anxiety in children and teenagers.
• Ways to prevent or overcome social anxiety.
• Available treatments for social anxiety.

Speech Anxiety Essay Prompt

Most people feel anxious when they have to present a speech in front of an audience. Even trained public speakers may experience anxiety before delivering a speech. People who look confident and relaxed while talking to an audience have mastered managing their feelings and using them to their advantage. While discussing speech anxiety, try finding answers to the following questions:

• What are the symptoms of speech anxiety?
• Why do people get nervous in front of an audience?
• What can help to overcome speech anxiety?
• Why does exercising help in reducing stress and anxiety?

Test Anxiety: Essay Prompt

It’s common for college students to feel anxious before exams. Yet, significant anxiety and stress before and during an important exam might have negative consequences. In your essay on test anxiety, you can provide detailed information on how to deal with it based on the tips listed below:

• Prepare for the test.
• Use study strategies to understand and remember your course material better.
• Take care of your physical health.
• Surround yourself with things that calm you.
• Talk with your teacher to know what to expect from the exam.

Overcoming Anxiety: Essay Prompt

Anxiety can stem from factors such as genetics, personality traits, and life experiences. Although psychotherapy and medication are often necessary for individuals with anxiety disorders to manage their emotional well-being, incorporating lifestyle adjustments and daily routines can also be beneficial. Consider centering your essay on practical daily actions that can help alleviate stress:

• Set goals to accomplish.
• Communicate with people.
• Stop smoking and reduce your consumption of caffeinated beverages.
• Solve any of your financial issues.
• Dedicate more time to your hobbies.
• Have some relaxation time .
• Identify and try to avoid your anxiety triggers.
• How is daily yoga effective for reducing anxiety?
• Does ethnicity and socioeconomic status have an effect on anxiety prevalence?
• Anxiety and acute pain related to the loss of vision .
• Divorce is the leading cause of children’s anxiety.
• The relation between the COVID-19 pandemic and increased anxiety rates.
• The impact of immigration on the growth of anxiety cases in society.
• The efficiency of open communication in overcoming anxious well-being.
• The efficacy of iron supplementation to reduce vulnerability to anxiety in women with heavy menses .
• Emotional issues anxiety causes and ways to cope with them.
• How does anxiety contribute to drug, alcohol, and nicotine consumption?
• The factors that provoke anxious states in college students.
• Generalized anxiety disorder in college students and potential treatment .
• Children and adolescents: age’s impact on increasing anxiety risks.
• The connection between anxiety disorder and fear.
• Stress at the workplace is a key provoker of anxiety in the 21st century.
• Frontline nurses’ burnout, anxiety, depression, and fear statuses .
• Triggers : the importance of finding causes of anxiety.
• The impact of anxiety on social relations with friends and relatives.
• The peculiarities of anxiety states in teenagers in high school.
• Anxiety as a result of perfectionism and fear of failure.
• Symptoms of anxiety, depression, and peritraumatic dissociation .
• The influence of anxiety on public speaking skills.
• Cultural differences in the expression and perception of anxiety.
• Psychological aspects of anxiety in situations of crisis.
• Digital detox is an effective method of anxiety reduction.
• The correlation between discrimination/prejudice and depression/anxiety .
• The relationship between social isolation and the development of anxiety disorders.
• Death anxiety: methods and strategies how to cope with the disorder.
• Quantitative properties of anxiety: magnitude and tone.
• The impact of economic instability on the level of anxiety in society.
• Evidence-based interventions for anxiety disorders .
• The types of anxiety disorder and their peculiarities.
• The key characteristics of anxiety disorder.
• The role of family relationships in the development of anxiety disorders.
• The symptoms of anxiety and ways to identify them at an early stage.
• Anxiety disorder treatment in an Afro-American boy .
• Psychological aspects of anxiety in adapting to a new culture or society.
• The relationship between the quality of sleep and the level of anxiety.
• Social media is a trigger of anxiety in the digital world.
• The role of gender stereotypes in the formation of anxiety in men and women.
• Depression and anxiety among college students .
• Anxiety is a result of the rapidly changing information society.
• The influence of literature on the perception of anxiety.
• Psychological fitness and its effectiveness in reducing anxiety.
• The use of therapy platforms in decreasing anxiety.
• Anxiety of musicians in music performance .
• Cyberbullying as a reason for emotional distress and anxiety.
• The role of childhood experiences in the development of anxiety later in life.
• Introversion and its contribution to a constant state of anxiety.
• The influence of religious and cult practices on reducing anxiety.
• Case studies of patients with anxiety and mood disturbances .
• The risk factors of anxiety in children with disabilities.
• Videogames are a key trigger of anxiety development.
• Mindful breathing strategy and its importance for reducing anxiety.
• The impact of psychological trauma on the development of chronic anxiety.
• Abnormal psychology: anxiety and depression case .
• Government support for mental health policy to reduce anxiety in the UK.
• The influence of ambition and high expectations on the level of anxiety.
• Managing anxiety in evidence-based practice .
• Political conflicts and their impact on the level of anxiety in society.
• The role of social support in managing and reducing anxiety.
• Anxiety and decision-making: literature review .
• Anxiety as a result of low self-esteem and problems with self-acceptance.
• The role of meditation and mental practices in anxiety management.

Social Anxiety Research Paper Topics

• Genetics is a leading cause of social phobia .
• The effects of social anxiety on professional and career development.
• Social anxiety disorder: diagnosis and treatment .
• Empathy and social anxiety: how understanding the feelings of others affects one’s own anxiety.
• The evidence-based pharmacotherapy of social anxiety disorder.
• The physical symptoms of social anxiety disorder.
• Prevalence rates of social anxiety disorder across different cultures.
• The impact of cultural factors on the development of social anxiety disorder.
• The public speaking anxiety analysis .
• Neural mechanisms that contribute to the resistance of social anxiety disorder.
• The potential of utilizing biomarkers to improve social anxiety treatments.
• The effective methods of anxiety disorder prevention.
• Cultural and social aspects of social anxiety: peculiarities and coping methods.
• The negative social experience is a trigger to social phobia.
• High anxieties: the social construction of anxiety disorders .
• Brain areas involved in the development of social anxiety.
• The peculiarities of treatment of social anxiety at an early age.
• Social anxiety at school or workplace: a way to overcome the phobia.
• Inclusive school environments as a way to support students with social anxiety.
• The role of self-esteem in the experience of social anxiety.
• School phobia: the anxiety disorder .
• The impact of social anxiety disorder on romantic relationships .
• The efficiency of technology-based interventions in the treatment of social anxiety.
• Social anxiety: Is there a way to overcome the fear of public speaking?
• The connection between social anxiety and fear of evaluation by others.
• Social anxiety and its consequences on cognitive processes .
• Social anxiety disorder and alcohol abuse in adolescents .
• The criteria for diagnosing social anxiety disorder.
• The role of parental expectations and pressure in the formation of social anxiety.
• Why do females more often experience social anxiety disorder than males?
• Social anxiety disorder is one of the most common anxiety disorders worldwide.
• Social aspects of depression and anxiety .
• Avoidance of social situations is a key symptom of social phobia.
• The influence of social anxiety on the expression of creativity and creative potential.
• Social anxiety and its consequences on the quality of life in adolescents.
• Metacognitive processes in the maintenance of chronic social anxiety.

Research Questions about Anxiety

• How does anxiety affect the body’s immune system ?
• What are the peculiarities of the treatment of anxiety at a young age?
• Is acceptance and commitment therapy effective in fighting anxiety ?
• How are inflammatory processes in the body related to anxiety disorders?
• What is the relationship between anxiety and gastrointestinal disorders?
• What effect does anxiety have on the cardiovascular system?
• What role do neurotransmitters like serotonin and GABA play in regulating anxiety?
• What are the stress and anxiety sources amongst students?
• How does genetics influence the likelihood of gaining medical anxiety disorders?
• What is the effectiveness of cannabis in treating anxiety disorders?
• How do gastrointestinal microbiota imbalances affect anxiety levels?
• How can specific allergies or sensitivities lead to increased anxiety?
• How does chronic anxiety disorder affect cortisol levels?
• How is emotion regulation therapy used for generalized anxiety disorder ?
• What role may neuroimaging play in understanding communicative anxiety disorders?
• How is anxiety diagnosed in people with disabilities?
• How does anxiety disorder depend on a person’s eating habits ?
• What are the effects of nootropics in treating anxiety disorders?
• What are the ways of managing general anxiety disorder in primary care ?
• Why is family support an important part of the anxiety treatment?
• How do gender differences affect the manifestation of anxiety disorders?
• What are the effective methods of preventing anxiety disorder?
• How does post-traumatic stress disorder contribute to the development of anxiety?
• How do doctors differentiate anxiety symptoms from signs of other medical conditions?
• How does standardized testing affect an individual with test anxiety ?
• What is the impact of chronic illnesses on the development of anxiety?
• How does alcohol impact an increasing level of anxiety?
• What methods of diagnosing anxiety disorders exist in medicine?
• Why certain medical conditions can trigger symptoms of anxiety?
• What is the role of emotional intelligence in overcoming social anxiety?
• What is the relationship between child maltreatment and anxiety ?
• How did COVID-19 contribute to increased anxiety among people in the US?
• How effective is psychopharmacology in treating social anxiety?
• What are the most common physical symptoms of anxiety in children?
• How do sleep disorders provoke social anxiety?
• What are the long-term effects of chronic anxiety on human health?
• How can parents and teachers release anxiety in children ?
• How can medical surgery affect anxiety levels in patients?
• How do hormonal imbalances contribute to heightened anxiety?
• What is the best way of treating adults with anxiety?
• Why benzodiazepines and SSRIs are often used in anxiety treatment?
• What brain areas are involved in the development of anxiety disorder?
• What is the holistic approach to anxiety disorder ?
• How can virtual reality simulation treatment help with medical anxiety?
• Anxiety disorder and its risk factors.
• Why does physical exercise positively impact social anxiety treatment?
• What advice are most often given by psychologists for the prevention of anxiety?
• Is depression and anxiety run in the family ?
• How can targeted medication improve the effect of psychotherapy in anxiety disorders?

Argumentative Essay Topics about Anxiety

• Social anxiety disorder is highly comorbid with other psychiatric disorders.
• Is anger the side effect of anxiety?
• Social media: the rise of depression and anxiety .
• Women are twice as likely as men to develop anxiety disorder.
• Breathing into a brown paper bag decreases the level of anxiety.
• Educational institutions should support students with anxiety symptoms.
• Social networks contribute to the development of anxiety.
• Summarizing and evaluating the concept of anxiety .
• Is virtual reality exposure therapy effective in treating anxiety-related conditions?
• Dismissing someone’s anxiety exacerbates the problem.
• Negative thinking is a serious anxiety trigger.
• Do certain cultural customs impact how anxiety is expressed and handled?
• Social support plays a vital role in treating anxiety disorders.
• Overcoming separation anxiety in children .
• People with anxiety disorder should seek professional help.
• Employers should provide flexible work schedules for workers with anxiety disorders.
• Anxiety disorder increases the risk of health complications.
• Does anxiety create problems in relationships?
• Anxiety often causes or triggers depression .
• Adult depression and anxiety as a complex problem .
• Academic pressures can contribute to anxiety in young individuals.
• Parents should control the social media usage of their children to protect them from anxiety.
• Is social isolation a contributing factor to the development of anxiety in older adults?
• Perfectionism is a personality trait that often correlates with increased anxiety levels.
• Overcoming anxiety leads to personal growth and increased resilience.
• The anxiety related to the COVID-19 virus uncertainty: strategy .
• Anxiety hinders an individual’s ability to concentrate and make decisions.
• Are anxiety disorders the most common mental disorders in the modern world?
• The constant state of alertness in anxiety leads to mental exhaustion and burnout.
• Anxiety disorder is a leading cause of tension headaches.
• Political upheavals increase collective anxiety on a societal level.
• Cognitive-behavioral therapy for generalized anxiety disorder and depression .
• A family history of mental health issues is a spread cause of anxiety.
• Do smartphone notifications contribute to technology-induced anxiety?
• Regular exercising helps decrease symptoms of anxiety.
• Workplace support is critical for persons dealing with anxiety at work.
• Excessive use of social media contributes to heightened anxiety levels.
• Effective art therapies to manage anxiety .
• Should workplaces implement mental health programs to reduce employee anxiety?
• People with anxiety disorder should do regular follow-up sessions to monitor their condition.
• Do financial concerns trigger the development of anxiety?
• Stigma prevents individuals with anxiety from seeking help.
• Is social anxiety more spread with a strong emphasis on individual achievements?
• General anxiety disorder treatment plan .
• Do genetic factors play a role in predisposing individuals to anxiety disorders?
• Love from friends and family is the best treatment for anxiety disorder.
• Telling other people about your anxiety is one of the most uncomfortable things.
• Caffeine use increases the severity of anxiety symptoms.

Anxiety Essay Topics for Informative Papers

• The major symptoms and signs of social anxiety disorder.
• What is generalized anxiety disorder (GAD)?
• Anxiety disorders, their definition, and treatment .
• The effective methods of coping with separation anxiety disorder.
• The important takeaways about pathological anxiety.
• Dos and don’ts for overcoming post-argument anxiety.
• Coping with anxiety in romantic relationships.
• Anxiety: advanced assessment of a patient .
• What are the peculiarities of social anxiety disorder?
• Cognitive behavioral therapy is effective in treating people who feel anxious.
• The strategies for alleviating anxiety in your pets.
• Seven things you can do to help your friend cope with anxiety.
• Anxiety disorders: diagnoses and treatment .
• What are the risk factors for anxiety in children and adults?
• The characteristics of high-functioning anxiety.
• Cognitive Behavioral Therapy (CBT) for anxiety disorders: How it works.
• The main causes of generalized anxiety disorder (GAD).
• “Depression, Anxiety, and Stress in Diabetes” by Chlebowy .
• What are the methods of treating anxiety in old age?
• The importance of early intervention: how to prevent anxiety in children.
• What does anxiety disorder feel like?
• The value of stress management skills in preventing anxiety.
• Generalized anxiety disorder and its prevalence .
• The benefits anxiety disorder can bring.
• How can antidepressants aid in coping with anxiety disorder?
• Self-guidance: how to prevent an anxiety attack.
• The genetic and hereditary factors that contribute to anxiety disorders.
• Dual diagnosis: anxiety disorders & developmental disabilities .
• How small acts of kindness can help with anxiety?
• Psychological strategies to reduce general anxiety and stress.
• How do you understand that you need assistance in coping with anxiety?
• Foods that can help reduce anxiety.
• Anxiety disorders: cognitive behavioral therapy .
• The effective methods of coping with anxiety in learning a new language.
• Top 12 ways to reduce the risk of anxiety disorders.
• The power of yoga and meditation in managing anxiety.
• How friends and family can provide support to someone with anxiety?
• What is the anxiety?
• The troubling link between domestic violence and anxiety .
• Finding a good anxiety therapist: methods and strategies.
• How does anxiety affect teenagers in high school?
• The main types of anxiety and their peculiarities.
• Anxiety disorder and its characteristics .
• How do you prepare yourself to better handle anxiety-provoking situations?
• The power of positive thinking in overcoming anxiety.
• The effective ways of dealing with an anxious mindset at work.
• Coping with anxiety on your own: The possible consequences.
• Fight-or-flight response in anxiety disorders .
• Famous people with high-functioning anxiety.
• How can a regular sleep pattern protect you from anxiety development?

