Heart racing, tears streaming down her face, Piper Lewis could only hold her knees close and wait for her body to quiet.

The feeling of being out of control had spread from her situation—one of homework deadlines and computer issues—to her body. She was shaking, hyperventilating and crying; all were physical responses over which she had no control.

Just three years ago, massage therapy major Lewis had never experienced a panic attack. But with the stress of college and life compounding, they were all too familiar to her by the time she faced this latest stressor.

In a 2015 study by the American College Health Association of more than 93,000 students on 108 campuses, 53 percent of them said they felt “more than average” or “tremendous” levels of stress. Thirty-six percent of those surveyed said a professional had formally diagnosed them with anxiety, panic attacks or depression—all mental health disorders for which stress can be a major contributor.

After her panic attack, Lewis reduced her work schedule and made self-care activities an integral part of her daily life.

AACC students, faculty and counselors have this advice for students for managing their stress:
1. Create a schedule.
Laying out big assignments for each class helps students get a “helicopter view” of a semester that is helpful not only for time management, but to gauge whether they are taking too many classes, said psychology professor Dr. Kellie McCants-Price.

2. Schedule time for self-care.
“Self-care is something that is very quick to go by the wayside when you get really busy,” said McCants-Price. Whether it’s scheduling an hour at the gym, making a salon appointment or setting aside Friday evenings for time with friends, McCants-Price said it’s important to deliberately block out time for self-care.

3. Make a list of things you enjoy.
For example, Lewis said getting up when her body naturally awakens and spending time doing religious devotionals are most effective for her.
AACC counselor Marguerite Falcon suggested spending time with friends, exercising, borrowing a friend’s dog for a walk in the park or even learning to skydive.

4. Give yourself permission to say “no.”
Lewis said the biggest breakthrough for her so far has been learning to “use her voice” to say when she is overwhelmed so she doesn’t take on too many responsibilities.
“I can’t do it all,” she said, “and that’s OK, because we’re all human.”

5. Build a network of supportive family or friends.
McCants-Price said it’s important to have friends or family who will help you be “the best you that you can be.” They might even notice before you do when your stress levels are getting too high, she said.

6. Ask for help.
Most professors want to help their students succeed, said McCants-Price, but they can’t help if they don’t know a student is struggling. If you speak up, you may find them willing to give one-on-one tutoring or occasionally extend a deadline to allow for difficult circumstances.
7. Step away from technology.
Whether you’re taking a walk alone or spending time with friends, put the phone away and be present, suggested McCants-Price.

8. Don’t use short-term coping solutions like drugs or alcohol.
Substances may relieve the stress of the moment, but they’re no substitute for developing real coping strategies, said McCants-Price.

9. Get professional counseling.
“Don’t be afraid to ask for help if you feel like you’re sinking,” said McCants-Price. “You’ll only sink further if you don’t.”

AACC has four counselors who see students for free for up to three visits per incident.