By C. O’Toole
I remember the first day of my freshman year of college achingly well. My parents and I said goodbye in the pouring rain on Newbury Street in Boston. I walked away from the car and didn’t look back. I wasn’t about to let them see me cry. After all, I was free! I was independent! I was starting art school, a lifelong dream. What could possibly be wrong?
Inside, I was coming completely unglued. I didn’t know what was happening to me exactly, but I felt not quite right. Over the next few weeks, I lost twenty pounds, started smoking two packs a day, and barely slept. I had trouble making friends. Saturday nights were spent alone, crying, in my tiny dorm room. I started skipping classes. I was having terrifying panic attacks.
I also missed home. But I was too embarrassed to admit it, too scared to tell my mom and dad that freshman year was all too much and I was in trouble.
Looking back, it is clear I was coping with major clinical depression, which I believe had started in earnest over the summer and had been exacerbated by the stresses of freshman year. Never having been depressed before, I wasn’t sure what it was. I just thought I was having normal “going away from home” issues and normal teenage angst. What I didn’t know was that my freshman year anxiety and depression were completely textbook.
Aaron S. Cohen, PhD, Senior Staff Psychologist, CalMHSA Student Mental Health Initiative Coordinator, Counseling and Psychological Services, University of California, Berkeley, says anxiety and depression among first-year college students are a tremendous problem.
“What I see behind the anxiety and depression in freshmen are transition issues,” Dr. Cohen says. “It’s a big life adjustment. There’s homesickness, a [tougher] academic world, and shifting to a world of more independence for some students. Students are struggling with family expectations, and adjusting to a new environment.”
“For many students,” says Dr. Noel Taylor, a New York City-based psychiatrist, “it’s the first time they’ve been away from home. They’re trying to negotiate living with a roommate and they may be trying to figure out how to manage their time and feeling overwhelmed by it.”
On top of all the “normal” freshman year stressors, there is also a history of depression in my family, which put me at higher risk for developing clinical depression.
“What puts people at a higher risk is, number one, if you’ve had a history of depression. Number two, if you have a family history of depression,” says Dr. Taylor.
“Students who’ve dealt with traumas throughout their life—and maybe they haven’t had any depression—may [also] be at greater risk,” Dr. Cohen adds.
Other factors that could fuel or spark a depression include using drugs or drinking, which I was doing a lot of.
“[Freshmen] may be encouraged for the first time to do a lot of drinking,” says Dr. Taylor. “The alcohol is something that sometimes helps precipitate [depression]. Binge drinking, frat drinking, and whatever else. They may also start drinking more just as a way of knocking themselves out. So the alcohol can precipitate [the depression], then as people get more depressed they drink more.”
What Dr. Taylor describes is exactly what I did. Luckily, I had the wherewithal to avoid the hard drugs that were making the rounds at school—like cocaine. But I was drinking. A lot. Self-medicating.
I knew people around me were aware that I was crumbling. I would leave classes crying and spill my guts to potential friends, scaring them away. But I didn’t know how to officially reach out for help. I could snap myself out of it, I thought. I just needed to “buck up.”
After all, this was art school—and artists are known for being angst—ridden. My depression, I believe, was glossed over by teachers and peers because it seemed a part of my artistic personality.
But what I had was every symptom of anxiety and depression in the book.
“With anxiety, people start to feel overly stressed, overly worried about things more than they normally do,” says Dr. Cohen. “They start to have what feels like a panic attack where they feel like they can’t breathe, or they get dizzy, or they’re having heart palpitations. With depression, they’ll start ruminating about things too often; things that were once enjoyable aren’t enjoyable; they feel kind of blue more often than not; they’re not engaging with friends; they may feel less worthy about themselves; they may eat too much or too little, sleep too much or too little and have thoughts of suicide.”
Check, check, check.
“The number one symptom that I see is all of a sudden, [students] don’t go to class,” says Dr. Taylor. “They retreat, sleep, and spend the whole day holed up in their rooms. They just lie in bed, they turn away from friends and become socially isolated, and will just withdraw and hole up and become paralyzed. They’re not interested or into anything. They have no energy, no drive—[they are] overwhelmed by everything. They may stop returning emails and texts and they just don’t want to talk to anybody.”