Anxiety Title Ideas for Cause-and-Effect Essays

• Muscle aches and breathing problems are the short-term effects of anxiety.
• Why does anxiety provoke memory issues?
• Effects of anxiety and ways to conquer it .
• Increased risk of developing migraines and headaches in people with anxiety.
• The role of chronic stress and traumatic events in the development of anxiety.
• Genetic links that increase a person’s risk of developing an anxiety disorder.
• What are psychosomatic manifestations of anxiety and their impact on the body?
• Substance abuse is a leading cause of anxiety.
• Generalized anxiety disorder’s impact on youth .
• The problems in interpersonal relationships are due to anxiety.
• Loss of a loved one and its impact on the development of anxiety.
• Are nail biting or skin picking the first signs of anxiety?
• Childhood experiences can cause the onset of anxiety disorders.
• What is the effect of anxiety on the nervous system and its functioning?
• DSM-5 anxiety disorders: causes and treatment .
• The key triggers of anxiety and their impact on a person’s overall well-being.
• The butterfly effect of anxiety: how small symptoms can become a disaster.
• Does a family history of anxiety disorder make you more prone to this disease?
• The physical consequences of anxiety: nausea, muscle tension, and fatigue.
• Reaction to stress: anxiety and yoga .
• How do the causes of anxiety change depending on the person’s age?
• Persistent and uncontrollable thoughts: how does anxiety impact people?
• The causes of anxiety among teachers giving face-to-face lessons.
• Chest and back pain are physical symptoms of anxiety.
• Relationship issues are the leading causes of anxiety disorder.
• The effects of marijuana on people with anxiety .
• Neurochemical imbalance and its connection with anxiety.
• What are the genetic causes of anxiety?
• The role of social media in triggering anxiety disorder.
• Migraines and headaches are concomitant manifestations of anxiety.
• How can daily tasks become the cause of anxiety?
• Anxiety disorders and their influence on daily life .
• Substance abuse and its impact on the development of anxious states.
• Decreased quality of life in people with anxiety disorders.
• The chain reaction of anxiety: From triggers to panic attacks.
• Hormonal changes in anxiety states and their impact.
• Trouble focusing on tasks due to racing thoughts in people with anxiety disorder.
• Causes and effects of anxiety in children .
• Procrastination and overthinking as behavioral effects of anxiety.
• Suicidal thoughts and their connection with high levels of anxiety.
• How does anxiety impact communication and collaboration at work?
• Social isolation as a result of anxiety disorders.
• Chronic stress is a factor contributing to anxiety disorder.
• Anxiety disorder: symptoms, causes, and treatment .
• Which social factors contribute to the appearance of anxiety?
• The fear of the unknown or unpredictable outcomes is a cause of anxiety.
• Why do people with anxiety disorder have problems with concentration and attention?
• Sociocultural factors that have an impact on the level of anxiety.

Titles for Anxiety Essays: Compare and Contrast

• How are anxiety disorders related to eating disorders like anorexia and bulimia?
• Psychotherapy or medication: what works better in treating anxiety?
• The behavioral, humanistic, and cognitive approaches to anxiety .
• The differences in how anxiety impacts children and adults.
• Stigma and shame of anxiety in different cultures.
• How do you differentiate anxiety from regular stress?
• What is the relationship between anxiety and anger?
• Panic attack vs. anxiety attack: key differences.
• George Kelly’s personal constructs: threat, fear, anxiety, and guilt .
• The peculiarities of anxiety disorder depend on the sexual orientation of the person.
• How is panic disorder related to anxiety?
• Meditation, prayer, traditional rituals: comparison of spiritual ways of anxiety treatment.
• How does the perception of anxiety differ in the US and Japan?
• Anxiety vs. post-traumatic stress disorder: main common features.
• The relationship between anxiety and sleep disorders .
• How does anxiety differ from stress in terms of physiological responses?
• The differences in anxiety symptoms in people of different ages.
• Developmental perceptions of death anxiety .
• How can gender-related cultural norms influence how anxiety is expressed?
• Aspects of anxiety: psychological and physiological sides.
• How does anxiety differ from schizophrenia ?
• The comparison of social and generalized anxiety.
• Historical views on anxiety: antique and modern times.
• The difference in how anxiety affects females and males.
• What do anxiety and obsessive-compulsive disorder have in common?
• Anxiety and depression during childhood and adolescence .
• Anxiety treatment: self-help resources or support groups.
• The comparison of biological mechanisms activated during fear and anxiety states.
• The cultural differences of anxiety perception: Nigeria vs. Sweden.
• Anxiety and bipolar disorder and their main differences.
• The effective methods of coping with anxiety: yoga or antidepressants.
• What are the cultural differences in anxiety expression?
• Anxiety in first-world countries or developing nations.
• The differences in help-seeking behavior in people of different religions.
• The peculiarities of treatment anxiety in Australia and the United Kingdom.
• How is anxiety connected to eating disorders?
• Anxiety in veterans vs. civilians: key differences.
• How does anxiety management differ from anxiety prevention?
• Physical and mental anxiety consequences and their comparison.
• How is anxiety described in different academic disciplines?
• The manifestation of anxiety in different mental health disorders.
• How does anxiety in parents are similar to the one that children have?
• Anxiety in urban and rural environments: Key triggers.
• The comparison of genetic and environmental factors of anxiety.

📕 How to Write Essays on Anxiety

Need to write an essay on anxiety but don’t know where to start? Let us help you! We’ve prepared detailed instructions that will help you structure your paper.

Anxiety Essay Introduction

An essay’s introduction aims to provide the reader with a clear idea of the essay’s topic, purpose, and structure. It serves as a roadmap for what the paper will cover. To write an introduction, follow these steps:

• Grab readers’ attention with a hook .
• Introduce the theme or issue you will be discussing.
• Provide some background information.
• Create a thesis statement.

Hook: According to the National Institute of Mental Health, public speaking anxiety, or glossophobia, affects approximately 40% of the population.

Background information: A fear of public speaking is classified as a social anxiety disorder characterized by shaking, sweating, dry mouth, rapid heartbeat, and squeaky voice.

Anxiety Essay Thesis

A thesis statement is often a sentence in the first paragraph of an essay that summarizes the paper’s main idea. Several tips can assist you in creating a strong thesis statement :

• Be specific.
• Build a strong argument.
• Make your thesis statement arguable.
• Provide evidence.
• Be clear and concise.

Thesis statement: Although fully overcoming speech anxiety may be impossible, employing various strategies can help manage and harness it for personal growth and success.

Essay about Anxiety: Body Paragraphs

Body paragraphs in an essay develop, support, and elaborate on the thesis statement or argument presented in the introduction, offering evidence, examples, and explanations. They provide the substance and structure that make the essay’s ideas clear and convincing to the reader.

There are several components that each paragraph of the main body needs to include:

• Topic sentence.
• Supporting evidence.
• Detailed explanation of the main points.
• Transition to the next paragraph.

Topic sentence: Deep breathing techniques can effectively alleviate pre-performance anxiety, particularly before public speaking engagements.

Supporting evidence: Practicing slow, deep diaphragmatic breathing helps activate the relaxation response. Additionally, deep breathing increases oxygen supply to the cerebral cortex, responsible for cognitive functions and conscious thought processes.

Anxiety Essay Conclusion

The conclusion is an essential component of your essay. It allows you to encourage your readers to consider the implications and solutions to an issue. A strong essay conclusion should do the following:

• Restate the thesis.
• Summarize the main points.
• Provide a clear context for your argument.

Rephrased thesis: Though completely overcoming speech anxiety is challenging, using different strategies can help control it and benefit personal growth and success.

Summary : In conclusion, nobody is perfect, and even seasoned speakers make errors in public speaking. Instead of pressuring yourself to deliver a flawless speech, it’s essential to remember that minor mistakes won’t detract from your overall presentation.

We hope that you’ve found our article helpful! If so, feel free to share it with your friends and leave a comment below.

• Thesis Statements; The Writing Center • University of North Carolina at Chapel Hill
• How to Write a Five-Paragraph Essay, With Examples | Grammarly
• How To Write a Good Essay Introduction in 4 Simple Steps | Indeed.com
• Conclusions | Harvard College Writinf Center
• Paragraphs; Topic Sentences: Writing Guides: Writing Tutorial Services: Indiana University Bloomington
• Anxiety Disorders – National Institute of Mental Health

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The Critical Relationship Between Anxiety and Depression

• Ned H. Kalin , M.D.

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Anxiety and depressive disorders are among the most common psychiatric illnesses; they are highly comorbid with each other, and together they are considered to belong to the broader category of internalizing disorders. Based on statistics from the Substance Abuse and Mental Health Services Administration, the 12-month prevalence of major depressive disorder in 2017 was estimated to be 7.1% for adults and 13.3% for adolescents ( 1 ). Data for anxiety disorders are less current, but in 2001–2003, their 12-month prevalence was estimated to be 19.1% in adults, and 2001–2004 data estimated that the lifetime prevalence in adolescents was 31.9% ( 2 , 3 ). Both anxiety and depressive disorders are more prevalent in women, with an approximate 2:1 ratio in women compared with men during women’s reproductive years ( 1 , 2 ).

Across all psychiatric disorders, comorbidity is the rule ( 4 ), which is definitely the case for anxiety and depressive disorders, as well as their symptoms. With respect to major depression, a worldwide survey reported that 45.7% of individuals with lifetime major depressive disorder had a lifetime history of one or more anxiety disorder ( 5 ). These disorders also commonly coexist during the same time frame, as 41.6% of individuals with 12-month major depression also had one or more anxiety disorder over the same 12-month period. From the perspective of anxiety disorders, the lifetime comorbidity with depression is estimated to range from 20% to 70% for patients with social anxiety disorder ( 6 ), 50% for patients with panic disorder ( 6 ), 48% for patients with posttraumatic stress disorder (PTSD) ( 7 ), and 43% for patients with generalized anxiety disorder ( 8 ). Data from the well-known Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study demonstrate comorbidity at the symptom level, as 53% of the patients with major depression had significant anxiety and were considered to have an anxious depression ( 9 ).

Anxiety and depressive disorders are moderately heritable (approximately 40%), and evidence suggests shared genetic risk across the internalizing disorders ( 10 ). Among internalizing disorders, the highest level of shared genetic risk appears to be between major depressive disorder and generalized anxiety disorder. Neuroticism is a personality trait or temperamental characteristic that is associated with the development of both anxiety and depression, and the genetic risk for developing neuroticism also appears to be shared with that of the internalizing disorders ( 11 ). Common nongenetic risk factors associated with the development of anxiety and depression include earlier life adversity, such as trauma or neglect, as well as parenting style and current stress exposure. At the level of neural circuits, alterations in prefrontal-limbic pathways that mediate emotion regulatory processes are common to anxiety and depressive disorders ( 12 , 13 ). These findings are consistent with meta-analyses that reveal shared structural and functional brain alterations across various psychiatric illnesses, including anxiety and major depression, in circuits involving emotion regulation ( 13 ), executive function ( 14 ), and cognitive control ( 15 ).

Anxiety disorders and major depression occur during development, with anxiety disorders commonly beginning during preadolescence and early adolescence and major depression tending to emerge during adolescence and early to mid-adulthood ( 16 – 18 ). In relation to the evolution of their comorbidity, studies demonstrate that anxiety disorders generally precede the presentation of major depressive disorder ( 17 ). A European community-based study revealed, beginning at age 15, the developmental relation between comorbid anxiety and major depression by specifically focusing on social phobia (based on DSM-IV criteria) and then asking the question regarding concurrent major depressive disorder ( 18 ). The findings revealed a 19% concurrent comorbidity between these disorders, and in 65% of the cases, social phobia preceded major depressive disorder by at least 2 years. In addition, initial presentation with social phobia was associated with a 5.7-fold increased risk of developing major depressive disorder. These associations between anxiety and depression can be traced back even earlier in life. For example, childhood behavioral inhibition in response to novelty or strangers, or an extreme anxious temperament, is associated with a three- to fourfold increase in the likelihood of developing social anxiety disorder, which in turn is associated with an increased risk to develop major depressive disorder and substance abuse ( 19 ).

It is important to emphasize that the presence of comor‐bid anxiety symptoms and disorders matters in relation to treatment. Across psychiatric disorders, the presence of significant anxiety symptoms generally predicts worse outcomes, and this has been well demonstrated for depression. In the STAR*D study, patients with anxious major depressive disorder were more likely to be severely depressed and to have more suicidal ideation ( 9 ). This is consistent with the study by Kessler and colleagues ( 5 ), in which patients with anxious major depressive disorder, compared with patients with nonanxious major depressive disorder, were found to have more severe role impairment and more suicidal ideation. Data from level 1 of the STAR*D study (citalopram treatment) nicely illustrate the impact of comorbid anxiety symptoms on treatment. Compared with patients with nonanxious major depressive disorder, those 53% of patients with an anxious depression were less likely to remit and also had a greater side effect burden ( 20 ). Other data examining patients with major depressive disorder and comorbid anxiety disorders support the greater difficulty and challenge in treating patients with these comorbidities ( 21 ).

This issue of the Journal presents new findings relevant to the issues discussed above in relation to understanding and treating anxiety and depressive disorders. Drs. Conor Liston and Timothy Spellman, from Weill Cornell Medicine, provide an overview for this issue ( 22 ) that is focused on understanding mechanisms at the neural circuit level that underlie the pathophysiology of depression. Their piece nicely integrates human neuroimaging studies with complementary data from animal models that allow for the manipulation of selective circuits to test hypotheses generated from the human data. Also included in this issue is a review of the data addressing the reemergence of the use of psychedelic drugs in psychiatry, particularly for the treatment of depression, anxiety, and PTSD ( 23 ). This timely piece, authored by Dr. Collin Reiff along with a subgroup from the APA Council of Research, provides the current state of evidence supporting the further exploration of these interventions. Dr. Alan Schatzberg, from Stanford University, contributes an editorial in which he comments on where the field is in relation to clinical trials with psychedelics and to some of the difficulties, such as adequate blinding, in reliably studying the efficacy of these drugs ( 24 ).

In an article by McTeague et al. ( 25 ), the authors use meta-analytic strategies to understand the neural alterations that are related to aberrant emotion processing that are shared across psychiatric disorders. Findings support alterations in the salience, reward, and lateral orbital nonreward networks as common across disorders, including anxiety and depressive disorders. These findings add to the growing body of work that supports the concept that there are common underlying factors across all types of psychopathology that include internalizing, externalizing, and thought disorder dimensions ( 26 ). Dr. Deanna Barch, from Washington University in St. Louis, writes an editorial commenting on these findings and, importantly, discusses criteria that should be met when we consider whether the findings are actually transdiagnostic ( 27 ).

Another article, from Gray and colleagues ( 28 ), addresses whether there is a convergence of findings, specifically in major depression, when examining data from different structural and functional neuroimaging modalities. The authors report that, consistent with what we know about regions involved in emotion processing, the subgenual anterior cingulate cortex, hippocampus, and amygdala were among the regions that showed convergence across multimodal imaging modalities.

