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The dark side of college life: Academic pressure, depression, suicide

Daniela Lamas / Knight Ridder Newspaper (KRT)

MIAMI - Caitlin Stork tried to kill herself the first time when she was 15. She was hospitalized, discharged, and attempted suicide again.

The doctors diagnosed depression and put her on Paxil. It wasn't until the drug drove her into a manic state that she was diagnosed with bipolar disorder, and prescribed lithium.

Stork is now a senior at Harvard University, still taking the mood-stabilizing lithium and the anti-psychotic Seroquel.

"You would never believe how much I can hide from you,'' Stork wrote for a campus display on mental health. "I'm a Harvard student like any other; I take notes during lecture, goof off … but I never let on how much I hurt.''

Stork is one of a growing number of college students coping with mental illness. More students, with more serious problems, are using campus mental health centers than ever before. The number of depressed students seeking help doubled from 1989 to 2001, according to one study, and those with suicidal tendencies tripled during the same period.

Suicide is the second leading killer of college students - with an estimated 7.5 deaths per 100,000 students per year, according to a study of Big 10 campuses from 1980 to 1990. Three New York University undergrads died in three separate apparent suicides this fall.

It's a complicated landscape, where it's easier to find blame than answers. Doctors and students point to increased academic pressure, starting at a much earlier age. In addition, there's easy access to drugs and alcohol in a culture where stress is the norm and sleepless nights a badge of honor.

Students with serious mental illness also are getting diagnosed and medicated earlier. As such, some young adults - like Stork - can make it to college, while they might not have years earlier.

Colleges acknowledge this is a hot issue. With limited funds, they've hired more psychiatrists, stepped up hours at counseling centers, instituted outreach programs throughout the campus and instructed teachers to watch students during exam times.

"Around this time, it's very, very hard, but we don't turn people away,'' said Florida State University's counseling center director, Dr. Anika Fields, who called the weeks before first-semester exams "crunch period.''

But critics say colleges need to do more. There's little evidence of which interventions work best, stigma still surrounds mental illness, and students describe a disconnect between counseling centers and the campus population.

Many schools simply aren't ready, says Stork: "The science is advancing faster than the universities.''

For students without diagnosed mental illness, it's still hard to recognize whether problems exist, and to ask for help. Having more counselors helps, they say, but it's not enough.

"A lot of students aren't that comfortable going up to a psychiatrist, and saying, 'Hey, I need some help,'" said Peter Maki, a University of Miami student and member of the group Counseling, Outreach, Peer Education (COPE).

Maki, a psychobiology major, is one of a group of students trying to turn COPE from a group that does "secretarial work" to a link between counseling center and student body.

"There's definitely a gap," said Ashley Tift, a University of Miami senior who chairs COPE. She referred a friend to the counseling center who was depressed and drinking too much. It helped, but she wouldn't have known where to turn if she weren't involved with COPE.

At Harvard, Stork heads a student group, the Mental Health Awareness and Advocacy Group. At a conference last year, members learned that personal contact has been proven the best way to reduce stigma - better than education.

They created an annual mental health awareness week, with panels, relaxation techniques and prominently displayed student narratives on bulletin boards in a heavily trafficked campus area. An undergrad with obsessive-compulsive disorder wrote about her need to wash her hands 50 times per day. A depressed freshman considered taking too many pills, lying in bed while everyone else seemed to welcome the new opportunities and activities.

With these and her own experiences in mind, Stork urges Harvard's resident advisors to "err on the side of nosiness" rather than risk missing a student in trouble.

When all safety nets fail, there's the threat of suicide.

In a nationwide study, 9 percent of college students admitted to "seriously considering attempting suicide" between one and 10 times in the 2002-2003 school year and just over 1 percent actually tried to kill themselves.

Jed Satow was a sophomore at the University of Arizona when he committed suicide in 1998. He was impulsive, acted without thinking of consequences, but neither his friends, professors or parents recognized his actions as signs of depression, said his father, Phil Satow.

"People don't know when their roommate or friend has crossed the line. This sort of thing is not generally talked about," said Satow, president and founder of the Jed Foundation, a nonprofit that aims to decrease the youth suicide rate. "The reality is that there needs to be cultural changes on college campuses to deal with stress and depression."

The Jed Foundation launched a free Web site this fall,, which links students to mental health centers, information and anonymous screening for issues including depression, eating disorders and suicide. Colleges can subscribe, enabling students to avail themselves of all the services.

"This allows students on their own, without stigma, to be screened 24 hours a day," Satow said. "If you take a public health approach, alerting the whole campus in what to look for, in all probability more kids like my son will come in. It's a real communal problem."



In a survey of nearly 20,000 students on 33 campuses, college students reported experiencing the following within the 2002-2003 school year:

-Feeling overwhelmed by all they had to do:

Male … Female … Total

Never: 10.8 … 2.6 … 5.4

1-10 times: 68.8 … 64.5 … 65.8

11+ times: 20.4 … 32.9 … 28.8

-Feeling so depressed it was difficult to function:

Male … Female … Total

Never: 60.6 … 52.6 … 55.2

1-10 times: 33.3 … 39.8 … 37.7

11+ times: 6.1 … 7.6 … 7.1

-Seriously considering attempting suicide:

Male … Female … Total

Never: 90.8 … 89.1 … 89.7

1-10 times: 8.2 … 10.0 … 9.4

11+ times: 1.0 … 0.8 … 0.9

-Attempting suicide:

Male … Female … Total

Never: 98.6 … 98.7 … 98.6

1-10 times: 1.2 … 1.2 … 1.3

11+ times: 0.3 … 0.1 … 0.1

-Source: American College Health Association, National College Health Assessment: Reference Group Executive Summary, Spring 2003.



Think your friend or child might have a problem? The following are some symptoms of depression, from the National Institute of Mental Health. Not everyone who is depressed experiences every symptom.

-Persistent sad, anxious or "empty" mood

-Feelings of hopelessness, pessimism

-Feelings of guilt, worthlessness, helplessness

-Loss of interest or pleasure in hobbies and activities, including sex

-Decreased energy, fatigue, being "slowed down"

-Difficulty concentrating, remembering, making decisions

-Insomnia, early-morning awakening or oversleeping

-Appetite and/or weight loss or overeating and weight gain

-Thoughts of death or suicide; suicide attempts

-Restlessness, irritability

-Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain

For more information, go to or call 866-615-NIMH (6464).

To contact The Jed Foundation, go to, or call 212-343-0016.


© 2003, The Miami Herald.

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Distributed by Knight Ridder/Tribune Information Services.




John Roberge / KRT Campus