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Depression for college students can be painful, disruptive, and
debilitating. It may impair you academically, socially,
romantically, or in relationships with family members. It can be
accompanied by cognitive impairments that make it hard to study and
a loss of will that make it hard to get motivated.
Depression is a complicated
phenomenon with many variations and types. Some of the symptoms
below are evident in people with depression, but they vary in
presentation and intensity.
Subjective feelings:
- Depressed
mood most of the day, nearly every day. Feeling sad or empty most
of the time.
- Decreased
interest or pleasure in most activities that used to be enjoyable.
- Feelings
of worthlessness or a drop in self-esteem.
- Excessive
or inappropriate guilt.
- Thoughts
of death or suicide.
- Feelings
of anxiety or restless agitation.
- Feeling
apathetic about most things that one used to care about.
- Decrease
in sexual interest or drive.
Behavioral or biological changes:
- Increase
or decrease in appetite.
- Changes
in weight (increase or decrease) without dieting.
- Decreased
ability to think or concentrate. No longer able to make decisions.
- Sleeping
much more or much less than usual.
- Withdrawal
from people and activities.
- Drop
in performance at school or work.
Different types of mood problems
Depression or Sadness?
We all
feel sad once in a while, when life has been especially harsh or
when we are disappointed by things. These feelings are transient and
usually don’t absorb us most of the time. We might have intense
bottled up feelings of sadness, and feel better when we talk to
people about our feelings. Crying feels like a release and relief.
Psychologists consider these periods of sadness, caused by life’s
stresses to be an adjustment
disorder with a depressed mood. This is not the same as clinical
depression.
Clinical Mood
Disorders
When
these feelings persist over more than a two week period, and are
present most of the time on most days, it is likely that someone has
clinical depression and
treatment should be considered. This is often characterized by a
profound sense of emptiness. Crying is not a release of emotions.
The depressed person feels empty before they cry, and empty after
they cry.
Depressed
feelings are normal when dealing with bereavement or loss of a
loved one, but when the symptoms persist more than two months,
treatment is recommended.
Most
clinical depressions end after six to nine months, but there is a
less intense form of depression, called dysthymia, that may persist
for years without resolving. Like Eeyore in Winnie the Pooh, the
dysthymia may color someone’s personality until they seem
indistinguishable from their depression.
Some
depressions are seasonal: they typically start in the fall and end
in the spring. These depressions are triggered by the decrease in
light that characterizes winters far from the equator. Called seasonal affective
disorders, these often begin during the college years but can
recur year after year without appropriate treatment.
A
special class of mood disorders is characterized by alternations
between periods of depression and periods of elevated mood. Bipolar I disorder is
characterized by major depressive episodes and a manic episode,
during which a person has an abnormally elevated, expansive, or
irritable mood which lasts at least a week The manic person
manifests the following symptoms:
- grandiose
or have an inflated sense of themselves
- decreased
need for sleep
- jumps
from thing to thing in their thoughts
- becomes
extremely distractible, focusing on trivial things
- puts
tremendous amounts of energy into school, work or creative
projects,
- becomes
excessively involved in pleasurable activities without regard to
dangerousness or reality. E.g. goes on buying sprees, gives away
large amounts of money they need for other things, gets involved
in wild sexual indiscretions.
In Bipolar II disorder, people
get intense, major depressive episodes, but their manic episodes,
called hypomanic episodes, are milder and less disruptive.
Finally,
a milder bipolar disorder, Cyclothymic disorder, is
similar to Bipolar II disorder, except people experience dysthymic
episodes instead of full clinical depressions.
These
bipolar disorders are especially difficult to treat because people
enjoy the highs of the mania or hypomania and do not want treatment,
even though they may be significantly impaired, or heading for a
depressive crash.
How do I know?
- Being
as honest with yourself as possible, how many of the "signs
of depression" did you recognize as applying to
yourself?
