Common Counseling Topics

People seek counseling because they are struggling with issues that affect the way they feel or inhibit their ability to go about their daily lives. Over time, these issues can interfere with relationships, affect school or work, create changes in appetite and sleep, and even create stronger feelings of anxiety, depression or stress. People seek counseling for a number of reasons—browse the items below to learn more about some of the most common counseling topics. Another great place for mental health resources is  

Anxiety and Panic

Anxiety is an uneasiness of mind, usually over an anticipated issue.  Anxiety causes apprehension and fear, and it is often accompanied by physiological symptoms such as sweating, increased pulse/heart rate, doubt about the nature and reality of the "threat", along with self-doubt are common signs of anxiety.

We all feel anxious at various points in our lives when our stress level becomes overwhelming.  Anxiety is similar to feelings of excitement, but it is best described in terms of worry, or an uneasy feeling of impending doom.  In a person with an anxiety disorder, the worry is persistent and habitual, often initiated by unrealistic thoughts or situations.  In addition, this worry seems uncontrollable and often interferes with the ability to concentrate or otherwise function normally.  This type of anxiety may be a learned habit, which, therefore, can be unlearned.

If anxiety is a problem that troubles you, contact the University Counseling Center at 615.966.1781 or complete the online appointment request form.

Date Rape

What is date rape?

Date rape is non-consensual sexual intercourse involving someone known to the victim. It can occur between friends or general acquaintances, and often occurs on dates.

What can I do to help:

Be there. Don't be judgmental.  Encourage the victim to seriously consider reporting the rape to law enforcement authorities. A counselor can provide the information the person will need to make this decision. Be patient. Remember, it will take the victim some time to deal with the crime. Let the victim know that professional help is available through the Counseling Center on campus, the Rape and Sexual Abuse Center, and the National Sexual Assault Hotline. Encourage him or her to call, but realize that only your friend can make the decision to get help. You may offer to go to the first appointment with the victim. The most important thing to remember is not to blame the victim. The rape was not his/her fault. Their behavior didn’t cause the rape; the rapist caused the rape.

If the assault has just occurred:

Stay with the victim. With the victim’s consent, report the assault to their RA (Resident Assistant). Encourage the victim to preserve evidence of the attack until the proper authorities arrive.

Statistics regarding sexual assault/abuse:

As many as one in four college women become victims of attempted or completed rape during their college years. In 60-80 percent of rapes, the assailant and the victim know each other and, of these, over half of the rapes happen on a date. It is estimated that only 10 percent of rapes are reported to the police. Seventy-five percent of the male perpetrators and 55 percent of the female victims report that alcohol was involved at the time of the incident.

Contact the University Counseling Center for help. 615.966.1781, or complete the online appointment request form. The University Counseling Center is located in the lower-level of Elam Hall.

Adapted from: Information available through the Rape Abuse and Incest National Network


Depression is a mood disorder experienced by many people ranging from mild to severe. However, clinical depression should not be confused with occasional "blue" moods, preoccupation or times when things just don't go well.

Many in the medical community believe depression is related to a chemical imbalance or other biological origin. The other significant consideration is that depression results from intense or prolonged negative life experiences. Feelings of anger, sadness and confusion commonly accompany unexpected or continuous struggles with life issues.

Some symptoms of depression are:

  • extreme sadness
  • decreased appetite; decreased motivation
  • lack of concentration
  • insomnia
  • excessive sleeping (especially during the day)
  • withdrawal from social activities
  • preoccupation with feelings of low self worth
  • isolation

Ask yourself two questions:

  1. How often do I feel this way?
  2. How long does the feeling last?

If you feel you are suffering from depression, the University Counseling Center can help. We can be reached at 615.966.1781 or complete the online appointment request form.

Eating Disorder

A whole range of issues can cause eating disorders. It may begin as a way to hide other concerns, and may be a symptom of thoughts, behaviors, and feelings over which the person does not feel control. These other concerns may be the catalysts for restricting caloric intake or for binge/purge cycles. Either of these can result in serious health problems and even death. Some "red flags" for recognizing the early stages of eating disorders are:

Anorexia Nervosa

  • Loss of menstrual period
  • Dieting when not overweight
  • Claiming to feel "fat" when not overweight
  • Preoccupation with food; calories
  • Denial of hunger
  • Intense fear of gaining weight or being fat
  • Excessive exercising
  • Frequent weighing

Bulimia Nervosa

  • Excessive concern about weight
  • Strict dieting followed by eating binges
  • Frequent overeating, especially when distressed
  • Binging on high calorie, sweet food
  • Expressing guilt about eating
  • Secretive vomiting
  • Use of laxatives

We are here to help. Please contact the University Counseling Center at 615.966.1781 or complete the online appointment request form.

