KRT CampusNew data from Student Health and Counseling Services shows that 17.8 percent of female students and 8.9 percent of male students at Washington University are currently diagnosed with depression. Corresponding national figures from a similar study are 14 percent and 7 percent.
“I think that our sample was large enough that the difference even in the case of men is likely significant,” wrote Alan Glass, director of Student Health and Counseling Services (SHCS), in an e-mail. He called depression one of the top three health problems facing colleges today, and a major problem at the University.
“The age group 18-25 has a really high incidence of depression,” he said in an interview.
The University data is from the National College Health Assessment, which SHCS administered to randomly selected students in October, while the national data was collected in a 2002 administration of the same study.
“We never before had data from our student body,” Glass said. “This is good data.”
Owing to the stigma attached to the disease, many college students remain unaware of the prevalence of depression in their peers.
“I don’t talk about it,” said sophomore Denise Umpierrez. “It’s a more of a personal thing. It’s a hard topic to talk about.”
Glass said that stigma is the biggest obstacle in helping students with depression get the treatment they need.
“We’re overcoming years worth of stigma around mental health issues,” he said.
The illness
Depression is a mental illness characterized by loss of energy, changes in appetite, irritability, sleep problems, feelings of worthlessness, difficulty concentrating, and suicidal or morbid thoughts according to the American Psychiatric Association.
“Hopelessness for me is what it was,” said Christine Win, class of 1998. “You feel so isolated, so cut off, that you can’t reach out to others.”
Ben Schartman, class of 2001, said that depression made his life burdensome.
“You don’t necessarily feel sad, just lifeless and ambitionless,” he said. “A little bit hopeless. I think I felt trapped, too, and out of my depth. Everything in my life became a burden.”
Though there is a genetic component to the illness, many of the risk factors are environmental. Stress is a trigger for depression and is common in college, explained Glass.
The stress factor is particularly important with exams coming up. EST Field Director Matthew Vogt said that EST sees an increase in mental health calls at the end of the semester, though these are not just depression-related calls.
Win said that exam time reveals students’ underlying depression, but does not necessarily cause it.
“Most likely the underlying problem is there through the semester,” she said. “During exam time, their coping mechanisms are severely deflated, so that’s why they see the symptoms.”
The stigma
According to Schartman, going through depression or seeing someone going through it destigmatizes the illness.
“The largest problem I had with depression was coming to accept it and admit to myself that I was depressed,” Schartman said.
He said he eventually tired of his happy facade and accepted the illness.
“I got sick of lying to myself and to other people,” said Schartman. “I got so damn tired of answering the universal question, ‘How are you doing?’ with, ‘Fine.’ It just felt so liberating to tell people the truth, that I wasn’t fine at all.”
Win was hospitalized for depression while in college, and afterwards worked to demystify the illness for others.
“I made it a priority to talk to students about depression,” she said. “I had a lot of success doing that. I was asked to come to sororities and to student groups.”
Now, as coordinator for peer health education in the Office of Health Promotion and Wellness (OHPW), Win works information about depression into many of the presentations she gives.
“If I’m doing a program about stress, I work in some sort of reminder that mental health can certainly be impacted by our nutrition, exercise and our stress level,” she said.
Francis Flanegan, a sophomore who has a family history of depression, said being close to depression made it easier for him to accept its frequency.
“I’m always on the lookout for symptoms,” he said, adding that he knows “at least half a dozen” depressed students.
The treatment
The American Psychiatric Association says that 80 to 90 percent of depressed people significantly benefit from treatment, and nearly everyone improves with medical care.
“Students don’t know how common it is, how treatable it is,” said Melissa Ruwitch, coordinator of OHPW.
Common treatments include psychotherapy and medication. Studies show that combining the two offers the best chance to successfully treat depression and prevent a relapse.
However, among students diagnosed with depression nationwide, only 35 percent are on anti-depressants and 24 percent are in therapy, according to the 2002 National College Health Assessment.
