Depression is a disturbance in mood, thought, and body characterized
by varying degrees of sadness, disappointment, loneliness, hopelessness,
self-doubt, and guilt. Most people tend to feel depressed at one time or
another; some people may experience these feelings more frequently or
with deeper, more lasting effects. In some cases, depression can last
for months or even years. The most common type of depression,
"feeling blue" or "being in a bad mood" is usually
brief in duration and has minimal or slight effect on normal, everyday
activities. In the next level of depression, symptoms are more intense
and last for a longer period of time. Daily activities become more
difficult but the individual is still able to cope with them. However,
feelings of hopelessness can become so intense that suicide may seem the
only solution. In severe depression a person may experience extreme
fluctuations in moods or even a complete withdrawal from daily routine
and/or the outside world.
Symptoms of Depression
Changes in Feelings and/or Perceptions
- Crying spells or at the other extreme, lack of emotional responsiveness
- Inability to find pleasure in anything
- Feelings of hopelessness, worthlessness and/or helplessness
- Exaggerated sense of guilt, self-blame or failure
- Loss of sexual desire
- Loss of warm feelings toward family or friends
- Pessimism about self, the world, the future
Changes in Behavior and Attitudes
- Lack of interest in prior activities
- Withdrawal from others
- Neglect of responsibilities and appearance
- Irritability, complaints about matters previously taken in stride
- Dissatisfaction about life in general
- Impaired memory, inability to concentrate
- Indecisiveness and confusion
- Reduced ability to cope on a daily basis
- Thoughts of death or suicide, suicide attempts
- Chronic fatigue and lack of energy
- Loss of appetite, or at the other extreme, compulsive eating
- Insomnia, early morning wakefulness, or excessive sleeping
- Unexplained headaches, backaches, and similar complaints
- Digestive problems including stomach pain, nausea, indigestion,
and/or change in bowel habits
Causes of Depression
When the source of depression is readily apparent, the individual can
expect the reaction to lessen and then fade away within a reasonable
amount of time. In cases where feelings of depression exist with no
apparent source, the depression may get worse because the person is
unable to understand it. This sense of loss of control may add to the
actual feelings of depression. Any number of stressors may be involved
in depression. This can include personality, or environmental factors
such as loss of a loved one, an unhealthy relationship, excessive
criticism and negativism, unrealistic expectations and difficulty in
expressing feelings. Biochemical factors, such as illness, infection,
certain drugs (including alcohol and even prescribed medications) and
improper diet and nutrition can create chemical imbalances which play a
significant role in some depressions. In general, depression is a
withdrawal from physical or psychological stress. Identifying and
understanding underlying causes of the stress is necessary in learning
to cope with depression.
Being honest with yourself about changes in mood or the intensity of
negative feelings as they occur will help you identify possible sources
of depression or stress. Examine your feelings and try to determine what
is troubling you -- relationships with family or friends, financial
responsibilities, and so forth. Discussing problems with the people
involved or with an understanding friend can sometimes bring about a
resolution before a critical stage of depression and stress is reached.
Even mild depression should be dealt with if it interferes with your
effectiveness. You might also try to :
- Change your normal routine by taking a break for a favorite
activity or something new-even if you don't feel like it
- Exercise to work off tension, help you relax, and perhaps improve
your ability to sleep
- Avoid known stressors
- Become more positive and active rather than criticizing and
waiting for others to act
- Learn to be specific, not vague about your feelings and to express
- Delay making long-term commitments, decisions or changes that make
you feel trapped or confined
See a physician, especially if physical complaints persist
Helping a Depressed Friend
Since severely depressed individuals can be very withdrawn,
lethargic, self-ruminating, and possibly suicidal, a concerned friend
can provide a valuable and possibly life-saving service. Talking
candidly with the individual regarding your concern for his or her
well-being will often help bring the problems out into the open.