In relation to treatment and building on our understanding of neural circuit alterations, Siddiqi et al. ( 29 ) present data suggesting that transcranial magnetic stimulation (TMS) targeting can be linked to symptom-specific treatments. Their findings identify different TMS targets in the left dorsolateral prefrontal cortex that modulate different downstream networks. The modulation of these different networks appears to be associated with a reduction in different types of symptoms. In an editorial, Drs. Sean Nestor and Daniel Blumberger, from the University of Toronto ( 30 ), comment on the novel approach used in this study to link the TMS-related engagement of circuits with symptom improvement. They also provide a perspective on how we can view these and other circuit-based findings in relation to conceptualizing personalized treatment approaches.

Kendler et al. ( 31 ), in this issue, contribute an article that demonstrates the important role of the rearing environment in the risk to develop major depression. Using a unique design from a Swedish sample, the analytic strategy involves comparing outcomes from high-risk full sibships and high-risk half sibships where at least one of the siblings was home reared and one was adopted out of the home. The findings support the importance of the quality of the rearing environment as well as the presence of parental depression in mitigating or enhancing the likelihood of developing major depression. In an accompanying editorial ( 32 ), Dr. Myrna Weissman, from Columbia University, reviews the methods and findings of the Kendler et al. article and also emphasizes the critical significance of the early nurturing environment in relation to general health.

This issue concludes with an intriguing article on anxiety disorders, by Gold and colleagues ( 33 ), that demonstrates neural alterations during extinction recall that differ in children relative to adults. With increasing age, and in relation to fear and safety cues, nonanxious adults demonstrated greater connectivity between the amygdala and the ventromedial prefrontal cortex compared with anxious adults, as the cues were being perceived as safer. In contrast, neural differences between anxious and nonanxious youths were more robust when rating the memory of faces that were associated with threat. Specifically, these differences were observed in the activation of the inferior temporal cortex. In their editorial ( 34 ), Dr. Dylan Gee and Sahana Kribakaran, from Yale University, emphasize the importance of developmental work in relation to understanding anxiety disorders, place these findings into the context of other work, and suggest the possibility that these and other data point to neuroscientifically informed age-specific interventions.

Taken together, the papers in this issue of the Journal present new findings that shed light onto alterations in neural function that underlie major depressive disorder and anxiety disorders. It is important to remember that these disorders are highly comorbid and that their symptoms are frequently not separable. The papers in this issue also provide a developmental perspective emphasizing the importance of early rearing in the risk to develop depression and age-related findings important for understanding threat processing in patients with anxiety disorders. From a treatment perspective, the papers introduce data supporting more selective prefrontal cortical TMS targeting in relation to different symptoms, address the potential and drawbacks for considering the future use of psychedelics in our treatments, and present new ideas supporting age-specific interventions for youths and adults with anxiety disorders.

Disclosures of Editors’ financial relationships appear in the April 2020 issue of the Journal .

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Recent developments in stress and anxiety research

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Stress and anxiety are virtually omnipresent in today´s society, pervading almost all aspects of our daily lives. While each and every one of us experiences “stress” and/or “anxiety” at least to some extent at times, the phenomena themselves are far from being completely understood. In stress research, scientists are particularly grappling with the conceptual issue of how to define stress, also with regard to delimiting stress from anxiety or negative affectivity in general. Interestingly, there is no unified theory of stress, despite many attempts at defining stress and its characteristics. Consequently, the available literature relies on a variety of different theoretical approaches, though the theories of Lazarus and Folkman ( 1984 ) or McEwen ( 1998 ) are relatively pervasive in the literature. One key issue in conceptualizing stress is that research has not always differentiated between the perception of a stimulus or a situation as a stressor and the subsequent biobehavioral response (often called the “stress response”). This is important, since, for example, psychological factors such as uncontrollability and social evaluation, i.e. factors that may influence how an individual perceives a potentially stressful stimulus or situation, have been identified as characteristics that elicit particularly powerful physiological stressful responses (Dickerson and Kemeny 2004 ). At the core of the physiological stress response is a complex physiological system, which is located in both the central nervous system (CNS) and the body´s periphery. The complexity of this system necessitates a multi-dimensional assessment approach involving variables that adequately reflect all relevant components. It is also important to consider that the experience of stress and its psychobiological correlates do not occur in a vacuum, but are being shaped by numerous contextual factors (e.g. societal and cultural context, work and leisure time, family and dyadic systems, environmental variables, physical fitness, nutritional status, etc.) and dispositional factors (e.g. genetics, personality, resilience, regulatory capacities, self-efficacy, etc.). Thus, a theoretical framework needs to incorporate these factors. In sum, as stress is considered a multi-faceted and inherently multi-dimensional construct, its conceptualization and operationalization needs to reflect this (Nater 2018 ).

The goal of the World Association for Stress Related and Anxiety Disorders (WASAD) is to promote and make available basic and clinical research on stress-related and anxiety disorders. Coinciding with WASAD’s 3rd International Congress held in September 2021 in Vienna, Austria, this journal publishes a Special Issue encompassing state-of-the art research in the field of stress and anxiety. This special issue collects answers to a number of important questions that need to be addressed in current and future research. Among the most relevant issues are (1) the multi-dimensional assessment that arises as a consequence of a multi-faceted consideration of stress and anxiety, with a particular focus on doing so under ecologically valid conditions. Skoluda et al. 2021 (in this issue) argue that hair as an important source of the stress hormone cortisol should not only be taken as a complementary stress biomarker by research staff, but that lay persons could be also trained to collect hair at the study participants’ homes, thus increasing the ecological validity of studies incorporating this important measure; (2) the incongruence between psychological and biological facets of stress and anxiety that has been observed both in laboratory and field research (Campbell and Ehlert 2012 ). Interestingly, there are behavioral constructs that do show relatively high congruence. As shown in the paper of Vatheuer et al. ( 2021 ), gaze behavior while exposed to an acute social stressor correlates with salivary cortisol, thus indicating common underlying mechanisms; (3) the complex dynamics of stress-related measures that may extend over shorter (seconds to minutes), medium (hours and diurnal/circadian fluctuations), and longer (months, seasonal) time periods. In particular, momentary assessment studies are highly qualified to examine short to medium term fluctuations and interactions. In their study employing such a design, Stoffel and colleagues (Stoffel et al. 2021 ) show ecologically valid evidence for direct attenuating effects of social interactions on psychobiological stress. Using an experimental approach, on the other hand, Denk et al. ( 2021 ) examined the phenomenon of physiological synchrony between study participants; they found both cortisol and alpha-amylase physiological synchrony in participants who were in the same group while being exposed to a stressor. Importantly, these processes also unfold over time in relation to other biological systems; al’Absi and colleagues showed in their study (al’Absi et al. 2021 ) the critical role of the endogenous opioid system and its relation to stress-related analgesia; (4) the influence of contextual and dispositional factors on the biological stress response in various target samples (e.g., humans, animals, minorities, children, employees, etc.) both under controlled laboratory conditions and in everyday life environments. In this issue, Sattler and colleagues show evidence that contextual information may only matter to a certain extent, as in their study (Sattler et al. 2021 ), the biological response to a gay-specific social stressor was equally pronounced as the one to a general social stressor in gay men. Genetic information is probably the most widely researched dispositional factor; Kuhn et al. show in their paper (Kuhn et al. 2021 ) that the low expression variant of the serotonin transporter gene serves as a risk factor for increased stress reactivity, thus clearly indicating the important role of dispositional factors in stress processing. An interesting factor combining both aspects of dispositional and contextual information is maternal care; Bentele et al. ( 2021 ) in their study are able to show that there was an effect of maternal care on the amylase stress response, while no such effect was observed for cortisol. In a similar vein, Keijser et al. ( 2021 ) showed in their gene-environment interaction study that the effects of FKBP5, a gene very closely related to HPA axis regulation, and early life stress on depressive symptoms among young adults was moderated by a positive parenting style; and (5) the role of stress and anxiety as transdiagnostic factors in mental disorders, be it as an etiological factor, a variable contributing to symptom maintenance, or as a consequence of the condition itself. Stress, e.g., as a common denominator for a broad variety of psychiatric diagnoses has been extensively discussed, and stress as an etiological factor holds specific significance in the context of transdiagnostic approaches to the conceptualization and treatment of mental disorders (Wilamowska et al. 2010 ). The HPA axis, specifically, is widely known to be dysregulated in various conditions. Fischer et al. ( 2021 ) discuss in their comprehensive review the role of this important stress system in the context of patients with post-traumatic disorder. Specifically focusing on the cortisol awakening response, Rausch and colleagues provide evidence for HPA axis dysregulation in patients diagnosed with borderline personality disorder (Rausch et al. 2021 ). As part of a longitudinal project on ADHD, Szep et al. ( 2021 ) investigated the possible impact of child and maternal ADHD symptoms on mothers’ perceived chronic stress and hair cortisol concentration; although there was no direct association, the findings underline the importance of taking stress-related assessments into consideration in ADHD studies. As the HPA axis is closely interacting with the immune system, Rhein et al. ( 2021 ) examined in their study the predicting role of the cytokine IL-6 on psychotherapy outcome in patients with PTSD, indicating that high reactivity of IL-6 to a stressor at the beginning of the therapy was associated with a negative therapy outcome. The review of Kyunghee Kim et al. ( 2021 ) also demonstrated the critical role of immune pathways in the molecular changes due to antidepressant treatment. As for the therapy, the important role of cognitive-behavioral therapy with its key elements to address both stress and anxiety reduction have been shown in two studies in this special issue, evidencing its successful application in obsessive–compulsive disorder (Ivarsson et al. 2021 ; Hollmann et al. 2021 ). Thus, both stress and anxiety are crucial transdiagnostic factors in various mental disorders, and future research needs elaborate further on their role in etiology, maintenance, and treatment.

In conclusion, a number of important questions are being asked in stress and anxiety research, as has become evident above. The Special Issue on “Recent developments in stress and anxiety research” attempts to answer at least some of the raised questions, and I want to invite you to inspect the individual papers briefly introduced above in more detail.

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Nater, U.M. Recent developments in stress and anxiety research. J Neural Transm 128 , 1265–1267 (2021). https://doi.org/10.1007/s00702-021-02410-3

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Accepted : 13 August 2021

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DOI : https://doi.org/10.1007/s00702-021-02410-3

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Risk factors associated with stress, anxiety, and depression among university undergraduate students

Mohammad mofatteh.

1 Lincoln College, University of Oxford, Turl Street, Oxford OX1 3DR, United Kingdom

2 Merton College, University of Oxford, Merton Street, Oxford OX1 4DJ, United Kingdom

3 Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, United Kingdom

It is well-known that prevalence of stress, anxiety, and depression is high among university undergraduate students in developed and developing countries. Students entering university are from different socioeconomic background, which can bring a variety of mental health risk factors. The aim of this review was to investigate present literatures to identify risk factors associated with stress, anxiety, and depression among university undergraduate students in developed and developing countries. I identified and critically evaluated forty-one articles about risk factors associated with mental health of undergraduate university students in developed and developing countries from 2000 to 2020 according to the inclusion criteria. Selected papers were analyzed for risk factor themes. Six different themes of risk factors were identified: psychological, academic, biological, lifestyle, social and financial. Different risk factor groups can have different degree of impact on students' stress, anxiety, and depression. Each theme of risk factor was further divided into multiple subthemes. Risk factors associated with stress, depression and anxiety among university students should be identified early in university to provide them with additional mental health support and prevent exacerbation of risk factors.

1. Introduction

Mental health is one of the most significant determinants of life quality and satisfaction. Poor mental health is a complex and common psychological problem among university undergraduate students in developed and developing countries [1] . Different psychological and psychiatric studies conducted in multiple developed and developing countries across the past decades have shown that prevalence of stress, anxiety, and depression (SAD) is higher among university students compared with the general population [2] – [4] . It is well established that as a multi-factorial problem, SAD cause personal, health, societal, and occupational issues [5] which can directly influence and be influenced by the quality of life. The level of stress cited in self-reported examinations and surveys is inversely correlated with life quality and well-being [6] .

Untreated poor mental health can cause distress among students and, hence, negatively influence their quality of lives and academic performance, including, but not limited to, lower academic integrity, alcohol and substance abuse as well as a reduced empathetic behaviour, relationship instability, lack of self-confidence, and suicidal thoughts [7] – [9] .

A 21-item self-evaluating questionnaire, Beck Depression Inventory (BDI), is the most common tool used for diagnoses of depression [10] . A BDI-based survey in five developed countries in Europe (European Outcome of Depression International Network-ODIN in the United Kingdom, Netherlands, Greece, Norway, and Spain) concluded that overall 8.6% (95% CI, 7.95–10.37) of the resident population are dealing with depression [11] . Similar studies confirmed that about 8% of the population in developed and developing countries suffer from depression [12] . Data from systematic review studies revealed that this depression rate is much higher among university students and around one third of all students in the majority of the developed countries have some degree of SAD disorders; and depression prevalence has been increasing in academic environments over the past few decades [3] .

Despite all the efforts to increase awareness and tackle mental health problems among university students, there is still an increasing number of depression and suicide among students [13] , indicating a lack of effectiveness of the measures adopted. In addition to an increase in the prevalence of mental health issues, comparing students and non-college-attending peers demonstrated that the severity of psychological disorders that students receive treatment for has also increased [14] . For example, the rate of suicide among adolescents has increased significantly over the past few decades [15] . In fact, suicide as a result of untreated mental health is the second cause of death among American college students [16] , emphasizing the importance of identifying and treating risk factors associated with SAD.

SAD can be manifested in different forms; however, some common overt symptoms include loss of appetite, sleep disturbance, lack of concentration, apathy (lack of enthusiasm and concern), and poor hygiene. Studying SAD is particularly important among university students who are future representatives and leaders of a country. Furthermore, most undergraduate students enter university at an early age; and dealing with SAD early in life can have long-term negative consequences on the mental and social life of students [3] . For example, a longitudinal study in New Zealand over 25 years demonstrated that depression among people aged 16–21 could increase their unemployment and welfare-dependence in long-term [17] .

A better understanding of SAD among students in developed and developing countries not only helps governments, universities, families, and healthcare agencies to identify risk factors associated with mental health problems in order to minimise such risk factors, but also provides them with an opportunity to study how these factors have been changing in the academia.

This review aims to provide an updated understanding of risk factors associated with SAD among post-secondary undergraduate and college students in developed and developing countries by using existing literature resources available to answer the following question:

“Aetiology of depression and anxiety: What are risk factors associated with stress, anxiety and depression among university and college undergraduate students studying in developed and developing countries?”

It is worth mentioning that this review focuses on SAD risk factors of university students in developed and developed countries, and does not cover underdeveloped countries which can have their own niche problems (such as poverty). However, this review takes into account international students who migrate from underdeveloped countries to developed and developing countries to pursue their education.

2.1. Aims and objectives

The aims of this review were to identifying principal themes associated with depression and anxiety risk factors among university undergraduate students. The objectives of this review are to design a rigorous searching methodology approach by using appropriate inclusion and exclusion criteria, to conduct literature searches of publicly available databases using the designed methodology approach, to investigated collected literature resources to identify risk factors associated with the depression and anxiety which have not changed, and to identify principal themes associated with SAD risk factors among university undergraduate students.

