Depression for college students can be painful, disruptive, and debilitating. It may impair you academically, socially, romantically, or in relationships with family members. It can be accompanied by cognitive impairments that make it hard to study and a loss of will that make it hard to get motivated.

Signs and Symptoms

Depression is a complicated phenomenon with many variations and types. Some of the symptoms below are evident in people with depression, but they vary in presentation and intensity.

Subjective feelings:

• Depressed mood most of the day, nearly every day. Feeling sad or empty most of the time.
• Decreased interest or pleasure in most activities that used to be enjoyable.
• Feelings of worthlessness or a drop in self-esteem.
• Excessive or inappropriate guilt.
• Thoughts of death or suicide.
• Feelings of anxiety or restless agitation.
• Feeling apathetic about most things that one used to care about.
• Decrease in sexual interest or drive.

Behavioral or biological changes:

• Increase or decrease in appetite.
• Changes in weight (increase or decrease) without dieting.
• Decreased ability to think or concentrate. No longer able to make decisions.
• Sleeping much more or much less than usual.
• Withdrawal from people and activities.
• Drop in performance at school or work.

Different types of mood problems

Depression or Sadness?

We all feel sad once in a while, when life has been especially harsh or when we are disappointed by things. These feelings are transient and usually don’t absorb us most of the time. We might have intense bottled up feelings of sadness, and feel better when we talk to people about our feelings. Crying feels like a release and relief. Psychologists consider these periods of sadness, caused by life’s stresses to be an adjustment disorder with a depressed mood. This is not the same as clinical depression.

Clinical Mood Disorders

When these feelings persist over more than a two week period, and are present most of the time on most days, it is likely that someone has clinical depression and treatment should be considered. This is often characterized by a profound sense of emptiness. Crying is not a release of emotions. The depressed person feels empty before they cry, and empty after they cry.

Depressed feelings are normal when dealing with bereavement or loss of a loved one, but when the symptoms persist more than two months, treatment is recommended.

Most clinical depressions end after six to nine months, but there is a less intense form of depression, called dysthymia, that may persist for years without resolving. Like Eeyore in Winnie the Pooh, the dysthymia may color someone’s personality until they seem indistinguishable from their depression.

Some depressions are seasonal: they typically start in the fall and end in the spring. These depressions are triggered by the decrease in light that characterizes winters far from the equator. Called seasonal affective disorders, these often begin during the college years but can recur year after year without appropriate treatment.

A special class of mood disorders is characterized by alternations between periods of depression and periods of elevated mood. Bipolar I disorder is characterized by major depressive episodes and a manic episode, during which a person has an abnormally elevated, expansive, or irritable mood which lasts at least a week The manic person manifests the following symptoms:

• grandiose or have an inflated sense of themselves
• decreased need for sleep
• jumps from thing to thing in their thoughts
• becomes extremely distractible, focusing on trivial things
• puts tremendous amounts of energy into school, work or creative projects,
• becomes excessively involved in pleasurable activities without regard to dangerousness or reality. E.g. goes on buying sprees, gives away large amounts of money they need for other things, gets involved in wild sexual indiscretions.

In Bipolar II disorder, people get intense, major depressive episodes, but their manic episodes, called hypomanic episodes, are milder and less disruptive.

Finally, a milder bipolar disorder, Cyclothymic disorder, is similar to Bipolar II disorder, except people experience dysthymic episodes instead of full clinical depressions.

These bipolar disorders are especially difficult to treat because people enjoy the highs of the mania or hypomania and do not want treatment, even though they may be significantly impaired, or heading for a depressive crash.

I think I might have a problem...

How do I know?

• Being as honest with yourself as possible, how many of the "signs of depression" did you recognize as applying to yourself?
• Have any of your friends or family members expressed concern to you about your current state?
• Do you have someone you trust with whom you could go over the list, to see how much each of you feels the list describes you?
• Realize that depression is treatable. People can improve with treatment, and should stay in treatment until their symptoms are completely gone, not just tolerably improved.
• One of the cognitive deficits that come with depression is the inability to imagine a future that is any brighter than the present. Realize that this feeling is a symptom of depression, and, though it is hard to believe it, things can get much better.