Family Problems

For many people, the process of growing up and dealing with loved ones has been one of peaks and valleys. When problems such as abuse, control, manipulation, substance abuse, etc., are present, the effects on children can last long after childhood. While all families experience problems, the members of families that have prolonged exposure to dysfunction are more likely to experience problems as an adult.

At times the impact of one's family dysfunction is felt most in relationships with others. In college settings you are exposed to a number of new relationships. Dating relationships, roommate relationships, and friendships can all highlight the impact that certain family dysfunction has had on your life.

We are here to help. Please contact the University Counseling Center at 615.966.1781 or complete the online appointment request form.

Grief and Loss

The loss of a significant relationship or the death of a loved one can trigger grief. For most who grieve, it is some comfort to know that the pain is normal and that others have shared a similar experience, and eventually achieved a resolution.

Normal grief reactions include:

  • tightness in my throat and a heaviness in my chest
  • mood changes over the slightest thing
  • what is there left for me to live for?
  • sometimes I feel angry
  • I cry at unexpected times
  • I can't concentrate
  • I feel my mind is on a merry-go-round that will not stop
  • I have trouble sleeping
  • I don't feel hungry
  • I'm eating all the time
  • I'm so lonely

These grief responses are all natural and normal after a loss. It is important to reach out and talk with people, and to cry when you need to. While profound grief is not a sign of mental illness, many people who experience it for a prolonged period may benefit from counseling.

If you are experiencing sadness due to a loss, please contact the University Counseling Center at 615.966.1781 or complete the online appointment request form.


Research indicates that as many as 70 percent of university students develop feelings of homesickness at some point during their college career. While the excitement, stress, and new surroundings of being in college are a part of every student's experience, the adjustments that have to be made are not always easy. It’s important to remember that you aren't the only one having these feelings and that there are many others that have to make the transition to college life along with you.

The process of adjusting to your new environment (e.g. your dorm room, new roommate, courses, and schedule) may seem exciting at first but may become somewhat overwhelming after the newness wears off. However, others may find that the process of making new friends, adjusting to the dorm, or missing your friends and family back home difficult from the start. Since most people find comfort in familiar surroundings and relationships, the process of leaving the familiarity of home and moving into a new environment can make this process stressful. It is important to remember that dealing with change can be a difficult process and that it is normal to have some difficulty adjusting. Since every student has varying degrees of connectedness to friends and parents, distance from home, and level of independence the impact of homesickness can vary greatly from person to person. Some common characteristics of homesickness are as follows:

  • A faint sense of loss when thinking about familiar things like friends, family, pets, and even your own bed.
  • Failure to get into a comfortable routine.
  • Being miserable and lonely and lacking the desire to get out of your room.
  • A strong resistance to return to school after a weekend visit or holiday.
  • Crying for no reason and an empty feeling like nobody understands.

If you are struggling with being homesick, the University Counseling Center may be able to help. We can be reached at 615.966.1781 or complete the online appointment request form.

Self-Mutilation or "Cutting"

What is self-mutilation or “cutting”?

Self-mutilation is a general term for a variety of forms of intentional self-injury. These behaviors may include cutting one's skin with razors or knives, biting, hitting, or bruising oneself, picking or pulling at skin or hair, or burning oneself with lighted cigarettes. For these individuals, self injury is a way of coping with or relieving painful or strong negative emotions, such as shame, fear, guilt, or anxiety. Although it is generally not a suicide attempt, this behavior is very dangerous.

How do I know there’s a problem?

You should suspect self-cutting if you notice a continuing pattern of unexplained (or poorly explained) cuts or scratches that never seem to heal. Self-cutters also tend to socially isolate themselves, wear baggy clothing or clothing that covers up their arms and legs (even in hot weather), and may show signs of depression.

What can I do to help?

Recognize that people who cut themselves often have other problems; like eating disorders, bipolar disorder, personality disorders, or drug/alcohol abuse and are in need of professional help. Listen to the person in a non-judgmental manner. Do not react with hostility or condemn the person. Offer to accompany the person to talk with a caring professional.

The University Counseling Center is here to help. Contact us at 615.966.1781 or complete the online appointment request form. We are located in the lower-level of Elam Hall.

Adapted from: Information available through the Nemours Foundation & S.A.F.E. (Self Abuse Finally Ends)


Stress can be a most debilitating problem when we become so frazzled that we don't function well and our work is affected. The stress which motivates us to go to class and to do our work is a good thing, but too much stress is counter productive and leaves us feeling overwhelmed and drained.

Four types of stress symptoms often appear:

  • Physical symptoms include fatigue, headache, insomnia, muscle aches and stiffness, heart palpitations, chest pains, cramps, nausea, trembling, sweating, frequent colds, etc.
  • Mental symptoms include decrease in memory and concentration, indecisiveness, mind racing or going blank, confusion and loss of humor.
  • Emotional symptoms include anxiety, nervousness, depression, anger, frustration, worry, fear, irritability, impatience, short temper, etc.
  • Behavioral symptoms include pacing, fidgeting, nervous habits like nail-biting, increased eating, smoking, drinking, crying, yelling, swearing, and blaming.

