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Dealing With Depression: What Everyone Should Know

Life can seem pretty bad when your boyfriend or girlfriend breaks up with you or you learn that your parents are separating. You can start feeling blue living away from home for the first time, and struggling to master difficult subjects can leave you feeling down. In fact, depression is fairly common among college students who often are living on their own for the first time, developing new relationships, and challenging old ideas. In most cases, time and self-help are the best treatments for these bouts of low self-esteem and occasional feelings of being sad, overwhelmed, and "just not up to the challenge."

Self-Help:

Though you may feel exhausted, apathetic, irritable, or bored, keep up a healthy routine. Eat nutritious, balanced meals; get adequate sleep and regular exercise; go to class; and continue hobbies you used to enjoy.

Speak with your friends. Get some support and learn how they've overcome depression. Look through some of the many books and tapes available on the subject, and check with your campus or community health or counseling center for more ideas and support. Above all, be kind to yourself; act as if you are worthwhile, and feelings of being worthwhile will return.

Why Bother Helping Yourself?

Depression is treatable. Although it is painful, depression also may be self-nourishing, feeding on the inactivity it invites. Don't prolong it. Help yourself, even if right now you feel hopeless, exhausted, or trapped by inertia. Pretend things aren't as bad as they feel just for the amount of time it takes to find a friend, listen to a self-help tape, or call the mental health center.

How Do I Know If I Need Professional Help?

You don't have to be "crazy" to seek professional help. In general, you should get professional help if your attempts at self-help are ineffective, and your depression:

  • Persists for several weeks
  • Becomes more severe
  • Leads to self-destructive thoughts and behavior

Many people don't get treatement because they don't realize they're depressed. They blame the depression on personal weakness, or they're so disabled that they can't reach out for aid. They may think, "What's the point? I'm hopeless," or "I should take care of my problems alone," or they may have simply forgotten what it feels like not to be depressed.

Even if you're not certain whether you need professional help, use the following symptom list developed by the National Institute of Mental Health for guidance. Get help if these symptoms are keeping you from enjoying life.

  • Persistent sad, anxious, or "empty" mood
  • Feelings of hopelessness, pessimism, guilt, worthlessness, and helplessness
  • Loss of interest or pleasure in ordinary activities, ranging from schoolwork to sex
  • Sleep disturbances (e.g., insomnia or oversleeping)
  • Eating disturbances (e.g., decreased or increased appetite and weight)
  • Decreased energy, fatigue, and feeling "slowed down"
  • Thoughts of death or suicide; suicide attempts
  • Increased restlessness and irritability
  • Difficulty concentrating, remembering, and making decisions
  • Physical symptoms- such as headaches, digestive disorders and chronic pain- that don't respond to medical treatment

Other signs that you may need professional help are feelings of being completely alone, separate, or different, and not wanting to spend time with friends or loved ones.

What Causes Depression?

Many factors "set the stage" for depression. Among the most important are your background, the skills and beliefs you use to cope with change, and any biological vulnerability you may have, including possible genetic predisposition, hormonal imbalances, or other serious physical problems.

The most common immediate cause of depression is the loss of personal worth and self-esteem. Frequently, this is brought on by external factors such as:

  • The breakup of a friendship or romance
  • Divorce or family separation
  • Death of a loved one
  • Academic or financial stress

Loss of self-esteem and personal worth can also be caused by internal factors such as:

  • Unrealistic standards and assumptions
  • Lack of effective coping skills
  • A feeling of not getting enough love or support from parents or other important people

In some cases, several causes may be tightly intertwined, creating a downward spiral. For example, Joe, a college sophomore, learns that his parents are getting divorced. Unaware that his parents were having problems, he begins to question his own judgment in relationships. Deciding that relationships can't be trusted, he breaks off with his girlfriend and starts spending less time with his friends. He stays in his room more often, brooding. He starts skipping class and questioning the value of school. As time goes by, he begins to care less about playing on the intramural football team or his weight-lifting routine- things that used to matter to him. Instead, he feels increasingly hopeless, worthless, and uncertain.

The interactions of a painful event, ineffective coping skills, negative thinking, and self-devaluating behavior have created a downward spiral. In Joe's case, he is able to end this spiral with the encouragement of his roommate and ex-girlfriend, and help from a campus mental health counselor.

"Masking" Depression

Get professional help if you are:

  • Having difficulties with alcohol, other drugs, tobacco, or food
  • Practicing unsafe sex or other forms of "sex with regrets"
  • Driving recklessly
  • Vandalizing property or stealing
  • Behaving in other ways that you believe- or your friends tell you- are destructive

Consciously or unconsciously, you may be doing these things to "mask" underlying depression


Helping Someone Who Is Depressed

You aren't responsible for your friend's depression. You can't fix your friend's life or change his or her mood. Although you may be tempted, don't try to give advice or take charge. Just listen.

