College and Depression

by National Institute of Mental Health (NIMH)

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 2 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.

About the Author

www.nimh.nih.gov
The National Institute of Mental Health (NIMH) is one of 27 components of the National Institutes of Health (NIH), the Federal government's principal biomedical and behavioral research agency. NIH is part of the U.S. Department of Health and Human Services.