2.2. Designed approach for literature review

A narrative review based on a comprehensive and replicable search strategy is used in this review. This approach is justified and preferred, over other approaches such as primary data gathering, because of the timescale of the research (2000 to 2020-temporal reasons), and extent of the research (developed and developing countries-spatial reasons).

2.3. Criteria for inclusion and exclusion of articles

Inclusion and exclusion criteria for articles and academic writings used in this review are as follows:

2.3.1. Date

2000 to 2020 are included Academic writings which are published between in this review. Initially, during a pilot search, search strategies covered 1990 to 2020. However, the majority of the search results (more than 80% of the search results and more than 88% of applicable search results) were from 2000 to 2020, which indicates the importance of mental health issue and increased awareness over the past two decades. Therefore, for the final search, papers from 2000 to 2020 were included.

2.3.2. Study design

Literatures included in this narrative review were primary research articles, review articles, systematic reviews, mini-reviews, opinion pieces, correspondence, clinical trials, and cases reports published in peer reviewed journals.

2.3.3. Country

The narrative review was limited to developed and developing countries definition by the United Nations Department of Economic and Social Affairs [18] . Abstract and method sections of search results were screened to check the country of research.

2.3.4. Language

Peer-reviewed articles published in English were only included in this narrative review.

2.3.5. The explanation for papers exclusion

The main reason for papers excluded from consideration after search results was that they focused on intervention and therapies associated with SAD. Other reasons for exclusion was that studies were conducted on a mixture of undergraduate and graduate students or focused solely only graduate students. Studies which focused on other types of mental disorders such as eating disorders but did not focus on SAD were excluded too. The conducted search did not exclude any gender or specific age category.

2.4. Strategies used for search and limitations

In this review, a robust and replicable search strategy was designed to identify appropriate articles by searching PubMed, MEDLINE via Ovid, and JSTOR electronic databases. These databases were selected because they encompass biopsychosocial papers published on SAD. The date chosen for this search was for articles published between 2000 to 2020 which covers the past two decades. Once key articles were identified, a search for citation of those papers was conducted, and the bibliography of those papers were further screened to identify potential articles which can be relevant.

2.5. Search terminologies used

To conduct searches in databases mentioned above, the following search terms were used: students stress, anxiety, depression risk factors, university stress, anxiety, depression risk factors, student mental health developed and developing countries, students stress, anxiety and depression developed and developing countries. The operation AND was used to connect stress, anxiety, depression, mental health, developed, developing, countries, students. The search for each term was conducted in all fields (title, abstract, full text, etc.).

2.6. Screening, selecting search results, and data extraction

The search results were exported into separate Excel and EndNote X8 files. Titles and abstracts from all articles were screened to determine their relevance to the topic of this review. Potentially relevant articles were fully read to establish their relevance. Each paper which was included according to the inclusion criteria described above was read fully. A word file was created to identify themes associated with SAD risk factors which is included in the Results. An initial search resulted in 1305 articles. The title and abstract of individual papers were read for relevance, resulting in 60 papers which were relevant for the research question asked in this review. All 60 papers were read completely, and from those, 19 were excluded based on the criteria mentioned before. Therefore, the total number of papers for consideration was 41. A flowchart explaining the procedure for identification, screening, eligibility, and inclusion of papers is shown in Figure 1 .

Figure 2 provides a quantitative summary of the papers included in this narrative review. In terms of the distribution of the countries where the research was conducted, included papers were mainly articles which carried out studies in the USA (n = 17), followed by China and Canada (each n = 5), UK (n = 4), Japan (n = 3), Germany and Australia (each n = 2), South Korea, Hungary, Switzerland (each n =1) ( Figure 2A ). As for article types included in this review, original research articles, including quantitative and qualitative studies, which relied on obtaining data including cross-sectional studies, interviews, case-control studies, surveys, and questionnaire, were the highest (n = 37) followed by meta-analysis, literature and systematic reviews ( Figure 2B ). Another interesting observation was that although the search was carried out from 2000–2020, most papers were concentrated in the period from 2016 to 2020 ( Figure 2C ). This can be due to the reason that mental health is becoming more important over the past few years. Alternatively, a higher number of papers included from 2016 onward can be due to unintended selection bias. The smallest study covered in this narrative review was conducted on 19 students and the largest one on 153,635 students, adding up to 236,104 students, who were included in articles covered in this narrative review in total. Most studies on mental health, anxiety, and depression use standardised approaches such as patient-filled general health questionnaires, Pearling coping questionnaire, internally regulated surveys, BDI, DSM-IV symptomology, and general anxiety and burnout scales such as Maslach Burnout Inventory.

3.1. Literature search results

Following the search protocol shown in Figure 3 , a list of included papers identified which can be found in the Table 1 .

3.2. Prevalence of mental health disorders in students

Literature showed that mental health problems are common phenomenon among students with a higher prevalence compared to the general public. For example, surveying more than 2800 students in five American large public universities demonstrated that more than half of them experienced anxiety and depression in their last year of studies [19] . Similarly, a survey of Coventry University undergraduate students in the UK showed that more than one-third of them had experienced mental health issues such as anxiety and depression over the past one year since they were surveyed [20] . In agreements with these results, Maser et al. [21] found that prevalence of mental health disorders including anxiety and depression was higher among medical students compared to the general non-student population of the same age. These studies demonstrated that the prevalence of SAD among students has remained higher than the average population over the past two decades.

SAD are not only prevalent among students, but also persistent. By conducting a follow-up survey study of students over two years, Zivin et al. [19] demonstrated that more than half of students retain their higher levels of anxiety and depression over time. This can be due to a lack of SAD treatment or persistence of existing risk factors over time.

3.3. Risk factors associated with stress, anxiety, and depression

SAD are multifactorial, complex psychological issues which can have underlying biopsychosocial reasons. Multiple risk factors which affect the formation of SAD among undergraduate university students in developed and developing countries were identified in this review. These factors can be categorized into multiple themes including psychological, academic, biological, lifestyle, social and financial. A summary of risk factors and their associated publications are shown in Table 2 .

3.3.1. Psychological factors

Self-esteem, self-confidence, personality types, and loneliness can be associated with SAD among university students. Students who have a lower level of self-esteem are more susceptible to develop anxiety and depression [22] . Also, students with high neuroticism and low extraversion in five-factor personality inventory [23] are more likely to develop SAD during university years [24] . Other psychological factors such as feeling of loneliness plays important roles in increasing SAD risk factors [24] . Moving away from family and beginning an independent life can pose challenges for fresher students such as loneliness until they adjust to university life and expand their social network. Indeed, Kawase et al. [24] showed that students who live in other cities than their hometown for studying purposes are more likely to develop anxiety and depression.

Some students enter the university with underlying mental conditions, which can become exacerbated as they transition into the independent life at university. While depression is higher among university and college students compared to the general public, students with a history of mental health problems, such as post-traumatic stress disorder (PTSD), are more prone to development of anxiety and depression during their university lives compared to students who did not have such experience before starting their degrees [25] . Furthermore, exposure to violence in childhood either at the household or the community correlates with SAD formation later in life and at University [26] . Therefore, low self-esteem and self-confidence, having an underlying mental health condition before beginning the university, personality type (high neuroticism and low extravasation), and loneliness can increase the probability of SAD formation in students.

3.3.2. Academic factors

Multiple university-related academic stressors can lead to SAD among students. One of these factors which was strongly present in many studies evaluated in this review was the subject of the degree. Medical, nursing, and health-related students have a higher prevalence of depression and anxiety compared to their non-medical peers [24] , [27] – [28] . Medical and nursing students who have both theoretical duties and patient-related work usually have the highest level of workload among university students, consequently deal more with anxiety and depression [27] , [29] . In addition, students who major in psychology and philosophy, similar to nursing and medical students, are more likely to develop depression during their studies compared to others [24] . These studies did not identify whether students who have underlying mental health conditions are more likely to choose certain subjects such as philosophy, psychology, or subjects which lead to caring roles such as nursing and medicine. Because of the nature of their work, medical and nursing students who deal with people's health can experience depression and anxiety as a result of fears of making mistakes which can result in harming patients [27] . Students with practical components in their degree are required to travel to unfamiliar places for fieldwork and work experience which can add to their stress and anxiety [27] .

Also, some prospective students, especially those who study nursing and medicine, usually do not have a clear understanding of the curriculum and workload associated with the subject before entering the university, therefore, they can face a state of disillusionment once they begin their studies at university [27] – [29] . It is worth mentioning that not all studies found a significant correlation between the subject of study and SAD development [30] . This can be explained by differences in sample type and size which results in variations existing in the amount of workload and curriculum in similar subjects taught in various universities in different countries.

Studying a higher degree can be a challenging task which requires mental effort. Mastery of the subject can negatively correlate with self-esteem, anxiety, and depression among university students with students who have a mastery of subject demonstrating a lower level of stress and anxiety [31] . Also, students who study in a non-native language report the highest level of anxiety and depression during their freshman years, and their stress levels decrease during the subsequent study years [32] . This can be explained by the fact that students who are studying in a foreign language usually are those who have migrated abroad, therefore, require some time to adjust to their new lives. Different studies showed that the level of anxiety and depression among both international and home students could correlate with the year of study with fresher students who enter the university and students at the final year of their studies experience the greatest amount of anxiety and depression with different risk factors [22] , [32] . While fresher students experience SAD because of challenges in adjustments to university life, past negative family experience, social isolation and not having many friends, final year students report uncertainty about their future, prospective employment, university debt repayment and adjusting to the life after university as major risk factors for their SAD [22] , [32] . Therefore, a shift in SAD risk factors themes are observed as students make a progress in their degrees.

Students spend a significant portion of their time at university being engaged with their academic activities, and unpleasant academic outcomes can influence their mental health. Receiving lower grades during the time of studies can negatively influence students' mental health, causing them to develop SAD [33] , [34] . Academic performance during undergraduate studies can determine the degree classification, which can, subsequently, influence students' opportunities such as employment success rate or access to postgraduate courses [27] . Conversely, both the number of students with mental health problem symptoms and the severity of students' SAD increase during exam time [35] , reflecting a direct relationship between academic pressure and students' mental health states. However, the causal relationship is not well-established; it is possible that depression and associated problems such as temporary memory loss and lack of concentration [36] are reasons for poor academic grades or inversely, students feel stressed leading to depression because of their poor performance in their exams. A mutual relationship can exist between grades and mental health, as having a poor mental health can reciprocally cause students to get lower grades [34] , leading to a vicious cycle of mental health and academic performance. Interestingly, students' sense of social belonging and coherence to the university community was reduced during exam periods [35] . This can be explained by the reduced participation rate of students in university social activities and clubs as well as an increased sense of competition with their peers. Furthermore, students interact directly and indirectly with teachers, lecturers, tutors, and other staff; therefore, the relationship between students and academic staff can influence students' mental health. A negative and abusive relationship with teachers and mentors can be another factor causing SAD among undergraduate students [27] .

On the other hand, being a part-time student is a protective factor for anxiety and depression, and part-time students have better mental health compared to students with full-time status [34] . This can be explained by financial securities which have a source of income can bring or because part-time students are usually older than full-time students [34] , and therefore, more emotionally stable. In conclusion, risk factors increasing SAD among university students include high workload pressure, fear of poor performance in exams and assessments, wrong expectations from the course and university, insufficient mastery in the subject, year of study, and a negative relationship with academic staff.

3.3.3. Biological factors

Mental health can be influenced by ones' physical health. Presence of an underlying health condition or a chronic disease before entering the university can be a predictor of having SAD during university years [31] , [33] . Students with physical and mental disabilities can be in a more disadvantaged position and do not fully participate in university life leading to SAD formation [33] .

An association between gender and depressive disorders have been observed in several studies [21] , [27] , [34] , [37] . Female students had a higher prevalence of SAD compared to male students. Interestingly, while female students demonstrated a higher level of SAD, the dropout rate of female students with a mental health problem from university was lower compared to their male counterparts [33] . On the other hand, while females are at a higher risk of developing depressive disorders, males with depressive disorders are less willing to seek professional help and ask for support due to the stigma attached to mental health [38] , causing exacerbation of their problem over time [20] .

Age can be another factor related to SAD. Younger students report a higher level of SAD compared to older students [34] , [37] . However, other meta-analysis studies did not find a significant correlation between students' age and their mental health which can be due to sampling differences [39] . Some studies showed that while older undergraduate students have a higher determination to do well in the university [40] , those who have family commitments are more prone to develop SAD during their degrees [27] . These discrepancies in findings can be explained by different sample sizes and types of studies which can be influenced by various confounding factors such as nationality, country of study, degree of studies, gender, and socioeconomic status. Similarly, a lack of correlation between depression prevalence and year of study is observed as some studies have reported a higher prevalence among earlier years of studies, while others have shown a higher prevalence among students as they move closer to the end of their studies [41] . These differences can be explained by different causes of depression in a different age; for example, while depression in younger adults can be due to changes in their environment and difficulties in adapting to a new life, older adults can have depression symptoms because of a lack of certainty for their future and employment. Nevertheless, differences exist between SAD risk factors associated with young and older students. Overall, biological risk factors affecting SAD include age of students, gender, and underlying physical conditions before entering the university.

3.3.4. Lifestyle factors

Moving away from families and beginning a new life requires flexibility and adaptation to adjust to a new lifestyle. As most undergraduate students leave their family environment and enter a new life with their peers, friends, and classmates, their behaviour and lifestyle change too. Multiple lifestyle factors such as alcohol consumption, tobacco smoking, dietary habits, exercise, and drug abuse can affect SAD. Alcohol consumption is high among students with SAD [28] ; a causal relationship was not been established in this study though.

Tobacco smoking is another risk factor associated with SAD which is common among students, especially students who study in Eastern developed and developing countries such as China, Japan and South Korea [24] , [42] . Most students, especially male students, smoke because of social bonding and the rate of social smoking is directly correlated with SAD [24] , [42] . Social smokers are less willing to quit smoking, and more likely to persist in their habit, resulting in long term negative physical and psychological health consequences [42] . Illegal substance abuse can be another factor important in SAD among young people [43] . Academic-related stress and social environment in university dormitories and student accommodations can encourage students to use illegal drugs, smoke tobacco and consume alcohol excessively as a coping mechanism, resulting in SAD [44] . Interestingly, students who perceived they had support from the university were feeling less stressed and were less at the risk of substance abuse [45] , indicating the important role of social support in preventing and alleviating depression symptoms. This is of particular importance as a new social habit and behaviour adapted early during life can last for a long time. Furthermore, students who do not have a healthy lifestyle can feel guilt, which can worsen their SAD condition [46] . Interestingly, Rosenthal et al. [47] showed that negative behaviours resulting from alcohol consumption such as missing the next day class, careless behaviour and self-harm, verbal argument or physical fight, being involved in unwanted sexual behaviour, and personal regret and shame could be the main reasons for depression associated with drinking alcohol, rather than the amount of alcohol consumed.

