Review of "Under Pressure and Overwhelmed"

Anxiety occurs in everyday life, but can be even more prevalent for those in college.  In Under pressure & overwhelmed: Coping with anxiety in college, the authors discuss issues of anxiety that pertain particularly to those students who are on their own and trying to juggle academic, social, financial, and occupational stressors.  

The authors state that they have two main goals for the book.  First, they want to "enhance students' awareness of the expected and normal stresses of college life and the ways in which?they are affected by them" (p. xi).  The second goal is to "describe the nature of anxiety, its common manifestations, and provide methods for effectively coping with it" (p. xii).   The authors not only succeed in meeting these goals, but exceeding them through providing detailed checklists and worksheets throughout the book.

The book is divided into three parts, with a total of fourteen chapters.  Part one is titled "Introduction to the Problem".   Chapters in this section include "The Anxious Campus" and "The Many Faces of Anxiety".  Part two is titled "Addressing the Sources of Anxiety in College Life".  It includes chapters titled "Adapting to Campus Life", "Facing Shyness and Social Anxiety", and "Making the Grade".  Part three is titled "Managing Anxiety and Related Conditions: Solutions and Effective Approaches".   There is also a four-page resource guide.

The authors include many figures in the book, which greatly add to its comprehension and applicability.  Figure 2.2 on page 23, for example, provides a graph with a continuum of anxiety ? including cartoon drawings depicting different levels of anxiety.  The authors write in the text that as the reader views the graph, he should keep in mind that anxiety can range from non-pathological to disordered.

In Chapter 2, "The Many Faces of Anxiety: Anxiety and the Anxiety Disorders", the authors discuss the three components of anxiety: cognitive, physical, and behavioral.  They also summarize the various anxiety disorders, including social anxiety disorder and panic disorder.  In Chapter 5, "Looking Good", the authors discuss the anxiety associated with maintaining a positive image, and provide activities for improving self-esteem.

In Chapter 14, the authors effectively address concerns that may hinder students from seeking counseling, such as the fear that one has to be "crazy" if they need professional help.  They also helpfully discuss the possible limits of confidentiality when seeking counseling services on campus.  It would have been helpful if the authors had mentioned that campus counseling centers may be experiencing an overwhelming demand for services, leading to a longer wait time for non-urgent appointments (Schuchman, 2007).

Throughout the book, the authors do an excellent job of differentiating "normal" anxiety, from anxiety which is so impairing it qualifies for a diagnosis.  The book focuses on the fact that "anxiety is the direct result of a person's judgment, or appraisal, of the risk or danger inherent in a situation" (p. 18).  According to the authors, this means that "how one things about or appraises situations plays a big part in their experience of anxiety" (p. 18).  In addition to discussing the role of appraisal in the onset of anxiety, the authors also discuss the neurobiological causes of anxiety.  The authors discuss the brain processes in an easy to understand manner.  

The book's references are up-to-date, and come from a wide variety of sources, such as the Journal of American College Health, the International Journal of Eating Disorders, the American Journal of Psychiatry, and various books and websites.  The book is of interest to college students, their families, and clinicians.  Even students who have a "normal" level of anxiety would benefit from the information and activities provided in this book.  

Schuchman, M. (2007).  Falling through the cracks: Virginia Tech and the restructuring of college mental health services.  New England Journal of Medicine 357(2): 105-110.

© 2009 Stephanie Moulton Sarkis

Stephanie Moulton Sarkis PhD NCC LMHC is the author of 10 Simple Solutions to Adult ADD:  How to Overcome Chronic Distraction & Accomplish Your Goals (2006) and Making the Grade with Adult ADD: A Student's Guide to Succeeding in College with Attention Deficit Disorder (2008).  She maintains a counseling private practice in Boca Raton, Florida, and is an adjunct assistant professor at Florida Atlantic University.  She can be contacted via www.stephaniesarkis.com and [email protected].