Recognizing and Helping Students in Distress

Responding to Depression

Depression is often misunderstood but is more than just feeling blue or the usual ups and downs of everyday living. It is a major problem in our society, on college campuses and elsewhere. The latest statistics show that over 22 million people suffer from depression in the United States. It is a very treatable condition. However, if left untreated, the symptoms may worsen and ultimately be more resistant to treatment. Most depressions are not something that you can simply “snap out of.” It is often this very notion of feeling "down or blue" and unable to get yourself out of the slump that alerts people to the possibility that there is more going on that requires intervention.

Some of the most common symptoms include: a prolonged sense of sadness or moodiness, irritability or anger, anxiety, difficulty sleeping which may include sleeping too much, having difficulty falling asleep, early morning awakening, etc.; loss of appetite or an increase in appetite; difficulty concentrating, forgetfulness, lack of desire or motivation to engage in usually pleasurable activities, social withdrawal, chronic worry, feelings of despair, hopelessness and possibly thoughts of suicide. If someone is experiencing feelings of hopelessness and thoughts of suicide they need immediate attention. If any of the other symptoms have persisted for more than two weeks on a fairly consistent basis, then counseling is strongly recommended.

All the causes of depression are not known, however, there are biological and emotional factors that can increase the likelihood that someone might develop depression. Research has shown that there is a genetic component to depression and that it does run in families. Certain life events may trigger a depressive episode such as losses and separations like deaths, moving away, divorce, romantic break-ups, sexual, physical or emotional abuse, chronic illnesses, abuse of alcohol and drugs. There are also certain medical conditions and medications that can also cause a depression such as thyroid disorders, diabetes, and some others. An unrecognized depression can lead to poor academic and work performance. Students may at times find that they do not have the energy or motivation to attend classes, or they may find it difficult to concentrate or focus on their work.

The Counseling Center can help students sort out what may be going on and provide appropriate help. If you sense the student is hesitant about seeking out treatment, telling them that other students with similar struggles have experienced success with treatment may help motivate them to get help.

Responding to Eating Disorders

While many college students know something about the major eating disorders, anorexia nervosa (restricting food) and bulimia nervosa (purging, often with bingeing), there is also much misinformation available. Also, there are other important eating issues that cause problems for many students.

Eating disorders can be confusing and misunderstood by parents, faculty, peers, and even the student her or himself. (While more women than men struggle with eating disorders, 15% are male.)

Here are some general facts about eating disorders:

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  The causes of the eating disorder usually are present years before there are symptoms
  
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  Individuals with significant eating disorders are not being stubborn or controlling – they really can not easily stop the behaviors even though they often want desperately to do so.
  
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  Talking with a student about what you notice will not make them worse.
  
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  Even if a student denies that there is a problem, expressing concern in a supportive, non-judgmental way can often lead later to them getting some help.
  
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  Students struggling with eating disorders often have a secondary problem with depression, obsessive-compulsive disorder, or other emotional disorder.
  
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  Students who you believe have lost a significant amount of weight or who may be purging (with vomiting, laxative abuse, etc.) excessively (often multiple times each day) should be brought to the attention of the Counseling Center (860-297-2415), the Health Center (860-297-2018), or the Dean of Students (860-297-2156), since these conditions can be very serious physically and can ultimately lead to serious medical complications (e.g., sterility, heart disease, kidney or liver disease, or death).
  
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  At the same time, students may often experience these disorders and remain in generally acceptable health, so it is often a difficult issue to get them into treatment, since they have a right to refuse treatment of any kind unless they are in imminent danger.
  

The Counseling Center is happy to consult with faculty about questions they have. Again, please understand that we can not discuss specific students, nor indicate that a particular student is or is not in treatment in the Center without a specific release signed by the student.

Responding to Psychotic Disorders

In relatively rare cases, students at Trinity as elsewhere may experience a psychotic episode and become quite detached from reality. This detachment may take the form of responding to hallucinations, delusions, or other seemingly strange behaviors. Here, as in all cases, if there is imminent danger to the student or someone else, call 911 or Campus Safety first, erring always on the side of caution. In the absence of apparent imminent danger, the Counseling Center will provide whatever help is required and will help mobilize the resources appropriate to the situation. When you call the Counseling Center, be sure to tell the person who answers the nature of the situation and your sense of its urgency.

Responding to Suicide Possibility

Sometimes emotional distress may become seriously debilitating and can lead to self-destructive thoughts and behaviors as a way of escaping emotional pain. Although suicide is a rare event, it is the second leading cause of death among college students. Suicidal states are often associated with major depression, acute anxiety with depression, post-traumatic stress disorder and bipolar disorder. Those who abuse alcohol or drugs have an increased risk of causing serious harm to themselves, including death even if their intentions were just to make a gesture. A student who confides in someone that he or she is feeling suicidal is often ambivalent about suicide and open to discussion and help. Those at high risk usually have a specific plan (and may refuse to tell you their plan), have the lethal means (e.g., medication, weapons, etc.) and tend to be or feel isolated.

What to look for:

Any expression of suicidal thoughts which may be verbal or in written material:

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  Pessimistic view of the future
  
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  Intense feelings of hopelessness, especially in combination with anxiety, feelings of alienation and isolation.
  
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  Frequent talk of death as a means of escape from distress
  
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  Previous suicide attempts
  
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  Personal or family history of depression and/or suicide attempts
  
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  Substance abuse
  
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  History of self-mutilation
  

What you can do:

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  All threats of suicide should be taken seriously (do not assume this is just attention seeking behavior)
  
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  Talk to the student in private or in a secure area
  
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  Listen attentively and empathically (this does not have to mean you agree with their perspective)
  
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  Keep your own limits in mind; don’t get more involved in the student’s life than is comfortable or appropriate
  
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  Generally speaking, those who engage in self-harming behaviors like cutting, burning, etc., are not actively suicidal but are still in need of treatment.
  
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  Remain calm and take the lead, ask the student directly about feelings and plans
  
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  Asking them about suicide will not put the idea in their head if it is not there already
  
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  Express care and concern, and assure the student that you will help them reach a professional.
  
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  Call Campus Safety (860-297-2222) and/or 911 if the student is in immediate danger, the student will be taken to the emergency room for evaluation
  
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  Escort the student to the Counseling Center if possible for immediate attention
  
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  If you feel overwhelmed or unprepared to help a student that you think may be suicidal, call the Dean of Students Office (860-297-2156) or the Counseling Center (860-297-2415).
  

What to avoid:

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  Minimizing the situation. All threats must be taken seriously.
  
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  Arguing with a suicidal student about the merits of living
  
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  Allowing friends to assume responsibility for the student without getting input from a professional.
  
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  Assuming the family knows that the student has suicidal thoughts or is in this much distress.