You’ve read the same paragraph four times, your roommate thinks you’re fine, and your campus counseling center’s website is open in another tab. Maybe you’re wondering whether to book there, find a therapist off campus, or wait until things get worse. Stress, anxiety and low mood are common in college. A review of 41 studies of undergraduates sorted the risk factors for stress, anxiety and depression into six groups: psychological, academic, biological, lifestyle, social and financial. Most of them will sound familiar.
This guide is for college and graduate students in Washington DC who want to know where to start. It covers what a campus counseling center does well, when an off-campus therapist is the better fit, how paying for therapy works, and what to do in a crisis.
What college students in DC are carrying
Some of the pressure is obvious: grades, a heavy course load, the classmate who seems to have an internship, a research job and a startup. DC adds its own version. Many students stack classes on top of an internship on the Hill or at a federal agency.
Competition itself can wear you down, depending on how you compete. In a survey of 713 college students in China, a cutthroat need to beat others went with more anxiety and worse sleep. Competing to get better at something yourself went the other way.
A packed schedule can feel normal when everyone around you is running the same pace. Other people’s pace is a poor measure of what you can carry. Feeling stretched thin for weeks is reason enough to talk with someone, even if you’re still making it to class.
Then there’s the rest of life. Money stress, a breakup, a family situation back home and the question of what comes after graduation all follow you into the library.
The transition is its own stress
Moving away from home means losing the people who used to notice when you were off. In focus groups with first-year university students in England, many said they hid their struggles from family and friends. Big lecture classes and dorm life left some of them lonely, even surrounded by people.
That hiding is part of why problems grow quietly. Sleep often slips before grades do, which makes it easy to tell yourself you’re fine.
Noticing it in a friend
The signs in someone else tend to be changes: skipping class or meals, sleeping much more or less, pulling away from people, or saying things like “what’s the point.” You don’t need to diagnose anything. Saying “you seem off lately, want to talk?” is enough to open the door.
When your campus counseling center is the right first stop
Most colleges have a counseling center, often called CAPS (Counseling and Psychological Services) or something close to it. It is usually free for enrolled students, and it is set up for what students bring in most: anxiety, depression, stress, relationships, family and identity questions.
Care usually starts with triage, a short first conversation about what’s going on and what kind of help fits. From there, the center may offer a few sessions with a counselor, workshops, help in a crisis, or a referral to someone off campus. Many campus centers work on a short-term model. That means focused work on the concern that brought you in, rather than open-ended weekly therapy.
Campus counseling is a good place to start when:
- Cost is the biggest barrier right now
- You’re not sure what you need and want help sorting it out
- Something happened this week and you want to talk to someone soon
- You’d like a referral to a therapist who fits what you’re dealing with
A common worry is that starting at the campus counseling center locks you in, or that seeing someone off campus means skipping it. Neither is true. Plenty of students begin with a short campus intake, get a clearer sense of what they need, and then decide where longer-term work fits best.
Your school’s counseling center website lists how to book, current hours and what to do after hours. It’s worth saving that page before you need it.
When an off-campus therapist fits better
Some students outgrow a short-term model, and some want something different from the start. An off-campus therapist can make sense when you want longer-term work on a pattern that keeps coming back, like the same fight in every relationship or the anxiety that has followed you since high school. It also leaves room for personal growth, not only getting through the week.
Privacy is another reason. Campus counseling is confidential, but some students would rather see someone with no connection to their school at all.
Then there is continuity. A therapist off campus may stay with you from one hard semester to the next, through summer and past graduation if you stay in the area. If you’ll leave town over breaks, ask about video sessions before you start. Therapists are licensed by state, so where you can be seen by video depends on where you’ll be.
Some needs call for specialized care either way. Eating disorders and substance use problems are usually treated by programs built for them, often with medical care alongside therapy. Your campus center or a therapist can help you find one.
How to choose a therapist
The relationship with your therapist matters more than most people expect. A review of 295 studies covering more than 30,000 adults in therapy found that therapy tends to go better when the working relationship is strong, whatever the approach.
Looking for a therapist off campus?