As I look back, I realize that if I’d had a broken leg, I would have gone to the ER immediately. So why was it different with depression? Quite simply, I was paralyzed and didn’t know how to help myself.
The Jed Foundation, which aims “to promote emotional health and prevent suicide among college and university students,” makes an important point on its website: “If you were in physical pain, you’d get it checked out. Mental health is just as important.”
But I just didn’t know how to reach out. Or even where to reach out. I didn’t know that depression could constitute an emergency, even though I was having persistent, gnawing thoughts of ending my own life.
“The person that’s depressed may either be too paralyzed to [reach out for help] or too ashamed to do it,” says Dr. Taylor. “But someone has to have the strength to say, ‘We’ve got a problem here, let’s fix it.’ People just wait until it’s ridiculously bad. It’s like they got a misdemeanor and made it a felony. Like, the person comes out and hasn’t taken a shower in weeks, they’ve skipped all their classes, and they’re flunking everything.
“I always ask, ‘How did it get this bad? You got incompletes on everything—why didn’t you go to your professors, why didn’t you call a dean, or the family? Why’d you let it get so bad?’ A lot of people—roommates and friends—will say they didn’t want to get personal, they didn’t want to get involved, they don’t want to embarrass [the person].”
Dr. Cohen believes that immediate intervention—before the problem escalates—is key.
“I like to see students get support when [they’re having] the normal transition issues, the normal nervousness issues, the normal sadness they might experience when they struggle in a class or have a relationship challenge,” he says. “They have the opportunity to talk to someone before that ‘normal’ nervousness and sadness turns into depression and anxiety. So that ‘normal’ sadness, that ‘normal’ nervousness doesn’t turn into something where you have to see a professional counselor. I think campuses need to look more broadly. We don’t have to wait until it’s depression, until they spiral out of control. Let’s try to get to them sooner.”
“In November, I will definitely hear from students that say, ‘I was depressed my junior year [of high school], I got to college, thought this was my clean slate, so I wasn’t going to get into treatment’,” Dr. Cohen adds. “Now, I’m falling behind in my classes, I have no friends, and I’m back into my depression. I wish I had thought proactively to get some support.’ Campuses are far better equipped for proactive support than reactive support. But sometimes the students don’t think they need the proactive support.”
“I’m a big proponent that students use their trusted faculty member to at least start talking and saying something is not right,” says Dr. Cohen.
Additionally, students can connect with their on-campus counseling center.
“Most campuses that have counseling centers usually have access to some kind of urgent drop-in hours,” he adds.
My tiny art school did not have a counseling center, and I was too embarrassed to reach out to a teacher—though in hindsight, I probably could have. It ultimately became clear to my parents that I needed immediate help. They flew me home, I went into treatment (medication and therapy), and took the next semester off and recovered at home. It took six months for the depression to even begin to lift.
But not before I had concocted elaborate plans to end my life.
According to The Jed Foundation, one in 10 college students has considered suicide.
But what does one do to help those students?
“Counseling services need to be notified,” says Dr. Cohen. “If a student is suicidal, has a plan and wants to do something, they need to call 911. They need to call emergency support.”
Dr. Cohen points out that at Berkeley, even when it’s two in the morning, there is access to counseling.
“We have an after-hours number on our campus that students can call if they’re feeling suicidal and a counselor will talk to them from the other end and make a decision that, if that counselor feels something could happen, they will call the police.”
But what if there is no after-hours number? There is always someone.
“1 (800) 273-TALK, the nationwide suicide hotline, is absolutely fantastic,” he says.
“If it’s after hours,” he adds, “they can call the national hotline, or, if someone’s really worried about them, they can call the residence life staff and then, [if it’s an emergency], the police. The police try their best to be as compassionate as they can. They are getting more and more mental health training.”
Luckily, my story had a happy ending. With my quick-thinking, fast-acting family, I was able to get the support I needed. Not everyone is as lucky.
If you or someone you know is struggling with anxiety and depression in college and needs support, get help. Whether it is from a friend, family member or school counseling services, help is there.
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