January 17, 2011
Researchers say severe mental illness is more common among college students than it was a decade ago, with most young people seeking treatment for depression and anxiety. A study presented at the American Psychological Association found that the number of students on psychiatric medicines increased more than 10 percentage points over the last 10 years.
A large part of the reason for this increase has to do with the success of treating younger high school-age students. Today, there are more effective public and private sector counseling programs for children. As a result, health experts say, more students with learning disabilities and emotional problems manage well during high school years and then go on to college
"These are youngsters many of whom in the past wouldn't have even finished high school," says Dr. Katherine Nordal, with the American Psychological Association. "Special education services in high school mean that more students with emotional difficulties and special needs are going on to college," with their more emotionally stable counterparts.
Nordal points to one recent study that showed approximately one out of every four or five students who visits a university health center for a routine cold or sore throat turns out to be "depressed."
While most colleges and universities have some form of mental health counseling, the majority are understaffed and overwhelmed, Nordal says. But treatment is there for students who persist and Nordal offers some advice to friends and family who want to help identify problems.
Symptoms grow slowly and insidiously, she says, over time.
"It’s not like flipping a switch and someone has normal mood and behavior one morning and then wakes up the next morning in some other kind of zone," she says.
There are also certain behaviors that should clearly sound an alarm: If young people are distancing themselves from friends, losing interest in things that they once enjoyed doing, becoming irritable or angry, having outbursts toward people who were close to them, experiencing changes in eating or sleeping patterns, having unexpected, unexplainable episodes of tearfulness — these are all potential symptoms of depression, anxiety or other emotional problems.
These problems can be exacerbated by the very nature of going off to college. For many young people, this is the first time they have left home for any period of time. They are outside the familiar and safe family structure, complete with parental discipline, control and advice. They may find themselves in a challenging new environment with a completely new set of peers.
Unfortunately, many new friends, says Nordal, just don't have the "reference point" on the student's "normal" behavior to make a judgment about erratic behavior or changed mood. Often it is close friends and family who know the student best — the new friends are just beginning to get to know them.
Even so, Nordal says if a student's new friends notice what appears to be obvious distance, difficulty or depression, they should suggest the student seek counseling. They can even pressure the student, she says, because in some cases, treatment can be life saving.
Dr. Jerald Kay, a child psychiatrist and chair of psychiatry at Wright State University School of Medicine in Dayton, Ohio, specializes in adolescent health and has worked with American Psychiatric Association committees on college mental health. He co-authored the book Mental Health Care in the College Community.
Recently, Kay treated a 22-year-old male student whose friends were worried about recent behaviors and urged the student to seek help. Kay notes the friends were worried about extreme alcohol problems. The student was drinking every weekend to the point where he blacked out and had no memory of what happened.
He was also not sleeping well, was no longer relating to his friends and had lost 15 pounds in just six weeks. Kay says soon after beginning psychotherapy, the student divulged that he had a plan to hang himself in the closet of his dormitory, on the clothes hook.
Luckily, Kay was able to successfully treat the student with psychotherapy and an anti-depressant. Today, the student is doing well. He has gained weight, is sleeping better and most importantly, his outlook on life has improved. So have his relationships with his friends, whose encouragement to get help likely saved his life.
While this student was able to keep his academics on an even keel, Kay says that's often not the case.
"A lot of the young people I see don't go to class," he says. "They're not able to complete assignments and you get the sense that academically they're going down in a spiral" and often drop out of extracurricular activities as well, and spend more and more time alone.
Kay says it is effective once students do get into treatment.
"Young people have a resilience, and with intervention, it can be life changing," he says.
Even so, Kay says college mental health programs are typically overwhelmed with the numbers of students needing help. And while there are mental health counselors, he notes that most schools have psychiatrists available only a few hours a week — a dire shortage of specialized help in such a time of great need, he says. And many schools have experienced recent budget cuts in mental health programs.