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Volume CXXXII, Number 15 |
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Depression's dangers
JEFF BENSON, M.D.
DUDLEY COE HEALTH CENTER
Dear Dr. Jeff: "People have told me they think I'm moody, and I guess I do get my fair share of the blues. How would I know if I'm depressed and need medication?" T.J.
Dear T.J.: We all feel blue and moody from time to time, and transitory feelings of sadness, self-doubt, or discouragement are likely to be perfectly normal and situational. Depression, on the other hand, lasts longer, is more intense, more pervasive, deeper, and incapacitating.
Depression comes in many forms and degrees. Common symptoms include the following:
-feelings of sadness, hopelessness or irritability, that
have no clear cause or seem out of proportion
-feelings of worthlessness, helplessness or guilt
-loss of interest in usual activities, including eating and sex
-insomnia or oversleeping, along with low energy levels and fatigue
-chronic aches and pains, especially headaches and abdominal pain, that
defy diagnosis and don't respond to treatment
-abusive use of alcohol or drugs (really "self-medication")
-persistent thoughts of death, self-harm, or suicide
There are a number of "symptom checklists" you can run through on your own if you think you might be depressed. Both the Health Center and the Counseling Center websites have a totally confidential and anonymous on-line self-screening test for depression (and alcohol abuse and eating disorders too). Both websites also have links to other sources of helpful information about depression and other screening tests.
You are, of course, always most welcome to come into the Health Center or the Counseling Center to talk things over. All of us have considerable experience in helping people sort their feelings out and certainly can help you figure out what the right next steps for you might be.
Depression is VERY common. Some experts estimate that 1 of every 5 adults will experience clinical depression at some point in their lives. American Family Physician reports that depression is the second most common chronic disorder, mental or physical, seen by primary care providers in their offices. 8 percent of adolescents, and even 2 percent of children are thought to suffer from depression.
Not surprisingly, depression is also very common here under the Pines. In the 2002 Spring Survey of Students, over 80 percent reported feeling depressed (more than just unhappy) at least a few times each year. More than half reported worrying about their mental health and more still felt negatively impacted by someone else's mental or emotional problems.
Bob Vilas, our Director of Counseling, has reported that in 2001-2002, 310 students visited the Counseling Center a total of 1,900 times, up from 1,300 visits per year by 225 students in the mid-nineties.
Bowdoin is by no means unusual in this regard. A recent article in The New York Times reported a 40 percent increase in student visits to Columbia University's Counseling Center over that same period of time. At Kansas State University, the number of students treated for depression doubled between 1989 and 2001, as did the percentage of students taking psychiatric medications, and, most unfortunately, the number of suicidal students there.
The Times report also considered underlying causes for these trends. It cited greater pressures on students to succeed academically and the breakdown of family support systems. It also suggested that there might be greater awareness of mental illness and an easing of the stigma attached to seeking psychiatric care.
Clearly, the greater availability of effective psychotropic medications with few untoward side effects has also played a central role. Medications have helped many people advance in their schooling and careers, when they might not have been able to do so years ago.
There are a wide variety of helpful treatments available for those struggling with depression. Come in to the Counseling Center or Health Center to talk it over.
There are also some student-led campus groups and activities that focus on depression and other emotional disorders. They hope to disseminate information about these problems, provide more open support for those who struggle with them, and help remove the embarrassment and sense of shame they have historically carried.
These student-led efforts are critically important. A national survey of college counseling service directors reported a total of 166 student suicides at 55 colleges last year. Only 20 of those students had ever been seen at their college counseling centers before their deaths.
Talk to us, and talk to each other.
Take good care of yourselves - and take good care of each other!
Jeff Benson, M.D.
Dudley Coe Health Center
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