Abstract
Rates of depression in college students are at an all time high. Millions of emerging adults are experiencing
symptoms that are making daily routines problematic. These symptoms may include, but are not limited to, drowsiness,
loss of appetite, sense of hopelessness, apathy, and irritability. Long periods of suffering through such feelings
are non-conducive to dealing with the demands of college life. The causes of depression are as unique as the individual
that experiences the disorder. For many students, however, depression can be attributed to stressors such as academic
pressure, inadequate social adaptation, inadequate sleep, and the stress of the overall transition to college life.
Reports show an inequality of depressive symptoms experienced by male and female students for unknown reasons,
but assumptions have been made. Students who suffer from depression risk serious health problems if positive steps
are not made to help with their symptoms. It is not uncommon for the traditional student age group to resort to
substance abuse and other risky behaviors to escape depressive symptoms. In many cases students experience eating
disorders, and others choose suicide. With an increasing demand for positive coping mechanisms, universities have
made an effort to offer free psychological services to students on their campuses. Although attempts have been
made, students are underutilizing the resources. Students and universities must work together to provide an effective
way to reduce depression in college students.
Introduction
More than 18 million adults, almost a tenth of the United States population above the age of 17, have been found
to demonstrate symptoms of a depressive disorder each year (Rosack, 2003). Depression is defined as a state of
intense sadness or despair that has progressed to a level that is troublesome to an individual’s social functioning
and the basic activities of daily living. Many people understand the feelings associated with depression as “lacking
motivation to get through the day” or “feeling sad and lonely for no obvious reason.” Common
feelings of depression may include but are not limited to irritability, fatigue, apathy, and sadness. When these
feelings become stronger and more consistent, substance abuse and risky sexual behavior tend to become outlets
for young adults who experience frequent low feelings (Swanholm, Vosvick, & Chng, 2009).
Although depression is more apparent in females, the disease does not discriminate on the basis of age, gender,
race, or any other demographics. Stress is a reoccurring factor in the lives of many individuals diagnosed with
this disorder. The theoretical work of Susan Lazarus and Richard Folkman in 1984 described the correlation between
stress and depression. Their cognitive-transactional theory explained the differences between internal and external
elements of stress. External components include environmental or outside stimuli, and internal aspects encompass
a person’s cognitive process (Swanholm, Vosvick, & Chng, 2009). The transaction between the two, as Lazarus
and Folkman describe the interaction of both components, is an ongoing negotiation. The AJHB reported that “the
meaning an individual attaches to a situation and how the situation is appraised determines whether the event is
experienced as stressful” (Swanholm, Vosvick, & Chng, 2009). With the importance placed on academic
success in our society and the need for rapid social and geographical adaptation, college students often fall victim
to these external components of stress.
Depression is being recognized much earlier in life than ever before. Fifty years ago the average age of onset
was around 30, whereas now teenagers are being diagnosed with depression every day. Joetta Carr, PhD, chair of
the American College Health Association’s National College Health Assessment, stated that “Clinical
depression often first appears in adolescence, and mood disorders in college are prevalent and can be life- threatening” ("Depression;
survey shows," 2004). The seriousness of this disorder, and the drastic changes of those it affects, calls
for immediate attention. Depression is a major concern for American Universities and many institutions are implementing
health and counseling centers for students, “enabling them to be successful in their college careers” ("Depression;
survey shows," 2004).
What is Depression?
Contrary to popular belief, clinical depression is far more than just a feeling of the “blues.” Depression
is a serious, and often underestimated, mental disease that affects both mind and body of millions of Americans
each year. Those experiencing true depression may often lose interest in daily activities, suffer from low self-esteem,
recognize a loss of energy, and experience difficulty with sleep patterns. If untreated, depression can result
in poor health, substance abuse, and suicide in more severe cases. Although no one factor has been labeled as the
cause of depression, oftentimes it is the result one or more of several reoccurring symptoms. Common forerunners
of depression include a neurological chemical imbalance that has links to heredity and genetics, chronic health
problems such as cancer or HIV, substance abuse, and high levels of stress.
There are several distinguished types of depressive disorders recognized by psychologists, with the most common
being clinical depression. The severity and specific symptoms may vary among those experiencing the disorder and
are as unique as the individuals themselves. However, in order to meet the criteria for clinical depression, a
consistent low and depressed feeling must be experienced for at least two weeks. From the time of diagnosis, some
people experience clinical depression for the remainder of their lives.