Psychotherapy is commonly called “talk” therapy, because a patient sits down with a therapist to talk about his or her problems. Aside from being a confidant, the therapist may give the patient advice on how to deal with depression day to day and help the patient through the illness.
“I did see a counselor here at SHCS,” recounted Schartman. “It was a good experience.”
Schartman said the counseling helped him to pull away from the high-stress academic environment, a key step in controlling his depression.
“I made my life and my expectations for myself a lot simpler, a lot humbler,” he said.
Anti-depressants-prescribed by psychiatrists, not psychologists-come in various forms, thanks to the pharmaceutical boom. All of them work by correcting the brain’s biochemistry, but different drugs act on different neurotransmitters. On a given person, certain drugs may work while others may not; and even with drugs that act on the same thing, results may vary.
A psychiatrist originally prescribed Schartman Prozac, which acts on the neurotransmitter serotonin. Schartman said the drug did not treat his depression.
“I didn’t feel like it had any effect,” he said. “It made me slightly less sexually active.”
However, he said that Lexapro, another drug that acts on serotonin, did help.
Serotonin-affecting drugs are under new scrutiny because they may increase the risk of suicide in users. Also, sexual side effects are common in these drugs. Other anti-depressants that act on different neurotransmitters have different side effects, often mild.
The consequences
Left untreated, depression can be harmful or even fatal.
“I’ve been depressed,” said one junior who requested his name not be used. “I dealt with it by abusing alcohol.”
Studies from the National Institutes of Health show that half of substance abusers also suffer from mental disorders like depression. A 1990 study in the Journal of the American Medical Association found that about 18 percent of depressed patients had a substance abuse disorder.
For most depressed students, the illness often translates into a poor GPA or difficulty with friends.
“As far as academic performance, when students are depressed, it’s really hard to function,” Glass said.
According to the National College Health Assessment, 39.4 percent of Washington University students felt so depressed at least once in the last year that they could not function.
But the biggest specter hanging over depressed students is the risk of suicide.
“It’s certainly possible to have suicide without depression, but depression is a major risk factor for suicide,” said Glass, later stressing, “Most people who are depressed do not become suicidal.”
The Jed Foundation, a college mental health group, reports that suicide is the second leading cause of death among college students. One in 12 college students make a suicide plan, and 7.5 out of 100,000 actually commit suicide.
“When I was a student here there was a successful suicide,” said Win. “I believe in this case it was an RA who was depressed.”
The solution
University health officials said that depression is a high priority, and they are taking active steps to address the problem.
“We’ve increased the number of counselors and psychiatrists,” Glass said. “Counselors from SHCS are actually assigned to residence halls so they develop a good working relationship with staff and students.”
Glass said the National College Health Assessment would also help the University combat depression.
“Collecting data, and careful analysis of that data, will help us allocate resources,” he said.
Ruwitch said that addressing depression ultimately requires “getting more of our clinicians in front of students.” However, she noted it is difficult to raise awareness throughout the University community.
“The challenge is getting people to come to something that’s about a depressing subject,” she said.
The last major depression awareness event took place in November 2002, when “Real World” star and University alumna Cara Kahn spoke in Graham Chapel about her experiences with depression. Additionally, two University health officials spoke.
Ruwitch said that large-scale efforts like Kahn’s lecture are difficult to organize. That event was a lucky break for the University, since it basically came pre-organized by sponsor Wyeth Pharmaceuticals.
Asked why there have not been more large scale events raising awareness about depression, Ruwitch responded that as prevalent as depression is, there are so many health problems in college that the University cannot just focus on one.
“There are a lot of important topics,” she said. “Depression is one of them,” adding that depression, for her, is one of the ten most important health problems.
Glass cited awareness as a key to removing the stigma from depression.
“My goal is to make it so that it’s no bigger deal to come to SHCS for anxiety and depression than a sore throat,” he said.