About 10 years ago, the counselling staff at Camosun College began to notice a disturbing trend. A larger portion of students at the college began suffering from fatigue, an inability to concentrate, thoughts of worthlessness, and insomnia. All of these things are symptoms of depression, according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders.
Through conversations with other counsellors across Canada it became apparent that an increase in depression was occurring nationwide.
“I decided early on that I needed to know more about depression, and depression management,” says Nancy Willihnganz, a counsellor at the Lansdowne campus.
Willihnganz set out to compile data from college counselling services across the country. She and a colleague did this twice, resulting in Canadian Counselling Centre Surveys for 2005 and 2006.
Both reports indicated that depression, anxiety, and relationship issues are the top three personal issues for which Canadian students seek counselling, with depression taking the top spot in 2006.
UNDER PRESSURE
Former Camosun student Amanda Nelson isn’t surprised that so many students feel depressed.
“There’s so much pressure put on students to have a career and be successful and get good grades,” says Nelson. “Most people are on loans so the pressure to succeed and the pressure to perform is really overwhelming.”
Nelson herself struggled with depression while attending the Hotel and Restaurant Management program at Lansdowne campus a few years ago.
“I just was in a constant slump,” she remembers, “and I wasn’t feeling satisfied with where I was at. I felt like I was weighed down when other people weren’t, and I didn’t know why I couldn’t get to where other people were.”
Although Nelson was aware of the counselling services available on campus, she didn’t like the idea of opening up to someone she didn’t know. She talked to a personal mentor, who suggested antidepressants. A quick trip to the doctor and Nelson had the prescription she was after.
“They do this wimpy little psychological examination, and basically anybody can get on them if they want to get on them,” she says.
A prescription for antidepressants can be obtained without any other forms of treatment. They are most commonly variations of drugs classified as SSRIs (selective serotonin reuptake inhibitors). Basically, the goal of the medication is to control the way serotonin interacts with the body and prevent mood swings. The right pill can be a blessing, but because slight differences in the medication can have big impacts on different bodies, it’s hard to predict the outcome.
“Because I did the trial and error process with finding the right antidepressant, there were a lot of side-effects,” she says. “Some antidepressants cause high anxiety or low anxiety, or appetite changes, or headaches… It was a nightmare to try and find the right one.”
Although Nelson was surprised at how easy it was to get a prescription for the medication, she’s grateful for the change she’s seen.
“After finding the right one, everything mellowed out,” she says. “They say when you take antidepressants you don’t really notice, but the people around you notice you being different, and that’s how it worked for me. I didn’t get as down in the low-lows like I normally would.”
One side effect of mood-altering drugs is the inability to feel extreme emotion at the other end of the spectrum, but Nelson says she didn’t have that experience.
“I understand that it’s something that keeps you level, but I still get happy and I still feel overjoyed and excited,” she says.
Although some critics say antidepressants are just a Band-Aid solution, Nelson feels they are working well for her.
“If your body chemistry is missing something, why not make it better, if it’s possible?” she says. “Before, I was kind of going up and down, I had no motivation, and was tired all the time… the typical symptoms. Being on them has been a relief.”
WHY THE LONG FACE?
Many people are wondering what has students feeling so blue.
“There’s a lot of speculation about that,” says Chris Balmer, a counsellor at Camosun College.
Because the western world appears to be more susceptible to depression, environmental factors are thought to be a cause.
“Society has become more complicated,” says Balmer. “People are impacted, particularly in cities, with all sorts of different kinds of pressures, expectations, stressors.”
Many psychologists and psychiatrists feel that the acceptance of depression by mainstream society has contributed to the normalization of the condition. It may also be a contributing factor to the rise in depression in postsecondary institutes.
“Before, people – and students in particular – that had mental illnesses weren’t even thinking about coming to college or university, because colleges and universities weren’t set up to accommodate them,” says Balmer.
Camosun has services in place for career, personal, educational, and cultural counselling, the cost of which is embedded in student fees. Students with a documented mental illness can receive support and assistance at the college’s disability resource centre as well.
“The system has changed over time, and that has really helped,” says Balmer. “Everybody probably knows somebody in their class who is struggling with a mental-health issue. They’re given the same chance to succeed as everyone else.”
Another reason why students are feeling depressed could be school itself. Results from the 2010 National College Health Assessment show that over 80 percent of students felt overwhelmed by everything they had to do, and 77 percent felt exhausted, but not from physical activity.
These feelings, combined with economic anxiety, changes in relationships, and the stress of day-to-day life, often lead to students feeling inadequate and hopeless.
