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Depression, Anxiety Persistent Problems at Universities

But more BU students seeking help, study finds

Depression and anxiety remain serious problems affecting nearly a quarter of BU students, according to data from a 2012 mental health survey—statistics that reflect a national trend. But there is encouraging news: more students are seeking help. And the University has stepped up efforts to identify and treat students in crisis.

Of the 1,696 undergraduate and graduate students responding to the 2012 Healthy Minds Study, 20 percent screened positive for anxiety or depression and 6 percent reported serious thoughts of committing suicide in the past year. While that number has remained steady since February 2010, the last time BU participated in the Healthy Minds study, the so-called “help gap” has narrowed, with 55 percent of troubled students receiving help as opposed to 46 percent in the earlier study.

The Healthy Minds Study, a collaboration of researchers based at the University of Michigan, is an annual national email survey that examines mental health issues among college students. The BU study is a partnership between Student Health Services (SHS) and the University of Michigan School of Public Health. Data collection for the 2012 BU study, coordinated by David Seeman, a Behavioral Medicine senior staff psychologist, was part of a national sample of 25,000 students at 29 universities.

“BU is a caring community, and what we’re doing is working,” says Dori Hutchinson (SAR’85,’96), a Sargent College associate clinical professor of occupational therapy and director of services at the BU Center for Psychiatric Rehabilitation. On National Depression Screening Day last October, BU held its fourth annual screening for depression, where students, faculty, and staff on both the Charles River and Medical Campuses can avail themselves of free, confidential screening and have the chance to speak with a clinician, who makes referrals to counselors and advises people on where to seek help.

“The first year, we referred 30 percent of those screened,” says Hutchinson. “This year, it was 65 percent. When we set up at the sites this year, students were waiting for us.” Hutchinson recalls that 10 years ago BU mental health services were marginalized, and there was a strong stigma associated with getting help. While the stigma endures, particularly in a few groups, this has changed dramatically, she says.

Students now can choose from a range of resources, including SHS Behavioral Medicine and Wellness and Prevention Services, the Center for Psychiatric Rehabilitation, the three-year-old Student Support Network, and the mental health advocacy group Active Minds. The University trains student health ambassadors, undergraduates who serve as liaisons between students and SHS.

BU faculty and staff are increasingly knowledgeable about these resources, and Kenneth Elmore (SED’87), dean of students, has made student mental health a priority by meeting regularly with campus mental health professionals.

“It’s a cultural change,” notes Hutchinson. “The University has made an investment in students’ well-being. BU has a wide continuum of responses.” Kids are struggling, she says. According to national statistics, student stress stems mainly from four areas—academics, family issues, finances, and relationships. But faculty, staff, and students are more alert to the signs of depression, anxiety, or other mental health problems. These include declining grades, isolation from friends and family, inability to concentrate, eating or sleeping excessively or not enough, risky sexual behaviors, and alcohol and drug use.

The BU study found that 53 percent of respondents reported having at least one day in the past month where emotional difficulty had impaired their academic performance, and 24 percent three or more days, a result fairly consistent with the 2010 study, whose responses were 51 percent and 21 percent, respectively. Of students who considered interrupting their studies at BU, 21 percent cited mental health concerns as the reason. Of students who screened positive for depression at the time of the 2012 study, 45 percent had received either medication or counseling during the past year, compared to 37 percent of those who responded to the 2010 study—a statistically significant difference, according to Seeman. Of students who received counseling, 58 percent were seen at Behavioral Medicine.

Despite efforts to heighten awareness that depressed students need not suffer in silence—“Tell Somebody” is Behavioral Medicine’s mantra—the 2012 study found that 22 percent of students didn’t know there were mental health services available at BU. Yet responses to open-ended questions in the survey paint a mostly positive picture of Behavioral Medicine at BU.

“Student Health Services helped in my improvement through providing psychiatric help,” wrote a female undergraduate. “My insurance doesn’t cover costs in Massachusetts so their care was essential.” A female graduate student hospitalized for major depression while studying at BU reported that “academic staff in my department and Behavioral Medicine were helpful and supportive; they gave me the necessary privacy and respect that helped me remain in school.” Other students credited Behavioral Medicine with providing regular counseling when they couldn’t afford to see outside therapists.

One consistent complaint received by Behavioral Medicine over the past few years is the lack of mental health resources on the BU Medical Campus. “Setting up treatment is difficult for students due to complications of getting to the Charles River Campus,” wrote one male graduate student.

