For Jenna Kaplan, the thought of taking a day off from university to manage her anxiety disorder only made her feel worse.
The now-23-year-old graduate student remembers grappling with panic attacks and sky-high stress levels during her undergraduate degree at Concordia University while trying to shine in a highly competitive theatre program.
Tests and social events -- cornerstones of the university experience -- were triggers, but she'd try to push through. When she sought help in first year, she was told she'd have to wait five months to see a psychologist at the school. Eventually, it all took a toll.
"There's so much pressure and I didn't know my limits," she said. "I'd push myself to go to school even when I was feeling absolute crap ... and have a panic attack in the bathroom."
Data suggests Kaplan is part of a growing contingent of students who experience anxiety, depression and high stress as they navigate the post-secondary education system, prompting schools to re-examine the supports they offer in an attempt to meet students' needs.
Earlier this year, about 55,000 students across 58 post-secondary schools responded to a survey that indicated more than 60 per cent of respondents were dealing with above average or tremendous stress levels.
The National College Health Assessment also found that 23 per cent of respondents had been diagnosed with anxiety, and 19 per cent had a depression diagnosis.
In 2013 -- when 38,000 students from 32 schools were surveyed -- 12.3 per cent of students had an anxiety diagnosis, and 10 per cent had been diagnosed with depression.
Schools have spent nearly a decade trying to figure out how to address students' needs, developing a patchwork of policies and initiatives to boost mental health and treat existing anxiety before it becomes a larger issue, said Paul Davidson, president of Universities Canada.
The advocacy organization, which represents 95 universities, has been working with institutions to figure out what works best.
It is also among a group gearing up to release a draft of the first voluntary standard for psychological health and safety of post-secondary students. The document will be up for public review until Oct. 31, and a final version is expected early next year.
One of the key considerations, Davidson said, is that each school has unique needs.
"Universities across Canada are very diverse," he said. "You've got large urban universities with close proximity to the most advanced health care in the world, and you've got smaller universities that are some distance from mental health supports."
An urban school can lean more on the broader mental health-care system, he said, while rural schools should make sure they have their own infrastructure in place.
Schools must also take students' lifestyles into account, Davidson said. If a school is made up mostly of students in residence, it makes sense to have in-person supports, but if it's a commuter school or a university that offers most courses online, services offered on the web or over the phone might be more appropriate.
Kevin Friese, assistant dean of students for health and wellness at the University of Alberta, said figuring out which services the school should offer and what should be left to the broader system has been a years-long journey.
"No one support is going to be the silver bullet," he said. "What works for one person may not necessarily be the right fit for another."
Friese said his Edmonton-based school offers a variety of services that include traditional counselling, peer support groups, on-campus outreach programs and an online platform called WellTrack that's used in several schools.
The service has educational modules based on techniques used in cognitive behavioural therapy that help students change their thought patterns. It also has a survey that helps users track their well-being.
But equally important, Friese said, is figuring out how the University of Alberta fits into the broader mental health system.
Students with more intensive needs -- for instance those who will likely need clinical support for much of their lives -- might be better served outside of the university, he noted. The school will connect students with outside support if needed, he said.
The school will also help students find support outside the university microcosm when they're approaching graduation, he said.
This is particularly important because fear about the transition to the so-called "real world" is top of mind for students, said Andrea Howard, an associate professor of psychology at Carleton University in Ottawa.
She said fears around employment stability and financial health abound among post-secondary students.
"Those sorts of day-to-day stressors can really accumulate," Howard said. "Those are the kinds of things that we see setting off symptoms, setting off eventually episodes of anxiety or depression."
That's compounded by the fact that when students head off to post-secondary, they're often away from their parents and other supports for the first time -- at a life stage when mental illness is most likely to present itself, she said.
When the everyday stressors grew too overwhelming for Kaplan in her second year of undergrad, she got a doctor's note and took a week off to regroup with her family, reconnecting with the support network she'd left behind. She also found alternate ways of coping, and has started practising mindfulness.
But the grin-and-bear-it strategy she used to employ is still all too common among her peers and needs to be addressed, she said.
"We drink a ton of coffee, put on some makeup and just go to class."