Everyone experiences stress. It cannot be eliminated, so if you find yourself feeling tired and irritable, restless, not sleeping well, and unable to relax on your own, you need to look for some positive stress reducing strategies. Many ways exist to manage stress in our lives.

Here is a list of ten good strategies:

  • Decrease or discontinue caffeine.
  • Exercise regularly.
  • Prayer, relaxation and meditation.
  • Get seven to eight hours sleep per night.
  • Have regular rest breaks and leisure time.
  • Develop realistic expectations.
  • Reframe situations positively.
  • Check your belief system.
  • Find and use a support system and talk it out.
  • Look for humor in every situation.

If you need help learning to relax, re-frame, or to talk things out, call the University Counseling Center at 615.966.1781 or complete the online appointment request form.

Substance Abuse

What is substance abuse?

It is when substances are used in a dependent or abusive manner to achieve some altered cognitive or emotional state. Over time, increased amounts of the substance are needed to achieve a desired result. Use of the substance is typically in a predictable manner with identifiable triggers and behavioral responses. Abuse of substances may be part of a growing dependency or the result of poor choices and reactions to personal crisis, acting out and experimentation, or irresponsible recreational choices.

How do I know there’s a problem?

Look for these warning signs:

  • Repeated irresponsible use of substance(s)
  • Repeated use of the substance, regardless of past legal or personal consequences
  • Repeated use, despite major problems in client's social life that are caused or worsened by substance abuse
  • Repeated use, regardless of physical consequences such as blackouts, passing out, vomiting, hangovers
  • Repeated failures to meet responsibilities

What can I do to help?

  • Listen to the person and be honest about your specific concerns.
  • Don’t promise to keep issues confidential if it is causing harm to your friend or others.
  • Think creatively about ways to connect the individual with others who can be supportive.
  • Offer to help the individual in seeking counseling or a 12-step meeting that fits their specific needs.

We can help. Contact the University Counseling Center at 615.966.1781 or complete the online appointment request form.

Adapted from: The American Association of Christian Counselors Treatment Planner


How can I know if someone is suicidal?

Some suicides occur without any outward warning, but most do not. Recognizing signs of someone at risk is the best way to prevent suicides. The following are danger signals of someone at risk:

  • Previous suicide attempts
  • Talking about death or suicide
  • Planning for suicide
  • Depression

Don’t be afraid to ask if an individual is considering suicide as an option.

How do I know if a suicide threat/attempt is serious enough to take action?

All suicide threats or attempts must be taken seriously, even those among students who have a history of making threats but never attempt. Remember it is not up to you to decide the severity of suicidal actions, but it is your responsibility to report.

What do I do if a student is talking about suicide?

  • Take it seriously!
  • Be willing to listen—do not try to argue anyone out of suicide. Let them know you care.
  • Do not promise to keep their thoughts a secret, let them know you want to make sure they are safe.
  • Encourage your friend to seek professional help. Offer to go with your friend to schedule a counseling appointment. If you are unsure what to say or do, contact someone in the counseling department.

What do I do if a student has made an attempt?

  • Do not leave the student alone until help is available.
  • Remove the student from any potentially dangerous items (i.e.: firearms, drugs, razors, and scissors).
  • Contact your RA (Resident Assistant)/Head Resident as soon as possible so they can determine if it is necessary to contact the police/medical services. If your RA/Head Resident is not available, call Campus Safety at 615.966.7600 or call 911.

We are here to help. Contact the University Counseling Center at 615.966.1781 or complete the online appointment request form. We are located in the lower-level of Elam Hall.

Adapted from: Information available through the Youth Suicide Prevention Education Program

Test Anxiety

Do you enjoy taking tests? Many people do actually look forward to the challenge of test taking. These people like the thrill of the unknown and the excitement surrounding the fact that they will be tested. However, many people do not like to take tests. The thrill of the unknown and the expectation of performance can sometimes spiral into a fear that reduces a student's capacity to produce. Test anxiety is a temporary condition relating to how a person responds to a testing situation. For some people this fear can result in physical symptoms. A person may experience increased heart rate, sweating palms, shortness of breath, or an ache in the stomach. A person may have trouble capturing known facts from their memory and an inability to organize thoughts. If you struggle with this type of response to tests, then there is hope and help for you.

Some ideas to help test anxiety:

  • Prepare thoroughly; the more prepared the less anxiety.
  • Study with a partner or group; go into the test with a sense of community.
  • Look at the test realistically; one test at a time. One test does not make or break the course.
  • Learn some relaxation techniques: deep breathing, positive visualization.

The University Counseling Center can assist you with channeling your excitement into a positive direction. You don't need to fear tests any longer.

If we can help, call us at 615.966.1781 or complete the online appointment request form.