In contrast, a moderate to vigorous level of physical activity can be a protective factor against developing SAD during university life [37] , [48] . Students who have a perception of having inadequate time during their studies do not spend enough time for exercise and can develop SAD symptoms [27] .

Another lifestyle-related risk fact associated with SAD is sleep. Many young people do not receive sufficient sleep, and sleep deprivation is a serious risk factor for low mood and depression [28] , [47] . Self-reported high level of stress and sleep deprivation is common among American students [31] , [49] . Insufficient sleep can act as a vicious cycle- academic stress can cause sleep deprivation, and insufficient sleep can cause stress due to poor academic performance since both sleep quality and quantity is associated with academic performance [28] . Overall, poor sleeping habit is associated with a decreased learning ability, increase in anxiety and stress, leading to depression.

Different negative lifestyle behaviours such as tobacco smoking, excessive alcohol consumption, unhealthy diet, lack of adequate physical activity, and insufficient sleep can increase the risk of SAD formation among university students.

3.3.5. Social factors

Having a supportive social network can influence students' social and emotional wellbeing, and subsequently lower their probability of having anxiety and depression in university [27] , [37] , [50] . The quality of relationship with family and friends is important in developing SAD. Having a well-established and supportive relationship with family members can be a protective factor against SAD development, which, in turn, can affect the sense of students' fulfilment from their university life [27] . The frequency of family visits during university years negatively correlates with SAD development [33] . Family visits can be more challenging for international students who live far away from their families, therefore adding to existing problems of international students who live and study abroad.

In contrast, having a negative relationship with family members, especially parents, can cause SAD formation among students in university [51] . Similarly, having a strict family who posed restrictions on behaviours and activities during childhood can be a predictor of developing SAD during university years [51] .

Also, it is shown that being in a committed relationship has a beneficial protective factor against developing depressive symptoms in female, but not male, students [52] . Interestingly, both male and female students who were in committed relationships reported a lower alcohol consumption compared to their peers who were not in committed relationships [52] .

Involvement in social events such as participating in sporting events and engaging in club activities can be a protective factor for mental health [32] , [37] . Assessing preclinical medical students' social, mental, and psychological wellbeing showed that while first year students demonstrate a decrease in their mental wellbeing during the academic year, they have an increase in their social wellbeing and social integration [53] . This can be explained by the time period required for fresher students who enter the university to adjust to the social environment, make new friends, and integrate into the social life of the university.

Access to social support from university is another factor which is negatively correlated with developing anxiety and depression [31] . It is worth mentioning that different universities provide different degrees of social support for students which can reflect on different anxiety and depression observed among students of different universities.

Importantly, sexual victimization during university life can be a predictor of depression. By surveying female Canadian undergraduate students, McDougall et al. [54] found that students who were sexually victimized and had non-consensual sex were at a higher chance of developing depression following their experience, emphasizing the importance of safeguarding mechanism for students at university campuses.

While the internet and social media can be great tools for maintaining a social relationship with classmates, pre-university friends and family members, it can have negative mental health effects. Excessive usage of social media and the internet during freshman year can be a predictor of developing SAD during the following years [55] . Students who have a higher dependence on the social media report a higher feeling of loneliness, which can result in SAD [56] . Students with internet addiction and excessive usage of social media are usually in first year of their degrees [55] , [56] which can reflect a lack of adjustment to university life and forming a social network. Also, students who use social media more often have a lower level of self-esteem and prefer to recreate their sense of self [56] , indicating an intertwined relationship between biopsychosocial factors in developing SAD among students.

Demographic status, ethnic and sexual minority groups including international Asian students, black and bisexual students were at an elevated risk of depression and suicidal behaviour [16] , [50] . The frequency of mental health is usually more common among ethnic minorities. For example, Turner et al. [20] showed that ethnic minority students report a higher level of anxiety and depression compared to their white peers; however, they do not ask for help as much. Other studies supported these findings by showing that students from ethnic and religious minorities, regardless of their country of origin and country in which they study, have a higher prevalence of anxiety and depression compared to their peers [50] . Also, students' expectations from university can be different among ethnic minorities students, and most of them do not have a sufficient understanding of the services that university can provide for them [40] .

Therefore, lack of support from family and university, adverse relationships with family, lack of engagement in social activities, sexual victimization, excessive social media usage, belonging to ethnic and religious minority groups, and stigma associated with the mental health are among risk factors for SAD in university students.

3.3.6. Economic factors

Students' family economic status can influence their mental health. A low family income and experiencing poverty can be predictors of SAD development during university years [22] , [50] , [57] , [58] . A higher family income can even ameliorate negative psychological experiences during childhood, which can have long-term negative consequences on the mental health of students once they enter university [57] . Also, experiencing poverty during childhood can have negative long-term consequences on adults, leading to SAD development during university life [58] .

Some students take up part-time job to partially fund their studies. Vaughn et al. [59] showed that relationship of employed students with their colleagues in the workplace could affect students' mental health; and those students who had a poor relationship with their colleagues had worse mental health. However, it is worth mentioning that a causal relationship was not established. It can be possible that students who have poor mental health cannot get along with their co-workers, resulting in an adverse working relationship.

Because of paying higher tuition fees and less access to scholarships and bursaries available, international students can have more financial problems, causing a higher degree of anxiety and depression compared to home students [60] .

Lack of adequate financial support, low family income and poverty during childhood are risk factors of SAD in students of undergraduate courses in developed and developing countries.

3.4. Stigma associated with mental health

While efforts have been put to reduce the stigma associated with receiving help for mental health problems, this still remains a challenge. For example, more than half of students who had SAD did not receive any help or treatment for their condition because of the stigma associated with mental health [19] , [61] . This is not related to the awareness of the availability of mental health resources which was ruled out by authors, as most of the students who did not receive any help for their mental health problem were aware of available help and support to them [19] .

Furthermore, the social stigma associated with receiving help for mental health problems was significantly associated with suicidal behaviour, acting as a preventive barrier to seek help (planning and attempt) [16] . Among students, those with a history of mental health problem such as veterans with PTSD are less likely to seek for help compared to non-veteran students [25] , making them more susceptible to struggling with untreated mental health.

4. Discussion

This review tried to identify and summarise risk factors associated with SAD in undergraduate students studying in developed and developing countries. The prevalence of SAD is high among undergraduate university students who study in developed and developing countries. Untreated SAD can lead to eating disorders, self-harm, suicide, social problems [28] . Similar to a complex society, differences exist among students leading to complicated risk factors causing SAD. Because different themes influencing SAD has been investigated as a distinct body of research by different literature, a concept map is created to demonstrate the relationship between various risk factors contributing to the development of SAD in undergraduate students in developed and developing countries. Figure 3 bridges risk factors concepts between different literature. For most students, entering university is a new step in their lives which is associated with certain challenges such as moving into independent accommodation, social identity, financial management, making decisions, and forming a social network. Different students have different needs depending on the stage of their degree, which needs to be fulfilled. For example, coping with a new university life style can be a challenging task for students who enter the university. This becomes more significant for students moving abroad for their studying who need to adapt to a new lifestyle, speak in a different language, and live away from their families. In agreement with this, different levels of anxiety and depression with different risk factors are observed among students as they progress in their degrees. On the other hand, students who are finishing their degrees can have SAD because of uncertainties about their future.

Students learn different modules in different degrees and have different abilities. Mastery of the subject can be a factor affecting students' sense of self-esteem, influencing their anxiety level and developing depressive symptoms. This partially can explain changes in risk factors observed as students' progress in their degrees. Final year students who adjust to the university environment and develop mastery in their subject can deal with academic pressure better compared to freshers who transform from secondary school life to university lifestyle.

Students can come with a varied and challenging background such as those who experienced household and domestic violence, sexual abuse, and child poverty which can make them susceptible to developing anxiety and depression once academic pressure is mounted. As universities are diverse environment which enrol students from different socioeconomic background and different cultures, universities need to identify risk factors for different students and have robust plans to tackle them to provide a fostering environment for future leaders of the society. Therefore, early mental health screening can help to identify those students who are at risk to provide them with special and additional mental health support. Students not only should be screened for their mental health state as they enter university, but also regular follow up check-ups should be conducted to monitor their conditions as they progress in their degrees to detect early signs of SAD.

University and academic staff can play a significant role in either exaggerating or ameliorating risk factors associated with anxiety and depression. While teachers and mentors can support students to cope with SAD, they can be a source of problem too by discriminating, bullying, and hampering students' progress.

Managing finance and expenses can be a challenging task for students who are stepping into an independent lifestyle and need to pay for their tuitions in addition to their maintenance fees. While some students have access to private funding, bursaries, and scholarships, other students receive loans which they need to pay back or have part-time jobs to meet their expenses. Students who work need to have a work-life balance and the time spent in their jobs can affect the quality of their education.

Fresher students try to establish their social network and might feel isolated, which can push them to excessive usage of social media to fill their social gap. While internet addiction and excessive usage of social media can have a negative impact on students' mental health, technology, such as mobile phone applications can be used in universities campuses to promote a healthier lifestyle and reducing risk factors among students. For example, many students refuse to receive face-to-face mental health counselling support during their anxiety and depression due to stigma associated with disclosure of mental health issues. Providing students with anonymized counselling services through mobile phone applications can be one way of delivering help to students at universities.

With the advent of social media platforms such as Facebook, Twitter, Instagram, TikTok, etc., more and more students rely on such networks for socialisation. While the internet and online platforms can have beneficial consequences for students, such as rapid access to a variety of online learning resources and keeping in contact with friends and families, excessive usage of social media and internet can have negative consequences on students' academic performance. A poor mental health state at the beginning of university life is a predictor of internet addiction later during the degree. Heavy reliance on the internet can be a coping mechanism for students with anxiety and depression to overcome their mental health problems.

As governments and educational bodies in developed and developing countries are emphasising recruitment of ethnic minority students to university to increase the range of equality and diversity among students, it is important to consider the mental health of those students in the university as well. Students in minority groups such as black, international Chinese and bisexual student report a higher level of anxiety and depression compared to other non-minority group students. This can be due to either pre-existing conditions which student experience before entering the university, and can be exacerbated during the university, or can be because of problems which can develop during university life.

Also, more mental health support is available in universities as the number of university students is increasing, and there is a better understanding of the importance of mental health in academia; however, the stigma associated with mental health has not changed proportionately.

While research and understanding of mental health have changed significantly over the past two decades and many more articles are present, risk factors associated with SAD remain unchanged.

One caveat with studies of mental health among student is that most studies have been conducted among medical and nursing students and neglected non-medical students. One potential explanation for the tendency to conduct depression surveys among medical students is the higher response rate as medical students are more willing to fill out the questionnaires and surveys. It is understandable that students studying medical subjects, who directly interact with the public and treating them once they enter the healthcare profession should have a reasonably sound mental health to be able to conduct their duties, but it does not justify neglecting the mental health of other students. Therefore, more research on mental health and risk factors associated with SAD of non-medical students is required in the future.

Another caveat with most mental health studies is that they are based on self-reports and surveys. Different people can have different perception and understanding of mental health and anxiety, and many confounding factors can influence the response of participants in the time of participation. Furthermore, students with severe mental health conditions are less likely to participate in any activity including surveys and questionnaires, leading to a non-response bias.

Another area which requires improvement in future studies of mental health is the categorisation of different types of depression and their severity. Depression and anxiety are a spectrum which can comprise of minor and major symptoms; however, most studies did not specify the scale of depression in their findings. Furthermore, while various risk factors were identified, a causal relationship between mental health and behaviours were not established.

While counselling services provided by universities in Western countries such as the UK and USA have increased over the past few years [62] , it is still not clear how effective such services are; therefore, more research is required to assess the effectiveness of counselling services at universities.

Therefore, a better understanding of the aetiology, associated factors is required for an effective intervention to reduce the disease incidence and prevalence among students in the population and providing them with a fostering environment to achieve their potential.

University undergraduate students are at a higher risk of developing SAD in developed and developing countries. Promoting the mental health of students is an important issue which should be addressed in the education and healthcare systems of developed and developing countries. Since students entering university are from different socioeconomic background, screening should be carried out early as students.

A personalized approach is required to assess mental health of different students. In addition, a majority of mental health risk factors can be related to the academic environment. A personalised, student-centred approach to include needs and requirements of different students from different background can help students to foster their talent to reach their full potential. Furthermore, more training should be provided for teaching and university staff to help students identify risk factors, and provide appropriate treatment.

5. Conclusion

Despite all the efforts over the past two decades to destigmatise mental health, the stigma associated with mental health is still a significant barrier for students, especially male students and students from ethnic and religious minorities to seek help for SAD treatment. Universities need to continue to destigmatise mental health in university campuses to enable students to receive more in campus support by providing designated time for positive metal health activities such as group exercise, physical activities, and counselling services. There is no shortage of athletic and group activities in form of clubs and social classes in most universities in developed and developing countries; however, more incentives such as athletic bursaries and prizes should be provided to students to encourage their participation in such activities which can act as protective factors against SAD development. Therefore, universities need to allocate more resources for sporting and social activities which can impact the mental health of students. Furthermore, an increase in mental health problems in universities has created a huge burden on university counselling services to meet the demands of students. More novel approaches, such as online counselling services can help universities to meet those increased demands.

Students in different years of studies deal with different risk factors from the time that they enter the university until they graduate, therefore, different coping strategies are required for students at different levels. Universities should be aware of these risk factors and implement measures to minimise those factors while providing mental health treatments to students.

Future studies are required to investigate long-term effects of experiencing SAD on students. A longitudinal study with a large randomly recruited sample size (different age, sex, degree of study, – socioeconomic status, etc.) is required to address how students' mental health change from entering the university until they graduate. Also, more extended follow up studies can be included to address the effect of depression and poor mental health on people's lives after they graduate from the university.

Abbreviations

Conflict of interest: All authors declare no conflicts of interest in this paper.

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143 Anxiety Research Topics: Ideas To Get You Started

Anxiety research topics cover a wider study field, including emotions leading to severe mental and physical changes, negative impact on social contact, and depression. Educators ask students to write about these topics to understand this mental health issue or disorder better. This study field is essential since doctors diagnose many people with mental health disorders in the contemporary world.

This article covers 140-plus anxiety research topics. It’s helpful because many learners struggle to pick interesting titles for their research papers when educators give them this assignment. With these ideas, you can select a topic you can comfortably work with and score your desired grade. But first, let’s understand anxiety better.

What Are Anxiety Research Topics?

Anxiety topics are prompts that focus on mental health issues and the effects of living with anxiety. They require students to research this disorder, write an essay, or complete a project to present the findings.

Universities and colleges require students in various faculties or schools to write about these topics. Some fields where learners write about anxiety include psychology, mental health, medication studies, and social work. Now let’s explore various titles to consider when writing your anxiety paper.

How To Research Anxiety Research Topics

Researching a topic for an anxiety research paper requires a student to follow specific steps. They are as follows:

• Understand the Assignment: First, understand what the educator wants you to research and learn how to analyze the topic.
• Choose a Topic: Select one topic in this article or develop your idea. Pick an exciting title that is narrow enough for your paper.
• Develop a Thesis Statement: Create a thesis to guide your research based on the assignment requirements and your topic. If you have difficulties with that, seek anxiety thesis statement assistance from our experts.
• Gather Resources: Use reliable sources such as scientific journals, books, and interviews to acquire content for the paper.
• Organize Ideas: Create a plan or outline to help you structure the main points of your essay.
• Write a Draft: Use notes from your research to develop each section of the paper according to your outline.
• Proofread & Revise: Once you finish drafting, read through it multiple times and edit errors before submitting it for grading.