No one knows why nearly a fourth of college students nationwide suffer from anxiety or depression. Maybe these disorders are identified more as their stigma is shed. Certainly the level of stress at a university such as BU accounts for some of this data, says Seeman. Or perhaps social lives spent increasingly online are taking a toll on real relationships—the inexorable replacement of friends with “friends,” he suggests. Students are also more likely to come to college with preexisting mental conditions because of the increased use of medication earlier in life, he says. Experts say that another factor for the numbers could be that the current generation of students feels more pressure to succeed, but has developed less resilience because of cultural changes—although this is difficult to verify.

For psychologists like Seeman, who are trying to make sense of a wide range of variables, the depression among young people poses a challenge. But the real news is that for students who are struggling, there is help.

It appears that stress, depression, and anxiety may hit some groups of students harder than students overall, says Seeman. For example, the BU data from the 2012 study indicate that nonheterosexual students struggle more with emotional issues such as anxiety, depression, and suicidal thoughts than do students in general. But these students are also more aware of needing help than other students and are making more use of therapy or medication, he says. On the other hand, international students and Asian-American students tend to be less aware of resources for help for mental health problems and tend to use therapy and/or medication less often. “Clearly this information will help us target outreach to these particular groups,” Seeman says.

“We are doing fairly well in supporting students in distress, but there are some gaps which could be collaboratively addressed—some in the form of stigma, some in lack of knowledge,” the report says. “We expect that the data from this effort will help improve the lives of present and future students at Boston University and nationwide.”

Among the psychological services available for students suffering from anxiety is the Center for Anxiety and Related Disorders, founded by David H. Barlow, CAS professor of psychology. The center offers cutting-edge treatments for faculty, staff, and students, as well as non-BU affiliated individuals. “We make every effort to expedite services to our own BU family, first and foremost”, says Lisa Smith, director and clinical associate professor. Clinical services are offered on a sliding scale fee with numerous programs offering free services to those who are eligible.

Those interested in seeking free, confidential mental health counseling can contact Student Health Services Behavioral Medicine. Students can also contact the Center for Psychiatric Rehabilitation and the Samaritans of Boston suicide hotline. Fee-based services are available through BU’s Albert & Jessie Danielsen Institute.

Active Minds at BU is a student organization that works to increase awareness of, provide information and resources about, and encourage others to seek help for, mental health issues.

19 Comments
Susan Seligson

Susan Seligson can be reached at sueselig@bu.edu.

19 Comments on Depression, Anxiety Persistent Problems at Universities

  • Bourgeoisie Disease on 03.22.2013 at 7:44 am

    “No one knows why nearly a fourth of college students nationwide suffer from anxiety or depression. Maybe these disorders are identified more as their stigma is shed.”

    The rampant increase in these pathological emotional conditions among modern people begs the question; is this the disease of the Bourgeoisie? Have we reached the point where not encountering historically challenging events leaves us unable to cope with more common events?

    Up until the past hundred years only the very affluent had all of their biological needs readily met but today few of us have to worry about needs like food, heat, shelter, water, safety etc. on a daily basis.

    Challenges of modern life are relatively benign and rarely elicit a fight or flight response and therefore may not activate the limbic system sufficiently and regularly enough to keep it functioning normally thereby creating the chemical imbalances implicated in these two emotional disorders.

    As an example, a person with OCD never has trouble stopping their compulsive behavior when someone yells fire.

    People who do not experience the historically more common challenges of daily living may react in a pathological way to events that would not have historically elicited a stress response.

    More slowly away from the computer and do something really exciting for a change!!

    • Michael on 03.22.2013 at 9:50 am

      You Sir, are right. I’ve been expecting someone to say that for a while.

    • Student on 03.22.2013 at 10:04 am

      Studies have shown that OCD is just as prevalent in developing countries as it is in developed ones. Doing “something really exciting” like living in poverty and danger, which it seems you’re suggesting, is not a magical solution to cure chemical imbalances.

    • Niki on 03.22.2013 at 11:20 am

      This is a really wrong view on depression.. You’re diluting the stresses that students encounter based on some “righteous” viewpoint that certain challenges aren’t worthwhile enough to deem attention.

    • BU Student on 03.22.2013 at 12:24 pm

      Here’s something super exciting – a year and a half ago I was in a near-head-on-collision-turned-rollover car accident that traumatized me and left me with PTSD that has cycled through suicidal tendencies, depression, and anxiety.
      I speak from experience when I say that “exciting” trauma does absolutely nothing to enhance your mental state of being.

    • Anon on 03.22.2013 at 12:28 pm

      As a BU student who has struggled with depression for quite some time, I can attest to the fact that depression is not the “disease of the bourgeoisie.” I grew up in a low-income household and an area riddled with rampant crime. Your blanket statement is pretty obnoxious seeing that not everybody that goes here is from a privileged background. Please climb off of your high horse and have several seats.

