Depression, especially during winter holidays, not unusual for students
By Kathryn Summers
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Annmarie Hancock remembers a Christmas two years ago when her world seemed to be falling apart. All her roommates drew names for a gift exchange, then went to the mall together to buy their presents. Annmarie started to wander around the mall feeling lost.
"I just wanted to cry."
She said she had no idea where to start and was overwhelmed with the prospect of buying one gift.
Annmarie went to a doctor over Christmas break because of some physical problems. The doctor determined that she was depressed, and the physical problems were a manifestation of the stress she was under.
Depression isn't something that's imagined, or all in a person's head. It's a serious medical disorder that affects about 10 percent of people in the United States every year, or about 19 million in 1998, according to the National Institute of Mental Health web site.
Many people don't realize they are depressed. At Utah State University, 10 percent is about 2,000. Of the 717 students who came into the Utah State University Counseling Center in the 1998-1999 school year, 202 suffered from a mood disorder, said Maren Seamons, the Counseling Center office manager. If the statistics hold true at USU, then there are about 1,800 people on campus who are depressed but aren't seeking help from the counseling center.
Some common symptoms of depression, according the NIHM web site, are feelings of hopelessness, pessimism, persistent sad or "empty" mood, loss of interest in previously pleasurable activities, a change in sleep patterns, lack of energy and ability to concentrate, and a change in appetite and weight. Some of these things are normal to experience at some time, but when several of the symptoms persist for weeks or months, it could signal depression.
Anyone can be affected by depression, but some are more likely than others to become depressed. Depression seems to be hereditary, and women are twice as likely as men to have an episode of depression. A serious loss, chronic illness, difficulty with a relationship, or unwelcome change in life patterns can trigger a depressive episode. Often a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive illness, according to NIMH.
When Annmarie's doctor diagnosed her as being depressed, he prescribed Prozac, the popular antidepressant in the family of drugs known as Selective Seratonin Reuptake Inhibitors, or SSRI. She took Prozac for nine months, but it didn't seem to be doing what she had hoped.
"Contrary to popular belief, it's not a high happy feeling," she said of the drug.
After a stressful summer job she went to a counselor who called her doctor and suggested changing Annmarie to Luvox, another SSRI drug. That didn't seem to work either, so Annmarie finally went to a psychiatrist, a medical doctor who specializes in treating mental disorders.
The psychiatrist listened as Annmarie explained how she felt and some of the stresses in her life. Then she explained to Annmarie that she had dysthymic depression, a less intense type of depression, but chronic and serious enough to keep her from functioning at full ability. The psychiatrist prescribed Celexa, another antidepressant in the same family as Prozac, but with different side effects. Annmarie said Pozac made her feel more anxious, but Celexa is more calming. Every person reacts differently to different medications, so it was important to find the right one for her personality.
Annmarie explained that any medical doctor can write out a prescription. Her experiences taught her the importance of going to a properly trained psychiatrist. For foot problems there are foot doctors, for eye problems there are eye doctors.
Psychological problems are real and there's a doctor for that, she said.
Dr. Gwena Couillard (pronounced KWEE-yar) is a counselor in the USU Counseling Center in the Taggart Student Center, room 306. She is a licensed marriage and family therapist, but she mostly does individual therapy at the center. She speaks with a beautiful soothing French accent and shows a genuine concern for people. She has worked at the center for nine years, so she has a lot of experience helping people deal with depression. Counseling is free for students. Couillard can't prescribe medication, but she can send students to the Student Health Center in the TSC, first floor, with a recommendation to the doctors there.
She said the counseling and health centers work together to give students the help they need. Often the health center gets students with physical symptoms of depression and sends them up for counseling, and the counseling center sends students down to the health center for medication.
Couillard said most students come in for counseling by themselves because they want to change something about their lives or attitudes. Often they will come after friends, family, or a doctor recommends counseling. Others just don't feel good and they want to change so they come in for help. Some are forced to come in, but most come because they realize they need help.
One student who recently went in for counseling described some of her experience. She didn't want to be identified other than as M.
