Yesterday I attended a lunch session titled Let’s Talk About Depression. Dr. Kelly Holder from the Office of Student Mental Health and Counseling ran the session. The talk covered many topics like: 1) What is depression and what is it to you? 2) What are some signs and symptoms of depression? 3) How are medical students affected by depression and mental health issues? 4) Factors that may play into depression. 5) Prevention and how to address depression. Finally, 6) Suicide prevention. Also, 7) We watched a video that talked about medical students and how they experience depression.

Firstly, I am not a medical student, I am a graduate student. Secondly, it does not matter if you are a student or not, this information applies and is helpful for anyone who welcomes it. Thirdly, I am not a trained medical professional by any means. I am someone who experiences anxiety on the daily and has loved ones that deal with depression. This post is about bringing awareness to depression, and how someone can seek help or help others. The following information is primarily from the PowerPoint presentation given by Dr. Kelly Holder. Supplemental information has been referenced by me or actual (real scientific) sources.

1. What is depression and what is it to you? 

Click here for the definition of depression and more information on the mental health illness from mayo clinic. In short, depression is a mood disorder resulting in sadness and lack of interest. Like many mental health disorders, depression is not something someone ‘snaps out’ of. Depression is a mental health disorder that effects those suffering emotionally and physically. Those who feel they suffer from depression or know someone who is suffering should seek a health professional.

What is depression to me? Depression is a soul sucking monster that steals the light and soul from my friends and family. I struggle intermittently with depression. I feel everyone in their lives do at some point but I have loved ones that struggle with depression more deeply and on a regular/daily basis. For those who struggle deeply with depression, I would take it away if I could. I do not wish any mental illness on anyone, and neither would your loved ones. You’re not alone. Let the ones you love know if you are struggling and seek help. You don’t have to do this alone.

2. What are some signs and symptoms of depression?

• Feelings of helplessness and hopelessness
• Loss of interest in daily activities
• Appetite or weight changes
• Sleep changes
• Anger or irritability
• Loss of energy
• Self-loathing
• Reckless behavior
• Concentration problems
• Unexplained aches and pains

3. How are medical students affected by depression and mental health issues?

Medical students and depression:

• 27% of medical students show symptoms of depression (reported as 1 in 4 medical students) and 11% reported suicide ideation [Rotenstein et al. (2016) JAMA]
• 15% of medical students screened positive for depression and sought psychiatric treatment [Rotenstein et al. (2016) JAMA]
• Third and fourth year students were more likely to report suicide ideation than first or second year students [Schwenk et al. (2010) JAMA]

General statistics on mental health issues in college students (Active Minds Impact Report, 2017):

• 39% of college students experience significant mental health issues
• 50% of cases of mental health issues begin by age 14
• 75% of cases of mental health issues begin by age 24
• 2/3 students with anxiety and depression don’t seek treatment
• The #2 leading cause of death among students is suicide (The #1 leading cause for those of you interested is unintentional/accidental injury)
• 85% of those with mental illness do not die by suicide because mental illnesses are treatable (Hooray! I am happy to see how high this number is but also sad for the remaining 15%. That is why I am writing this post. SPREAD THE AWARENESS!)
• 67% of college students first tell a friend they are feeling suicidal before anyone else
  • Please talk to a friend, loved one, and/or health professional if you have feelings of suicide. If you do not feel comfortable talking to someone who knows you, call the Suicide Prevention Hotline at 1-800-273-8255 (TALK) and talk to someone who is trained in talking to those who have suicidal ideations. Remember, you are not alone.

General statistics on mental health issues in the United States (2018 Statistics from Mental Health America):

• 18% (over 43 million) American adults have a mental health illness
•  9.6 million experience suicidal ideation
• 56% of adults struggling with a mental health illness do not seek treatment

4. Factors that may play into depression.

• Loneliness and isolation
• Lack of social support
• Recent stressful life experiences
• Family history
• Marital or relationship problems
• Financial strain
• Early childhood trauma or abuse
• Alcohol or drug abuse
• Unemployment or underemployment
• Health problems or chronic pain

5. Prevention and how to address depression with others.

Prevention:

• Create a wellness plan
  • Recognize warning signs
  • Use your own coping strategies (some of mine are spending time with loved ones, exercise, and bubble baths)
    • Others: adjust quality of sleep, eating a healthy diet, avoid alcohol, connecting with others, meaningful and mood enhancing activities
    • Treatment: psychotherapy (cognitive behavioral therapy) or medication
  • Socialize with others
  • Reach out to family and friends
  • List names and numbers of mental health professionals and crisis hotlines

Addressing depression with others:

• Talk to them about your concerns and how you’ve seen a change in them
• If a conversation comes up about suicide, you may as well ask if they are thinking about killing themselves
  • this seems blunt and is hard to hear but will be effective especially if they are thinking of making an attempt
• Be patient and do not push the person about the subject
• Sometimes it’s just about staying calm and being a good listener
• Give them information about different treatment options (if they are open to it)
• Be there for them when they need to talk

6. Suicide prevention.

If you feel or know someone who feels they are going to commit suicide or have suicidal ideations, contact the Suicide Prevention Hotline at 1-800-273-8255 (TALK).

