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Feeling down lately? Depressed? Or are you worried about a persistently despondent friend or family member? You’re not alone. How to handle your own depression and help others who may be depressed are among the most common questions we receive at Student Health 101.

About seven percent of adults in the US experience a major depressive episode each year, according to The National Survey on Drug Use and Health (2012). In a 2012 survey of students with diagnosed mental health issues, depression was the most commonly cited condition, says the National Alliance on Mental Illness (NAMI).

Clinical depression can be a serious impediment to academic success and a risk factor for dropping out of school. Yet the majority of students surveyed by NAMI (57 percent) had not accessed the clinical services or academic accommodations designed to help them recover and succeed.

Martha,* 44, is an online student studying early childhood education. She struggles to balance coursework with her responsibilities at home. Nearly two decades ago, Martha was diagnosed with depression—the mental health issue that affects an estimated 16 million adults in the US every year.

Decline

Martha always had a passion for education, yet being a student has become exhausting. Her rigorous workload and high standards for herself, combined with family demands, are barriers to finding the time and space she needs in her life.

She takes up to 50 hours a week to tackle a full-time load of online courses. “It just feels like school work is all there is. The online courses roll one to the next without a break, so I am putting constant pressure on myself,” Martha says. “I love to learn, but that feeling has fallen away. Now, school feels like it’s killing me.”

Martha has no time to work, so money is tight and she lacks health insurance. She has little opportunity for activities she enjoys, nor energy for them.

These stressors could be exacerbating Martha’s depression. Stressful episodes, including academic and personal problems, can increase the risk of developing depression or cause a recurrence for those who have suffered previously.

Treatment

Having undergone treatment in the past, Martha has developed some of the coping skills needed to tackle the symptoms of her depression. “We all need time to relax,” she says.

She took a month off over the summer to spend more time with her husband, adult daughter, and teenage son. “I usually don’t have much time to hang out with them, but summer should be summer,” she says. She also no longer home schools her children.

Martha will regain health insurance in a few months and will seek professional treatment for her depression. Martha says her “drug of choice” is exercise, which relieves stress and boosts her mood. Prayer helps her achieve a sense of calm. Going to the movies provides escape. Martha is about halfway through her four-year program and is trying to keep things in perspective. “I have to hang in there and have confidence everything will work itself out.”

*Name changed for privacy.

What is depression?

Depressed is a word we hear a lot. “I feel depressed.” “You okay? You seem depressed.” Usually, it’s not immediately obvious whether we’re talking about a passing sense of discouragement that almost everyone experiences at times, or clinical depression, the debilitating mental health condition. Here’s how to tell the difference:

“Depression is a common but serious mental illness typically marked by [persistent] sad or anxious feelings,” according to the National Institute of Mental Health (NIMH). “It interferes with daily life and causes pain for both you and those who care about you.” Depression is mostly characterized by deep despondency that lasts most of each day for longer than two weeks, limiting everyday functioning.

  • Major depressive disorder is disabling enough to interfere with daily functioning.
  • Milder, chronic depression is called dysthymia.
  • Minor depression tends to be less severe or shorter term. Left untreated, it’s a risk factor for major depressive disorder.

What are the symptoms?

  • Prolonged sadness for at least two weeks
  • Loss of interests and pleasure (anhedonia)
  • Anxiety, agitation, or restlessness (akathisia)
  • Anger or increased irritability
  • Difficulty concentrating, organizing, and making decisions (executive dysfunction)
  • Internal loneliness
  • Feelings of guilt and hopelessness
  • Thoughts of death and suicide
  • Fatigue
  • Changes in appetite, with weight gain or loss
  • Unexplained physical ailments (somatic symptoms)

How depressed are students?

  • Among full-time college students aged 18—22, eight to nine percent experienced a major depressive episode in the past year, according to The National Survey on Drug Use and Health (2008—2010 data). Among US adults aged 18 and older, the rate was just under seven percent.
  • Thirty-one percent of college students reported feeling “so depressed that it was difficult to function” at some time in the past year, in a 2013 survey by the American College Health Association National College Health Assessment. (This is not a measure of diagnosed clinical depression.)
  • Almost 20 percent of people with depression report being diagnosed before age 18, according to NAMI.
  • Women appear to be more vulnerable to depression than men.

WHAT ARE SCIENTISTS DOING ABOUT DEPRESSION?

Depression research is multi-disciplinary, involving a variety of scientific methods. Its ultimate goal is effective prevention and treatment. Areas of investigation include:

  • The functional, structural, and neurochemical brain differences that characterize depression.
  • Identifying risk factors: psychological, behavioral, genetic, and/or neurobiological.
  • The enduring effects of childhood abuse and neglect in increasing vulnerability to depression.
  • The effects of psychotherapy on brain mechanisms and symptoms of depression.
  • Identifying the brain mechanisms that increase the likelihood of self-injury and suicide.
  • The neurobiology of executive dysfunction, which appears to be related to an abnormally intense reaction to errors and negative feedback.
  • Neurobiological predictors of treatment response in depression, to improve treatment selection and minimize the trial-and-error approach.

WE ASKED STUDENTS HOW THEIR FRIENDS AND FAMILY HELPED THEM THROUGH DEPRESSION

* names changed for privacy

They pointed me in the direction of professional resources and spent time doing activities with me.
Dave K., graduate student, Emory University in Atlanta, Georgia

They support me and don’t try to fix everything. They understand that it is a chemical imbalance and not a defect in my own personality.
Carol M., graduate student, University of Wyoming in Laramie

Friends have checked in on me by calling or stopping by, making food and bringing it over, and asking me out to get me out of the house.
Ashley M., Valencia College in Orlando, Florida

It was important that I took the first step by sharing my difficulties with depression. I have had many supportive people that haven’t fixed it for me, but provided me with resources and opportunities to work with my depression.”
Rachel G., University of California, Irvine

They nudged me out into the sunshine—helped me get or stay active. For me, it is the light and getting out. My friends are great at taking the time, making the time, to help me get out and be in the world instead of in the shadows watching or hiding away completely.
Mike J., Michigan Tech University in Houghton

Any period of transition can sometimes lead to depression. I have found that the key is to keep fighting it by not letting depression stand in the way of my long-term goals. My family has anyways encouraged me by reminding me that, no matter what happens, life goes on and that they will always be there to support me.”
Andrew K., graduate student, Northern Illinois University in Dekalb

Understanding depression


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Frances Raquel Narvaez lives in Vancouver, BC, Canada. She is pursuing a Master's in Journalism at the University of British Columbia.