Picking the correct topic for your research paper is essential to your project’s success. Whether you’re writing a master thesis or college research paper, please choose a topic you’re comfortable with to enjoy researching and writing about.

Social Anxiety Research Paper Topics

Social anxiety is when individuals experience fear and anxiety in social situations. Intense self-consciousness, stress, and shyness characterize social anxiety. Here are some research paper topics for students to explore:

• The effects of social anxiety on college students
• How does social anxiety differ from shyness?
• Cognitive behavioral therapy strategies for treating social anxiety disorder
• Analyzing the causes of social anxiety disorders in adolescents
• Investigating how social media use relates to social anxiety
• Investigating coping mechanisms for people with social anxiety disorder
• Role of emotional intelligence in overcoming social anxiety
• The use of virtual reality to treat social anxiety
• Therapeutic strategies for helping people with social anxiety
• How does social anxiety affect mental health?
• Understanding the role of genetics in social anxiety
• The link between perfectionism and social anxiety disorders
• Exploring support groups as a way to manage social anxiety symptoms
• How can social workers help people with a social anxiety disorder?
• Discussing the use of psychopharmacology in treating social anxiety disorder
• Comparative study of social anxiety between kids and adults
• Exploring the relationship between stress and social anxiety
• Understanding how physical exercise benefits people with social anxiety
• Analyzing the role of cognitive restructuring in treating social anxiety disorder
• Investigating the impact of culture on dealing with social anxiety

These are great topics to consider when researching and writing about social anxiety. Nevertheless, they require time and effort to present a winning essay.

Communicational Anxiety Research Topics

Communicational anxiety is an anxiety disorder characterized by intense fear and avoidance of speaking situations, leading to physical symptoms. Here are some research paper topics for students to explore:

• Exploring the relationship between anxiety and public speaking
• How can cognitive behavioral therapy help in reducing communication anxiety?
• Investigating the role of technology in lowering communicational anxiety
• Investigating the impact of social media on communicational anxiety
• Analyzing coping mechanisms for people with communicational anxiety disorders
• Understanding how cultural differences affect communicational anxiety symptoms
• Comparing treatment strategies for different types of communication anxiety disorders
• The use of virtual reality simulations to treat communication anxiety
• Understanding how parental support helps in reducing communication anxiety symptoms
• Investigating the role of genetics in communicational anxiety disorders
• Exploring the benefits of mindfulness techniques for dealing with communicational anxiety
• Social media usage and its impact on communicational anxiety development
• Evaluating different types of talking therapies for communicational anxiety treatment
• Exploring group therapy for people with communicational anxiety disorder
• Analyzing the relationship between low self-esteem and communication anxiety
• Comparing performance strategies for overcoming public speaking fear and anxiety
• Exploring peer support as a way to manage communication anxiety symptoms
• Investigating the effects of cognitive restructuring on communicational anxiety
• Understanding how physical exercise benefits people with communication anxiety disorders
• Exploring the role of positive self-talk in reducing communicational anxiety symptoms
• Investigating the relationship between personality traits and communicational anxiety
• Analyzing the impact of social class on communication anxiety symptoms
• Exploring how neuroimaging can help understand communication anxiety disorders
• Comparing different types of relaxation techniques for treating communication anxiety
• Investigating social support structures as a way to manage communicational anxiety symptoms
• Understanding how meditation benefits people with communication anxiety disorders
• Investigating the impact of social support on communicational anxiety symptoms
• Exploring the role of music therapy in reducing communication anxiety
• Analyzing the effects of art therapy in treating communication anxiety disorders
• Comparing different self-help strategies for overcoming public speaking fear and anxiety

These are great topics worth exploring for any student interested in communication anxiety. However, they require time to investigate and analyze information to write a high-quality paper.

Medical Anxiety Research Topics

Medical anxiety is a persistent fear of medical procedures and treatments that can interfere with an individual’s ability to seek medical help. Here are some research paper topics about medical anxiety for students to explore or to use for a thesis in nursing when it comes to anxiety:

• Investigating the relationship between medical anxiety and avoidance behaviors
• Exploring the impact of cognitive restructuring on reducing medical anxiety
• Understanding how technology can help in managing medical anxiety symptoms
• Analyzing different types of relaxation techniques for treating medical anxiety
• Can virtual reality simulation therapy treat medical anxiety disorders
• Comparing different self-help strategies for overcoming fear and anxiety related to medical procedures
• Can art therapy reduce medical anxiety symptoms
• Investigating the role of mindfulness techniques in managing medical anxiety symptoms
• Exploring the effects of music therapy on medical anxiety disorders
• Understanding how social support structures help in treating medical anxiety
• Analyzing cognitive and behavioral interventions for reducing medical anxiety symptoms
• Investigating the role of genetics in determining risk for developing medical anxiety disorders
• Examining different treatment strategies for people with severe medical anxiety disorder
• Assessing the effectiveness of pharmaceutical interventions for reducing medical anxiety symptoms
• Analyzing coping skills used by people to manage their fear and anxiety during a doctor’s visit
• Exploring how different forms of exercise help in treating medical anxiety disorders
• Evaluating the effects of self-help books and online resources on reducing medical anxiety symptoms
• Investigating social media impact on medical anxiety development
• Understanding how nutrition can play a role in managing medical anxiety disorder symptoms
• Examining different types of talking therapies for treating medical anxiety disorder
• Investigating the relationship between low self-esteem and medical anxiety
• Comparing performance strategies for overcoming fear and anxiety related to medical procedures
• Exploring group therapy as a way to manage medical anxiety symptoms
• How neuroimaging can help understand medical anxiety disorders
• Examining the role of different types of meditation in treating medical anxiety disorders
• Investigating the correlation between stress and medical anxiety disorders
• Understanding the effects of sleeping habits on the development of medical anxiety disorders
• Analyzing different coping strategies used to manage fear and anxiety during a doctor’s visit
• Can cognitive behavioral therapy (CBT) treat medical anxiety disorders
• Exploring how self-efficacy helps manage medical anxiety symptoms better

Students interested in medical anxiety can research and write about these titles. Nevertheless, prepare to investigate various information sources to write a winning paper about these topics.

Advanced Anxiety Research Topics

You may be pursuing a master’s or Ph.D. degree and wants to write a research paper about anxiety. In that case, advanced topics such as these might be more suitable:

• Analyzing the impact of social anxiety on academic performance
• Investigating the effects of different mindfulness practices for treating generalized anxiety disorder
• How cognitive behavioral therapy can help in treating panic disorders
• Self-help strategies for overcoming fear and anxiety related to public speaking
• Exploring the role of family therapy in managing stress and anxiety symptoms
• Evaluating the effectiveness of online interventions for reducing social anxiety symptoms
• Understanding the comorbidity between obsessive-compulsive disorder and social anxiety disorder
• Exploring the role of culture in developing anxiety disorders
• Examining different types of group therapy for treating anxiety and depression
• Investigating how trauma can increase the risk of developing anxiety disorder symptoms
• Analyzing different coping strategies used to manage fear and anxiety during a job interview
• Examining the effectiveness of exposure therapy as a treatment for social anxiety disorder
• Understanding how genetics affects the onset of panic attacks
• Exploring how technology usage increases stress and anxiety levels in people
• Investigating the impact of sleep deprivation on generalized anxiety disorder (gad) symptoms
• Assessing the effects of nootropics in treating anxiety disorders
• Understanding how different stress management techniques help in reducing anxiety symptoms
• Exploring the connection between chronic pain and anxiety disorders
• Examining the neurobiological effects of cannabinoids on generalized anxiety disorder
• Investigating cognitive flexibility as an effective treatment for anxiety and panic attacks
• Examining how early childhood experiences can lead to developmental anxiety disorders
• Exploring unmet mental health needs of people with anxiety disorders
• Understanding how exercise helps in decreasing symptoms of stress and anxiety
• Analyzing different types of brain stimulation as a way to treat anxiety disorders
• Investigating the effects of online support groups for patients with anxiety disorders
• Examining the role of neurochemistry in the development and treatment of anxiety disorders
• Exploring different pharmacological therapies for anxiety and social phobias
• Assessing the usefulness of hypnotherapy for managing stress and anxiety levels in individuals.
• Investigating the connection between traits of perfectionism and anxiety disorders
• Analyzing how different life stressors increase the risk of suffering from anxiety and panic attacks
• Understanding how cognitive behavioral therapy can help in treating post-traumatic stress disorder symptoms
• Examining the role of mindfulness practices in reducing symptoms of generalized anxiety disorder
• Investigating the impact of yoga and meditation on mental health problems related to anxiety
• Evaluating the effectiveness of neurofeedback training as a treatment for anxiety and social phobia
• Exploring different coping mechanisms used by patients with an obsessive-compulsive disorder
• Analyzing the impact of childhood trauma on developmental anxiety disorders
• Investigating the role of support groups in treating anxiety disorders
• Understanding how lifestyle changes can help to manage stress and anxiety levels in people.
• Examining the long-term effects of cognitive behavioral therapy on panic attacks
• Evaluating different treatments for reducing social anxiety symptoms

These anxiety research paper topics are ideal for students pursuing higher studies. Writing about some of these titles may require thesis help from expert dissertation writers.

Anxiety Research Questions

Research questions about anxiety can also be an excellent basis for research. Here are research questions to consider when writing about anxiety:

• What is the most effective treatment approach for anxiety
• How do genetics affect anxiety development?
• What strategies can help manage fear and anxiety during a job interview?
• Can child abuse increase the risk of developing an anxiety disorder?
• Are social support groups beneficial for people with anxiety disorders?
• Can family therapy reduce the symptoms of generalized anxiety disorder?
• Are there over-the-counter medications for alleviating anxiety symptoms?
• Are mindfulness practices helpful in treating social phobias?
• How do stress management techniques influence anxiety levels in individuals?
• What role does diet play in reducing anxiety and panic attacks?
• Does hypnotherapy help manage stress and post-traumatic stress disorder?
• What are the effects of cannabinoids on the severity of generalized anxiety disorder?
• Can cognitive flexibility relieve anxiety disorders?
• Can lifestyle changes reduce stress and anxiety in people with mental health issues?
• Is trauma-focused cognitive behavioral therapy an effective treatment for anxiety disorders?
• How can different medications influence social anxiety symptoms?
• What are the long-term effects of exercise on stress and anxiety levels?
• What is the role of nutrition in treating anxiety disorders?
• Are there essential oils that can reduce stress and anxiety?
• Can yoga improve mental health outcomes among those suffering from anxiety issues?
• Are there any natural remedies for anxiety symptoms?
• What are the best strategies for managing chronic stress and anxiety?
• Can virtual reality therapy treat phobias and other anxiety disorders?

These are unique anxiety research topics for academic papers. Consider any of them when the educator assigns you an anxiety paper.

Get Custom Help Online

Even if you pick easy anxiety topics, you may lack the time, skills, or experience to write winning papers. Luckily, you can get help from the best dissertation writers online. Our experts are fast, and they always deliver well-researched essays. Just tell us, “ do my dissertation ” and we’ll write a quality paper to earn you the best grade in your class or school. Contact us today!

What is an anxiety research topic?

Research topics on anxiety are prompts that require researchers and writers to examine various aspects of anxiety disorder. They may cover the causes, effects, and treatment of anxiety. Educators provide anxiety topics or allow students to choose theirs.

Which is the best anxiety research topic?

The best anxiety research topic will depend on the researcher’s interest and the project’s scope. It should focus on a specific anxiety-related subject, such as examining the link between childhood trauma and developmental anxiety disorders.

What are some research questions about anxiety?

Some research questions about anxiety cover aspects like the most effective treatment approach for post-traumatic stress disorder, genetic effects on developing panic attacks, and strategies for managing fear and anxiety during various social situations.

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• How to Write a Thesis Statement | 4 Steps & Examples

How to Write a Thesis Statement | 4 Steps & Examples

Published on January 11, 2019 by Shona McCombes . Revised on August 15, 2023 by Eoghan Ryan.

A thesis statement is a sentence that sums up the central point of your paper or essay . It usually comes near the end of your introduction .

Your thesis will look a bit different depending on the type of essay you’re writing. But the thesis statement should always clearly state the main idea you want to get across. Everything else in your essay should relate back to this idea.

You can write your thesis statement by following four simple steps:

• Start with a question
• Write your initial answer
• Develop your answer
• Refine your thesis statement

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Table of contents

What is a thesis statement, placement of the thesis statement, step 1: start with a question, step 2: write your initial answer, step 3: develop your answer, step 4: refine your thesis statement, types of thesis statements, other interesting articles, frequently asked questions about thesis statements.

A thesis statement summarizes the central points of your essay. It is a signpost telling the reader what the essay will argue and why.

The best thesis statements are:

• Concise: A good thesis statement is short and sweet—don’t use more words than necessary. State your point clearly and directly in one or two sentences.
• Contentious: Your thesis shouldn’t be a simple statement of fact that everyone already knows. A good thesis statement is a claim that requires further evidence or analysis to back it up.
• Coherent: Everything mentioned in your thesis statement must be supported and explained in the rest of your paper.

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The thesis statement generally appears at the end of your essay introduction or research paper introduction .

The spread of the internet has had a world-changing effect, not least on the world of education. The use of the internet in academic contexts and among young people more generally is hotly debated. For many who did not grow up with this technology, its effects seem alarming and potentially harmful. This concern, while understandable, is misguided. The negatives of internet use are outweighed by its many benefits for education: the internet facilitates easier access to information, exposure to different perspectives, and a flexible learning environment for both students and teachers.

You should come up with an initial thesis, sometimes called a working thesis , early in the writing process . As soon as you’ve decided on your essay topic , you need to work out what you want to say about it—a clear thesis will give your essay direction and structure.

You might already have a question in your assignment, but if not, try to come up with your own. What would you like to find out or decide about your topic?

For example, you might ask:

After some initial research, you can formulate a tentative answer to this question. At this stage it can be simple, and it should guide the research process and writing process .

Now you need to consider why this is your answer and how you will convince your reader to agree with you. As you read more about your topic and begin writing, your answer should get more detailed.

In your essay about the internet and education, the thesis states your position and sketches out the key arguments you’ll use to support it.

The negatives of internet use are outweighed by its many benefits for education because it facilitates easier access to information.

In your essay about braille, the thesis statement summarizes the key historical development that you’ll explain.

The invention of braille in the 19th century transformed the lives of blind people, allowing them to participate more actively in public life.

A strong thesis statement should tell the reader:

• Why you hold this position
• What they’ll learn from your essay
• The key points of your argument or narrative

The final thesis statement doesn’t just state your position, but summarizes your overall argument or the entire topic you’re going to explain. To strengthen a weak thesis statement, it can help to consider the broader context of your topic.

These examples are more specific and show that you’ll explore your topic in depth.

