April 3, 1998

More than just 'feeling blue'

They call depression the "common cold" of mental illness. And the campus experts who treat students with depression say over the last 10 years there has been an increase in the number and severity of cases.

About four per cent of the people who walk through the doors of University Health Services are suffering from severe anxiety or depression, says physician Dr. Teresa Stelfox. "Since 1981, I've seen a 30 to 40 per cent increase in the number of people I see." Down the hall, in Student Counselling Services, director Dr. Howard Saslove, says his numbers have steadily climbed throughout the last decade.

In 1996-97, Priority One Human Resources Inc., the firm retained by the university to provide employee and family assistance programs for staff, saw about 300 staff members and many of their dependents. About 20 per cent -- that's about 60 people -- reported being on the edge or experiencing full-blown depression, says Dr. Wes Penner. That's down slightly from the numbers in 1993, when layoffs, fear of layoffs and workloads were big workplace issues on campus.

How do you know if you're depressed? The signs aren't always obvious. Experts typically have to ask a lot of questions to confirm diagnoses. There are early-warning signs, however. Stress is the obvious one. Students will sometimes tell Saslove they simply walked out of their exams. Others will stop attending classes. They have trouble sleeping, maintaining their motivation and self-esteem, experience feelings of hopelessness, and become increasingly withdrawn. Saslove and Penner agree it is often a disintegrating relationship that forms part of the problem. In the worst-case scenarios, people will admit they are suicidal.

Is there more depression around today? Definitely, yes, says Penner, and that's borne out by study after study. The increase is due to the fact that we live in fast, precarious and cynical times, a time when society and the economy are changing at an unprecedented pace. That means more stress, the precursor to depression, says Penner.

The U of A rates are similar to national rates. According to mental health associations in the U.S. and Canada, about five per cent of the population experiences mild symptoms of depression -- that's about 1.5 million Canadians. At least one in six experiences a serious or major depressive episode in their life.

Not surprisingly, the incidence of depression on campus among students increases around exam time. And, says Penner, high rates of absenteeism are associated with depression.

Who's most at risk? Women suffer depression twice as frequently as men, but men often hide their depression and don't report it. The American Psychological Association's task force on women and depression found 37 per cent of depressed women had experienced some physical or sexual abuse by age 21. Urban residents report more commonly than rural residents. And the baby boom generation, with its unprecedented rates of divorce and relocation, is the most at-risk group in North America, say experts. Unlike the common cold, however, students and staff suffering from depression can do something about it. University Health Services has seven part-time psychiatrists on staff. Counselling does work, says Saslove.

In the short term, counsellors and physicians help students defer exams and assignments that may be simply overwhelming students. They may refer them to their family physician. In the longer term, counsellors help students sort out priorities and causes, and talk about their underlying belief systems. "In many cases we ask about work load," explains Saslove. Some students will be working two part-time jobs, carrying a full course load, doing sports, volunteering and socializing.

However, "If they have the opportunity to work out their problems, they become stronger and forge ahead. If they can name it, face it and deal with it, their self-esteem goes up." Saslove says the sad part, however, is that once people come to see him, they're typically not coming for preventative reasons.

There are many resources people suffering from depression can draw on. But they're up against some formidable cultural hurdles. The stigma still exists, says Penner. Saslove points out this is a culture of individualism. There's a reluctance to come forward and admit mental illness, particularly among professors. He sees more support staff than professors and more women than men.

As for students, many have high expectations of themselves and when they don't meet them, they feel ashamed. Their self-esteem is on the line. And despite strict confidentiality, students are often fearful everyone on campus will know they're suffering from depression. One 21-year-old international student last year become so withdrawn, he became depressed and eventually psychotic. He finally sought help at Health Services and eventually got back on track. "Human beings are social; they need to laugh, to cry and to share their feelings," explains Stelfox.

"We tend to reinforce the work ethic more than self care," says Saslove, who believes the focus has to shift from treatment to prevention and screening.

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