Recognizing Signs Of Student Distress

The following signs of student distress when immediately present, or presented over a period of time, suggest that the problems with which a student is dealing with are more than “typical”, and may indicate the need for a referral.


  • in sleep patterns (insomnia or extreme sleepiness, nightmares)
  • in appetite (overeating or loss of appetite)
  • in energy level (hyperactivity or exhaustion)
  • in mood (more irritable, more excitable, or more depressed)
  • in performance or activity (compulsive, erratic, or diminished)
  • in academic performance or behavior:
  1. Poor performance and preparation
  2. Excessive absences or tardiness
  3. Repeated requests for special consideration, especially when this represents a change from previous functioning 
  4. Unusual or changed pattern of interaction
  5. Avoiding participation
  6. Dominating discussions
  7. Excessively anxious when called upon
  8. Excessive test, or class assignment related anxiety
  9. Disruptive behavior
  10. Problems with roommates or family

Physical Complaints Of Unknown Origin:

  • headaches, skeletal pain, gastrointestinal disturbances, cardiovascular problems, frequent illness or accidental injury, dizziness, or extreme weakness

Atypical Appearance:

  • hyperactivity or very rapid speech
  • swollen or red eyes
  • change in personal hygiene or dress
  • excessively thin or overweight


  • from activities and social interaction
  • from emotional involvement with others
  • from academic work and classroom participation
  • from family and friends

Emotional Overreaction:

  • spells of crying
  • hypersensitivity
  • outbursts of anger inappropriate to the situation
  • violent behavior


  • reckless driving
  • excessive risk taking
  • unsafe and / or inappropriate sexual behavior
  • general impulsivity

Substance Abuse:

  • overuse or regular use of illicit drugs, alcohol, nicotine, and / or medication (without medical monitoring)
  • exudes smell of alcohol, marijuana, or nicotine from person
  • alcohol / drug use in connection with the following:
  1. driving a car
  2. engaging in unsafe or unwanted sexual behavior
  3. interfering with academic, work or social responsibilities
  4. family, friendship, or relationship conflicts
  5. displays of reckless or aggressive behaviors


  • inability to concentrate or focus
  • persistent memory lapses
  • restlessness
  • preoccupation


  • feelings of pessimism, helplessness, or hopelessness
  • feeling out of control
  • anxiety
  • self preoccupation
  • negative self evaluation
  • references to suicide

Poor Contact With Reality:

  • irrational conversation
  • obsessional ruminations or worrying
  • exaggerated suspiciousness or fear
  • apparent distortions of reality (auditory or visual hallucinations, inability to distinguish fantasy from reality), disorientation

Inappropriate Behavior:

  • behavior inappropriate to the setting or situation
  • dangerous or threatening (to self or to others) behaviors
  • bizarre or strange behaviors
  • anti-social and / or illegal acts (stealing, forcible sex)


  • panic feelings
  • physical shakiness
  • obsessive and ruminating thoughts
  • rapid heart rate
  • shortness of breath
  • persistent worrying