Your thesis statement should match the goals of your essay, which vary depending on the type of essay you’re writing:

• In an argumentative essay , your thesis statement should take a strong position. Your aim in the essay is to convince your reader of this thesis based on evidence and logical reasoning.
• In an expository essay , you’ll aim to explain the facts of a topic or process. Your thesis statement doesn’t have to include a strong opinion in this case, but it should clearly state the central point you want to make, and mention the key elements you’ll explain.

If you want to know more about AI tools , college essays , or fallacies make sure to check out some of our other articles with explanations and examples or go directly to our tools!

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A thesis statement is a sentence that sums up the central point of your paper or essay . Everything else you write should relate to this key idea.

The thesis statement is essential in any academic essay or research paper for two main reasons:

• It gives your writing direction and focus.
• It gives the reader a concise summary of your main point.

Without a clear thesis statement, an essay can end up rambling and unfocused, leaving your reader unsure of exactly what you want to say.

Follow these four steps to come up with a thesis statement :

• Ask a question about your topic .
• Write your initial answer.
• Develop your answer by including reasons.
• Refine your answer, adding more detail and nuance.

The thesis statement should be placed at the end of your essay introduction .

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Writing Anxiety

What this handout is about.

This handout discusses the situational nature of writer’s block and other writing anxiety and suggests things you can try to feel more confident and optimistic about yourself as a writer.

What are writing anxiety and writer’s block?

“Writing anxiety” and “writer’s block” are informal terms for a wide variety of apprehensive and pessimistic feelings about writing. These feelings may not be pervasive in a person’s writing life. For example, you might feel perfectly fine writing a biology lab report but apprehensive about writing a paper on a novel. You may confidently tackle a paper about the sociology of gender but delete and start over twenty times when composing an email to a cute classmate to suggest a coffee date. In other words, writing anxiety and writers’ block are situational (Hjortshoj 7). These terms do NOT describe psychological attributes. People aren’t born anxious writers; rather, they become anxious or blocked through negative or difficult experiences with writing.

When do these negative feelings arise?

Although there is a great deal of variation among individuals, there are also some common experiences that writers in general find stressful.

For example, you may struggle when you are:

• adjusting to a new form of writing—for example, first year college writing, papers in a new field of study, or longer forms than you are used to (a long research paper, a senior thesis, a master’s thesis, a dissertation) (Hjortshoj 56-76).
• writing for a reader or readers who have been overly critical or demanding in the past.
• remembering negative criticism received in the past—even if the reader who criticized your work won’t be reading your writing this time.
• working with limited time or with a lot of unstructured time.
• responding to an assignment that seems unrelated to academic or life goals.
• dealing with troubling events outside of school.

What are some strategies for handling these feelings?

Get support.

Choose a writing buddy, someone you trust to encourage you in your writing life. Your writing buddy might be a friend or family member, a classmate, a teacher, a colleague, or a Writing Center tutor. Talk to your writing buddy about your ideas, your writing process, your worries, and your successes. Share pieces of your writing. Make checking in with your writing buddy a regular part of your schedule. When you share pieces of writing with your buddy, use our handout on asking for feedback .

In his book Understanding Writing Blocks, Keith Hjortshoj describes how isolation can harm writers, particularly students who are working on long projects not connected with coursework (134-135). He suggests that in addition to connecting with supportive individuals, such students can benefit from forming or joining a writing group, which functions in much the same way as a writing buddy. A group can provide readers, deadlines, support, praise, and constructive criticism. For help starting one, see our handout about writing groups .

Identify your strengths

Often, writers who are experiencing block or anxiety have a worse opinion of their own writing than anyone else! Make a list of the things you do well. You might ask a friend or colleague to help you generate such a list. Here are some possibilities to get you started:

• I explain things well to people.
• I get people’s interest.
• I have strong opinions.
• I listen well.
• I am critical of what I read.
• I see connections.

Choose at least one strength as your starting point. Instead of saying “I can’t write,” say “I am a writer who can …”

Recognize that writing is a complex process

Writing is an attempt to fix meaning on the page, but you know, and your readers know, that there is always more to be said on a topic. The best writers can do is to contribute what they know and feel about a topic at a particular point in time.

Writers often seek “flow,” which usually entails some sort of breakthrough followed by a beautifully coherent outpouring of knowledge. Flow is both a possibility—most people experience it at some point in their writing lives—and a myth. Inevitably, if you write over a long period of time and for many different situations, you will encounter obstacles. As Hjortshoj explains, obstacles are particularly common during times of transition—transitions to new writing roles or to new kinds of writing.

Think of yourself as an apprentice.

If block or apprehension is new for you, take time to understand the situations you are writing in. In particular, try to figure out what has changed in your writing life. Here are some possibilities:

• You are writing in a new format.
• You are writing longer papers than before.
• You are writing for new audiences.
• You are writing about new subject matter.
• You are turning in writing from different stages of the writing process—for example, planning stages or early drafts.

It makes sense to have trouble when dealing with a situation for the first time. It’s also likely that when you confront these new situations, you will learn and grow. Writing in new situations can be rewarding. Not every format or audience will be right for you, but you won’t know which ones might be right until you try them. Think of new writing situations as apprenticeships. When you’re doing a new kind of writing, learn as much as you can about it, gain as many skills in that area as you can, and when you finish the apprenticeship, decide which of the skills you learned will serve you well later on. You might be surprised.

Below are some suggestions for how to learn about new kinds of writing:

• Ask a lot of questions of people who are more experienced with this kind of writing. Here are some of the questions you might ask: What’s the purpose of this kind of writing? Who’s the audience? What are the most important elements to include? What’s not as important? How do you get started? How do you know when what you’ve written is good enough? How did you learn to write this way?
• Ask a lot of questions of the person who assigned you a piece of writing. If you have a paper, the best place to start is with the written assignment itself. For help with this, see our handout on understanding assignments .
• Look for examples of this kind of writing. (You can ask your instructor for a recommended example). Look, especially, for variation. There are often many different ways to write within a particular form. Look for ways that feel familiar to you, approaches that you like. You might want to look for published models or, if this seems too intimidating, look at your classmates’ writing. In either case, ask yourself questions about what these writers are doing, and take notes. How does the writer begin and end? In what order does the writer tell things? How and when does the writer convey her or his main point? How does the writer bring in other people’s ideas? What is the writer’s purpose? How is that purpose achieved?
• Read our handouts about how to write in specific fields or how to handle specific writing assignments.
• Listen critically to your readers. Before you dismiss or wholeheartedly accept what they say, try to understand them. If a reader has given you written comments, ask yourself questions to figure out the reader’s experience of your paper: What is this reader looking for? What am I doing that satisfies this reader? In what ways is this reader still unsatisfied? If you can’t answer these questions from the reader’s comments, then talk to the reader, or ask someone else to help you interpret the comments.
• Most importantly, don’t try to do everything at once. Start with reasonable expectations. You can’t write like an expert your first time out. Nobody does! Use the criticism you get.

Once you understand what readers want, you are in a better position to decide what to do with their criticisms. There are two extreme possibilities—dismissing the criticisms and accepting them all—but there is also a lot of middle ground. Figure out which criticisms are consistent with your own purposes, and do the hard work of engaging with them. Again, don’t expect an overnight turn-around; recognize that changing writing habits is a process and that papers are steps in the process.

Chances are that at some point in your writing life you will encounter readers who seem to dislike, disagree with, or miss the point of your work. Figuring out what to do with criticism from such readers is an important part of a writer’s growth.

Try new tactics when you get stuck

Often, writing blocks occur at particular stages of the writing process. The writing process is cyclical and variable. For different writers, the process may include reading, brainstorming, drafting, getting feedback, revising, and editing. These stages do not always happen in this order, and once a writer has been through a particular stage, chances are she or he hasn’t seen the last of that stage. For example, brainstorming may occur all along the way.

Figure out what your writing process looks like and whether there’s a particular stage where you tend to get stuck. Perhaps you love researching and taking notes on what you read, and you have a hard time moving from that work to getting started on your own first draft. Or once you have a draft, it seems set in stone and even though readers are asking you questions and making suggestions, you don’t know how to go back in and change it. Or just the opposite may be true; you revise and revise and don’t want to let the paper go.

Wherever you have trouble, take a longer look at what you do and what you might try. Sometimes what you do is working for you; it’s just a slow and difficult process. Other times, what you do may not be working; these are the times when you can look around for other approaches to try:

• Talk to your writing buddy and to other colleagues about what they do at the particular stage that gets you stuck.
• Read about possible new approaches in our handouts on brainstorming and revising .
• Try thinking of yourself as an apprentice to a stage of the writing process and give different strategies a shot.
• Cut your paper into pieces and tape them to the wall, use eight different colors of highlighters, draw a picture of your paper, read your paper out loud in the voice of your favorite movie star….

Okay, we’re kind of kidding with some of those last few suggestions, but there is no limit to what you can try (for some fun writing strategies, check out our online animated demos ). When it comes to conquering a block, give yourself permission to fall flat on your face. Trying and failing will you help you arrive at the thing that works for you.

Celebrate your successes

Start storing up positive experiences with writing. Whatever obstacles you’ve faced, celebrate the occasions when you overcome them. This could be something as simple as getting started, sharing your work with someone besides a teacher, revising a paper for the first time, trying out a new brainstorming strategy, or turning in a paper that has been particularly challenging for you. You define what a success is for you. Keep a log or journal of your writing successes and breakthroughs, how you did it, how you felt. This log can serve as a boost later in your writing life when you face new challenges.

Wait a minute, didn’t we already say that? Yes. It’s worth repeating. Most people find relief for various kinds of anxieties by getting support from others. Sometimes the best person to help you through a spell of worry is someone who’s done that for you before—a family member, a friend, a mentor. Maybe you don’t even need to talk with this person about writing; maybe you just need to be reminded to believe in yourself, that you can do it.

If you don’t know anyone on campus yet whom you have this kind of relationship with, reach out to someone who seems like they could be a good listener and supportive. There are a number of professional resources for you on campus, people you can talk through your ideas or your worries with. A great place to start is the UNC Writing Center. If you know you have a problem with writing anxiety, make an appointment well before the paper is due. You can come to the Writing Center with a draft or even before you’ve started writing. You can also approach your instructor with questions about your writing assignment. If you’re an undergraduate, your academic advisor and your residence hall advisor are other possible resources. Counselors at Counseling and Wellness Services are also available to talk with you about anxieties and concerns that extend beyond writing.

Apprehension about writing is a common condition on college campuses. Because writing is the most common means of sharing our knowledge, we put a lot of pressure on ourselves when we write. This handout has given some suggestions for how to relieve that pressure. Talk with others; realize we’re all learning; take an occasional risk; turn to the people who believe in you. Counter negative experiences by actively creating positive ones.

Even after you have tried all of these strategies and read every Writing Center handout, invariably you will still have negative experiences in your writing life. When you get a paper back with a bad grade on it or when you get a rejection letter from a journal, fend off the negative aspects of that experience. Try not to let them sink in; try not to let your disappointment fester. Instead, jump right back in to some area of the writing process: choose one suggestion the evaluator has made and work on it, or read and discuss the paper with a friend or colleague, or do some writing or revising—on this or any paper—as quickly as possible.

Failures of various kinds are an inevitable part of the writing process. Without them, it would be difficult if not impossible to grow as a writer. Learning often occurs in the wake of a startling event, something that stirs you up, something that makes you wonder. Use your failures to keep moving.

Works consulted

We consulted these works while writing this handout. This is not a comprehensive list of resources on the handout’s topic, and we encourage you to do your own research to find additional publications. Please do not use this list as a model for the format of your own reference list, as it may not match the citation style you are using. For guidance on formatting citations, please see the UNC Libraries citation tutorial . We revise these tips periodically and welcome feedback.

Hjortshoj, Keith. 2001. Understanding Writing Blocks . New York: Oxford University Press.

This is a particularly excellent resource for advanced undergraduates and graduate students. Hjortshoj writes about his experiences working with university students experiencing block. He explains the transitional nature of most writing blocks and the importance of finding support from others when working on long projects.

Rose, Mike. 1985. When a Writer Can’t Write: Studies in Writer’s Block and Other Composing-Process Problems . New York: Guilford.

This collection of empirical studies is written primarily for writing teachers, researchers, and tutors. Studies focus on writers of various ages, including young children, high school students, and college students.

You may reproduce it for non-commercial use if you use the entire handout and attribute the source: The Writing Center, University of North Carolina at Chapel Hill

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10 New Thesis Statement about Depression & Anxiety | How to Write One?

Did you know according to the National Institute of Mental Health; it is estimated that approximately 8.4% of adults are patients of major depression in the US? Well, depression is a common illness globally that affects a lot of people. Yet, the reasons for this psychological sickness vary from person to person and numerous studies are being conducted to discover more about depression.

Therefore, college and university students are currently assigned to write research papers, dissertations, essays, and a thesis about depression. However, writing essays on such topics aims to increase the awareness of physical and mental well-being among youth and help them find solutions.

However, a lot of students find it pretty challenging to write a thesis statement about depression and seek someone to write my essay . No worries! In this article, you will learn about what is a good thesis statement about mental health and some effective methods and approaches to write a killer headline and compose an astonishing essay about depression.

5 Thesis Statement About Depression:

• “The complexity of depression, which includes biological, psychological, and environmental components, emphasizes the need for individualized treatment plans that consider each person’s particular requirements.”
• “Depression in the workplace not only affects an individual’s productivity but also carries economic implications, emphasizing the importance of fostering a mental health-friendly work environment.”
• “Alternative, holistic approaches to mental health care have the potential to be more successful as the link between creative expressions, such as art therapy, and depression management becomes more commonly recognized.”
• “It is critical to enhance geriatric mental health treatment and reduce the stigma associated with mental illness in older people since depression in senior populations is typically underdiagnosed and mistreated.”
• “The link between early childhood adversity and the risk of developing depression later in life accentuates the importance of early intervention and support systems for children exposed to adverse experiences.”

5 Thesis Statements about Anxiety & Depression :

• “Depression and anxiety Co-occurring disorders are a major concern in mental health, necessitating integrated treatment options that meet the unique challenges that co-occurring diseases provide.”
• “The utilization of technology-driven therapies, such as smartphone apps and telehealth services, is a realistic approach of addressing persons suffering from anxiety and depression, while also increasing access to mental health care.”
• “The examination of the gut-brain connection and its potential role in anxiety and depression showcases a burgeoning area of research that could lead to novel treatments emphasizing nutrition and gut health.”
• “Adolescents who experience both anxiety and depression face a serious issue that calls for comprehensive school-based mental health programs and preventative measures to promote young people’s mental health.”
• “Exploring the impact of sociocultural factors and the role of community support systems in the experience of anxiety and depression provides insights into the development of culturally sensitive mental health interventions.”

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Follow 7 Proven Methods to Compose Thesis Statement about Depression

A thesis is the overview of the concepts and ideas that you will write in your research paper or in the essay. Yet, a thesis statement about anxiety focuses more on the stress and depression topics for the paper you’re working on, which can be written by following the tips given below.

Nonetheless, you can compose an outline by covering the points mentioned below:

1. Pick a good study topic and perform a basic reading. Look for some intriguing statistics and try to come up with creative ways to approach your subject. Examine a few articles for deficiencies in understanding.

