 |
 |
 |
|
When I took a part-time
job and started living off-campus, my course work fell apart.
I couldn't concentrate or sleep, and I was always IRRITABLE
and angry. - Leah, sophomore year
|
After two years of straight
A's, I couldn't finish assignments anymore. I felt exhausted
but couldn't sleep, and drank A LOT. I couldn't enjoy life
like my friends did anymore. - John, junior year
|
I've always been anxious
and never had much confidence. College was harder than I expected,
and then my parents divorced, which was traumatic for me.
After a while, all I did was cry, sleep, and feel waves of
panic. - Marta, freshman year
|
They are college students who got depressed...got treatment...and
got better.
College offers new experiences and challenges. This
can be exciting - it can also be stressful and make you, or someone
you know, feel sad. But when "the blues" last for weeks,
or interfere with academic or social functioning, it may be clinical
depression. Clinical depression is a common, frequently unrecognized
illness that can be effectively treated.
What is Clinical Depression?
Clinical depression can affect
your body, mood, thoughts, and behavior. It can change your eating
habits, how you feel and think about things, your ability to work
and study, and how you interact with people.
Clinical depression is not
a passing mood, a sign of personal weakness or a condition that
can be willed away. Clinically depressed people cannot "pull
themselves together" and get better.
Depression can
be successfully treated by a mental health professional or certain
health care providers. With the right treatment, 80 percent of those
who seek help get better. And many people begin to feel better in
just a few weeks.
Types of Depressive Illness
Depressive illnesses come in
different forms. The following are general descriptions of the three
most prevalent, though for an individual, the number, severity,
and duration of symptoms will vary.
Major depression is manifested
by a combination of symptoms that interfere with your ability to
work, sleep, eat, and enjoy once pleasurable activities. These impairing
episodes of depression can occur once, twice, or several times in
a lifetime.
Symptoms of Major Depression
- Sadness, anxiety, or "empty"
feelings
- Decreased energy, fatigue,
being "slowed down"
- Loss of interest or pleasure
in usual activities
- Sleep disturbances (insomnia,
oversleeping, or waking much earlier than usual)
- Appetite and weight changes
(either loss or gain)
- Feelings of hopelessness,
guilt, and worthlessness
- Thoughts of death or suicide,
or suicide attempts
- Difficulty concentrating,
making decisions, or remembering
- Irritability or excessive
crying
- Chronic aches and pains not
explained by another physical condition
A less intense type of depression,
dysthymia, involves long-term, chronic symptoms that are
less severe, but keep you from functioning at your full ability
and from feeling well.
In bipolar illness (also
known as manic-depressive illness), cycles of depression
alternate with cycles of elation and increased activity, known as
mania.
How to Recognize Depression
The first step in defeating depression
is recognizing it. It's normal to have some signs of depression
some of the time. But five or more symptoms for two weeks
or longer, or noticeable changes in usual functioning, are all
factors that should be evaluated by a health or mental health professional.
And remember, people who are depressed may not be thinking clearly
and may need help to get help.
I kept
asking myself, "How could I be depressed? I'd had a normal
family life, had been getting good grades, and hadn't experienced
any big trauma - where did my depression come from?" -
John
What Causes Depression?
The causes of depression are
complex. Very often a combination of genetic, psychological and
environmental factors is involved in the onset of clinical depression.
At times, however, depression occurs for no apparent reason. Regardless
of the cause, depression is almost always treatable.
Family History - Depression
often runs in families, which usually means that some, but not all,
family members have a tendency to develop the illness. On the other
hand, sometimes people who have no family history also develop depression.
Stress - Psychological
and environmental stressors can contribute to a depressive episode,
though individuals react differently to life events and experiences.
In coping with stress, some people
find writing in a journal, exercising, or talking with friends helpful.
But in clinical depression you need some form of treatment (usually
medication and short-term psychotherapy) to start feeling better
soon.
I had a
period of nearly constant turmoil when I wanted to "come out"
to my friends about being gay but didn't want to be treated like
an outsider. A good friend made jokes about homosexuals and I was
afraid of what he'd say about me. That stress played a big part
in my becoming depressed. - Josh
My family
wanted me home every other weekend and I didn't fit in there anymore.