As you talk with your friend, share your concern and willingness to
- Acknowledge the pain and suffering
- Do not try to "cheer up" the individual
- Do not criticize or blame as feelings of depression cannot be
- Do not sympathize and claim that you feel the same way as he or
- Try not to get angry with the depressed individual
If the depression appears to turn to thoughts of suicide, urge the
individual to seek professional help. If the person resists such a
suggestion and you feel that suicide is likely-contact a professional
yourself, so you will know how to best handle the situation.
When Professional Help is Necessary
Depression is treatable and needless suffering can be alleviated. A
mental health professional should be consulted when an individual
experiences any of the following circumstances:
- When pain or problems outweigh pleasures much of the time
- When symptoms are so severe and persistent that day-to-day
functioning is impaired, and/or
- When stress seems so overwhelming that suicide seems to be a
Qualified mental health professionals can help identify the causes
and sources of depression and can help the individual find ways to
University students typically encounter a great deal of academic,
personal, and social stress during their educational experience. While
most students cope successfully with the demands of college life, for
some the pressures can become overwhelming and unmanageable.
Faculty and staff are often in the direct position to identify
students in distress. Moreover, faculty and staff are often perceived
by students as the first point of contact in obtaining advice and
support. Your expression of interest and concern may be critical in
helping a student reestablish the emotional equilibrium necessary for
This guide is designed to assist you in working with students in
distress. Counseling Center staff members are available to offer
Recognizing Distressed Students
At one time or another, everyone feels depressed or upset. However,
when some of the following signs are present the student is probably
- withdrawal from usual social interaction
- unwillingness to communicate
- inability to sleep or excessive sleeping
- loss of appetite or excessive appetite
- unexplained crying or outbursts of anger
- irritability, aggressiveness, agitation, nonstop talking
- poor personal hygiene
- excessive or irrational worrying (at odds with reality or
- poor communication (garbled and slurred speech; disjointed and
- loss of contact with reality (seeing/hearing things that aren't
there, beliefs or actions at odds with reality or probability)
- suspiciousness, irrational feelings of persecution
- feelings of shame, guilt, poor self-esteem
Changes in Personal Relationships
- death of a family member or close friend
- difficulties in family or marriage relationships
- dating and personal relationship difficulties
Drug and Alcohol Abuse
- indications of excessive drinking or drug abuse
- loss of interest and motivation, decreased school performance,
- changes in physical appearance and behavior
- decline in interactions with peers
- reduced memory, concentration, and attention span
Undecided or Uncommitted About Educational Direction
- lack of alternative goals when failing
- dissatisfaction with academic major
- unrealistic educational aspirations
- confusion about interests, abilities, or values
- chronic indecisiveness or choice conflict
- decline in course work and class participation
- deficient reading speed or comprehension
- poor study habits
- incapacitating and irrational test anxiety
- repeated requests for special considerations
- increased absences from class
- disruptive behavior in class
What Can You Do?
The options you choose depend upon the urgency of the situation. For
students who are having difficulty but seem able to cope fairly well,
you may choose not to intervene, to limit your interaction to the
classroom issue, or to deal with it on a more personal level. If you
judge a situation to be more urgent or an emergency, you might decide
that more active and timely involvement on your part is appropriate.
If you choose to approach a student, or if a student seeks you out
for help with personal problems, here are some suggestions that might
make the situation more comfortable for you and helpful for the student.
- Talk to the student in private when both of you have time. Give
the student your full attention.
- Listen to the thoughts and feelings in a sensitive, non-
threatening way. Let the student know you hear by repeating back the
gist of what the student has told you.
- Be specific regarding the behaviors that have raised your
concerns, and avoid making generalizations, criticizing, or judging
(e.g., "I noticed you've been absent from class lately and I'm
concerned" rather than "Where have you been lately?
Goofing off? Being lazy?").
Work with the student to clarify options and the costs and benefits
of each option.
When Should You Make a Referral?