    • Anon on 03.22.2013 at 3:52 pm

      To someone who suffers from mental illness, your comment is extremely offensive.

    • Meowsy on 03.23.2013 at 11:18 pm

      “As an example, a person with OCD never has trouble stopping their compulsive behavior when someone yells fire.”

      This is a ridiculous example that illustrates that you clearly lack a basic understanding of mental illness. I have found that many people with opinions like yours on mental illness do not understand it at all. I wish people were better educated on the subject of mental illness so that they would not jump to such ignorant conclusions.

    • A on 03.24.2013 at 1:44 pm

      It is a myth that people who are well off suffer from these diseaes. There are anorexics with no access to food, poor people with depression anxiety. You just never hear about them because they can’t get help. The reason it never showed up in the past is because no one ever thought these things existed, nor did they care. Clearly, you don’t care either.

  • Katie on 03.22.2013 at 11:21 am

    Mental illness is a real thing and not just something that rich people with nothing to do develop.

  • Anonymous on 03.22.2013 at 11:32 am

    First, to the author of the previous comment, I must respectfully and emphatically ask that you reconsider your theory, which is valid as a theory but becomes dangerous as you begin to assert it as fact. I don’t know how many times anyone has tested whether yelling “fire” (or otherwise putting people in life-threatening situations) to someone stuck performing compulsions helps treat OCD. In fact, you might be unaware of the high overlap between OCD and PTSD, which suggests that OCD can develop as a means of coping with traumatic experience, quite the opposite of what you suggest in your post.

    Second, I think it is most critical that instead of simply citing BU’s achievements with regards to mental health, that our institution take a deeper look at the large cracks through which students are falling. It is understandable and important to highlight achievements, but we must not blind ourselves to the significant shortcomings that still exist and put students at risk, such as the lack of sufficient mental health coverage through the student insurance plan.

    • NM on 03.22.2013 at 5:00 pm

      To your second comment: YES!

      I am a graduate student going part time at 8 credits. I am one credit shy of being eligible for student health services at al, and thus affordable counseling.

  • Bourgeoisie Disease on 03.22.2013 at 3:01 pm

    The suggestion that somehow my opining anything but my unconditional support for the notion that mental illness is a genetic disorder with no environmental component is somehow elitist is what is absurd.

    I am very well versed in this area of research and have the academic credentials and real world work experience to back up my opinions.

    You are free to disagree with me but please refrain from attacking the messenger just because you do not find my opinion to be politically correct.

    The fact is, that the incidence and prevalence of these disorders is alarming and at odds with biology. We are driven to survive and when this instinctive response is attenuated and/or the fear response exacerbated it is only logical to raise the question of whether something in our modern lives has induced a down regulation of the limbic system in such as way as to make pathological anxiety and depression occur in 25% of otherwise healthy young people.

    To do otherwise would be irresponsible and illogical.

    • NM on 03.22.2013 at 4:58 pm

      The reason depression and anxiety have been on the rise may have absolutely nothing to do with people’s social status. While I don’t have the academic credentials you claim to have, I strongly suspect that few health professionals were diagnosing depression and anxiety until recently. It is entirely possible that the reason we’re seing an increase is because these ailments are better known and more easily recognized while the actual incidence and prevalence have remained unchanged.

    • X on 03.23.2013 at 3:27 am

      Nobody was attacking you, and nobody was saying it was purely genetic. The issue is that you’re placing blame on the people who are suffering by implying that they are sick simply because they need to “move slowly away from the computer and do something exciting”. Feel free to question whether or not the way we live effects the increasing rates of depression/anxiety as long as you back up your theories with evidence. So far, you have provided little to none. If you’re well versed and intelligent, prove it. At the moment I’m not convinced.

