Depression can hurt college students

Cynthia T. Pegram / Lynchburg News & Advance
Published: January 10, 2008

Depression can come into a student's life without telltale glumness and the blues - it can be relentless fatigue, edgy temper, inability to concentrate and constant friction with roommates.

"Depression is the number one issue students bring to our office," said Anne Hershbell, clinical director of Counseling Services at Lynchburg College.

"They talk about a cluster of issues, but depression is behind it," said Hershbell, a licensed clinical psychologist and one of three speakers at Thursday's faculty and staff workshop at LC on "Depression and the college

student."

Depression is a mood disorder, and can be treated by a number of methods, including medication and cognitive behavioral therapy.

Helping the depressed student calls for awareness within the campus community - from other students, to faculty, staff, the health center, chaplain's office, counseling center, academic alert team and the dean's office.

About 11 percent of LC undergraduate students seek help at the student-counseling center, said Hershbell, and of those only about one-quarter come on their own

initiative.

"Three-quarters come with the help of someone else - very often a faculty member," said Hershbell. "People really do need a nudge to get help."

Other than parents and peers, she said, it is the faculty and staff who see a student most often - several times a week over a period of weeks.

"You are in a special position to identify students in distress."

A caring and private conversation with a student whose demeanor, work, and class attendance have gone downhill may provide the first step to help. It doesn't call for mental health expertise or probing - nothing except encouragement to get help. "It's not your job to be a diagnostician," she said.

Students can come to college with untreated depression already a part of their lives.

Clinical psychologist Terry Jefferson, who practices in Lynchburg, told of a student who obviously had untreated depression for years, but had been unaware of it because of its insidious onset in his life.

As he improved through treatment, the student told Jefferson, "The sun came out."

Although it can exist alone, some illnesses, such a hypothyroidism, can have depression as a symptom. Depression can co-exist with disorders like anxiety, post-traumatic stress disorder, substance abuse and bipolar disorder.

Young people at risk for depression often have suffered a major loss in their lives.

And for college students that can be a situation like having always wanted to be a doctor, but then failing organic chemistry. That kind of trigger can happen to overachievers as well as underachievers and those without much social support.

Depression has a significant genetic component, Jefferson said, "not so much a cause, as a vulnerability."

Many kinds of therapy are used. Jefferson prefers cognitive behavioral therapy, which tries to change distorted

thinking.

The premise is "how you think determines how you feel. If you change how someone thinks, that can change how they feel."

New medications for mental illness are playing an important role in treatment of depression - in the short term and the long term.

Dr. Michael E. Judd, a psychiatrist, said it's important to identify depression early "and get into treatment as soon as

possible."

"It clearly has a biological component, a chemical imbalance and we can treat it effectively and significantly improve the quality of peoples' lives."

The prevalence of major depression, nationwide, he said, is 17 percent and twice as high in females as males across the age range.

People who have depression enter a downward spiral.

Without treatment some depression will run its course in "six very unpleasant months," said Judd. "The problem is, people don't recognize that," he said.

Each year, between 8 percent and 19 percent of people with depression become so seriously ill they must be hospitalized. And each year 35,000 people commit suicide, and that number is an underestimate, he said.

When someone has depression, "you should always ask about suicide," said Judd. "It doesn't mean you're giving him an idea."

Medications can make a significant difference, but a "positive response" is not enough, said Judd, and many physicians don't understand that. A positive response is defined as a 50 percent reduction in symptoms.

"Response is not good enough - treat people to remission, back to their usual function," said Judd. "People should accept nothing less than that."