The calls came in the middle of the night. She was having a panic attack. She was lonely. She was afraid. She was bitter.
"I dread each time the phone rings, not because I don't want to talk to her," Lorraine, a Bergen County woman, said of her daughter earlier this year. "But because I have a fear that I won't be able to be as supportive as she needs me to be."
Three things helped her daughter. She got treatment. She got medication. And, perhaps not coincidentally, she graduated.
Earlier this year, she suffered from depression, something that researchers say affects 15 percent of college students. Those numbers are probably growing, mental health professionals say, as the pressure to perform and socialize increases.
As they prepare for their first day of classes, educators and counselors say they're paying closer attention to an illness that - if left untreated - can become something much worse.
"The number of actual suicides at Rutgers is small, but any suicide is too many," said David Chandler, director of the Rutgers College counseling center. "In some places, there are plenty more."
According to the National Mental Health Association, suicide has become the third leading cause of death for those aged 15 to 24, and the second leading killer in the college population. These statistics demonstrate the seriousness of suicide, which is often linked to untreated depression, researchers say.
"There have been more documented cases of students seeking help from the [college] counseling centers," said Chris Condayan, a spokesman for the NMHA. "It could be anything. ... When they're in high school, they may be getting straight A's. Then they get to college and it's harder. Another thing is being on your own. It's a big life change."
Sometimes these cases even get national attention. Earlier this year, University of Wisconsin student Audrey Ruth Seiler cited depression as the reason she faked her own kidnapping. She was placed under a doctor's care and pleaded guilty to obstructing police.
Lorraine said she first noticed the signs when her daughter was in high school. She saw it in her eating habits - she'd order a bagel at a restaurant but not eat a bite of it. She'd act bitter and withdrawn.
Being at a college that was four hours away, her mother admits, probably exacerbated the problem. No longer did she have "the support of home," Lorraine said. "When she went to college, she could hardly drag herself to class," she said.
Colleges have taken the issue seriously. Some have used the Internet as a tool to inform
people about students and depression. Many colleges, like St. Mary's College of California, have put together Web sites that identify the symptoms of depression, and what to do about them.
According to the St. Mary's Web site, those symptoms include: a feeling of sadness most of the day, and nearly every day; anxiety or irritability; markedly diminished interest or pleasure in most activities; feelings of helplessness and hopelessness; and thoughts of suicide.
The National Institute of Mental Health also offers a Web site, at nimh.nih.gov/publicat/ students.cfm, on which three students talk about their experiences with depression and what they did about it.
The institute recommends seeking professional help. But making that step isn't always easy, it suggests. So it offers these tips: "Don't give in to negative thinking. ... Take an active role in getting better ... Be good to yourself while you're getting well."
"Depression can make you feel exhausted, worthless, helpless, and hopeless, making some people want to give up," according to the NIMH. "Remember, these negative views are part of the depression, and will fade as treatment takes effect."
The most important thing people can do, Chandler said, is get treated. While suicide rates have gone up, the Rutgers administrator said he's seen students in general take a more active role in protecting their mental health.
"There are more services in general available," he said. "There are new anti-depressant medications that have appeared in the past decades. And more students are coming to college these days having already taken them."
Lorraine now feels confident that her daughter is OK. But she also realizes that, as she begins her new career as a teacher, that she may feel new pressures.
"Fortunately, things have gotten better," she said.
The Coping column appears every other Tuesday. To suggest topics, write to Tom Davis, The Record, 150 River St., Hackensack, N.J. 07601 or e-mail email@example.com. Please include your phone number with all correspondence.
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