  • Ashley on 03.23.2013 at 4:12 am

    Personally, my experiences dealing with depression at BU were pretty lousy. I knew I needed long term help (I had been seeing a counselor and psychiatrist at my previous college for a full year, and still had a long way to go), so I wanted a referral to an outside CBT person and Psychiatrist. Because they’ll only do a semester or two of treatment here.
    They wouldn’t give me a referral even though I specifically said that was all I wanted. Instead, I had to talk to the same counselor over and over. She was awful. She never listened to me, had no insight, and never followed through on paperwork no matter how many times I asked. She also would tell me about how other people have it worse than I did. I felt worse after talking to her. At the time I thought it was all in my head, but now that some time has passed I realize she was completely out of line.
    And it wasn’t just her. It always felt like they were too busy to care, because they’re short staffed. Scheduling appointments was difficult, and if I needed an appointment more than once a week it was impossible. This was not a problem at my previous university (UVM) or at my current therapist’s office. I also saw a psychiatrist at SHS, and she was better but still unhelpful. She would always tell me to talk to the counselor about my problems, even when I said I was uncomfortable with the counselor. I explicitly said I was going to hurt myself, and she essentially told me not to and then sent me on my way. All I wanted was a referral, and instead I was made to feel guilty, alone, and unheard for months before finally I got one since my time ran out.
    By the time I finally got a referral, my problems had gotten much worse. Partly from the way they treated me, because it made me feel like all professionals were going to treat me as poorly as they did. It felt like getting actual help was impossible, and that I would feel this awful forever. It was all very hopeless. I planned my suicide and ended up in the ER.
    The hospital set up an appointment with SHS for me to follow up. I wanted to scream, but instead I showed up and lied my way through the entire appointment because I knew they were too incompetent to help me and I already had an appointment made somewhere else for a couple weeks later.
    Now it’s been about a year, and I’ve been getting counseling and have a psychiatrist out in the real world. I am being treated so much better, and I’m finally making progress. All SHS did was delay my progress and make me angry. I’m still angry, because I know other people are probably being treated the way I was treated there. And it’s wrong.
    HOPEFULLY, I just had a bizarre experience, and other people are getting the help they need. If not, BU needs to step up their methods for supporting students. I love BU to pieces, but seriously. They can do better.

    On a side note, why doesn’t BU just have a counseling center instead of making it some weird spawn of SHS? It’s not comfortable being in a hospital setting. While physical and mental health are connected, they aren’t the same and the treatments are very different, so I don’t see why BU arranges it like they’re the same thing.

    • Bourgeoisie Disease on 03.25.2013 at 3:02 pm

      I am not blaming anyone I am simply making a point. Why do you insist on personalizing an academic observation. As for Dx of depression and anxiety people have been seeking out anxiolytics for decades to deal with the stresses of modern life.

      The human mind is unique in that we have the ability to ponder our plight and when we have more time to ponder it and less real things to worry about it is not unreasonable to suspect that people might be reacting with pathological levels of anxiety to environmental stimuli that should not illicit a fight or flight type response from the limbic system.

      Again you do not have to agree with me but someone needs to take the less politically correct low road and suggest that maybe just maybe we can deal with anxiety and depression without so quickly resorting to throwing drugs at these disorders; to begin doing this we need to start with the assumption that some cases will respond to life style changes better or as well as they will to drugs just as obesity and associated disorders of sugar metabolism etc. respond to changes in diet and exercise.

    • BUstudent on 08.01.2013 at 10:40 pm

      Ashley, I had a very similar experience at BU. As a freshman, I was suicidal because of my emotionally and physically abusive boyfriend. One night I went over the edge when he really struck a nerve. I went to bed, but my body woke itself up the next morning at 5:00. I was in such a state that everything is a blur now that I think back to it, but I couldn’t picture myself living any longer– I was having one of the worst panic attacks I could have ever imagined and I couldn’t see any other options for myself.
      That morning I tried committing suicide. My then-boyfriend knew I was losing it and called the school without me knowing. Long story short I ended up in the hospital. A few days later I had to meet with ResLife, who told me that “living in a dorm is a privilege” and that I was “a threat to other students.” The person in charge made me take out and turn over my ID card and read to her all of the phone numbers and tell her what each service offered. I understood her intention, but the way she spoke to me and went about everything was very degrading. She was basically talking down to me and treating me terribly– like I didn’t deserve to go to BU or be a part of the community, when I really just needed some help getting through a tough phase. I didn’t even bother to report this, even though my RA encouraged me to, because I already had enough on my plate. I agree, I think BU has so many resources for students dealing with mental health illnesses, but the faculty may need to reevaluate the way they deliver their messages to students. If they treat students the way they treated either of us, it could make matters worse for someone instead of help.

  • Bourgeoisie Disease on 03.25.2013 at 3:12 pm

    This issue is complex but it can be argued that physical exercise induced changes in stress hormones and neurogenesis in the the limbic system that over time may make it less prone to anxiety disorders and depression.

    In fact, ‘Cessation of voluntary wheel running increases anxiety-like behavior and impairs adult hippocampal neurogenesis in mice.

    As the impaired neurogenesis is predicted to increase a vulnerability to stress-induced mood disorders, the reduction of physical activity may contribute to a greater risk of these disorders.

    Nishijima T, Llorens-Martín M, Tejeda GS, Inoue K, Yamamura Y, Soya H, Trejo JL, Torres-Alemán I.
    Behav Brain Res. 2013 Feb

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