ANXIETY AND DEPRESSION WHEN YOU ARE STUDYING

DEPRESSION AND ANXIETY ON CAMPUS Depression and anxiety on college campuses have risen to epidemic proportions. There are a variety of suspected causes for the alarming trend, which is supported by numerous studies, including a February 2010 Healthy Minds Study finding that 20 percent of BU students surveyed fit the criteria for anxiety or depression. Today we begin a three-part series examining depression and anxiety among BU students. Part one offers an overview and a look at what’s behind the increase and who is most at risk. In part two, we show the faces of depression and anxiety through a series of candid interviews with students. The series concludes with information on how to get help, what that help involves, and how some students suffering from depression and anxiety—treatable conditions—have found hope, and a way out. Carrie Landa scans her weekly schedule and shakes her head. The computer screen is a mélange of colors, each with a meaning. Light green signals an open spot for new patient intakes at Student Health Services Behavioral Medicine, where she works as a staff psychologist. Turquoise is for emergency appointments. Gray floats as lunch (or more space to cram in work). And cream reveals open slots for patient counseling. There is no cream; the inn is full. This is why: one of every three college students nationally, according to recent surveys, has sought mental health counseling. At BU, one of five undergraduate and graduate students surveyed screened positive for depression or anxiety. About a quarter of that group report that they have seriously contemplated suicide. “I started here in 2009 and before that everybody had said this time of year, after spring break, is the worst,” Landa says. “This year we’re all saying this is the worst it’s ever been.” In just 10 years, the number of students receiving services at Behavioral Medicine has more than doubled, to 10,523 last year. Landa estimates that figure will jump again this year, by 2,000 students, with the overwhelming majority treated for depression and anxiety. There is also unsurprising evidence that far more students need mental health services than have sought care. The 2010 Healthy Minds Study, an annual national online survey of college students about mental health issues by the University of Michigan, reveals that 36 percent of the 1,400 BU student respondents thought they needed mental health help during the previous year. Yet less than two thirds of those said they sought help. During this year’s National Depression Screening Day, 30 percent of the 216 BU students who came to the free screening offered by Behavioral Medicine staff were referred to treatment. Last year, 64 students showed up for the screening, and the referral rate was also 30 percent. College years have long been a time of psychological stresses. As academic pressures rise and fall, so do anxiety levels. Roommate and relationship problems, homesickness, and adjustment to college life plague students now as before. And the college years are when most people question and explore who they are—which can be both exciting and unsettling. But those situations don’t explain the sudden surge of students seeking help for depression and anxiety. Why is this generation, now more than ever, in need of help? The answer, according to mental health professionals, reflects what is ailing society in general. Margaret Ross, the director of Behavioral Medicine at BU, says American culture has changed dramatically since she started counseling students decades ago. “All the technology has made it different growing up,” Ross says. “Parents have micromanaged the lives of their children. They do everything on computer. They don’t have the common sense that people in the past may have had in knowing when they need help.” The global economic slump has taken its toll as well, Ross says. Students worry that there won’t be jobs when they graduate. Parents have had to dig deeper into their pockets to finance a college education, some taking out a second mortgage, and that knowledge wears on students, who feel pressure to enter a field that is hiring instead of one they like. Dori Hutchinson, director of services at BU’s Center for Psychiatric Rehabilitation, speaks often with students struggling with the choice of passion versus profession. “Somewhere along the line as they mature,” she says, “they’re recognizing that this is not who I am but this is what I’m supposed to be. And so that discordance can be really painful for kids.” Hutchinson sees how students feel pressure to succeed even before they enter college. They come to BU with “this headset that Bs are not good enough,” she says. “It’s driven by this collective anxiety that we have in our world these days that you have to be good at everything you do.” Parents also hover over their children too closely, she says. “We parent differently and we protect our kids from a lot of normal disappointments in the name of getting a leg up. They get to college and their parents aren’t here to do that anymore. There are kids who can’t decide what to choose to eat. That creates anxiety.” Landa sees another culprit in the mix: Facebook. The social media website is a tool students use constantly to interact with friends, all the while comparing how their virtual lives measure up (or don’t) to those of others. “There is a very big need for immediacy in our culture and almost an intolerance of things that are uncomfortable or bad,” she says. She also says that in recent years more students arrive at college already in treatment for depression, anxiety, or personality disorders. “We do have students here ill enough that 20 to 30 years ago they wouldn’t have been coming to college,” Landa says. “They are showing up here and succeeding here, but still needing the support that we offer.” That is where Hutchinson and her colleagues can step in. At the Center for Psychiatric Rehabilitation, staff members help students learn how to manage the responsibilities and pressures of schoolwork and social life. “We do whatever it takes to help them stay here at the University,” Hutchinson says. At BU, a broad cross-section of students makes use of mental health services—from freshmen to U.S. military veterans—but some groups are more at risk for developing depression or anxiety. Among them are minority and international students, those who identify as LGBTQ, athletes, and students involved in Greek life, according to University mental health professionals. “Any time you feel ostracized, not in the mainstream, or discriminated against, I think that can create some depression,” says David Seeman, a senior staff psychologist at Behavioral Medicine. International students can have a tough time adjusting simultaneously to college life and to a new culture. Their support network of friends and family is thousands of miles away, and their home culture may frown on seeking help for mental health problems.