M met with Dr. Couillard on Dec. 10 for the first time. M said she first had to fill out an hour's worth of paperwork a few days before and talk with a counseling center intern to determine her need for counseling. She said it was intimidating because she had to "spill all your horrible stuff there."
When M met with Couillard she said she first felt afraid because Couillard knew "all the dirt I hold back." They started with small talk, but M said finally she began to talk about her problems because "it's been building up for so long, I just needed to let it out."
M described Dr. Couillard as being sincere in her actions and concern. She could tell she wanted to help her and it wasn't just Couillard's job. She was genuine, caring, and sensitive to the needs and feelings of her patient. M called Couillard an "instant friend you could trust."
Anyone who deals with mental health issues uses the Diagnostic and Statistical Manual of Mental Disorders, most commonly referred to as DSM-IV. The book, published by the American Psychiatric Association, provides the only comprehensive classification of all recognized psychiatric disorders in print.
Couillard said she uses hers a lot. She has a smaller version for her office, but there is a large book in the counseling center reception area. She said defining the types of depression can be "very complicated and very complex and no one remembers this without looking in the book,"
If she feels that a patient could benefit from medication, Couillard said she tells her patients that they are free to choose. Medication "will not cure psychological reasons why they feel depressed, but will take the edge off so they won't feel so low all the time." If people feel physically better, then they have more energy and more courage to fight the psychological reasons for depression.
Annmarie said her medication doesn't make her happy.
"It calms the other things so I can be the person I am," she said. Medication helps her cope, but "It's up to me to feel happy," she said.
Couillard said sometimes there are other ways to cope with depression than drugs.
Exercise daily, eat good regular meals, and force yourself to do activities that are fun, but that you don't want to do, she said. Medication can get very expensive, especially without insurance. One SSRI drug called Zoloft costs $2 per pill. Doctors usually recommend being on medication for at least six months.
There are some types of depression that require medication. Bipolar depression, characterized by bouts of mania followed by bouts of depression, has a huge chemical component and must be treated with medication.
"You don't will yourself out of depression. You can pretend you are OK, but it's deeper than deciding to be happy," Couillard said. Counseling can help people who suffer from depression to get to the root of their problems. Medication can only treat the symptoms.
She enjoys her job because "the nice thing about depression is, it lifts. It's very common to see someone after five or six sessions [of counseling] coming out of it. That's exciting."
She said to keep herself upbeat she tries to find a balance. She gets involved in other things besides counseling, like organizing or attending workshops and seminars. She has a mix of clients and if someone isn't willing to change their life in order to quit feeling depressed, she will quit counseling that person.
Not every depressed person is just depressed. Some can be manipulative takers. People may gain sympathy by being depressed so they don't try to do anything to get feeling better. The main reason for being depressed is "thinking crooked thoughts," she said.
They blow things out of proportion and don't want to hear rational thoughts. Someone who wants help will listen. She said it is important to identify the intentions of the people she counsels.
"People who are depressed need to cope with the symptoms," she said. Friends can take them out, and "it's OKto push," she said. The last thing depressed people want to do is have fun, so friends can help make them go have fun.
Supportive friends and family can really help people who suffer from depression. Be a listening ear, but know your limits and how much you can hear so you don't become their therapist or "dumping basket," she suggested. "Know what you are willing to give."
For Annmarie, Christmas is a hard time of year because she is depressed, which is one strike. The finals add extra stress, which is another strike. Seasonal Affective Disorder, also called SAD also affects her. It's "gloomy, sad, dirty, and wet" outside, which makes her feel even more depressed, a third strike. Add Christmas preparations on top of that and it can all be too much to handle. Luckily, with the help of her medication and the support of family and friends, Annmarie has found she can cope with the stress of it all.
She said she takes each day as it comes. She tries to relax and write down all the steps to get things done.
"If it stresses you out so much you're going to be crying over it, and can't even decide where to start," she will just "put it on the back-burner," and wait until she can deal with part of it.
If you think you or someone you know suffers from depression, resources are available to help. The counseling center has brochures that can help identify the symptoms.
The Internet can also be a good resource, but look for reliable sources.
If you think you are depressed, the most important thing to remember
is that there are people who can and will help, but you have to ask.