March 5, 2007 (Vol. 5, No. 3)
Beating the Blues: Coping with Depression
by Dr. Annecy Baez, Director
Lehman College Counseling Center
College is an exciting journey of personal growth and transformation. The first few weeks are filled with the excitement of new beginnings, but as the semester moves on, demands multiply. For some students, the semester may become a roller-coaster ride of stress and worry. It doesn't take long for the stress to precipitate anxiety in some, and sadness in others. When the sadness continues for days and weeks and affects the individual's capacity to function, some individuals realize that they may need help, and they often reach out for it. Other students, however, may not seek help, and their sadness may continue until it becomes debilitating. Often, they hide their depression, feeling ashamed of what others may think, and believe that it is a sign of weakness.
What Is Depression?
In its mildest form, depression can be seen as being in low spirits, "feeling blue," or as someone once described, "not feeling a light inside of me." We all know our minds and our bodies, and when something is shifting negatively within us; however, for many individuals it is difficult to come to terms with the fact that they may be suffering from depression.
There are many types of depressive disorders. The American Association of Suicidology notes that Major Depressive Disorder is the most prevalent mental health disorder and that approximately 19 million American adults suffer from depression. Common symptoms occur almost every day for a period of two weeks or more, and often interfere with an individual's daily function:
- Depressed mood (e.g., feeling sad or empty)
- Lack of interest in previously enjoyable activities
- Significant weight loss or gain, or decrease or increase in appetite
- Insomnia or hypersomnia
- Agitation, restlessness, irritability
- Fatigue or loss of energy
- Feelings of worthlessness, hopelessness, guilt
- Inability to think or concentrate, or indecisiveness
- Recurrent thoughts of death, recurrent suicidal ideation, suicide attempt or plan for completing suicide.
Many people who suffer from depression insist that they have an undiagnosed medical problem. Why is this so common? It is common because depression hurts, physically and emotionally. When someone is suffering from depression, it feels as though they have an illness. They are fatigued, they may have aches and pains in different areas of their body, they can't eat or they eat too much. They can't sleep or they sleep too much. They also can't concentrate on their schoolwork, and they forget things easily. Depression causes procrastination, poor academic performance, and social isolation.
Many times, depressed persons may lose interest in the things they loved; they feel helpless and worthless; they begin to worry a lot and may experience anxiety. In its most intense form, anxiety may trigger panic attacks: rapid heart palpitations that make individuals feel they are having a heart attack.
Other Types of Depression
Depression can take other forms as well.
Dysthymia, sometimes referred to as chronic depression, is a less severe form of depression, but the symptoms linger for a long period of time, perhaps years. Those who suffer from dysthymia are usually able to function. They go to work, come to school, but they report that they are consistently unhappy.
Seasonal Affective Disorder (SAD) has symptoms that are seen with any major depressive episode. This type of depression often occurs each year at the same time, usually starting in fall or winter and ending in spring or early summer. Most recently, therapists and researchers are beginning to see a form of SAD known as "summer depression," which begins in late spring or early summer and ends in fall.
Postpartum Depression is a type of depression that can occur in women who have recently given birth. Often, postpartum depression interferes with the mother's ability to bond with her baby. At times, mothers may be obsessed with thoughts of hurting their newborn children.
Bipolar Disorder, also known as manic-depressive illness, affects millions of people each year. This condition takes individuals on an emotional roller-coaster, seesawing between feelings of greatness to intense feelings of depression. Most individuals suffering from Bipolar will do impulsive things during a manic phase. At times, they may dress provocatively and act out sexually. They change their speech pattern, too, speaking quickly and saying everything that is on their mind. They may not sleep and have wild ideas of success. Treatment is available and enables individuals to manage these mood swings.
Many of those suffering from depression begin to feel depleted by these symptoms and often begin to have thoughts of suicide. Research shows that the highest risk of suicide is among those individuals who suffer from Major Depressive Disorder.
The American Association of Suicidology reports that in 2004 more people died from suicide than from homicide. Suicide ranks as the 11th leading cause of death, and homicide ranks 13th.
The suicide rate is highest for the elderly (ages 65+). Suicide knows no boundaries; it occurs among all socio-economic and ethnic groups. More men than women commit suicide because they generally use more lethal methods. Suicide is the second leading cause of death among college students. When it comes to gender, more females attempt suicide than males—three female attempts for each male attempt—but more males die from suicide than females: four male deaths by suicide for each female death by suicide. The highest rate of suicide is among white males (73%).
Most suicidal individuals want to live, but they are unable to find alternative solutions to their problems.
Warning signs include statements or behaviors that indicate an individual may be at risk for suicidal behaviors:
- The person may express that they no longer have a reason to live and find no purpose in life.
- For many, there is an increase in alcohol or substance abuse.
- The individual may begin to withdraw from family and friends.
- There may be increasingly dramatic mood signs, agitation, and anxiety.
- Rage, anger, and hopelessness.
Family members and friends often do not know what to do, and feel that talking about suicide will increase the potential of its occurrence. Talking about suicide does not cause a person to become suicidal; instead, it increases the chances that a person may seek help, and begin to recover from their depression.
If you are concerned that you, or someone you know, may be at risk for suicide, the Lehman College Counseling Center strongly encourages you to do one or more of the following:
- Contact a mental health provider within your community. The Center's website has a list of New York City hospitals and crisis mobile units to help you in this referral process.