- Have
any of your friends or family members expressed concern to you
about your current state?
- Do
you have someone you trust with whom you could go over the list,
to see how much each of you feels the list describes you?
- Realize
that depression is
treatable. People can improve with treatment, and should stay
in treatment until there symptoms are completely gone, not just
tolerably improved.
- One
of the cognitive deficits that come with depression is the
inability to imagine a future that is any brighter than the
present. Realized that this feelings is a symptom of depression,
and, thought it is hard to believe it, things can get much better.
If you're still unsure, but concerned, call Counseling and Psychological Services and schedule an appointment with one of our
psychologists (see below).
What can I do?
The sooner someone seeks
help for depression, the less likelihood that it will affect
relationships, school or work. Call Counseling and Psychological Services and
schedule an intake appointment. You and one of our psychologists
will decide together where you can get the help that best suits your
needs.
How do you treat depression? What helps?
There are many things that help improve the
symptoms of depression, and, for many people, actually resolve the
depression.
·
Individual
psychotherapy – Individual psychotherapy can be helpful to
people with depression. Cognitive-behavioral therapy, interpersonal
therapy, and psychodynamic therapy have all been show to be
useful.
·
Group
psychotherapy – Special groups are available for people with
depression that combine cognitive therapy with traditional group
therapy and psychoeducational materials.
·
Medication –
There are dozens of medications that can be used to treat
depression. There is no sure way to predict which medication may
help a person or which side effects, if any, and individual will
experience. It generally takes several weeks for antidepressant
medications to work. Although any physician can prescribe
antidepressants, we usually recommend that you get your initial
prescription from a psychiatrist, to take advantage of their vast
experience with these medications and to minimize the time it takes
to find the correct medication for you. You need to work very
closely with a physician when trying an antidepressant, especially
some people find an increase in suicidal thoughts and impulses when
taking antidepressants. Be willing to try more than one medication
if you do not get good results.
·
Light treatment –
Exposure to very bright light shortly after waking can decrease or
eliminate the symptoms of seasonal affective disorder. Special
lights are available that can be used on a daily basis without
damaging the eyes with ultraviolet light. Some people need to have
bright light exposure at the end of the day in addition to the
morning light. Recent research suggests that bright light might also
help people with depression that is not seasonal.
·
Exercise – It is
not clear exactly how exercise helps people with depression.
Nevertheless, there is very strong data that indicates that 30
minutes of aerobic exercise (even brisk walking) is tremendously
helpful for most depressed people.
·
Brain stimulation
– In rare cases electroshock therapy or the newer transcranial
magnetic stimulation (TMS) is used to treat depression without
medication. The
·
Nutrition – There
is a growing body of evidence that dietary changes can help some
people with depression. Epidemiological data strongly suggests
increases in omega-3 fatty acids in one’s diet can help depression.
There are numerous studies, which suggest different nutritional
supplements may be helpful to people with depression, but most of
them are small and not large enough to definitively indicate this.
St. John’s Wort, an herbal supplement shown to be helpful in mild
depression, should be treated as a drug and only taken under the
care of a physician.
·
Treating medical
conditions – There are many medical conditions that can
masquerade or amplify as clinical depression. It is important that
one consult with a physician to make sure there are no underlying
physical problems that are going untreated. Though not as common as
depression, infections, endocrine disorders, or other metabolic
disturbances can look like depression in their early stages.
What
help is available at Rutgers?
Should I be?
- How
many of the signs
of depression did you recognize in your friend's
behavior?
- Have
you ever tried to talk to them about your concern? Are they
getting help? Are they willing to go for help?
- Are
they getting help, but seem to be getting worse anyway?
Many students become
convinced they have a friend or roommate with a problem, but are
afraid they will alienate their friend if they approach them.
Paradoxically, depressed people need people more than ever, but
usually push people away, withdraw, or behave in ways that make
others want to avoid them. Talking to depressed people may not
always be a pleasurable task.
