My students are anxious, and they’re not making it up.

A meta-analysis of surveys found that one-third of college students met criteria for a mood disorder, with higher rates among women, first generation college students, and racial minorities. Since many of my students are all three, I guess I shouldn’t be surprised that a half-dozen of them have cried in office hours, that more than a quarter have a disability accommodation, and many midterms only trickled in with the refrain, “I tried, but I was too anxious…”

As someone who knows how he would have been counted in that meta-analysis, my heart sinks when I hear about the suffering that gets recounted to me, and when I think about how is happening under the surface that I don’t hear about. As an educator, I want to know how to respond: do I usher everyone to Counseling and Psychological Services? Remain detached but supportive, or hint that, if I haven’t been there, I’ve been somewhere similar? Stay firm because, you know, you won’t get extensions for anxiety in the workplace?

And then, as a researcher, I just kind of want to know what the hell is going on.

In medical sociology, we tend to examine new “epidemics” through two lenses, both of which invariably have more than just a grain of truth. If we look at the “social determinants” of health, absolutely none of this is surprising. Not only is the university admitting more and more of the disadvantaged students who are more likely to suffer from anxiety and depression, it’s failing them as soon as they get here: Berkeley’s recent move to slash services to help Community College transfers (about 70% of the students in my class) adjust is case in point. I think well-meaning lefties prefer to remain on this terrain, because the solutions are intellectually convenient even if politically unlikely: re-fund public education and give students the resources to study without worrying whether they’ll be evicted.

Social determinants, though, are for the quants: I tend to be more interested in the “social construction” side of things—think, “when does stress get labeled as ‘anxiety’, or normal sadness become pathological ‘depression’?” And it’s here, I think, that the questions I’m trained to ask as a researcher start to get more uncomfortable as soon as I apply them to my own students.

An anecdote: nearly all the TAs in our class had a student come at the last minute, declaring that they work forty-hours a week, that they have dependents, that their lives are really quite stressful and they need an extension. We drew a hard line. There are plenty of students under these circumstances, and they get organized and get it done. Grades dropped as a result.

Each of us also had a student who came to us evoking mental health troubles, varying from suicidal ideation to diffuse anxiety. This time, by-and-large, we were lenient, even as they blew through renegotiated deadlines and even those with recognized disabilities stretched their university-granted accommodations beyond recognition.

And so the first question that makes me uncomfortable is this: at what point does knowing the right ways to describe the very real distress many of my students are feeling become, itself, a new form of educational capital, a tacit skill that allows some but not others to stake a claim on the university’s dwindling resources? And why is medical hardship privileged over social hardship?

The university’s answer—which we hear on the rare occasions we have some training in pedagogy—is that we should let the Disabled Students Program, Social Services, or Counseling and Psychological Services sort it out. It seems obvious—graduate students in sociology are not social workers, even if the general population doesn’t know this—but also naïve. Even the disability letters we get refer to “negotiations” over deadlines and allowances for “reasonable” absences.

And so we’re in a never-ending state of triage, evaluating not just the severity of the challenges people are facing but the appropriateness of their response to them. If a student asks for a 48-hour extension because they have suicidal thoughts—something 30% of college students in a survey across 12 countries report having at some point—should we calmly grant the request, or leap into action, sending campus police out for a wellness check? If this question strikes you as absurd, you probably haven’t proctored a take-home exam lately.

The final question is about what validating these labels, both as an institution and as individual educators, of “disorder” and “disability” means for the students themselves. Since I’m teaching a social theory course, I feel comfortable paraphrasing Foucault, who tells us that classifications don’t just describe the world, they bring the things they label into being. As someone who identifies in varying degrees with “being” and “having” “major depressive disorder”, I know that framing things in terms of brain chemistry and pathology can be empowering—and also render me even more hopeless than when I was just “really, really sad.”

Even if both would register the exact same on a survey of “psychological distress”, is it different to be “super stressed” about an exam, versus the exam exacerbating an “anxiety disorder”? I think it’s not. It points to two very different understandings of the self and points us to very different responses.

I often assume that taking my student’s difficulties means some combination of listening and active accommodation, assuming that they are they experts in managing their own difficulties. But then I read that clinical psychology tells us that the best treatment for anxiety and trauma is to do what anti-stigma campaigns have told us not to; push people to confront their fears. I guess that means pointing out to someone who’s anxious about writing a take-home exam that they probably won’t be any less anxious in two weeks. It means seeming unsympathetic and uncaring. And taking on that role—I find the idea anxiety-inducing and depressing.