Our Dupont Circle therapists work with college and graduate students in person and by secure video across DC, Maryland and Virginia.
Psychodynamic therapy, emotion-focused therapy, cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) are all sound approaches. For worry that won’t let up, here is more on therapy for college student anxiety. What matters most is finding someone you can talk to honestly. Psychologists, licensed professional counselors and clinical social workers all provide talk therapy. These questions to ask a new therapist are a good start, before your first session or during it.
Paying for therapy off campus
An in-network therapist has agreed on a rate with your insurer. An out-of-network therapist hasn’t, so you pay up front and your plan reimburses part of it. Many therapists in DC, including those at The Therapy Group of DC, are out of network. At our practice, we file out-of-network claims electronically for you so your plan can reimburse you.
Before you start, call your insurer, whether it’s a student health plan or a parent’s plan, and ask:
- Does my plan cover out-of-network mental health care?
- What’s my deductible, and how much have I met this year?
- After the deductible, what share of each session do you pay back?
- Is there a limit on sessions per year, or do I need preauthorization?
Our post on how out-of-network benefits work goes deeper. If cost is what’s in the way, start with your campus center. Off campus, The Capital Therapy Project, founded by The Therapy Group of DC, provides lower-fee services, so that financial barriers are less likely to prevent you from getting care.
Therapy at our Dupont Circle office
We’ve worked with students from colleges and universities across the DC area, in the city and across the river in Virginia. Our office is in Dupont Circle, and we also see people by secure video anywhere in DC, Maryland and Virginia. Several of our psychologists can also see you by video in many other states through PSYPACT, an agreement between member states.
Many of our therapists are trained in psychodynamic therapy, which looks at the patterns underneath what you’re feeling now. That might be why a B-minus can feel like a verdict on you, or why rest feels like falling behind. We also work with academic stress, relationships, identity questions and big transitions.
We find that the first few weeks of therapy go to building trust and telling your story. When a therapist can stay with you across semesters, summers and the move after graduation, that groundwork carries forward. If you expect to leave DC over the summer, it helps to ask about video sessions before your first appointment.
You can read more about our therapy for college and graduate students.
Managing stress between classes
Coping skills won’t replace care for bigger problems, but they make the week easier while you find it. Start small and pick one or two.
Plan the week, not just the day
Protect your sleep first
Move between classes
Pause on purpose
Keep one standing plan with people
Lower the bar on perfect while you’re at it. A finished paper you turned in beats the brilliant one still open on your laptop. If the stress hasn’t eased after a couple of weeks, or it’s getting worse, that’s a reason to talk to someone now.
If you or a friend is in crisis
If you’re in immediate danger, call 911 or go to the nearest emergency room. For anything short of that, call or text 988, the Suicide and Crisis Lifeline, at any hour. Many campus counseling centers also see students in crisis the same day and run an after-hours line. Save your school’s number in your phone now.
- 988 Suicide & Crisis Lifeline: call or text 988.
- Crisis Text Line: text HOME to 741741.
- Immediate danger: call 911.
Once things are calmer, a counselor or therapist can help you write a safety plan. It lists your warning signs, what helps you cope, people to call and safe places to go. Keep it on your phone so it’s there when you need it.
If you’re worried about a friend, stay calm, listen without arguing, and ask directly whether they are thinking about suicide. Asking does not put the idea in their head. Offer to sit with them while they call 988, or walk with them to the counseling center. Then check in the next day. We’ve written more on how to help a friend who might be thinking about suicide. Supporting someone through a crisis is heavy, and the 988 Lifeline also takes calls from people worried about someone else.
Taking the first step
Start with whatever is easiest: a campus triage appointment, a friend you trust, or a therapist off campus. You don’t need the right words. “I haven’t felt like myself” is enough to begin.
You don't have to sort out this semester alone
Whether you start at your campus counseling center or with us, the first step can be small. Our DC therapists see students in Dupont Circle and by secure video.
Last updated: October 2026
This blog is for informational purposes only and does not constitute medical or mental health advice. Always consult with a qualified mental health professional for personalized guidance regarding your specific situation.