If you have experienced this
or are still unsure how concerned you should be, call Counseling and Psychological Services and schedule an appointment with one of our
psychologists to talk about this. We can help you decide whether
your friend needs help, and how best to approach them.
Most people with depression have strongly
conflicting attitudes about others' knowledge of their struggles.
They are often ashamed of their depression and think it is an
indication of being weak-willed or inadequate. These negative
beliefs are usually distortions, caused by the depression itself. It
may be helpful when talking to a depressed person to let them know
that you know it takes courage and strength to go for help and that
you don’t view seeking help as a sign of weakness or deficiency.
What do I do?
·
Talk to your friend and
tell them you suspect they might be depressed and ask them if they
are getting help. Give them contact information for Counseling and Psychological Services and encourage
them to call and set up an appointment.
·
Offer to go with them to
their first appointment. Depressed people may not have the will or
energy to make it to their first appointment on their
own.
·
Ask them if there are
things you can do to help, realizing that you are their friend, not
their therapist, and you can’t fix them or be responsible for their
mental health. Depressed people often avoid the very activities that
help them get better. Ask your friend how much you can push them to
join you in activities when they are isolating themselves or
avoiding social contact.
·
Take care of your self.
Having a close friend or family member who is depressed can be
exhausting. You can start to feel helpless yourself. Realize that
depressed people don’t perk up after a good cry or hear-to-heart
talk, but nevertheless greatly appreciate your listening presence.
Many depressed people report after recovery how grateful they were
for their friends’ presence, even if they were unable to express it
at the time.
·
If your depressed friend
talks about suicide or some sort of serious self-harm, get them
immediate help. Always take such talk seriously. Do not try to
assess whether or not they are a real threat or are just expressing
strong feelings. Let professionals make that judgment call. Remember
that most people who complete a suicide tell someone about it
first.
Many people with depression think about suicide. When very depressed,
it may seem like an opportunity to escape the emptiness and pain of
the depression. The emptiness and pain will eventually end, but
depressed people cannot see this due to the distortions in
cognition.
- When
people are suicidal they need immediate help. If their suicidal
thoughts turn into suicidal impulses, with intentions to actually
harm themselves, they may require hospitalization until the
suicidal impulses can be treated.
- Do
not try to judge whether someone else’s suicidal intent is
serious. Call someone professional, or get the person immediate
medical help.
- The
cognitive distortions of depression may make suicide seem like the
only solution to the person’s problems. Generally, suicidal
thoughts are not fully rational.
- When
people are stopped from killing themselves, they are almost
universally glad someone stopped them from killing himself or
herself. If someone “made you promise” to keep their “secret”
before telling you about their suicidal plans, go ahead and break your promise. They
can only thank you if they live to have their depression treated.
- If
you live in a dormitory on campus you can contact someone on
residence life staff to arrange an immediate evaluation either at
a counseling center or a community agency. If you are someone else
is in danger of hurting themselves and you can’t reach someone you
can call 911 (Off campus), or 6-911 (On campus).
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A wide variety of help is available,
including psychological assessment and treatment recommendations,
short-term individual psychotherapy, group psychotherapy, medical
assessment and monitoring, and psychiatric evaluation and monitoring
of medication usage.
Administrative Help:
·
If you live in a dormitory, you can talk to
your preceptor, building director, or area coordinator about
yourself or someone else. They are especially useful in emergencies
when someone is struggling with self-harm.
·
College deans, student services staff, or
the graduate dean can help you negotiate with professors if your
depression is affecting you academic work.
·
Students with chronic depression can get
help from the Disabilities Services Office at each college.
Counseling and Psychological Services:
Other Campus Resources:
For comments on this web-site, contact Mark J. Forest, Ph.D. or call 732-932-3966.
This page last updated:
June 27, 2007
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Rutgers, the State University is an equal opportunity affirmative
action institution.
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