Guest Q&A with Psychiatrist Dr. Rafael Freire:

Understanding Anxiety, Depression, and Student Mental Health

University life can be exciting, but it can also bring intense pressure, uncertainty, and emotional challenges. Many student

s experience anxiety, burnout, or low mood at some point during their academic journey, yet it can be difficult to know when these feelings are part of normal stress and when they may signal something more serious.

To help answer some of the questions students often have about mental health, Project Happiness reached out to Dr. Rafael Freire, MD, PhD, an Academic Psychiatrist and Associate Professor in the Adult Division of the Department of Psychiatry at Queen’s University. Since joining Queen’s in 2019, Dr. Freire’s clinical work has focused on adult psychiatry, particularly mood and anxiety disorders. His research and publications explore topics including anxiety disorders, obsessive-compulsive disorder, and mood disorders.

We asked Dr. Freire to share his insights on some common questions university students have about anxiety, depression, and mental well-being.

How do you tell the difference between anxiety, depression, and burnout when symptoms overlap?

According to Dr. Freire, many symptoms—such as worrying, panic attacks, low mood, fatigue, changes in appetite, and sleep disturbances—can appear across multiple mental health conditions.

“These symptoms are often associated with adjustment disorders, anxiety disorders, and mood disorders,” he explains.

In many cases, these reactions are part of normal psychological responses to stress. For example, short-term emotional reactions to a clear stressor—like exams or major life changes—may reflect healthy coping processes. However, when symptoms become chronic or occur without an identifiable stressor, they may indicate a psychiatric disorder.

Ultimately, Dr. Freire notes that mental health professionals are best equipped to evaluate symptoms and make an accurate diagnosis.

What are the most common mental health struggles among university students today?

Dr. Freire sees several recurring challenges affecting students’ mental health.

Academic stress is a major factor, as students often feel pressure to perform well while adjusting to new responsibilities. Being away from home can also reduce support from family and friends, making it harder to cope with stress. Relationship challenges, substance use, and other life stressors can further contribute to emotional strain.

“In most cases, anxiety, stress, and mood changes are part of healthy psychological processes,” he says. However, individuals who are already predisposed to anxiety or mood disorders may find that these stressors trigger the onset of a psychiatric condition.

In recent years, Dr. Freire has also observed emerging trends. Substance use—including potent cannabis products, opioids, and psychedelics—has become more widespread and may contribute to mental health concerns. Additionally, excessive use of social media and addiction to electronic games are increasingly affecting students’ well-being.

Why do many students hesitate to seek professional help?

Although stigma around mental health has decreased over time, Dr. Freire says it still plays a significant role in preventing students from accessing care.

Many young people worry about being labeled or treated differently by peers, family members, or professors. Others feel ashamed about needing help or admitting they are struggling.

Cultural and language barriers can also make discussing mental health with professionals uncomfortable for some individuals. In addition, misconceptions about treatment often discourage students from seeking support.

“For example, people are often afraid that medications will sedate them, change their personality, or make them addicted,” Dr. Freire explains. “These outcomes are uncommon.”

Similarly, some people believe therapy is simply talking about problems without real solutions. In reality, numerous clinical trials have demonstrated that different forms of psychotherapy can be highly effective for treating mental health conditions.

What role do everyday habits play in maintaining mental health?

Dr. Freire emphasizes that lifestyle habits play a critical role in supporting mental well-being.

Healthy routines—including balanced nutrition, consistent sleep schedules, regular exercise, and maintaining social connections—can significantly influence mental health. Finding balance between work, studying, leisure, and social activities is also important.

During periods of high stress, he recommends practical coping strategies such as mindfulness practices, breathing exercises, spending time in nature, exercising, and connecting with loved ones.

When should someone consider seeking professional help?

While trying to manage stress with healthy coping strategies is valuable, there are times when professional support becomes important.

“If mental health issues continue for a prolonged period of time or have a significant impact on functioning, one should consider seeing a psychiatrist or another mental health professional,” Dr. Freire advises.

Seeking help early can make a meaningful difference in recovery and overall well-being.

How can community and kindness support mental health?

Finally, Dr. Freire highlights the importance of social connection.

Strong support systems—whether through friendships, peer groups, or community involvement—play an important role in mental health. While social support does not make someone immune to mental health challenges, it can significantly improve the recovery process.

“Having psychosocial support doesn’t make people immune to mental health issues,” he explains, “but it definitely makes recovery easier.”

Project Happiness sincerely thanks Dr. Freire for sharing his expertise and contributing valuable insights to support student mental health and well-being.

If you or someone you know is struggling, remember that support is available. Reaching out—to friends, campus resources, or mental health professionals—can be an important first step toward feeling better.

1. Student Wellness Services - mental health support hotline (613) 533-2506

2. Campus Security and Emergency Services - for emergencies (613) 533-6111

3. Project Happiness Email: projecthappiness@clubs.queensu.ca

Other resources: 

1. Canadian Mental Health Association - Ontario Division - (416)-977-5580

2. Suicide Crisis Helpline: 9-8-8

By: Dr. Freire, Laura Merrin & Ashley Wilson