After years of caring for college students as a physician, plus raising two of my own, I have learned that many things that derail the college experience are surprisingly predictable. Most are preventable — or at least fixable — if students know what to expect. While these are five things I wish every college student knew before setting foot on campus, it’s not too late for your student to find this advice useful. Homesickness doesn’t mean you’re in the wrong place Many students immediately assume they chose the wrong school when they are feeling anxious and missing home. After years of hearing that college will be “the best years of your life,” students are often shocked to find themselves sitting alone in their dorm room, sad, lonely, struggling in class, sleeping poorly, feeling exhausted and perhaps hating the food. They are often convinced their struggles mean they are disappointing their family, especially if they are attending their dream school or if they are a first-generation college student. On top of feeling like a failure, they need only glance at social media to see that clearly all their friends are having the time of their lives, though I know that is the highlight reel effect. Young adults typically prioritize sharing their social media-worthy successes, rather than their challenges. Homesickness is common, along with broader challenges of connection and adjustment. Roughly 60 per cent of students feel a lack of companionship, left out or isolated at least some of the time, according to the Spring 2026 American College Health Association-National College Health Assessment, or ACHA-NCHA, survey, which includes data from more than 44,000 undergraduates at 86 institutions. Encouragingly, though, 71 per cent of students felt they belonged at their university, suggesting that despite loneliness or possibly homesickness, most students are also adjusting to college life. In my experience, the students who struggle the most often live close enough to run home for Sunday dinner, do their laundry or attend a sibling’s event, especially on the weekends. For many students, frequent trips home make it more difficult to build a life on campus. The students who are thousands of miles from home don’t have that choice, so they typically attend more university events, find new study spots around campus or simply hang out in the dorm laundry room, giving them proximity to others in the same boat, which leads to connections. Staying on campus only works, however, if you leave your dorm room. Sitting on your bed scrolling through social media or playing games with virtual friends won’t cure homesickness either. My advice is to develop roots. Start with trying three completely unrelated clubs to join — perhaps a service organization, a board game club, your major’s academic club or an intramural sport. If you weren’t a high school athlete and are worried about the level of competition, look for fun alternative sports such as cornhole or something totally unique like canoe battleship (such as sink or swim at Texas A&M University). The point is to pursue at least three activities that spark your interests and start connecting with others who appreciate the same things. Many early college friendships or clubs are like temporary tattoos — try them out and see whether they are the right fit for you, without the worry of a lifelong commitment. Quality sleep is important and underrated A tired brain makes everything worse. Emotions can rage out of control. Learning, processing and retention of new information are impaired. Focus and problem-solving decline. Then you bomb a quiz or a test and trigger a cycle of test anxiety. Dorms may be the worst setting for quality sleep. They are loud, bright, hot and smelly, and never mind that you had to add other people in your bedroom. Control what you can. Block out light with a sleep mask; use headband-style headphones and guided meditations to buffer sound; and place a fan near your bed to cool your sleeping space and add white noise. Most importantly, communicate early with your roommate about sleep schedules, expectations and respect for each other’s privacy. The most common mistake that I see college students making is not staying up too late; it’s having an inconsistent wake-up time. If you have early classes two days, but sleep till noon the other days, you are disrupting your body’s circadian rhythm, which reduces your sleep quality and increases daytime fatigue. Instead, prioritize getting up at the same time each day, adding in a short early afternoon nap if needed. Obviously, total sleep quantity matters, too. If you choose to study or party till 2 a.m., make sure that you’re able to sleep till 10 a.m. Academic anxiety doesn’t mean college isn’t for you College isn’t necessarily harder than high school, but it’s different. Students who excelled in essay exams in their Advanced Placement or International Baccalaureate courses may discover that college exams lean more on multiple choice or best answer format, which often requires a different skill set and study strategy. How to adapt to that change? Prioritize meeting every professor within the first two weeks of school by going to their office hours and simply introducing yourself. Doing so will not only connect you with the professor and likely increase your personal investment in class lectures but will also significantly improve your comfort level asking them for help later in the semester. Please don’t be that student who shows up during finals week begging for extra credit because you need a better grade. The professor likely has no idea who you are because you never went to office hours and barely showed up for class. If you develop class performance or test anxiety that is causing your brain to go blank despite solid preparation, talk with your campus counseling center or student health services. Anxiety is increasingly affecting academic performance, with nearly 30 per cent of students noting that anxiety negatively impacted performance in a class or delayed progress towards their degree, according to Spring 2026 ACHA-NCHA data. Fortunately, there are many practical techniques you can learn to help you break the cycle of panic, starting with simple measured breathing exercises. Alcohol can ruin more than one night Not everyone drinks, but alcohol affects nearly everyone. The sober student carries the extra pressure of deciding when it’s time to help for their drunken friend, and they may even get stuck paying the car share driver extra because their friend vomited during the ride. When to get that friend help is the most common question I get around alcohol. You should be able to fully wake up someone who is intoxicated and sleeping. If you are shaking their shoulders and loudly calling their name and there is minimal or no response, consider that person unconscious and call 911. Blood alcohol levels rise for nearly an hour after the last drink, so remember that a drunken and arousable friend can still become unconscious later. Never leave them to sleep it off. Please go back and check on them. Alcohol impairs your judgment — you know that. Realize, however, that this impaired judgment means you may decide to drink more than you planned or make sexual decisions that sober you would not have chosen. Not remembering the night does not mean you won’t have consequences. Drunken hookups rarely involve protection for sexually transmitted infections or pregnancy, and I see far too often how these consequences can totally derail your college plan. Those STIs can often cause disproportionate emotional fallout that damages students’ self-worth, strains their mental health or hinders their academic success. Get some help before it’s desperately needed Whether it’s a sore throat, anxiety, depression or academic trouble, do not wait until you are in crisis to seek help. Problems are generally easier to address and treat in the earlier stages, though students often hesitate to prioritize being evaluated because they think their situation isn’t bad enough to see a doctor, therapist or professor. One practical tip: Student counselling, health and academic success centers are rarely busy the first few weeks but often have long waits by midterms. I frequently remind students that part of their tuition includes many of these resources — they are prepaid, not free. If you take any prescription medications, schedule an appointment right away to get established with a doctor and learn to navigate the system when you aren’t ill or injured. Head to the academic success center early, if only to update your resume, learn about career networking platforms or get feedback on your first paper. The college students who thrive and succeed don’t typically ace every exam, pick the perfect friends and magically escape the freshman flu. These students stumble as much as others, but they learn when, where and how to seek help — and don’t hesitate to act on it.
