Stemming the Rising Tide of College Depression

I sit in my office at our campus psychiatry clinic on a chilly February morning, calling a mother, something my patient has given me permission to do. I know the mother will be upset by what I tell her, but I also know she is part of the circle of care essential to her daughter’s recovery. My goal is to impart hope even while delivering bad news.

“I’m here with Angela, and we’re on speaker phone. I wanted to let you know that Angela is going to admit herself to our local psychiatric hospital for treatment of depression.”

There is a long pause on the phone. “This doesn’t make any sense. I know Angela was feeling sad last semester after failing her chemistry class and changing majors. But isn’t it normal to be sad?”

Angela cries softly. “Mom, this is much worse than feeling sad. I’ve been so depressed I don’t want to live. When I told my roommate that I was planning on taking an overdose, she brought me here. She’s in the waiting room and will take me to the hospital.”

Angela’s mother catches her breath. Angela looks panic-stricken, worried she has overwhelmed her mother. I give Angela a comforting look while responding to her mother.

“I know this is scary for you, but I’m glad Angela opened up to her roommate and is willing to go to the hospital. This is the start of Angela getting help, and with treatment, she should fully recover.”

As soon as we hang up, Angela’s mother makes arrangements to visit so she can support Angela and meet with her inpatient team. After a short hospitalization, Angela goes home to continue treatment. When Angela returns to school the following semester, she is feeling markedly better.

The large majority of depressed students recover. With therapy, medication, or a combination of both, they continue in school. They incorporate wellness activities like yoga and exercise into their lives. They seek relationships that improve their mental health.

But if you are the mother or father receiving the phone call, you may feel frightened and alone. If your child broke a leg or had mononucleosis, you could tell someone, but could you tell them your child is depressed?

We often avoid talking about our children’s mental health problems with friends. Even if we don’t have negative perceptions of mental illness, we worry that our neighbors do. If we can start a dialogue with other parents, we might feel less alone and learn about treatment options. A great organization for connecting families experiencing mental illness is the National Alliance on Mental Illness, which offers support groups, education, and advocacy.

Parents sharing ideas and support is essential as depression on campus is increasing. According to the 2017-2018 Healthy Minds Study, 37 percent of college students screened positive for depression, nearly double the rate in 2014-2015. However, only 53 percent of college students who screened positive for depression or anxiety received any kind of treatment in the last year.

The high rate of untreated college depression is concerning, as it can lead to distress, school failure, and self-harm. The worst possible outcome is suicide. Sadly, suicide rates for people aged 15-24 rose 44 percent from 2010 to 2017.

What stops students from receiving help for depression? Some students may not seek help, fearing that parents, friends, or others will judge them negatively for getting mental health treatment. In fact, the Healthy Minds Study showed that 47 percent of college students agree with the statement: “Most people would think less of someone who has received mental health treatment.”

Other students may not get treatment for depression because they face roadblocks when they seek mental health services. Often, there are not enough campus or community resources to meet the growing mental health needs of university students. At some schools, therapy and psychiatry treatment is provided on a short-term basis. Students may be referred off campus but face financial and transportation challenges in accessing care.

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What can parents do to ensure a depressed college student gets the mental care they need?

Getting Our Kids Talking About Depression and Mental Health

Starting and continuing a dialogue with our children about mental health may encourage them to seek treatment when they need it. Address any concerns they have that you or others would judge them negatively for getting mental health treatment. Let them know that depression often occurs in young adults, and you support treatment. Here are some tips for talking about depression with your college student.

1. Talk about mental illness and depression in a nonjudgmental way. Use language that shows you understand mental illness is a medical problem, not a moral failing or weakness.
2. Teach your children about signs and symptoms of depression: sadness, anger, irritability; lack of enjoyment in activities; poor sleep or sleeping too much; eating too much or too little; a decline in grades; spending more time alone; self-harm or talk of not wanting to live.
3. Tell your children that people recover from depression and other mental health problems with comprehensive treatment including some or all of these tools: lifestyle changes, medical evaluation, therapy, medication.

For more information about how to talk with your child about distressing feelings, read Joanna Lilley’s article “My Young Adult is F.I.N.E.” Lilley, a therapeutic consultant, discusses how to respond when your college student says, “I’m fine,” but is not. Also, watch Jason Reid’s TEDx Talk “The most important conversation you will have with your kids.” Reid, whose son died by suicide, advises not to take, “Yes I’m O.K.” for an answer to the question, “How are you doing?” Dig deeper and insist on therapy if you are concerned.

Helping College Students Access Treatment for Depression

Partner with your college student to locate on- and off-campus resources.

1. Mental health treatment: Encourage your child to establish care with a therapist and/or psychiatric provider to continue treatment as long as is necessary. Treatment could occur on campus, off campus, or a combination of both. Often, counseling centers have case managers who can facilitate community referrals.
2. Disability resource center: Your child can register at the college disability resource center and get accommodations that may include a reduced course load, exams in a quiet setting, and coaching.
3. Success coaches: Several colleges have success coaches who can guide your child towards academic success and campus involvement, taking into account mental health needs.

If your child opens up to you when they experience depression, you have won half the battle. Your next challenge is helping your student find treatment in a nationally underfunded, understaffed mental health care system. Take heart. Call on your Herculean strength and Odyssean optimism to find your child the care they need. Guide your college student until they can navigate their own journey of recovery.

©2019 Marcia Morris, All Rights Reserved.
Details have been altered to protect patient privacy.