- Call 1-800-273-8255 (TALK), the National Suicide Prevention Hotline, for a referral.
- Call the Counseling Center at (718) 960-8761.
- Call 911.
Causes and Treatment of Depression
The causes of depression vary from individual to individual, from a sudden disappointment to the loss of a relationship, transferring from one college to another, changing jobs or losing one. The first year and senior year of college are two vulnerable years for students. Graduations and celebrations, such as birthdays, may trigger depression in others. Medical illnesses, such as thyroid problems, may cause depression, as well as sudden illnesses or chronic illness. A history of poor eating, lack of exercise, and high levels of stress may cause depression as well. Unresolved past history of trauma and sexual trauma are also linked to depression.
Treatment for depression is effective 60 to 80 percent of the time; however, only 25 percent of individuals with depression receive adequate treatment. The risk for repeated episodes and suicide attempts are increased when depression is accompanied by alcohol and substance abuse.
If left untreated, depression leads to a higher rate of recurrent depressive episodes and a higher rate of suicide. The most successful treatment for depression is counseling or psychotherapy, with or without medication. For some individuals, a combination of psychotherapy and medication works best. Many depressed individuals do not want to be on medication; however, the longer the depression is untreated, the higher the risk for suicide and recurrent episodes.
Certain types of psychotherapy, particularly Cognitive Behavior Therapy (CBT), can help resolve the psychological or interpersonal problems that contribute to depression. CBT helps to identify negative thoughts and feelings that affect an individual's behavior.
Interpersonal Psychotherapy (IPT) is one of the short-term therapies that have been proven to be effective for the treatment of depression. IPT addresses the interpersonal issues that cause, affect, and maintain depression and targets events that may have caused the depression and/or maintains it. Areas of focus may be related to relationship conflicts (e.g., husband/wife, mother/daughter), role transitions (e.g., the first year of college), or grief (e.g., loss of a loved one).
Dialectical Behavior Therapy (DBT) has been highly successful in treating individuals with suicidal ideations and attempts. It is designed for those who have experienced self-harm, impulsivity, unstable relationships, extreme mood swings, or suicidal thoughts and urges.
Many students are not aware that their insurance will pay for psychological treatment, but only their insurance will determine the mental health provider or mental health agency that they can attend. For those students who do not have insurance, assistance is available at the Lehman Health Center, where they can apply for insurance. Please check the Health Center's website for information regarding medical insurance.
What can we do to help someone who is depressed?
If someone is severely depressed and having suicidal thoughts, it is highly recommended that s/he go to the emergency room of the nearest hospital for an evaluation. Although many individuals would prefer not to be hospitalized, this option provides a time and place to stabilize and recover.
The most important thing to do is to encourage a friend to seek appropriate treatment. It is often hard to do this. Individuals who believe they are dealing with their own problems or think that seeking out social support is a weakness will have the most difficulty in seeking help.
At times, a person needs to be escorted to a clinic or a hospital. It is the best that can be done for someone who is depressed and may be suicidal. Depressed individuals need empathy, support, and encouragement. Hear them out. Listen to them. Go to the gym with them or take a nature walk. This often provides great relief. Nutrition is important, as well as increasing their level of activity through sports, dance,and exercise. Slowly becoming involved in activities that are pleasurable also reduces depression. These pleasurable activities differ from one individual to another, but may include prayer, going out with a friend, sports, or creative activities like photography, art, visiting a museum, writing in a journal, or writing poetry.
The Lehman College Counseling Center
Located in Room 114 of the Old Gym Building, the Counseling Center provides confidential brief individual and group counseling, crisis intervention, and referrals to campus services and outside mental health agencies for all registered Lehman students. Services are free to all Lehman College students, and provided by qualified licensed professionals. The Center is open Monday, Thursday, and Friday, from 9 a.m. to 5 p.m.; Tuesday and Wednesday, from 9 a.m. to 7 p.m.; and Saturday, from 10 a.m. to 2 p.m.
Screening for Mental Health
The Center's website is registered with Screening for Mental Health, Inc., (SMH). SMH programs now include both in-person and online programs for depression, bipolar disorder, generalized anxiety disorder, post-traumatic stress disorder, eating disorders, alcohol problems, and suicide prevention. The site offers visitors free, anonymous online screening.The Jed Foundation is committed to reducing the young adult suicide rate by furthering understanding of the underlying causes of suicide; by increasing awareness of the issue of college student mental health and suicide; and by creating effective prevention programs on college campuses. Ulifeline is one of those programs and can be found on the Counseling Center's website as well. Ulifeline provides an array of online resources on mental health issues to students on campus and also allows students to access our Counseling Center from within their Ulifeline site. Faculty and students can go online and ask questions, review surveys and polls, and download mental health fact sheets.
Groups and workshops: On Wednesday, March 14, at 2 p.m., the Counseling Center will hold a workshop on "Understanding Depression," and on Wednesday, March 28, at 2 p.m., it will sponsor a videotape presentation on the "Truth About Suicide." Both workshops will be facilitated by Dr. Baez. If there is sufficient student interest, Dr. Baez will also arrange to hold an eight-week Depression Prevention Course.