The following are useful listening techniques.

  1. Be supportive. Don't deny or minimize your friend's pain. Don't try to talk your friend out of any feelings or make judgmental comments about them.
  2. Show that you care. Stay in touch and stay interested.
  3. Be honest. If a friend's behavior or comments frighten you, say so. Don't try to be superficially cheerful, but do reassure your friend that this feeling is temporary and depression is treatable.
  4. Know when to back off. If you start to feel angry or frustrated because your friend doesn't seem to be listening or changing, explain that you need time out and will continue the conversation later. You may find that short, periodic discussions work best.

If you have a friend who you believe is denying a serious depression, you may want to speak with a mental health professional about how to proceed. Let your friend know you're concerned. Don't be too polite to bring up the topic, but be tactful. Ask whether the person feels he or she is depressed and continue asking questions to encourage frankness. Keep an open mind about how the person evaluates his or her situation and use the listening skills listed above.

If You Feel Suicidal

If you feel suicidal and are thinking about hurting or killing yourself, call the suicide or emergency hotline (get the number from the information operator or the local telephone directory) or contact your mental health center immediately.

As one student who attempted suicide advises, if you're thinking you can't live anymore, ask for help. Suicidal feelings are intense, but the impulse will pass, especially if you talk to a close friend, counselor, or member of the clergy to get some relief from the pain.

How Do You Know If a Friend Is "Really" Suicidal?

There is no foolproof checklist for identifying a suicidal person. Suicide, like much other human behavior, is difficult to predict. Take any suicide talk or attempt seriously. Professional help is needed, even if you don't think your friend means to succeed. A suicidal gesture is serious and dangerous. It may accidentally result in permanent injury or death.

Warning Signs Of A Suicide Attempt

Warning signs that a person may be preparing for a suicide attempt include:

  • Displaying the symptoms of serious depression listed above
  • Increasing use of alcohol and other drugs, and increasing engaging in high-risk activities such as reckless driving or physical fights
  • Getting the means for killing oneself (e.g. buying a gun, stocking up on sleeping pills)
  • Giving away prized possessions
  • Statements indicating a desire to get even with significant others, or "make them sorry"
  • Discussing suicide, the hereafter, and/or wills and other legal matters related to death

In addition, studies have shown that people who have attempted suicide in the past are at risk for repeating, and people who have relatives who attempted suicide are often more likely to make attempts.

Professional Help

Getting help is a sign of strength, not weakness. With professional help, you can speed up your recovery and short-circuit relapses. "Toughing it out" alone is unnecessary and keeps you tied to old ideas.

Professional Treatment Methods

Several kinds of treatment are available. Work with a mental health practitioner to decide which one, or combination, is right for you. Don't be reluctant to try different methods- while it may take a little while to find the best approach for you, between 80 and 90 percent of all people with depression respond to treatment.

Psychotherapy. Several forms of "talk therapy" have been shown to be very helpful. Therapy may be short- or long-term; focus on behavior, thinking, feeling, or some combination of the three; and involve interacting with a therapist by yourself or as part of a group.

Medication. Various prescription drugs are now on the market that have proven value in treating some types of depression. However, some have unpleasant side effects and you may need to try different types of antidepressants. These drugs are always used under supervision of a physician.


Helping a Friend Who Is Suicidal

Use the listening skills described in the section on helping a depressed friend, but don't back off. In addition:

  • Explain to your friend that you're concerned about the situation.
  • Find out if your friend has a specific plan for committing suicide and how far he or she has gone in carrying it out.
  • Get your friend professional help immediately. Contact the suicide prevention hotline, hospital emergency room, or local crisis center.
  • Make an agreement with the person that he or she will not attempt suicide while you're finding help.

Some things not to do:

  • Don't assume the situation will take care of itself.
  • Don't leave your friend alone.
  • Don't be sworn to secrecy.
  • Don't act shocked or surprised at what your friend says. Don't challenge, dare, or use verbal shock treatments.
  • Don't argue or debate moral issues.

Once the immediate crisis is over, encourage your friend to get follow-up care. Keep in mind that a quick recovery from suicidal feelings may be your friend's attempt to deny- consciously or unconsciously- the intensity of the depression, and that the suicidal feelings may return.

Trying to help someone who is suicidal can be scary. Consider getting professional advice and support for yourself. And remember that you are not responsible for the impossible- you can encourage a friend to get professional help, but you cannot stop someone intent on committing suicide.