Anxiety and Depression in Undergraduate Students Literature Review


A literature review is essential for research because it provides the researcher with an avenue of understanding the information that other researchers have gathered from previous research. This is essential because the researcher will have an opportunity of understanding how the study can be designed. More to this is that the researcher may be able to have a background of the expected research. More to this is that the review of literature is essential because it guides the researcher on the different ways they can deal with research challenges that may hamper the validity and reliability of their findings. The topic was on depression and anxiety among undergraduate students. There is a high prevalence of these mental health disorders owing to the lifestyle adopted, the pressure from guardians among other factors. With the growing concern that this population is facing, there is a need for immediate interventions that need to be adopted for their well-being.

Two primary sources of literature were used for the retrieving of the reviewed literature sources, that is, Google Scholar and Medline. The primary criterion of secluding the causes was the limitation of publications by the year of publication whereby all the resources used were only those published between 2013 and 2019. The keywords used for the search of literature included; “Anxiety,” “Depression,” “Undergraduate,” “University/College.” In the search for literature, there were a total of 18 sources that were found to be eligible for the review. Upon further scrutiny, four were rejected because of redundancy and two were dismissed because their validity and reliability were not satisfactory.

Themes in the Reviewed Literature

There were three themes that appeared to be prevalent in the reviewed. One related to the cause of the worldwide depression and anxiety among these students coming from the pressure they face as students. The second them was the poor lifestyle and decisions that the students exposed themselves two. The last them was on the further health issues that come as a result of depression and anxiety. The themes were selected because they covered the causes and the health effects of the mental problems under study.

Societal Pressure as a cause of Anxiety and Depression

The reviewed literature reveals that the growing prevalence of depression and anxiety among the college students is the increased pressure on the students to perform not only in their classes but also in their life after college and universities. The assumption of society does not take into consideration the prevailing challenges in the society, which include scarcity of opportunities. More to this is that parents and guardians make assumptions that their children should performance far as the necessities are provided and yet they fail to take into account other challenges that may hinder the performance of these students.

Iqbal, Gupta, and Venkatarao (2015) undertook a study that was aimed towards establishing the prevalence of stress and anxiety among college student. From their result, they made an observation that performance expectations were a leading cause of depression and anxiety among these participants of their study. This pressure increased with the number of years one has been in the institution. Students in their fifth year of learning were observed to have higher levels of depression compared to those in their second year of learning because of the growing intensity of the education (Iqbal, Gupta & Venkartarao, 2015).

Postgraduate plans were another defined cause of the increased depression and anxiety among these individuals. Lipson, Zhou and colleagues (2016) confirmed that students in their second last years of education are more depressed because of the pressure for them to match the expectations of society. These observations were identified to be in support of the findings by Iqbal and his colleagues. Anxiety was also determined to be common among these students. The reason behind this growing anxiety levels as identified to be common among transfer students and those that come from minority communities (Liu, Stevens, Wong, Yasui & Chen, 2019).  New students find it challenging to cope with the new environment which also includes the making of new student. On the other hand, students that come from minority communities have a fear of being racially discriminated or stereotyped. The pressure to fit in among these students is the reason behind their depression and anxiety (Liu, Stevens, Wong, Yasui & Chen, 2019).

Lifestyle Decisions Choices as a cause of Anxiety and Depression

 Aside from the societal pressure, students in institutions of higher learning expose themselves to risks of anxiety and depression with the lifestyle they lead, and the decisions they make. The outcome of their decisions has been associated with growing trends or stress and anxiety. Iqbal and his colleagues (2015) observed that alcohol and smoking are the leading inadequate lifestyle approaches that expose the students into depression.  The students that were taking drink had higher anxiety scores (11.7) compared to the non-smokers who had a mean score of 8.28. The findings of their research, however, revealed an impressive result when it came to alcohol. Those who took alcohol had low anxiety rates compared to those that did not, but this was in the short term (Iqbal, Gupta & Venkantrao, 2015). Walters, Bulmer, Troiano, Obiaka, and Bonhomme (2018) affirmed these findings by identifying substance abuse, depression and anxiety to be universal health issues that affect undergraduate students. They, however, cautioned on the approach taken in dealing with these health issues. This s because alcohol taking and substance abuse may be outcomes or the root causes of depression and anxiety.

 Living off-campus was another cause of depression and anxiety among some of the student. It was noted that learners that were staying out of campus had a pressure of keeping up with time and information because they lived far from the learning facilities (Beiter et al., 2015). The case was different among those living within the campus owing to their easiness of getting to classes and even the assurance of getting help when they face a problem.

 Romantic relationships were identified to be among the leading cause of anxiety and depression because of the attachment that the partners had developed towards each other (Porter & Chambless, 2017). Porters and Chambless (2017) went ahead to observe that in the absence of immediate support mechanisms, victims of relationship break-ups may end up experiencing severe depression. Supporting these claims were Mihailescu and his colleagues (2016) who focused their research towards understanding the impact of anxiety and depression towards academic performance. In their study, they made an observation that broken relationships are among the cause of depression and anxiety among students in colleges because most prefer not to talk about it while most social institutions do not provide support for these people.