Signs and Symptoms
There are several general signs that are characteristic of those who suffer from depression. Abrupt change in
mood or motivation and decreased concentration are primary symptoms that will overtly affect the social and academic
endeavors of a college student. Those who suffer from depression experience more severe feelings of irritability
and sadness, which are easily distinguishable from an ordinary bout of unhappiness. Some describe their experience
as a feeling of emptiness or mental exhaustion. Sufferers of depression also report an inevitable feeling of hopelessness
with a bleak outlook on the future. Whereas many college students are often eager to enjoy the company of friends
and social events, losing interest in these common activities may be a result of depression. A Canadian study reported
that “research has consistently found personality traits that are related to depression, [including] unassertiveness,
dysfunctional attitudes, external locus of control, and diminished masculine sex-role orientation” (“Depression:
survey shows,” 2004).
Sleep plays a major role in depression as well. Some individuals may experience insomnia, the inability to fall
or stay asleep at night. Disturbances with sleep can directly bring about physical complications such as increased
levels of fatigue and decreased energy, making simple tasks like going to class feel like an impossible ordeal. On
the other end of the spectrum, there are those who experience oversleeping with a condition known as hyper-somnia
that can be just as debilitating.
Guilt and a diminished feeling of self-worth are also often recognized with a depressive state. Difficulty with
basic memorization and the inability to concentrate result in the diminishing of skills such as time-management
and are non-conducive to the demands of college life.
Literature Review
External Stressors
The transition to college-life presents a variety of stressors for students. In a university setting, students
are faced with a range of stressors that, if not handled carefully, can potentially create strain on an individual’s
life. Sources of stress vary from one person to the next, but there are some overlapping stressors that many students
encounter. The American Journal of Health Behavior identified the management of new choices concerning employment,
interpersonal relationships, sexual behaviors, and living arrangements to be common potential stressors for students
(Swanholm, Vosvick, & Chng, 2009). As if the many social factors of college-life are not enough to manage,
a demanding collegiate curriculum has to find its place in the scheme of things. Whether or not, or the degree
to which, these external factors create a stressful situation for individuals relies heavily on their choices,
circumstances, and personality (Swanholm, Vosvick, & Chng, 2009).
Of the most prevalent stressors in college
life, the most consistent trends leading to depression were from employment and relationship status. “In
a recent study of the correlates of depression in college students,” reported a Texas study,” both
an unemployed status and not being in a relationship were associated with higher levels of depressive symptoms.” It
went on to say, “unemployment was related to higher levels of depression and lower self-esteem in a population
of emerging adults, ages 18-25” (Swanholm, Vosvick, & Chng, 2009). Although many may initially assume
that added stress from student jobs, which are time consuming and require increased physical labor, may create
a greater burden than unemployment, the opposite has been proven. Monetary concerns and the financial burden college
often presents have been confirmed to lead to depressive symptoms in students.
A perceived inadequate social adjustment to
a new lifestyle can readily produce feelings of depression (Wilbert & Rupert, 1986). Those students who are
not in a relationship may experience feelings of loneliness during their college experience. Loneliness shows a
positive correlation with feelings of powerlessness, distrust, and especially depression. Negative self-image and
views of others are a result of loneliness, and such negative attitudes deter the possibility of establishing a
romantic relationship (Wilbert & Rupert, 1986).
With maintenance of a hectic lifestyle and
busy schedule, college students fail to allow for the recommended eight hours of sleep. “Early mornings for
classes or sports workouts and late nights of studying or partying are considered the norm for many college students,
leading to disturbances in their sleep habits,” reports a Pittsburgh study conducted on the correlation between
sleep and depression in college students (Girgenti, Mills, & Brooks, 2009). This particular study provided
support for the hypothesis that sleep and specific aspects of depression are related, and individuals with sleep
disturbances might be at an increased risk for development of the disorder. Inadequate rest proves to be both a
cause and an effect of depression. Being on either end of the spectrum is counterproductive for students who must
successfully juggle a demanding routine of class, work, and social activities.
Gender Differences
Depression may be becoming noticeable more than in years past, but that is not the only pattern researchers are
noticing. Depressive symptoms are more common in female students than in their male counterparts (Barrett & Boggiano,
1991). Females are reported to have a ten percent higher chance of experiencing depressive symptoms, with an average
of 50 percent of women reporting difficulty functioning in day-to-day activities ("Depression; survey shows," 2004).
A study conducted by Marty Barrett and Anne Boggiano at the University of Colorado discussed two possible reasons
for increased levels of depression on female students (1991). Body image and concern over interpersonal relations
are areas that receive more acknowledgements from women than men. These authors noted that females are heavily
socialized to be concerned about others and establishing intimate relationships. They considered that this particular
area of a female’s identity might become the leading drive for social interaction and fulfillment. Moreover,
90 percent of female emerging adults reported dissatisfaction with their current body image and a desire to lose
at least ten pounds. An inability to reach the ideal body type, as portrayed by the media, can promote poor self-image
and result in heightened levels of depression among women (1991).