Look for suicide risk factors:

• Gender (Males have higher suicide rates than females according to the CDC and National Institute of Mental Health)
• Age – The statistics for the American Foundation of Suicide Prevention states that individuals in the age range of 45 – 54 have the highest suicide rate but if you look at the graph in the link, you can see there is not much difference in age ranges and suicide rates. The highest crude rate being 20.1 (ages 45 – 54) and the second lowest being at 14.46 (ages 15 – 24).
• Chronic physical illness (fibromyalgia patients [Rodriquez et al. (2014) Neuropsych Dis Treat] )
• Mental illness
• Use of alcohol or other substances
• Less social support
• Previous attempts
• Organized plan for a suicide attempt

7. Five things I think are important to address from the video we watched (the video that I cannot remember the name of but it was only 12 minutes and I’m giving you a run down anyway).

1. Depression is not only emotional but also physical.
   • This is common in all types of mental illness. I know this from experience.
   • When someone has depression or anxiety, they can’t just snap out of it. Mental illness is not a voluntary state of mind. it is a struggle mentally with physical symptoms. Physical symptoms which can cause chronic pain, and lead to increased morbidity and decreased quality of life if not taken care of.
2. Don’t be afraid to talk to a health professional.
   • The video stated how some students feel they can’t talk to a health professional, psychiatrist, or psychologist at their institution because they don’t want others to know they have a mental illness. Another fear is that having a mental illness may impact them from progressing in the program or getting a job outside of school.
     • First of all, doctor/patient confidentiality. What is said between you and your doctor will stay between you and your doctor.
     • Second of all, you have a greater chance of not progressing or finding your dream job if you don’t take care of yourself now and treat the symptoms of your mental illness. Mental illnesses like depression and anxiety have a great way of holding you back or making it very hard to proceed. Trust me, I have experience.
3. Everyone copes differently.
   • In the video they show a student struggling with depression and ways she coped with her mental illness. She used kickboxing, and talking with friends. How they phrased this was, “this is how so and so copes with depression”. I love this because I heard, “You don’t have to do what so and so is doing, Do whatever helps you”.
   • Some things that help me: Coloring, talk to loved ones, hugs, bubble baths, my cats, exercise, watching a funny TV show or a funny movie, removing myself from the stressful situation, chocolate (in moderation), my fiance, my fiance’s butt, etc. These are ideas you can try but I highly suggest you take a second and ask yourself, “What makes me happy” and whatever that is, do it.
4. Don’t be afraid to seek therapeutic or medicinal treatments.
   • Don’t be afraid to talk to someone. Having a health profession, especially someone trained in mental health issues (like a therapist), is AWESOME! Why? Because it is non-biased. I can tell them anything and not feel judged, and I feel supported at the same time. As Kelly Holder said, “You don’t have to bring anything to the table. You don’t have to offer anything. We are here for you”.
   • As far as medicine goes, I am not trying to force any type of medication or suggest this is the best option; I am only speaking from experience and what has helped me. I use my coping mechanisms and therapy first when my anxiety is extremely bad but there are times when it is so bad I become physically ill. This is when I know I need medicinal therapy. The medicine I am normally prescribed is in the form of a selective serotonin re-uptake inhibitor (SSRI). These work wonders but all come with side effects. It’s best to research into the different types of SSRI’s and discuss options with your doctor.
5. Working through a mental illness will help you with your career (especially if you are going into education or the medical field).
   • This was the last thing in the video that I loved. The person named so and so who talked about their struggles with depression mentioned she was not ashamed of her mental illness anymore because she knew it could help her in her career as a medical professional. I highly agree with this. Understanding mental health illnesses and being aware that you are not alone will help you mentor others who may struggle with similar types of mental health issues and let them know they are not alone. It’s a win, win 🙂

Ok… so this post was really long but I am very passionate about mental health and hope you all took something from this. Remember, you are not alone. Talk to someone. Anyone.