MONEY FOR NOTHING
Besides the emotional aspect of depression, there’s an economic factor. Antidepressants are the second-most renewed prescription under the student medical plan, according to Michel Turcotte, Director of Operations for the Camosun College Student Society. Although the cost of most antidepressant medication is partially covered by the plan, Camosun students still spent over $20,000 on antidepressants during 2010-2011 school year.
For some, the introduction of SSRI antidepressants is thought to be a correlating factor in the increased prevalence of depression worldwide.
According to a report called The Marketization of Depression: The Prescribing of SSRI Antidepressants to Women, by Jane Currie, prior to the first well-known SSRI depression was only considered to affect 100 people per million.
Since the appearance of Prozac in 1988, depression rates have soared. They are now considered to be in the range of 50,000 to 100,000 cases per million.
Currie also points out that between 1981 and 2000, the total prescriptions for all antidepressants increased by 353 percent. This begs the questions: are we truly suffering from such soaring rates of depression, or is the marketing of pharmaceuticals playing a role?
Former Camosun student Rebecca Spencer (not her real name) has mixed feelings about antidepressants. She started going to counselling in middle school when she was around 14 or 15.
“I never necessarily thought I was depressed; it was a label put on me by concerned parties in my life,” she says.
Depression is characterized by a series of symptoms. Not everyone who’s depressed has all the symptoms, but everyone who’s depressed has at least some of them on most days.
“I wasn’t necessarily labelled as depressed altogether, but it was this ambiguous mélange of depression, anxiety, being a teenager, coping with pressures, being sensitive, being a perfectionist… all sorts of labels were assigned to me,” says Spencer.
She also suffered from a common symptom of depression: loneliness, or despondency, which often creates a self-perpetuating cycle of isolation.
“I went through a lot of periods of not being able to get out of bed, not being interested in anything around me, and getting really upset over little things,” she says. “Looking back it just seems regular. Like, of course I wouldn’t want to get out of bed, because school was really boring. And of course nothing interested me because the things that I was interested in were not valued. I was interested in reading and writing and going for walks by myself. And I was happy doing those things, but I guess I wasn’t acting like a ‘normal’ person.”
Diagnosing and treating depression can be difficult because of the variety of symptoms. Spencer decided to try antidepressants, with the support of her parents and a psychologist.
“The way the psychologist talked to me about it was there are several components to feeling happy, and there are different ways that you can take care of yourself. Those ways are healthy eating habits, limiting substance abuse, exercising, doing things that make you happy, but that sometimes those ways need a little boost. Sometimes drugs can help you to achieve your goals of healthy living. Sometimes they are not achievable all on their own,” says Spencer.
The medication wasn’t presented as a be-all and end-all solution; it was more like one component among several solutions.
“How my psychologist described it was A is the medication, B is exercise, C is healthy eating, D is positive thought processes,” she says. “I did realize that I could achieve more ‘success,’ as defined by society, if I functioned more normally, but I didn’t have the skills to do so.”
Next came the trial and error phase of her therapy. “I started with Effexor, then Paxil, Zoloft, back to Paxil,” she says. “I was on Trazodone at the same time. It’s an anti-anxiety pill, but I used it for sleeping.”
For younger people, experimenting with antidepressants can be a dangerous game. Most drugs aren’t tested on people under 18 or 19 so safe dosages can be hard to calculate. Beyond that, the teenage years are a period of rapid growth and change in hormones and body chemistry. Adding more chemicals to the mix can be confusing.
“I felt like I was living in a fog,” says Spencer. “Nothing good, nothing bad; just neutral. No feelings of euphoria, no feelings of stimulation, whether to the point where I was overwhelmed or to the point where I felt good and connected. No feelings of inspiration, no feelings of excitement, but none of despair either.”
Spencer feels that, for her, antidepressants were an attempt at a temporary solution that didn’t deal with the underlying issues in her life.
“They didn’t work for me. I think if messages that we held in society were more inclusive, in terms of what success is, I would have felt less pressure to conform, because I put a lot of pressure on myself,” she says. “I also felt a lot of pressure growing up to succeed in all sorts of areas, especially academically.”
Spencer feels a lot better about herself now, but, like Nelson, there were often times when she looked around and it seemed like everyone else was easily coping with all sorts of situations.
“If peoples’ differences and peoples’ ways of functioning in the world were celebrated and were more diverse in our society there might be less of a need for antidepressants. If the definition of normal was broadened, I think that I would have felt less alienated and confused,” she says. “I would have felt less like I had something in me that needed to be fixed.”