Extracurricular activities were, on the other hand identified as being a residual reason behind stress and anxiety among undergraduates. According to Yussuf, Rahim, Baba, Ismail and Pa (2013), these activities are a good distraction towards negative behaviors. However, over engaging in some may increase the pressure of performing which already exists among the students. By this, therefore, they end up exposing themselves to depression in cases where they fail to get the performance they have been training for. Farrer, Gulliver, Bennet, Fassnatch and Griffin (2016) emphasized on the need for these students to have a balance for their personal life, education and extracurricular activities. Young adults have were identified to have challenges in meeting up this balance and therefore exposing them to the risks of stress and anxiety (Farrer, Gulliver, Bennet, Fassnatch & Griffin, 2016).

Health Factors and Effects of Anxiety and Depression

The review of the literature identified the lack of health structures as possible reasons behind the growing prevalence of mental health problems in institutions of higher learning. Thomas, Cassady & Heller (2017) identified the absence of research as a leading reason behind the inadequate support systems that would aid in the provision of support to this group of people. By this, therefore, those that face these challenges lack a place or a person they can go to. Thomas, Cassady & Heller (2017) identified the lack of coping skills as the outcome of the lack of a system to help the patients.

Jackson, Pathirana, and Gardiner (2016) focused their research towards understanding the health effects of anxiety and depression about risks of hypertension. In the findings they identified a positive correlation between the two mental disorders with hypertension. The risk of hypertension, however, increases in patients that have both depression and anxiety (Jackson, Pathirana & Gardiner, 2016). Adding to this, Rotenstein and others (2016) observed that depression and anxiety was also an indicator of stress among the patient; therefore, the three or any of the two would exist as co-occurring disorders. Other health issues that the Rotenstein and colleagues (2016) associated with depression and anxiety was suicide where they associated high suicide rates with depression and anxiety. The absence of support systems in social institutions including universities and colleges was the reason behind the increasing suicide rates among young people (Thomas, Cassady & Heller, 2017).


Anxiety and depression are worrying about health concerns that are lowering the quality of life among undergraduates. The literature review has looked at the societal pressure that students face as far as the expectations of the society which include good grades and enjoyable life after school. More to this the pressure to fit in a new institution also adds up to the pressure and anxiety. Lifestyle choices such as substance abuse and alcohol consumption and lack of coping skills to deal with breakups is another reason for the depressions. The growing prevalence of the condition has been attributed to the lack of support systems in higher learning facilities because there are limited researches that provide frameworks or providing support systems to these individuals. Stress has been identified by the reviewed literature as a possible co-occurring disorder with either depression and anxiety and therefore creating a need for the stress to be also assessed regularly. Another health issue identified as being caused by stress and anxiety is hypertension, and it has been confirmed that the risk of hypertension is more pronounced if a person suffers from both the conditions at a go. More concerning is the problem of suicide and suicidal thoughts which is as a result of depression and anxiety due to insufficient support measures.





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Farrer, L. M., Gulliver, A., Bennett, K., Fassnacht, D. B., & Griffiths, K. M. (2016). Demographic and psychosocial predictors of major depression and generalised anxiety disorder in Australian university students. BMC psychiatry16(1), 241.

Iqbal, S., Gupta, S., & Venkatarao, E. (2015). Stress, anxiety and depression among undergraduate medical students and their socio-demographic correlates. The Indian journal of medical research141(3), 354–357.

Jackson, C. A., Pathirana, T., & Gardiner, P. A. (2016). Depression, anxiety and risk of hypertension in mid-aged women: a prospective longitudinal study. Journal of hypertension34(10), 1959-1966.

Lipson, S. K., Zhou, S., Wagner III, B., Beck, K., & Eisenberg, D. (2016). Major differences: Variations in undergraduate and graduate student mental health and treatment utilization across academic disciplines. Journal of College Student Psychotherapy30(1), 23-41.

Liu, C. H., Stevens, C., Wong, S. H., Yasui, M., & Chen, J. A. (2019). The prevalence and predictors of mental health diagnoses and suicide among US college students: Implications for addressing disparities in service use. Depression and anxiety36(1), 8-17.

Mihăilescu, A. I., Diaconescu, L. V., Ciobanu, A. M., Donisan, T., & Mihailescu, C. (2016). The impact of anxiety and depression on academic performance in undergraduate medical students. European Psychiatry33, S341-S342.

Porter, E., & Chambless, D. L. (2017). Social anxiety and social support in romantic relationships. Behavior therapy48(3), 335-348.

Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., ... & Mata, D. A. (2016). Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. Jama316(21), 2214-2236.

Thomas, C. L., Cassady, J. C., & Heller, M. L. (2017). The influence of emotional intelligence, cognitive test anxiety, and coping strategies on undergraduate academic performance. Learning and Individual Differences55, 40-48.

Walters, K. S., Bulmer, S. M., Troiano, P. F., Obiaka, U., & Bonhomme, R. (2018). Substance use, anxiety, and depressive symptoms among college students. Journal of Child & Adolescent Substance Abuse27(2), 103-111.

Yusoff, M. S. B., Rahim, A. F. A., Baba, A. A., Ismail, S. B., & Pa, M. N. M. (2013). Prevalence and associated factors of stress, anxiety and depression among prospective medical students. Asian journal of psychiatry6(2), 128-133.


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