How to Know If Your College Student Needs Therapy in DC

CollegeAnxietyTherapy in Washington DC
Written By Aimee Caramico

Your student calls on Sunday night. They say the week was “fine,” but they sound worn out. A class is going badly. They have not seen the friends they were excited about a month ago. You ask if they want help and get a quick “No, I’m good.”

You know your child well. You also know college is a big change, and that being quiet on the phone doesn’t automatically mean something is wrong. So you’re left weighing what you can see against what you can’t.

That uncertainty is familiar to many parents. In the 2024–2025 Healthy Minds Study, 37% of surveyed college students screened positive for moderate or severe depressive symptoms, and 33% screened positive for moderate or severe anxiety symptoms. In the American College Health Association’s Fall 2024 National College Health Assessment, 30% of respondents said anxiety had negatively affected their academics. These surveys describe groups, not your student. They help explain why struggles that look private from the outside are common on campus.

A parent does not need to figure out a diagnosis from across town or across the country. The more useful question is whether your student seems to be managing, whether things are getting harder, and whether they might welcome support. That can be true whether they attend Georgetown, GW, Howard, American, or another school in Washington, DC.

Look for a change in how they’re living

College students miss classes, change plans, stay up too late, and sometimes go quiet. One of those things on its own tells you little. You have a better starting point than a checklist: your memory of how your student usually handles a hard week.

Maybe they used to complain about a class and then go to office hours. Now they avoid opening messages from the professor. Maybe they were always a bit private, but they still talked about a friend or something they were looking forward to. Now every call seems to end with “I don’t know” or “It doesn’t matter.” The change from their usual can be more revealing than whether a behavior matches a symptom list.

It also helps to notice whether difficulties are piling up. A student who is sleeping poorly may start missing class, then feel embarrassed about falling behind, then avoid a friend who might ask about it. In a phone call home, they may mention only the missed class. You may not hear the rest until later.

You won’t see everything, and your student may not tell you everything. That’s part of becoming an adult. Still, you can ask what a typical day looks like, whether they’re getting to class, and who they turn to when something goes wrong. You are trying to understand how life feels to them, not build a case.

When ordinary college stress starts to take over

School is slipping, and they can’t seem to get back on track

A poor grade can be disappointing without becoming a crisis. Pay closer attention when your student is missing several classes, letting assignments go, avoiding professors, or refusing to check grades because they already expect bad news. Some will insist they can catch up while their workload keeps growing.

If this is happening, “Why aren’t you working harder?” probably won’t open the conversation. Ask what they run into when they try to start. They might be exhausted, distracted, afraid of doing poor work, unsure what to tackle first, or dealing with something unrelated to school. An academic advisor can help with the course problem. If distress is making it hard to use that help, a therapist may be useful too.

Their days are shrinking

A student may need a weekend alone. It’s different if they have stopped going to clubs, meeting friends, eating with other people, or leaving their room. They might say they are busy, but sound lonely when they describe their week. They might live among hundreds of students and still feel there is no one they can call.

Ask for details instead of asking whether they have friends. “Who did you spend time with this week?” or “Is there anyone in your class you could ask for notes?” may get a more honest answer. Your student may be adjusting slowly, or they may want connection but feel too anxious, low, or out of place to make it happen.

You keep hearing “I’m fine,” but they don’t sound fine

Some students cry. Others become unusually irritable, stop joking, or sound flat when they talk about things they used to care about. You may notice the change before they do. Or they may know something has shifted but not want to alarm you.

It is tempting to name what you think is happening: “You sound depressed.” That can make a student feel analyzed. Try describing what you hear: “You haven’t sounded like yourself lately. How have you been feeling?” Then leave room for an answer you didn’t expect. They may be worried about grades, a relationship, money, discrimination, or something they are not ready to discuss with you.

Worry is deciding what they can and can’t do

Exam nerves are part of college. Anxiety may need attention when your student skips class to avoid being called on, spends hours rewriting a simple email, or cannot make ordinary decisions without asking you to reassure them. They may know the worry is out of proportion and still feel unable to move past it.

Avoidance can look like laziness from the outside. A student may put off an assignment because starting it brings on dread, then feel worse as the deadline approaches. If fear is repeatedly keeping them from school, friendships, or things they care about, talking with a therapist may help them work out what is happening and what they want to change.

Sleep, eating, or substance use has changed

A college schedule may be irregular. What matters is whether changes are getting in the way of basic life. Your student might be sleeping through classes, lying awake most of the night, skipping meals, or avoiding eating with friends. They could be exercising despite an injury or following food rules that leave little room to eat spontaneously.

You might also hear that they need cannabis to sleep, alcohol to socialize, or medication that wasn’t prescribed to them to finish schoolwork. These behaviors have different causes and deserve a calm, specific conversation. Ask what role they play in your student’s week and whether the student feels in control of them. A healthcare professional can help assess physical concerns, and a therapist may help with the distress beneath them.

Small tasks have become hard to manage

Your student may call about a roommate disagreement, an appointment they cannot bring themselves to make, or an email they have rewritten ten times. You find yourself reminding them about deadlines, making calls, or handling decisions that used to be theirs.