2. Make a list of your references and jot down when you come across a noteworthy quotation. You can cite them in your paper as references. Organize all of the information you’ve acquired in one location.

3. In one phrase, state the purpose of your essay. Consider what you want to happen when other people read your article.

4. Examine your notes and construct a list of all the key things you wish to emphasize. Make use of brainstorming strategies and jot down any ideas that come to mind.

5. Review and revise the arguments and write a thesis statement for a research paper or essay about depression.

6. Organize your essay by organizing the list of points. Arrange the points in a logical sequence. Analyze all elements to ensure that they are all relevant to your goal.

7. Reread all of your statements and arrange your outline in a standard manner, such as a bulleted list.

Final Words

So, what is an ideal way to write a thesis statement about depression for your research paper or essay? We hope you have a thorough idea of the essay you’re writing before picking a thesis statement about mental well-being. That will assist you in developing the greatest thesis for our essay.

But don’t get too worked up over your thesis statement for a research paper on mental disorders. Our professional subject experts have produced a list of thesis statements about mental health and depression themes for research paper writing, so you’ve got your job cut out for you. For your essay assignments or assignments, we will also offer appropriate thesis statements.

If you’re still confused about which statement to use, contact us right away. We have a staff of highly qualified and seasoned writers who can assist you with your essay or research work and guarantee that you receive the highest possible score.

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Anxiety Disorders in Children and Adolescents Research Paper

Introduction, anxiety disorders, causes of anxiety disorders, prevalence of anxiety disorder, differentiating criteria, progression of the disorder, physical considerations, implication for assessment, treatment consideration.

The nature of the environment in which people live is characterized with extremely high levels of uncertainties about future events. While people often anticipate good things to happen in their lives, there is always an almost established fact that bad things are also most likely to be experienced.

These expectations form the basis of anxiety in people that defines a sense of worry or an uneasy feeling due to unascertained phenomenon that are always expected to happen. Though some impacts of anxiety are normal, there are some that are realized to have adverse effects and end up being termed as disorders.

This paper seeks to discuss anxiety disorders in children and adolescents. The paper will look into anxiety disorder with respect to its causes, prevalence, classification, progression and treatment among other aspects.

Impacts of anxiety with respect to either good or bad occurrences are under normal circumstances understood as normal reactions to whatever is expected to happen. An anticipation of a negative happening is however in most cases realized to have an induced level of fear or even stress to an individual. When a negative expectation results in an extreme negative reaction in terms of fear and worry then it is classified as an anxiety disorder.

The definition of anxiety disorder thus distinguishes it from normal anticipations that may not enlist any form of worry to an individual.

Instances such as anxieties following anticipation for an appointment are for example considered to be normal in adults while a child who is being taken away from home to attend school may be extremely scared at the fact that he or she is going to be separated from the mother or whoever was closely taking care of him or her.

The disorders are further identified when the individuals get extremely fearful while there is actually no solid reason to develop such fears. A child who is being taken to school for example develops fears while he or she is going to be securely brought back home.

Instances of young children who are actually in perfect health conditions developing extreme fears of suffering from diseases such as cardio vascular complications or even cancer when they absolutely have no symptoms or reasons for such fears also forms basis for anxiety disorders among children and adolescents.

Though anxiety disorders were not anciently considered by professionals, attention has currently been devoted to it to realize that a significant numbers of the young generation are victims. It was, for instance, realized by the year 2008 that teenagers are almost constantly under anxiety disorder complications with either subsequent or even simultaneous cases of disorders by an individual (Chandler, n.d.).

Factors that cause anxiety disorders have not individually been identified with specific disorders that are realized. These factors have at the same time not been agreed upon by experts as to their exact impacts on anxiety disorders. Causes of the disorders are however postulated to range from “biological, psychological to social factors” (Bernstain, 2010, p. 476).

The factors may individually or in combination result in any particular or groups of anxiety disorders. Biological factors as identified with anxiety disorders are associated with the genetic engineering that explains the transfer of traits from parents to their offspring along blood relations.

This means that children and adolescents are more likely to suffer from the disorders if their parents were associated with anxiety disorder complications.

The opinion over causes of anxiety disorders has been supported by research that has linked anxiety disorder to genetic relations. It has for instance been established that twins developed similar responses to anxieties. Attitudes that are realized among such twins to illustrate connectivity in their responses have been used to explain their anticipations and fears as well.

It is thus crowned that this connectivity is derived from genetic relation of twins that are derived from their parents. Though research has not been successfully completed to identify the specific genes that are related to anxiety disorders, it has been agreed that the association between anxiety disorders and genetic properties are significant.

Psychological factors such as stress and environmental conditions also directly contributes to anxiety disorders (Bernstain, 2010)

Bourne Edmund (2005) on the other hand explains causes of anxiety disorders in form of a wider point of view. One of his classifications of causes of anxiety disorders is a set of long term factors that accumulate on an individual child or adolescent to lead to anxiety disorder. He in addition to the genetic factors illustrated the conditions that surround a child’s life as factors to anxiety disorders.

The communication that children receive from their parents or that which they witness around them is identified to be a cause of the disorder. Negative opinions that children grasps from their environment as they grow up for instance induces fear among them over uncertainties that life has for them.

The manner in which children are raised such as having a perfectionist parent who has extreme standards for children also induces insecurity into fears. Treatment and social environment that children are offered that may induce stress together with a destabilized emotional condition of a child is also a long term factor into anxiety disorder.

Apart from the hereditary elements into anxiety disorders, other biological causes include “panic attacks, physiology of panic, generalized anxiety among others” (Bourne, 2005, p. 32).

There are also a number of occurrences that are realized to cause anxiety disorders on a short term basis.

Realized attacks on an individual that can include “significant personal loss, significant life change and stimulants and recreational drugs” (Bourne, 2005, p. 32) together with “conditioning and origin of phobia and trauma, simple phobias and post traumatic stress disorders” (Bourne, 2005, p. 32) are also realized to be causes of anxiety disorders.

Anxiety disorders are also caused by developments in an individual’s life that could be in the form of mental capacity or behavior (Camh, 2009).

There are varying reports over data with respect to the prevalence of anxiety disorders in the society in general. According to Sadock et al . (2007), prevalence rate of anxiety disorders range from a minimum rate of about eight percent to a maximum value of almost thirty percent. The wide range of values was however narrowed down to reflect a prevalence of about ten percent among young individuals.

According to a research as discussed by the authors, there existed a variety of types of anxiety disorders with different prevalence rate that contributed to the overall realized rates. Generally realized anxiety disorder was for example realized to be the most common with a prevalence rate of almost seven percent followed by disorder due to separation.

Disorder due to response to environment was realized to follow in level of significance. A consideration of anxiety disorder due to separation was realized to be more serious in younger children and reduced with age to have adolescents realize less of separation based anxiety disorder.

At the same time, the anxiety disorder due to separation was realized to be evenly distributed among boys and girls giving the sense of insecurity some level of independence with respect to sex, at least at the younger age. This particular type of disorder was at the same time realized to be more significantly realized within the age gap of seven to eight years of a child (Sadock et al ., 2007).

Dziegielewski (2009) on the other hand presented the figures over prevalence of anxiety disorder to be about ten percent among children and adolescents. This was however far below the generally realized prevalence level which was reported to be almost twenty five percent.

The level of anxiety disorder was attributed to factors such as difficulties that the children and the adolescent encounter in their academic environment as well as even their social environment in general. This prevalence level according to the author is expected to rise in future due to developments that have improved the capacity to identify and diagnose anxiety disorders (Dziegielewski, 2009).

The presentation of anxiety disorders in children to be just one of the factors to the disorders among adults as the children grow is an illustration of higher prevalence rate of the disorders in adults as compared to children and the adolescents. More factors such as “medical conditions, medication use and functional status” are reported to contribute to the complications among adults (Dziegielewski, 2009, p. 302).

History of prevalence of the complications in earlier periods also revealed averagely the same rate of prevalence. A consideration of the prevalence of anxiety disorders in the 1980s for instance revealed a rate of about ten percent which is consistent with the currently reported data.

Whereas developments have been made with respect to diagnosis of anxiety disorders, meaning that more disorders are noticed contrary to previous periods, the constancy in the realized cases imply that the actual prevalence of the disorders are decreasing.

This is because the data which were previously reported had a lot of omissions that are currently taken care of. If this factor is taken into consideration and adjustments made to the previous data, then it would be realized that the earlier durations would have realized higher prevalence rates (Essau & Petermann, 2002).

Differentiating criteria is an approach to diagnosing disorders on the basis of observations that are made on an individual. The criteria use the change in conduct of the patient to identify the existence of disorder complications.

According to the concept, an individual suffering from anxiety disorder will suffer from change or difference in behavior to exhibit factors such as “negativistic, oppositional and defiant behavior” (House, 2002, p. 46) that will be contrary to normally observed behavior.

There are a variety of approaches to the view of progression of anxiety disorders. One of the approaches as illustrated by Connolly et al . (2006) is the stage in life in which a child or an adolescent can suffer from anxiety disorder. This can thus be viewed as the progression of anxiety disorders in and individual’s life as he or she grows up.

The progression is at the same time realized in an individual’s entire life as anxiety disorders develop to even be realized by individuals in their old age. The initial experience of young babies to factors such as darkness or even sudden touch that can include falls are examples of fears and worries that can be reported at early stages of life.

The infants with time develop fondness to people around them and at the same time exhibit fears over people whom they do not recognize. This is normally realized in terms of the infants rejecting strangers and even crying when the strangers get too close to them. As the kids grow older even to the preschool age, they are realized to develop other forms of fears.

At this stage, the children are more worried over imaginative things and even fears of separation from individuals with whom they have close ties such as their mothers, fathers and even siblings. Further advancement in age of the children at the same time realizes new fears and worries.

In the early ages in school, children are realized to have fears that relates to features such as “illness, injuries and natural disasters” (Connolly et al ., 2006, p. 1). These fears eventually develop to other levels as the children become concerned over their capacities in academic work.

There are normally developed fears about how other people perceive their performance. Parties such as their peers knowing their level of performance becomes a bother and in most cases lead to concealment of their work. They also at this stage of life develop fears over any form of threat to their health (Connolly et al ., 2006). These changes are at the same time characterized with disorders (Connolly et al ., 2006).

The nature of anxiety disorders that leads tom variations in behavior of individuals such as a person being rebellious or just changing to abnormal practices contrary to that which is normally expected by the society has a variety of impacts. One of the direct impacts of such withdrawals by individuals is the self confinement and involvement in substance abuse.

As a result, the victims build an association in which they can derive consolation from substance abuse. It is from this avenue that violence is realized with respect to anxiety disorders. Though the level of rebellion that is directly induced by disorders my be translated into physical reactions such physical fights due to emotional changes and stress, involvement in drugs fuels violence among this category of individuals.

Withdrawal into these groups exposes an individual to habits such as hostility that leads to violent physical encounters. Under extreme cases, these issues culminate to “assaults and murder in some cases” (Oltmanns et al ., 2008, p. 160). Anxiety disorders are thus associated with negative physical impacts (Oltmanns et al ., 2008, p. 160).

Assessment of aspects of lives of individual children or even adolescents is identified to be a continuous process that is realized through out their lives. Conducted by a variety of parties from the moment that a child is conceived and in all his all her life time, assessment is realized from parties such as parents and family members in domestic set ups.

At the same time, assessments in academic institutions as well as among age mates and those encountered during interactions with medical professionals offer an individuals status on evaluation. Assessment thus has the implication of revealing any possible disorder (Mash & Barkley, 2007).

The wide percentage of anxiety problems as realized among children and the effects tat such complications have on the individuals as they grow up lays down the mandatory need to offer treatments to victims of anxiety disorders. This is because if the complications go unattended to, the implications means a lost efficiency or even productivity of the individual victim due to the associated mental effects of the complications.

A great deal of consideration is thus normally called for to offer medical attention to the victims. According to Mash Eric, the process of administering treatment to a patient who is suffering from anxiety disorders is supposed to a comprehensive one that has a diverse consideration of elements. The first step in administering treatment is the identification of the need for such treatment.

This is because there are normally some fears and worries that are not necessarily anxiety disorders. This will form the basis of whether or not a person should be subjected to treatment. In the consideration of whether or not treatment should be administered, it should also be predetermined as to whether the treatment will be effective in solving the problem as realized by the individual.

Since the problem is more psychological than medical, consideration of the approach to be applied as well as the people to be involved in the treatment process must also be seriously made. The atmosphere in which treatment is to be offered with considerations of how well the patient will receive the treatment is also a factor to be considered.

Timing of treatment and monitoring to check its effectiveness as well as any need for adjustment in the process also forms important basis for treatment of anxiety disorders. The consideration of the approach to treatment is then followed by development of an appropriate model to be applied.

One of the identified models for treatment as explained by Mash involves identification of the problem realized by the patient which is then followed by making appropriate research into the problem. An outline is then made for the treatment which makes provisions for the main activities to be involved in the treatment process.

This is then followed by administering of treatment and further monitoring steps to ensure that the treatment is successfully applied. One of the particular treatment approaches that have been realized and implemented over time is the use “cognitive behavior” approach (Mash, 2006, p. 9).

This approach employs the forces of relation as realized between the individual patient and his or her relatives has been applied together with psychological treatments to help victims out of anxiety disorders (Mash, 2006).

According to Connolly, Suarez and Sylvester (2011), the treatment of anxiety disorders should begin with a plan which should identify the level of seriousness of the complication as well as the impacts that are being realized by the victim.

Possible treatments that can then be applied include “psychotherapeutic treatments, cognitive behavioral therapy, parent- child and family interventions and pharmacologic treatment” among others (Connolly, Suarez & Sylvester, 2011, pp. 102 & 103). There is thus a variety of treatments for anxiety disorders.

Bernstain, D. (2010). Essentials of Psychology . Belmont, CA: Cengage Learning.

Bourne, E. (2005). The anxiety & phobia workbook . Oakland, CA: New Harbinger Publications.

Camh, A. (2009). What causes anxiety disorders? Web.

Chandler, J. (n.d.). Anxiety disorders in children and adolescents . Web.

Connolly, S., Suarez, L & Sylvester, C. (2011). Assessment and Treatment of Anxiety Disorders in Children and Adolescents . Web.

Connolly et al . (2006). Anxiety disorders . New York, NY: Infobase Publishing.

Dziegielewski, S. (2009). Social work practice and psychopharmacology: a person-in-environment approach . New York, NY: Springer Publishing Company.

Essau, C & Petermann, F. (2002). Anxiety disorders in children and adolescents: epidemiology, risk factors and treatment . New York, NY: Psychology Press.

House, A. (2002). DSM-IV diagnosis in the schools . New York, NY: Guilford Press.

Mash, E. (2006). Treatment of childhood disorders . New York, NY: Guilford Press.

Mash, E & Barkley, R. (2007). Assessment of childhood disorders . New York, NY: Guilford Press.

Oltmanns, T., Martin, T., Neale, M., & Davison, C. (2008). Case studies in abnormal psychology . Hoboken, NJ: John Wiley & Sons.

Sadock et al . (2007). Kaplan & Sadock’s synopsis of psychiatry: behavioral sciences/clinical psychiatry. Philadelphia, PA: Lippincott Williams & Wilkins.

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