I'd argue constantly with my father, who still treated me like a
child. My sister thought I was 'uppity.' Everyone was miserable
and I felt guilty. - Kim
College and Stress
Common stressors in college life
include:
- Greater academic demands
- Being on your own in a new
environment
- Changes in family relations
- Financial responsibilities
- Changes in your social life
- Exposure to new people, ideas,
and temptations
- Awareness of your sexual identity
and orientation
- Preparing for life after graduation
Psychological make-up
can also play a role in vulnerability to depression. People who
have low self-esteem, who consistently view themselves and the world
with pessimism, or are readily overwhelmed by stress may be especially
prone to depression.
For Marta, her feelings of being
"not good enough" were worsened by the stress of the academic
demands of college and the emotional conflict caused by her parents'
divorce, which combined to trigger her episode of major depression.
Bipolar Disorder (Manic Depression)
As mentioned earlier, bipolar
disorder is a type of depressive illness that involves mood swings
that go from periods of depression to periods of being overly "up"
and irritable. Sometimes the mood swings are dramatic or rapid,
but most often they occur gradually, over several weeks. The "up"
or manic phase can include increased energy and activity, insomnia,
grandiose notions and impulsive or reckless behavior, including
sexual promiscuity.
Medication usually is effective
in controlling manic symptoms and preventing the recurrence of both
manic and depressive episodes.
During
a manic episode, I stayed awake for five days straight, but had
a lot of energy. I spent my tuition on a major shopping spree and
long distance phone calls. I also had sex with several guys that
I hardly knew. At the time, I felt so great that I couldn't see
that there were serious problems with what I was doing. - Teresa
Suicide
Thoughts of death or suicide
are usually signs of severe depression. "If you're feeling like
you can't cope anymore, or that life isn't worth living, get
help," advised Darrel, a student who tried to kill
himself during his freshman year. "Talking to a professional
can get you past those intense feelings and save your life."
Suicidal feelings, thoughts,
impulses, or behaviors always should be taken seriously.
If you are thinking about hurting or killing yourself, SEEK HELP
IMMEDIATELY. Contact someone you trust to help you: a good friend,
academic or resident advisor, or:
- Staff at the student health
or counseling center
- A professor, coach, or advisor
- A local suicide or emergency
hotline (get the phone number from the information operator or
directory)
- A hospital emergency room
- Call 911
If someone you know has thoughts
about suicide, the best thing to do is help him or her get professional
help.
"I'm back from the edge,"
Darrel continued. "Now that I've gotten some treatment, I know
how to keep from being out there again."
Depression and Alcohol and Other Drugs
A lot of depressed people, especially
teenagers, also have problems with alcohol or other drugs. (Alcohol
is a drug, too.) Sometimes the depression comes first and people
try drugs as a way to escape it. (In the long run, drugs or alcohol
just make things worse!) Other times, the alcohol or other drug
use comes first, and depression is caused by:
- the drug itself, or
- withdrawal from it, or
- the problems that substance
use causes.
And sometimes you can't tell
which came first... the important point is that when you have both
of these problems, the sooner you get treatment, the better.
Getting Help - Treatment Works
If you think you might be depressed,
discuss this with a qualified health care or mental health professional
who can evaluate your concerns. Bring along an understanding friend
for support if you are hesitant or anxious about the appointment.
Several effective treatments
for depression are available and can provide relief from symptoms
in just a few weeks. The most commonly used treatments are psychotherapy,
antidepressant medication, or a combination of the two. Which is
the best treatment for an individual depends on the nature and severity
of the depression.
Sharing your preferences and
concerns with your treatment provider helps determine the course
of treatment. Certain types of psychotherapy, particularly cognitive
behavioral therapy, can help resolve the psychological or interpersonal
problems that contribute to, or result from, the illness. Antidepressant
medications relieve the physical and mood symptoms of depression
and are not habit-forming. In severe depression, medication is usually
required.
Individuals respond differently
to treatment. If you don't start feeling better after several weeks,
talk to the professional you are seeing about trying other treatments
or getting a second opinion.