Even though a student asks for help with a problem and you are
willing to help, some circumstances may indicate that you should suggest
that the student use other resources. For example: The problem or
request is one you know you can't handle...you believe that personality
differences will interfere with your ability to help...you know the
student personally (as a friend, neighbor, relative) and think you could
not be objective enough to help...the student is reluctant to discuss a
problem with you...after working with the student you find that little
progress has been made...you feel overwhelmed, pressed for time, or at a
high level of stress yourself.
What Happens at the Counseling Center?
Once the student contacts the Counseling Center, an appointment is
made for an initial interview. This is usually within a few days from
the time of contact. In an emergency, the student is seen that day.
During the student's first visit to the Counseling Center,
information forms are completed. These can be waived in emergencies.
During the first appointment, a counselor assesses the student's needs
and the ways the Counseling Center might be able to help. Options the
counselor considers include individual counseling, groups or workshops,
or referral to private or community counseling services. Some students
may leave the initial appointment feeling able to handle their concerns
without further assistance.
If the student and counselor agree that individual counseling is
appropriate, a series of appointments may be scheduled. The Center
offers up to twelve individual sessions per academic year to students.
Typically, students need four or five sessions with a counselor. At busy
times of the year, it may be two weeks or so before regular appointments
begin. Students are encouraged to keep in touch if their level of
distress increases prior to scheduled appointments.
Students need to know that services provided at the Counseling Center
are free and confidential. Information is released only with a student's
written permission. This means that a counselor cannot discuss the
student's situation with the faculty member unless the student provides
written permission. Faculty are encouraged to contact the student and
ask them if they saw a counselor and how it went. Exceptions to
confidentiality may occur if there is of clear danger to self or others
or in the case of court-ordered subpoenas.
How Do You Make a Referral?
When you have decided that a student might benefit from professional
counseling, it is usually best to express your recommendation in a
straightforward, matter-of-fact manner. Make it clear that this
recommendation represents your best judgment based on your observations
of the student's behavior. Be specific regarding the behavior that has
raised your concerns and avoid making generalizations or attributing
anything negative to the individual's personality or character.
Except in an emergency, the option must be left open for the student
to accept or refuse counseling. If the student is skeptical or reluctant
for whatever reason, simply express your acceptance of those feelings so
that your own relationship with the student is not jeopardized. Give the
student room to consider alternatives by suggesting that perhaps you can
talk after the student has had some time to think it over. If the
student emphatically says "No," respect the decision and again
leave the situation open for possible reconsideration later.
Once the student has agreed that counseling might be useful, there
are several possible steps to take, depending on the urgency of the
situation and how committed the student is to following through on the
- Give the student information about the Counseling and Student
Development Center and urge the student to call for an appointment.
- Offer to let the student call from your office right then so that
a public commitment will have been made.
Accompany the student yourself to ensure that the student arrives at
the Center and to provide the necessary information. The Center would
appreciate your calling ahead if a student is being brought over or sent
directly in an emergency, so that plans can be made to have a counselor
Additional Consultation Is Available to You
If you have concerns and questions about a student, staff members at
the Counseling Center are available to help you:
- Assess the situation, its seriousness, and potential referral.
- Learn about resources, both on- and off-campus, so you can suggest
the most appropriate help when talking with the student.
- Learn the best way to make a referral if appropriate.
- Clarify your own feelings about the student and consider the ways
you can be most effective.
What Is Anxiety?
Anxiety is a physiological state which calls you to
action, motivating you to engage in productive behaviors such as
studying for a test, finishing a project, asking someone out.
When Is Anxiety a Problem?
When it affects your daily life such as you . . .
- Can’t do regular activities at all or as well as
you usually do
- Avoid regular activities
- Worry excessively without any apparent reason
- Occasionally become immobilized with fear
- Can’t cope with the fear and know it is
- Can’t get the anxiety symptoms to go away
Anxiety which disrupts your life may fit one of these disorders
Generalized Anxiety Disorder
Recurring fears, worries or persistent sense of something bad
happening. The reason for the intense feelings may be hard to identify.
