Understanding depression
A student’s journey
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Feeling down lately? Depressed? Or are you worried about a despondent friend? You’re not alone. Many of the questions we receive at Student Health 101 involve dealing with depression.
About eight percent of Canadians aged 15–24 report symptoms consistent with a mood disorder, according to the Canadian Community Health Survey—Mental Health (2012). The Canadian results from the 2012 American College Health Association National College Health Assessment found that depression was second only to anxiety as the most common issue among students with diagnosed mental health conditions.
Clinical depression can be a serious impediment to academic success. Yet many students struggling with depression haven’t reached out for help. Only 37 percent of those who met the criteria for a mood disorder had consulted with a professional, according to the 2002 Canadian Community Health Survey, Mental Health and Well-being.
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Brandy, 21, studies Psychology at a university in Ontario. For the past year, she has been battling depression—a common and debilitating mood disorder that disproportionately affects university-aged individuals, according to the Canadian Community Health Survey—Mental Health (2012).
Trigger & decline
Towards the end of high school, Brandy’s parents kicked her out of their house. She spent the next two weeks on friends’ couches. “It was a difficult time for me. I didn’t have a lot of support, and I have a history of bad things happening to me,” she says. Brandy had a kidney transplant when she was younger, which she feels affected her social life and relationships.
When Brandy started university, she felt overwhelmed by the large groups of people. She spent her first year going straight from where she was living to class and back. “I have never been a social person so it was [hard] for me. It made me want to distance myself from school life,” she says. “I didn’t want to talk to anybody.”
Brandy lost interest in the things she was passionate about, such as the charity initiative that she created when she was 15.
“When you’re depressed, you think that you are not worth anything,” she says. “You see yourself in a very negative light. And [you feel] an overwhelming sadness and a lot of loneliness.”
Treatment
Brandy began to experience gastrointestinal problems. She suspected that the physical symptoms might have something to do with her declining emotional health, which led her to seek the help of her school’s health services.
She was referred to a university counsellor and prescribed antidepressants. Brandy has difficulties talking about her feelings, but her fiancé encouraged her to push through her discomfort. “It took [a few] months for treatment to start working,” she says.
She slowly increased her participation in school life and got involved with her charity organization again. She joined a provincial association dedicated to raising awareness about organ donation, and took up swimming.
Brandy is still dealing with depression, but she is on a road to recovery. “You have to focus on taking moments for yourself to check your emotions. Counselling gives you a place where you can vent and get your negative emotions out.”
What is depression?
Depressed is a word we hear a lot. “I feel depressed.” “You okay? You seem depressed.” Usually, it’s not immediately obvious whether we’re talking about a passing sense of discouragement that almost everyone experiences at times, or clinical depression, the debilitating mental health condition. Here’s how to tell the difference:
Those experiencing depression are “grappling with feelings of severe despair over an extended period of time,” according to the Canadian Mental Health Association (CMHA). “Almost every aspect of their life can be affected, including their emotions, physical health, relationships, and work.” Depression is mostly characterized by deep despondency that lasts most of each day for longer than two weeks, limiting everyday functioning.
- Major depressive disorder is disabling enough to interfere with daily functioning.
- Milder, chronic depression is called dysthymia.
- Minor depression tends to be less severe or shorter term. Left untreated, it’s a risk factor for major depressive disorder.
What are the symptoms?
- Prolonged sadness for at least two weeks
- Loss of interests and pleasure
- Anxiety, agitation, or restlessness
- Anger or increased irritability
- Difficulty concentrating, organizing, and making decisions
- Internal loneliness
- Feelings of guilt and hopelessness
- Thoughts of death and suicide
- Fatigue
- Changes in appetite, with weight gain or loss
- Unexplained physical ailments
How depressed are young adults?
- Among Canadians aged 15–24, 8 percent experienced a mood disorder in the past year, according to the 2012 Canadian Community Health Survey—Mental Health.
- Thirty-eight percent of Canadian college and university students reported feeling “so depressed that it was difficult to function” at some time in the past year, in the American College Health Association National College Health Assessment. (This is not a measure of diagnosed clinical depression.)
- Over 68 percent of young adults with a mood or anxiety disorder report that symptoms started before age 15, according to the 2002 Canadian Community Health Survey, Mental Health and Well-being.
- Women appear to be more vulnerable to depression than men.
What causes depression?
Despite the prevalence of depression, its causes and neurobiological mechanisms remain mysterious. Several factors are known to contribute, including:
- Genetics Depression tends to run in families.
- Neurobiology Depression involves abnormalities in the biochemical brain functioning. Rapid brain development in the teen years increases vulnerability.
- Hormonal changes Adolescence is the peak period for the onset of depression.
- Stressful experiences Adolescence and young adulthood involve major life transitions, including leaving home and going to college or university, as well as romantic relationships. These involve being tested in new ways with seemingly higher stakes. Those demands can contribute to depression.
WHAT ARE SCIENTISTS DOING ABOUT DEPRESSION?
Depression research is multi-disciplinary, involving a variety of scientific methods. Its ultimate goal is effective prevention and treatment. Areas of investigation include:
- The functional, structural, and neurochemical brain differences that characterize depression.
- Identifying risk factors: psychological, behavioural, genetic, and/or neurobiological.
- The enduring effects of childhood abuse and neglect in increasing vulnerability to depression.
- The effects of psychotherapy on brain mechanisms and symptoms of depression.
- Identifying the brain mechanisms that increase the likelihood of self-injury and suicide.
- The neurobiology of executive dysfunction, which appears to be related to an abnormally intense reaction to errors and negative feedback.
- Neurobiological predictors of treatment response in depression, to improve treatment selection and minimize the trial-and-error approach.
WE ASKED STUDENTS HOW THEIR FRIENDS AND FAMILY HELPED THEM THROUGH DEPRESSION
* names changed for privacy
There are countless ways, big and small, that my friends and family have supported me during these difficult, confusing, and frustrating episodes. The one that works the most, and which is reiterated the most is, ‘It’s okay to hurt. We love you no matter what. We will always be here for you and you are not alone.’
Robyn A., Trent University in Peterborough, Ontario
My spouse was a key support and someone whom I could approach if the signs and symptoms of depression were negatively affecting my everyday life. She educated herself on the illness and was always willing to listen when I had a bad day.
Chris M., University of Lethbridge in Alberta
My boyfriend helped me through the hard times by encouraging me to keep going and reminding me of what I had accomplished so far.
Natalie P., Collége Salette in Montreal, Quebec
My friends were all there for me, in varying degrees and at different times. They encouraged me to get out, listened to me, and gave me my space when I needed it. I had come so far in my life personally up until that period—they somehow convinced me to get my act back together, to not regress, and to continue working hard to achieve my goals.
Christine L., Concordia University in Montreal, Quebec
It was hard for my friends to help me. It is important to reach out to friends when struggling with depression. I had trouble reaching out though. I constantly thought that I was burdening my friends and was fearful that if I confided in them too often, they would eventually cut me out of their lives.
Nancy C., University of Guelph in Ontario
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