Making a Decision
Don't let fear of what others might say or think
stop you from doing what's best for you. Parents and friends may
understand more than you think they might, and they certainly want
you to feel better.
Taking the First Step
I knew I was depressed
but thought I could pull out of it by myself. Unfortunately, friends
reinforced this attitude by telling me to just toughen up. When
that didn't work, I felt even worse because I had 'failed' again.
When a friend suggested I talk to his counselor, I resisted at first.
In my mind, professional help was for weak, messed up people. But
then, I hit a bottom so low that I was willing to try anything.
- John
I decided
to try treatment when my friends got fed up with me. They didn't
want to talk about my problems any more, but my problems were the
major focus of my life. I needed someone who could help me understand
what was happening to me. I'd seen ads for the counseling center
and decided to give it a try. - Kim
When I
began considering suicide, I knew I needed serious help. My resident
advisor helped me call a local hotline where I got some good referrals.
It was just a phone call, but it was the starting point that got
me to the professional help I needed. - Leah
Help Yourself: Be an Informed Consumer
Don't give in to negative thinking.
Depression can make you feel exhausted, worthless, helpless and
hopeless, making some people want to give up. Remember, these negative
views are part of the depression, and will fade as treatment takes
effect.
Take an active role in getting
better. Make the most of the help available by being actively
involved in your treatment and by working with a qualified therapist
or doctor. Once in treatment, don't hesitate to ask questions in
order to understand your illness and the way treatment works. And,
if you don't start feeling better in a few weeks, speak with the
professional you are seeing about new approaches.
Be good to yourself while
you're getting well. Along with professional help, there
are some other simple things you can do to help yourself get better,
for example: participating in a support group, spending time with
other people, or taking part in activities, exercise, or hobbies.
Just don't overdo it and don't set big goals for yourself. The health
care professional you are seeing may suggest useful books to read
and other self-help strategies.
Helping a Depressed Friend
The best thing you can do for a depressed friend
is to help him or her get treatment. This may involve encouraging
the person to seek professional help or to stay in treatment once
it is begun. The next best thing is to offer emotional support.
This involves understanding, patience, affection, and encouragement.
Engage the depressed person in conversation or activities and be
gently insistent if you meet with resistance. Remind that person
that with time and help, he or she will feel better.
Helpful Resources
The professionals at a student
health center or counseling service, the Resident Advisor in your
dorm, your family health care provider, and your clergy can be helpful
resources for getting treatment. You also might contact any of the
following organizations in your area for mental health services
or referrals:
- A community mental health
agency
- A hospital psychiatric outpatient
department or clinic
- A private or nonprofit counseling
center
- Your local Mental Health
Association
The telephone directory or information
operator at your school or in your community, or a local hotline,
should have telephone numbers for these and other mental health
services.
Finding Affordable Treatment
People are sometimes reluctant to seek help because
they are concerned about the cost of treatment. Services at college
counseling centers are often low-cost or free. Also city or county
mental health services are often offered on a "sliding scale" (the
fee is based on your financial resources). Check out any health
insurance you may have and see if it pays for private mental health
services.
Is It Worth It?..........Yes!!
Actually, while the depression
was painful, working to get better has taught me a lot about who
I am and how to stay healthy. - Marta
Getting
treatment definitely changed my life for the better and helped me
avoid flunking a semester. - John
For Additional Information About Depression Write To:
6001 Executive Boulevard, Room
8184, MSC 9663
Bethesda, MD 20892-9663
For free brochures on depression
and its treatment, call: 1-800-421-4211.
For More Information About NIMH
The Office of Communications
and Public Liaison carries out educational activities and publishes
and distributes research reports, press releases, fact sheets, and
publications intended for researchers, health care providers, and
the general public. A publications list may be obtained by contacting:
Office of Communications and
Public Liaison, NIMH
Information Resources and Inquiries Branch
6001 Executive Blvd., Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513
TTY: 301-443-8431
FAX: 301-443-4279
Mental Health FAX 4U: 301-443-5158
E-mail: nimhinfo@nih.gov
NIMH home page address: http://www.nimh.nih.gov
NIH Publication No. 97-4266
|