Sudden, intense, unprovoked feelings of terror or dread which
often lead to concern about when another attack will occur; one frequent way of
coping is to restrict activities in hopes of limiting the possibility of another
Intense fears about certain objects or situations. Specific
phobias involve things such as certain animals or flying in airplanes. Social
phobia is fear of social settings or public places.
Persistent, uncontrollable, unwanted feelings or thoughts and
routines in which individuals engage to try to prevent or rid themselves of
these thoughts. Examples include excessive hand washing or house cleaning for
fear of germs or excessively checking something for errors.
Post-traumatic stress disorder
An individual who experienced severe physical or emotional
trauma such as a natural disaster, an accident, a crime may experience anxious
thoughts, feelings and behaviors when reminders of the traumatic event are
While anxiety disorders can begin at anytime, they often begin
in adolescence or early adulthood. In some disorders, there is evidence of a
genetic or family predisposition.
How Can You Manage Your Anxiety?
Managing anxiety means practicing the thoughts, feelings and
behaviors of good self-care. The following areas need to be part of a
comprehensive anxiety management program. For managing high anxiety all these
areas need to be considered. If your anxiety is more intermittently a difficulty
for you, you may want to pick and choose some areas to focus on.
Physiological responses of body tension, poor
breathing, and bodily reactions to cumulative stress as well as dietary and
nutritional factors. Do you:
Practice deep breathing when feeling
Use relaxation strategies such as deep
muscle relaxation, meditation or biofeedback?
Exercise regularly, particularly doing
Exclude from your diet stimulants and
substances that stress the body such as excess caffeine, sugar, nicotine,
salt or alcohol?
Handling feelings in a healthy way keeps anxiety
Do you tend to ignore feelings?
Are you able to identify your feelings?
Do you hesitate or refuse to express your
feelings rather than take the risk of hurting someone or being hurt
Do you avoid anger at just about any cost?
What you say to yourself about a situation
determines your feelings and behaviors in that situation. Managing anxiety often
involves changing the messages you give to yourself to be more positive. Do the
messages you give yourself :
Include excessive "what-if"
thinking in which you imagine the worst possible outcome before facing the
Judge and evaluate you in very critical
Say you are supposed to be perfect, that
what you do is not good enough?
Say you cannot change the situation and you
are helpless to have any impact?
Show worry about how others respond to you
or what they think of you?
Phobias and panic can be very frightening when
they occur. You can learn to anticipate them and how to respond when they occur.
Can you . . .
Keep a perspective that it is just a
reaction of your body and not a serious health problem, i.e. deflate the
Learn to talk gently and calmly to
yourself, using your repertoire of skills developed in above areas such as
more productive self-talk, deep breathing and muscle relaxation.
For phobias, learn about imagery
desensitization and how to use it for yourself.
Assertiveness in your interactions with others
will help to decrease feelings of helplessness and anxiety. Do you . . .
Assert yourself, ie. Ask for what you want
and stand up for your rights?
Say no to some things you do not want to
Feel you avoid being manipulated by others?
Continued difficulty with anxiety interfering
with your daily life may be addressed by using medication. An assessment by your
physician or a psychiatrist can help to decide if medication would be helpful
Where Is Help Available?
Managing anxiety requires the development of new
skills, behaviors and thinking processes. While you may be able to learn some of
these on your own, you may find it helpful to seek the assistance of
professionals who are trained to deal with anxiety issues.
Counseling Services on campus, offers
several options to assist you in addressing anxiety concerns:
Workshops on anxiety management, stress
management, biofeedback, procrastination, assertiveness, and communication
in relationships are some of the programs available to assist you in
developing new management skills. See our brochure for specific programs.
The Self-Development Program offers many
materials that you can use on your own or in conjunction with counseling.
A self instructional guide describing these materials and others on-campus
Individual counseling is available to
assist you in assessing your concerns about anxiety and how to address
Referrals for services in the community,
including psychiatric assessments for medication.