If you're still unsure, but concerned, call the Counseling Center and schedule an appointment with one of our psychologists (see below).

What can I do?

      The sooner someone seeks help for depression, the less likelihood that it will affect relationships, school or work. Call the Counseling Center and schedule an intake appointment. You and one of our psychologists will decide together where you can get the help that best suits your needs.

How do you treat depression? What helps?

      There are many things that help improve the symptoms of depression, and, for many people, actually resolve the depression.

·         Individual psychotherapy – Individual psychotherapy can be helpful to people with depression. Cognitive-behavioral therapy, interpersonal therapy, and psychodynamic therapy have all been shown to be useful.

·         Group psychotherapy – Special groups are available for people with depression that combine cognitive therapy with traditional group therapy and psychoeducational materials.

·         Medication – There are dozens of medications that can be used to treat depression. There is no sure way to predict which medication may help a person or which side effects, if any, an individual will experience. It generally takes several weeks for antidepressant medications to work. Although any physician can prescribe antidepressants, we usually recommend that you get your initial prescription from a psychiatrist, to take advantage of their vast experience with these medications and to minimize the time it takes to find the correct medication for you. You need to work very closely with a physician when trying an antidepressant, especially because some people find an increase in suicidal thoughts and impulses when taking antidepressants. Be willing to try more than one medication if you do not get good results.

·         Light treatment – Exposure to very bright light shortly after waking can decrease or eliminate the symptoms of seasonal affective disorder. Special lights are available that can be used on a daily basis without damaging the eyes with ultraviolet light. Some people need to have bright light exposure at the end of the day in addition to the morning light. Recent research suggests that bright light might also help people with depression that is not seasonal.

·         Exercise – It is not clear exactly how exercise helps people with depression. Nevertheless, there is very strong data that indicates that 30 minutes of aerobic exercise daily (even brisk walking) is tremendously helpful for most depressed people.

·         Brain stimulation – In rare cases electroshock therapy or the newer transcranial magnetic stimulation (TMS) is used to treat depression without medication.

·         Nutrition – There is a growing body of evidence that dietary changes can help some people with depression. Epidemiological data strongly suggests increases in omega-3 fatty acids in one’s diet can help depression. There are numerous studies which suggest different nutritional supplements may be helpful to people with depression, but most of them are small and not large enough to definitively indicate this. St. John’s Wort, an herbal supplement shown to be helpful in mild depression, should be treated as a drug and only taken under the care of a physician.

·         Treating medical conditions – There are many medical conditions that can masquerade or amplify as clinical depression. It is important that one consult with a physician to make sure there are no underlying physical problems that are going untreated. Though not as common as depression, infections, endocrine disorders, or other metabolic disturbances can look like depression in their early stages.

I'm worried about my friend...

Should I be?

• How many of the signs of depression did you recognize in your friend's behavior?
• Have you ever tried to talk to them about your concern? Are they getting help? Are they willing to go for help?
• Are they getting help, but seem to be getting worse anyway?

      Many students become convinced they have a friend or roommate with a problem, but are afraid they will alienate their friend if they approach them. Paradoxically, depressed people need people more than ever, but usually push people away, withdraw, or behave in ways that make others want to avoid them. Talking to depressed people may not always be a pleasurable task.

      If you have experienced this or are still unsure how concerned you should be, call the Counseling Center and schedule an appointment with one of our psychologists to talk about this. We can help you decide whether your friend needs help, and how best to approach them.

      Most people with depression have strongly conflicting attitudes about others' knowledge of their struggles. They are often ashamed of their depression and think it is an indication of being weak-willed or inadequate. These negative beliefs are usually distortions, caused by the depression itself. It may be helpful when talking to a depressed person to let them know that you know it takes courage and strength to go for help and that you don’t view seeking help as a sign of weakness or deficiency.

What do I do?

·         Talk to your friend and tell them you suspect they might be depressed and ask them if they are getting help. Give them contact information for the Counseling Center and encourage them to call and set up an appointment.

·         Offer to go with them to their first appointment. Depressed people may not have the will or energy to make it to their first appointment on their own.

