Krista Van Slingerland remembers being so anxious about playing varsity basketball in her first year at Ottawa's Carleton University that she would vomit before practices.

By her third year, she had nearly stopped eating, was barely sleeping and was overwhelmed by negative thoughts.

Things got so bad that she started cutting her arms with a steak knife.

Her coach noticed she was suffering and asked her to quit the team. It was a low point, but she found help.

She was diagnosed with depression, received talk therapy and medication, and began to feel better.

Now, at age 22, Van Slingerland wants make sure other student athletes don't have to endure what she did.

That's why she and a fellow student-athlete, Samantha DeLenardo, started the Student-Athlete Mental Health Initiative (SAMHI) last year on campus at the University of Ottawa, where Van Slingerland is now pursuing a master's in Human Kinetics.

SAMHI is an awareness group that is spreading the word about the unique challenges student athletes face -- like coaches who push too hard, and the fear of losing social support should they ever leave the team.

They post stories from suffering student athletes on their website, and promote them on social media.

Members also speak publicly, sharing their experiences with varsity teams on campuses around North America and encouraging the groups that govern athletics to develop mental health policies.

Later this year, DeLenardo will address both the Ontario Coaches Conference and the annual general meeting of Canadian Interuniversity Sport, the main group overseeing varsity athletics in Canada.

Van Slingerland, meanwhile, is working on a nationwide survey about student athlete mental health that she hopes will inform policies.

One thing they are trying to get across is that student athletes often face more pressure than the average student.

"Being a rookie sucks and everyone knows it," says Van Slingerland. "It's emotionally and physically exhausting."

It's also hard on self-esteem.

"You go from a point where you're really good in your sport because you're the oldest," she says, "to a point where you're not the best, and you're maybe sitting on the bench."

On top of that, non-athletes may not understand how important sports can be to an athlete's identity.

For example, the first counsellor Van Slingerland consulted about her mental health concerns didn't seem to realize how hard it would be to quit the team -- not just because she had put so much work into it, but also because fellow athletes had become her main source of social support.

Social support is needed even more when someone is struggling. Another common problem is coaches who put winning above athlete health.

At Carleton, the coach pushed Van Slingerland to be mentally tough, which made her anxious, and made it even harder to admit she was struggling.

Shaunna Taylor, a private athlete counsellor who sits on the board of the Canadian Sport Psychology Association (CSPA), agrees that student athletes face unique mental health challenges.

"The extra time demands, performance pressure and coaching styles make them more vulnerable," she says. "It's hard enough being a first-year student."

Taylor agrees that coaches can be part of the problem.

"Some are very mindful," she says, "others are dictatorial."

She suggests that many coaches could do better if they take a 'Mental Health First Aid' course from the Mental Health Commission of Canada.

Van Slingerland, meanwhile, is back on the courts after a year away, during which she focused on her health and getting into graduate school.

Things are much better on her new team at Ottawa U., thanks in part to a "mental health action plan," that she made and shared with her coach and teammates. She wrote down what can trigger her depression, what it looks like when she is suffering, and how people can help if they believe she is in trouble.

Now, instead of being asked, 'how are you physically feeling?' her coaches and teammates ask, 'How are you mentally?' she says, and 'How can we help?'