It is natural to pitch in. But if your help has become the only thing keeping their life moving, ask what is making the next step feel so hard. They may need academic assistance, a doctor, or simply time to talk through a decision. If anxiety, low mood, grief, or overwhelm is making ordinary tasks feel impossible, therapy can be part of the answer.

If they say something that worries you

Take comments such as “There’s no point,” “I can’t do this anymore,” or “Everyone would be better off without me” seriously. Ask what they mean. If you think they could hurt themselves, ask directly whether they are thinking about suicide. That may feel blunt, but it is clearer than hinting around the subject.

The National Institute of Mental Health’s warning signs guide describes signs that can include feeling trapped or like a burden, along with changes in behavior. You don’t have to decide on your own how serious a comment is. If your student may be in immediate danger, stay in contact while you reach crisis or emergency support.

Campus counseling or a private therapist?

Campus counseling is often the easiest first step. Your student can ask what appointments are available, how long they last, and whether the center can provide the kind of support they want. Services vary from one college to another. Some students find that campus counseling gives them enough help; others want more consistent appointments or a therapist with experience in a particular concern.

Private therapy can be a good fit for a student who wants care outside the university, expects to need ongoing support, or prefers to choose a therapist based on approach and experience. Cost, scheduling, transportation, and insurance all matter. So does the student’s sense of whether they can talk to that person. There is no prize for choosing one route first; what counts is finding support they can use.

For students looking for therapy in Washington, DC, North Star Psychological Services offers therapy for college students at our Dupont Circle practice. The page explains the service and gives students a place to start comparing options. They can ask about availability, fees, and fit before deciding whether to schedule.

How to bring up therapy without taking over

A student who hears “You need therapy” may hear criticism, even when you mean, “I love you and I’m worried.” Try starting with something concrete: “You’ve missed classes, and you sound exhausted when we talk. What’s going on?” Then listen. You do not have to agree with every explanation to show that you have heard them.

If they are open to help, ask what kind would make the first step easier. Maybe they want to contact campus counseling themselves. Maybe they would like you to find a few private therapists, check costs, or help draft an email. Offer practical help without insisting on updates about what they discuss in therapy. Your student is an adult, and privacy can help them speak freely.

If they refuse, try to understand the reason. They may not have time, may worry about money, or may have had a bad experience before. They may feel that accepting therapy means admitting they cannot handle college. You can answer questions and leave the option open without pressing for a decision on the spot. “You don’t have to decide now. I’m here if you want help looking” is a complete response.

When to get help right away

If your student says they want to die, describes a plan to hurt themselves, seems severely confused, cannot care for basic needs, or is in immediate danger, don’t wait for a routine appointment. Ask where they are, keep them on the phone if possible, and arrange help near them.

In the United States, you or your student can call or text 988 for crisis support. Call 911 for immediate danger. If your student is on campus, campus emergency services may be able to reach them. You can contact crisis or emergency services even if you are unsure exactly how to judge the risk.

Therapy for college students in Washington, DC

A student doesn’t need to be at a breaking point to try therapy. They may be falling behind, feeling isolated, worrying constantly, or finding it hard to talk with people they usually trust. Sometimes they simply know they don’t feel like themselves. They can start there; they don’t have to arrive with a diagnosis or a polished explanation.

North Star Psychological Services offers therapy for college students in DC from our Dupont Circle office. If your student wants to explore care, they can contact us to ask about availability and next steps. You can share the page or help with the practical details. The decision to begin belongs to your student.

Common questions from parents

How can I tell whether this is a rough adjustment or something more?

Ask whether your student is getting some relief between hard moments. A student who has a rough week, then reconnects with friends and catches up on sleep, may be finding a way through. A student who keeps missing class, withdrawing, or sounding hopeless may need more support. You do not have to settle the question before suggesting a conversation with a counselor.

What if my student says they’re fine?

You can accept the answer and still tell them why you asked: “Okay. I’m glad you told me. I asked because you’ve sounded exhausted and I care about you.” Leave an opening to talk again. If they have said something that makes you fear for their immediate safety, seek help rather than relying on reassurance alone.

Should I help find a therapist, or let them do it?

Ask what they would prefer. Some students appreciate help comparing locations and fees; others want to handle the search privately. You can offer to research a few options, then let them choose who to contact. That keeps your support practical without making therapy feel like another decision being made for them.

What if they tried campus counseling and didn’t like it?

Ask what didn’t work. Maybe the wait was too long, the counselor didn’t feel like a good fit, or the student wanted more consistent care. They can ask the campus center about other resources or look for a private therapist in DC. One disappointing experience does not mean they have run out of ways to get help.

Should I call the college if I’m worried?

If your student is safe, it is usually best to speak with them first and encourage them to contact the relevant campus office. If they may be in immediate danger, you cannot reach them, or they have talked about suicide, contact campus emergency or student support resources. The school may not be able to share private information about an adult student, but you can still tell the appropriate office what concerns you.

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Related reading and support:

Aimee Caramico
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