·         Ask them if there are things you can do to help, realizing that you are their friend, not their therapist, and you can’t fix them or be responsible for their mental health. Depressed people often avoid the very activities that help them get better. Ask your friend how much you can push them to join you in activities when they are isolating themselves or avoiding social contact.

·         Take care of your self. Having a close friend or family member who is depressed can be exhausting. You can start to feel helpless yourself. Realize that depressed people don’t perk up after a good cry or heart-to-heart talk, but nevertheless greatly appreciate your listening presence. Many depressed people report after recovery how grateful they were for their friends’ presence, even if they were unable to express it at the time.

·         If your depressed friend talks about suicide or some sort of serious self-harm, get them immediate help. Always take such talk seriously. Do not try to assess whether or not they are a real threat or are just expressing strong feelings. Let professionals make that judgment call. Remember that most people who complete a suicide tell someone about it first.

Suicide: A Permanent Solution to a Temporary Problem

      Many people with depression think about suicide. When very depressed, it may seem like an opportunity to escape the emptiness and pain of the depression. The emptiness and pain will eventually end, but depressed people cannot see this due to the distortions in cognition.

• When people are suicidal they need immediate help. If their suicidal thoughts turn into suicidal impulses, with intentions to actually harm themselves, they may require hospitalization until the suicidal impulses can be treated.
• Do not try to judge whether someone else’s suicidal intent is serious. Call someone professional, or get the person immediate medical help.
• The cognitive distortions of depression may make suicide seem like the only solution to the person’s problems. Generally, suicidal thoughts are not fully rational.
• When people are stopped from killing themselves, they are almost universally glad someone stopped them from killing himself or herself. If someone “made you promise” to keep their “secret” before telling you about their suicidal plans, go ahead and break your promise. They can only thank you if they live to have their depression treated.
• If you live in a dormitory on campus you can contact someone on residence life staff to arrange an immediate evaluation either at a counseling center or a community agency. If you or someone else is in danger of hurting themselves and you can’t reach the people above, you can call 911 (Off campus), or 9-911 (On campus).

What help is available at Rutgers?

      A wide variety of help is available, including psychological assessment and treatment recommendations, short-term individual psychotherapy, group psychotherapy, medical assessment and monitoring, and psychiatric evaluation and monitoring of medication usage.

Administrative Help:

·         If you live in a dormitory, you can talk to your preceptor, building director, or area coordinator about yourself or someone else. They are especially useful in emergencies when someone is struggling with self-harm.

·         College deans, student services staff, or the graduate dean can help you negotiate with professors if your depression is affecting you academic work.

·         Students with chronic depression can get help from the Disabilities Services Office at each college.

College Counseling Centers:

• Cook College Counseling Center.
  Cook Campus Center, Cook Campus.
  732/932-9150. Director: Marta Aizenman.

• Douglass College Psychological Services.
  Federation Hall, Douglass Campus.
  732/932-9070. Director: Mary Ann Jensen.

• Livingston College Counseling Center.
  Rm. 247 Tillett Hall, Livingston Campus.
  732/445-4140. Director: Kenneth Roy.

• Rutgers College Counseling Center.
  • 17 Senior Street, College Avenue Campus.
    732/932-7884.
  • 8 Lafayette Street, College Avenue Campus.
    732/932-3966.
    Director: David Chandler.

• University College Office of Advising and Counseling.
  14 College Avenue (Miller Hall).
  732/932-8074. Dean of Student Support Services: Kay Lynch.

Other Campus Resources:

• University Psychiatric Service.
  Hurtado Health Center, College Avenue Campus.
  732/932-7402 X233

• Rutgers Psychological Clinic (Graduate School of Applied and Professional Psychology).
  Psychology Building Annex, Busch Campus.
  732/445-6111.
  Director: Dr. Donald Morgan.

• Hurtado Health Center.
  11 Bishop Place, College Avenue Campus.
  732/932-7402.
  

• Busch/Livingston Health Center.
  Hospital Road and Avenue E, Livingston Campus.
  732/445-3250.
  

For comments on this web-site, contact David Chandler or call 732-932-7884.

This page last updated: February 13, 2004

Rutgers, the State University is an equal opportunity affirmative action institution.