James Donaldson on Mental Health – Helping College Kids With Depression

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James Donaldson on Mental Health – Helping College Kids With Depression

What to watch for and who can help

Writer: Rachel Ehmke

Clinical Experts: Roy Boorady, MD , David Friedlander, PsyD

What You’ll Learn

  • Why do kids starting college sometimes develop depression?
  • What are some common signs of depression?
  • What can parents do to support college kids who are experiencing depression?

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Starting college is exciting, but it’s also stressful. For some kids, so many changes and new responsibilities all at once can trigger depression. The lack of structure and support also makes college an especially difficult time for kids to cope with depression.

If you notice big changes in your child’s mood or behavior, check in with them. Some signs of depression, like crying or feeling sad a lot, may be obvious. But others, like being irritable or having a hard time concentrating, are more subtle. If you hear that your child is spending a lot of time alone or quitting things they used to love, they might be depressed. Using drugs or alcohol a lot can also be a sign.

If your child has already been dealing with depression before college, it’s a good idea for them to get in touch with the school’s counseling center ahead of time. That way, they know who to talk to if they need support. And if your child has been taking medication, the transition to college is a bad time to stop. If your child wants to stop, it’s best to wait until they’ve settled in and the stress of first year has passed. Then their doctor can help them stop the medication safely.

If your child is dealing with depression for the first time, encourage them to get help at school. Many colleges offer a limited number of free therapy sessions to students. They can also refer your child to a local therapist for continuing care. It’s also important for kids to maintain a regular schedule, get plenty of sleep, and eat nutritious meals. With the right support systems, students can adjust to their new environment and start to feel better.

Going to college is an exciting time in the lives of young people, but for some students depression gets in the way. Whether it’s their first brush with the disorder or not, college can act as a catalyst for the onset of depression in many young people, and, on their own for the first time, the timing couldn’t be worse.

Roy Boorady, MD, a child and adolescent psychiatrist at the Child Mind Institute, says he gets “lots of calls first semester” about college kids who are having a hard time. “Usually what they end up doing is calling their parents in the middle of the night. Then their parents call me and say, ‘I’m getting two and three o’clock in the morning calls from my child who is crying and depressed and unhappy. What do we do?’ ”

Children can be depressed at younger ages, but the older they are the higher the prevalence rates. Experts consider risk factors for depression to be a combination of genes and environment. Some kids might be genetically at risk for developing depression, but they will be fine until they experience an environmental stressor that flips the switch and sends them into depression. It makes sense that college could be that stressor.

The stress of a new environment

“Leaving home is a huge transition for kids, and I think we underestimate the difficulty that a lot of kids have,” says Dr. Boorady. Away at college, suddenly kids find themselves in a new environment without any of the structure or supports — academic or emotional — they’ve always been able to rely on. Kids might have complex feelings about how they should be relating to the people back home, or think that they don’t fit in with their new peers.

Independent for the first time, they might also be embracing the college lifestyle: erratic sleeping habitsnon-nutritious (or nonexistent) meals, and an unstructured schedule — especially if they’re skipping classes — that can leave them feeling unglued.

College is also something of a pressure cooker for depression because the more you’re surrounded by people who are depressed, the more likely you are to become depressed yourself.

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Depression signs to look out for

Detecting depression in kids college students who are away from home can be difficult. Some depression symptoms, like uncharacteristic sadness and crying, are straightforward, but others, like trouble concentrating and irritability, are less so. People with depression also tend to isolate themselves and take less pleasure in things they used to enjoy, so if you hear that your child is spending too much time alone in their dorm room or quitting the things that used to make them happy, they might be depressed.

Worrisome alcohol and substance use can also be a sign. For many kids, things come to a head towards the end of the semester, when academic demands become more pressing and seem insurmountable.

College is a time to become more adult and independent, and parents should respect this and give kids the space they need to grow. But if you notice any changes in their mood or behavior that worry you, don’t ignore them. Their fellow students and new professors don’t know them as well as you do, so they might not recognize when there is a problem.

Getting help

Treating depression when kids are away at college can be complicated. Colleges have health centers on campus with professionals who can help, but convincing kids to go there can be “a feat in itself,” notes Dr. Boorady. That’s why he advises that kids who have already struggled with depression should contact the mental health professionals on campus before going to college. Having already made that initial contact and already knowing who and what to expect makes asking for help much easier.

If your child hasn’t used the health center yet but seems to need support, let them know that they can help. Kids are often reluctant to take the first step, so be supportive and encouraging. Parents may also be able to schedule an appointment, but because of confidentiality laws you shouldn’t expect the school to give you information about your child’s health unless them have given their authorization to do so.

Keep in mind that health centers typically limit the number of sessions students can receive, but they will make referrals to other professionals located nearby. If your child has depression they will likely need ongoing treatment, either for therapy or for monitoring medication or both. Traveling back home for health care often isn’t realistic and receiving consistent treatment is important, so it’s good to find a provider your child can rely on in the community.

Not a good time to stop medication

Finally, it isn’t uncommon for kids who have already been diagnosed with depression to want to stop taking medication before going to college so they can get a “fresh start.” This can be very dangerous if unsupervised. With depression there is a risk of relapse, so if your child wants to stop taking their medication, the dosage should be lowered very gradually and they should be closely monitored by their doctor throughout the process — going cold turkey is never a good idea.

Stopping treatment right before college is also risky for another reason: “The first year is so stressful, so I want kids to have a successful first year,” says Dr. Boorady. “Then when they come back we can discuss if it’s a good idea to go off medication.”

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