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

About eight percent of college students experience a major depressive episode each year, according to The National Survey on Drug Use and Health (2008–2010). 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 college. 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.

Johnathan, 21, majors in writing and music at a Massachusetts college. His buoyant smile belies the 18 months he has spent recovering from depression—the most commonly diagnosed mental health issue among college students, according to a 2012 NAMI survey.

Trigger & decline

Johnathan was a first-year student in college when a serious romantic relationship ended. “I would often feel I didn’t deserve to find love and companionship,” he says. In addition, he struggled academically: “I had teachers who put me down and made me feel like a failure in music.”

As his mood declined, Johnathan stopped practicing music. “I’d stare at a wall…I didn’t really have the energy. He awoke in the middle of the night, and feared going to some of his classes, which seemed to give him headaches and stomachaches. His grades declined from As to Cs. “The weird thing about depression is when you have it, it’s like a smoke that surrounds you. It makes every one of your passions and brightest qualities hazy,” he says. The feeling of being alone became hard to shake. When he talked to old friends and his parents about his feelings, “I felt like I was being a burden and overly dependent on them for help.”

“There was one night when I thought of jumping off a bridge. Maybe if people saw my face on some five-minute news clip, they’d care.”

The thought of his family and friends, and his twin brother, who passed away in infancy, changed his mind. “I felt as if there was more that I was meant to do. The very moment I decided not to take my life was the moment I decided to truly live,” he says.

Treatment

Halfway through Johnathan’s first year, Student Life staff noticed the “depressing” poems he posted on Facebook. They helped him get an assessment, and shortly afterward he was diagnosed with depression.

Johnathan underwent counseling and became more able to share his experiences. “As long as you realize that in the end, only you are the creator of your own happiness, it is okay to talk to friends and lean on them for support–as long as you are there for them as they are for you. It is okay to be vulnerable.” He also started a band. “I now measure my worth not by where I end up (acquisitions or achievements) but by the good I do along the way.”

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 young adults?

  • 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). About 40–45 percent of them received treatment.
  • 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 made my first therapy appointment and drove me there. That was the only way to get me to go, but I’m so glad that I did.
    Mark H.*, University of Wisconsin, Stout
  • Don’t try to relate, don’t try to offer advice, just listen when I need to talk.
    Leila J.,* Drexel University in Philadelphia, Pennsylvania
  • I found that a close friend of mine had recently experienced worse and was able to make improvements in her situation. This made me realize it’s more common than I thought to actively address depression.
    Jen P.,* Valencia College in Orlando, Florida
  • My older brother taught me how to run a workout. I learned to use exercise and sports as incredibly effective stress management. It really changed my life.
    Miriam K., University of Rochester, New York
  • My campus provides group therapy, which helps a lot. There are resources there, you just need to use them!
    Sarah G., Northern Illinois University in DeKalb
  • Friends recorded a video of themselves saying words of comfort and saying funny things to make me laugh.
    Lee N.,* Johns Hopkins University in Baltimore, Maryland
  • My younger sister looked me in the eyes and challenged me to not become someone who falls through the cracks. She inspired me to be better, and she doesn’t even know it.
    Dana H.,* University of Colorado in Colorado Springs
  • The biggest help is when people are willing to spend time with you, even when you’re not fun to be around
    Aryelle Y., University of Wyoming in Laramie
  • So many people when they get down block people from their life. Let them try and make you happy.
    Sam S.,* University of Minnesota Rochester
  • My best friend finally sat me down and said, “It’s okay that you’re sad. You don’t have to be happy all the time.” I was finally able to actually address my depression and get to a better place.
    Abigail Z., Colorado School of Mines in Golden
  • I have been hospitalized three times for suicidal depression. Sometimes knowing how loved/supported I am actually made it harder because it made me feel guilty that their love/support wasn’t enough to make me not depressed. It was such a catch-22, though, because I couldn’t have made it through those times without their support.
    Candy M.,* University of Rochester, New York

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.