By Becky Meline, LIMHP

They walk in with a duffel bag of laundry, hug you and head straight to their old room. Two days later, they're still in there. Is that normal college exhaustion or a sign something's wrong? Usually it's rest. But Thanksgiving is your best chance all semester to notice the difference.

What's normal when a college student comes home for Thanksgiving?

Lots of sleep, a little moodiness and some pushback on house rules are normal. Your student has been running their own life since August, and they're worn out right before finals.

Home is complicated, too. In a TimelyMD survey of more than 1,200 college students, about half said they felt stressed or anxious about going home for break, and family was the top source of that stress. Most also said being home helps. Both can be true.

Parents: give them the first 24 hours. Skip the grade check at the kitchen table. Feed them, let them sleep and just enjoy having them back.

What are the signs my college student is struggling?

Watch for changes that last more than a few days or don't fit the kid you know. One rough afternoon isn't a pattern. A whole break of it might be.

• Sleep that never ends (or never starts). Napping all day, up all night, still exhausted.

• Pulling away. Skipping the hometown friends they always made time for.

• Grades they won't talk about. "It's fine," with no details.

• Changes in eating or drinking. Barely eating, or drinking more than you'd expect.

• New irritability. Snapping at everyone over small things.

• Hopeless talk. "What's even the point?" or talk of being a burden.

College is prime time for this. NAMI notes that about 75% of mental health conditions begin by age 24, which is why the college years matter so much.

Parents, watch for this: a single sign alone usually isn't cause for alarm. A cluster of them that sticks around is worth a conversation.

How do I talk to my college student about mental health without a fight?

Pick a side-by-side moment, lead with what you've noticed, then mostly listen. Big sit-down talks feel like an interrogation. Car rides, walking the dog or late-night snacks in the kitchen feel easier.

Try something like:

• "You seem really wiped out. How's the semester actually going?"

• "I'm not trying to fix anything. I just want to know how you're doing."

If they shrug you off, that's okay. You've opened the door, and many students come back to it a day or two later.

Students: if you're reading this, telling one person at home "it's been a rough semester" counts. You don't need the whole story figured out to start.

My student is 19. What can I actually do?

Legally, less than you'd like. Practically, more than you think. Federal privacy laws mean campus counselors and doctors usually can't share information with you unless your student gives written permission.

So ask, gently, whether they'd sign a release so you can be part of the plan. Before they head back, help them find their campus counseling center's number. Offering to make the first call together lowers the bar a lot.

Can they keep seeing a therapist after they go back to campus?

Often, yes, especially if they go to school in Nebraska. A Nebraska-licensed therapist can usually keep meeting with a client by telehealth anywhere in the state.

A student at UNL, UNO, Creighton or Midland can start with a therapist in Omaha or Blair over break and keep going by video once classes resume. For out-of-state schools, the rules depend on where your student is physically located. There is an inter-state compact that is being issued that will help break down these barriers; but until it is enacted, we are limited to seeing kids in the states in which we are licensed.

FAQ

Is it normal for my college student to sleep all day over Thanksgiving break? For the first few days, usually yes. Most students arrive short on sleep after midterms and late nights. If they're still sleeping most of the day near the end of break, seem flat or hopeless, or can't get up for things they enjoy, that's worth a gentle check-in.

When is it a crisis, and who do we call? If your student talks about wanting to die, being a burden or hurting themselves, don't wait. Call or text 988, the Suicide & Crisis Lifeline, any time, day or night. Stay with them while you reach out. If someone is in immediate danger, call 911.

Can my college student do therapy by telehealth in Nebraska? Yes, if they're physically in Nebraska during sessions. A Nebraska-licensed therapist can see them in person over break and by secure video after they return to a Nebraska campus. Students at out-of-state schools may need a provider licensed where they live.

Get support over break and beyond

You don't have to figure this out alone. Focus Therapy & Performance Coaching sees young adults in person in Omaha and Blair over break, then by telehealth across Nebraska after they head back. Call 402-513-4416 or visit focustherapyomaha.com to get started.