Unlike women, male students tend to have a more accurate body image and a healthy physical expectation. Although
men may not represent the majority of depressed college students, they do make up a significant amount of the statistic.
Stressors for men tend to be related more toward academic achievement and intelligence levels (Barrett & Boggiano,
1991).
Response to Student needs and Student Utilization
The American College Health Association developed
the National College Health Assessment to help researchers, health service providers, faculty, and student affairs
professionals to assemble information about students’ ideas, behaviors, and understanding of the most relevant
health matters ("Depression; survey shows," 2004). This survey is currently the largest inclusive set
of data reporting on the health of college students. It encompasses the feedback of more than 160,000 students
enrolled in 274 institutions.
In the spring of 2000, the ACHA-NCHA determined that 10.3 percent of college students reported being diagnosed
with depression; in just four years that number rose nearly 5 percent ("Depression; survey shows," 2004).
This most recent study surveyed almost 50,000 students at 74 different institutions across the country. With the
national rise of depression and depressive symptoms on college campuses, it is important that universities appropriately
respond to the health needs of their students. Although college depression is typically mild in intensity, failure
to respond could present a serious problem. Seventy-five percent of depressed college students experience symptoms
for more than three months, with half reporting that they had considered suicide (Vredenburg, O’Brien, & Krames,
1988). This statistic does not come as a surprise because “suicide is the third leading cause of death for
those aged 15-24 and the second leading cause of death of college students,” reported the American Journal
of Health Behavior (Swanholm, Vosvick, & Chng, 2009). Untreated depression also often results in physical
illness and mental illnesses, such as anxiety and eating disorders. A survey on college depression announced that “data
recognize that there is a clear need for colleges and universities to continue to deliver, or increase their capacity
to deliver, campus mental health services” ("Depression; survey shows," 2004).
Within the past decade, there has been a considerable amount of research conducted on college depression, and
in return, institutions have implemented changes within university counseling services to respond to the psychological
needs of students. Unfortunately, despite recent efforts made by colleges and universities, researchers find that
only a small number of students are utilizing the resources made available to them. Just as the reported incidents
of depression are more frequent with female students, women are also more likely to utilize the readymade services
provided by universities. However, records show that as few as three percent of all first-year students who experience
depressive symptoms take advantage of professional counseling services (Raunic & Xenos, 2008). This statistic
boggles the mind, considering that most American universities provide psychological counseling and other services
to students and faculty free of charge.
Several possible explanations for the underutilization of free university psychological services include self-sufficiency,
lack of social support, denial, unwillingness to discuss personal problems, lack of awareness of available services,
and the perception of the stigma associated with counseling (Raunic & Xenos, 2008). It is important that these
potential barriers are researched and combated by universities. For example, universities could make an effort
to publicize available services to first-year students. Early knowledge of services and the advertising of healthy
coping mechanisms can help ease the minds of the population undergoing the most drastic lifestyle change. Programs
may also be implemented to help students adjust to their new environment and external stressors before they become
overwhelming.
Discussion
Depression is a very serious topic on college campuses across the country. The detrimental, and sometime irreversible,
effects that depression has on students is not to be taken lightly. Although we may all experience bouts of unhappiness,
depression is far more than that. Common misconceptions about the disease and stigmas placed on those who may have
experienced it often take away from its severity.
Millions of students are suffering as a result of this epidemic and are in need of support from friends, family,
and their college community. Education about how to recognize and cope with depression is not appropriately being
delivered to students. Changes in our society have caused emerging adults to have to deal with stressors that were
not as much of an issue in generations past.
Conclusion
In order for colleges and universities to decrease the growing number of students battling depression, they must
fully understand illness, the causes, and the effects it has on the university and student population. Preventative
programs may need to be implemented to address the root of depression and possible healthy coping mechanisms for
students. Both students and universities need to be able to identify risk factors, external stressors, and signs
and symptoms of the disease. More knowledge and a better understanding of what students are experiencing can assist
schools to provide adequate services but more importantly help students feel more comfortable in utilizing the
resources.
Because depression is often a gateway for more serious health risks and unproductive behavior such as suicide,
substance abuse, and eating disorders, it is imperative that students and universities work together to combat
the disease. Although colleges and universities may be working to improve mental health services, they should not
be the only ones striving to make a difference in the lives of students. Enrollees at these institutions should
take ownership of their own health and well-being and support one another. Student led organizations that target
women and promote healthy body-image, for example, may help lessen a major stressor while also providing a secure
social network for those who are at high risk of suffering from depression.
By working together, students and institutions of higher education have the potential to make a significant difference
in the battle against depression on college campuses. With resources in place, education and promotion must be
the focus of those trying to make a difference. By educating students and getting them to rally together in support
of one another, a positive change is bound to be the end result.
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