This article will briefly review some basics about depression and then provide you with practical advice about what your role is when helping someone who is depressed.
What is depression?
For sake of clarification this article is about clinical depression. There is the very common depression that lasts for a short period of time up to a day or two. This is a very natural reaction to difficult or unpleasant life experiences that result in a recovery to your natural mood without professional assistance or medication.
The depression we are concerned about is clinical depression. Depression is often diagnosed when these feelings persist for a period of two weeks or more. Depression is also associated with an altering of ones daily life. Three common examples are, not getting out of bed, avoiding activities you once looked forward to, and a lowering of ones personal hygiene and appearance.
Taking a closer look at depression you will find that there are different types:
Bipolar depression is associated with drastic mood swings both up and down. The depression traits are the same as for those of major depression. The manic side often is associated with an inflated sense of self importance, racing thoughts, increased energy, increased desire for sex, inappropriate social behavior, and extreme feelings of joy and happiness.
Seasonal Affect Syndrome (SAD) is associated with the change of the season, typically the colder, darker days of winter. Common signs of SAD are an increased need to sleep, cravings for carbohydrates, and weight gain.
Major depression is a general term to characterize a long period of abnormally low feelings of happiness. Traits often associated with major depression include: depressed mood, worthlessness, hopelessness, fatigue or lack of energy (the feeling of “dragging oneself around”, decreased motivation, negative or pessimistic thinking, loss of interest in friends, activities, hobbies, or work, change in eating habits, weight gain or loss, sleep problems, including waking up early, frequent crying, difficulty concentrating, remembering, or making decisions, and thoughts of death or suicide/suicide attempt.
Dysthymia is a chronic ongoing depression, often found to be a mild depression starting at a young age and lasting throughout life. People with Dysthymia are often described as numb, negative thinkers and unable to enjoy anything, even things they once used to enjoy.
What does depression mean?
Depression does not mean a person is weak, unstable, or crazy. Depression is simply a medical illness such as a common cold or a broken foot. Your body has an ailment and needs assistance to recover. Depression is a medical illness linked to the biochemistry of the brain. Changes in the chemistry of a brain can be altered through therapy and/or medicine. A person with depression cannot “snap out of it”, just like you cannot “snap out of” a broken foot.
Possible causes about depression:
Depression is a very common illness. Despite the saying that college is supposed to be some of the best years of one’s life, depression is very common on college campuses. Scientists are still uncertain how and why the chemical changes in the brain occur, however many of the stresses associated with depression are found in the college setting; making new friend, new found freedom and responsibility, financial concerns, physical wellness often deteriorates, academic concerns, family pressures, the breakup of a significant relationship, and the general difficulties of moving through stages of development and maturity. Other factors that are believed to be associated with the development of depression are hereditary, other medical conditions, psychological makeup and fluctuating hormone levels.
How to help someone who is depressed:
First of all you need to ask yourself why you think someone is depressed. A person will most likely show a noticeable change in his or her demeanor when depressed.
The best thing you can do as a RA is to ask the person you are talking to how they are doing/feeling. This is another time to pull out those counseling skills that were covered in RA training.
Even the most caring person often feels uncomfortable asking someone if they are depressed. If you really want to know how someone is doing you are going to have to ask real questions, going beyond the light conversation that you may have with some of your residents. Rather than asking how are you doing, ask someone to tell you about his/her day. Ask open-ended questions that stimulate a response other than yes or no or other one-word answers. Other possible questions that you can tailor to your personality and the specific situation are:
When was the last time you were happy?
What are you looking forward too?
What kind of problems are you having?
Who are you talking to for help?
When is the last time you…(list something they usually do for fun – going to the movies, or would never miss – skipping class)?
Managing a situation that is “over your head”
Jeff Haugaard, a professor in Cornell’s Psychology department and a faculty fellow for the residence hall I work in, suggests keeping the following phrase in the back of your head when you feel that you are dealing with any situation that is over your head. “When in trouble, self disclose on the double.” Whenever you are in a difficult situation because someone has disclosed something to you that you do not feel qualified to handle, think of this catchy phrase and say what you are feeling. Examples might be:
• I am feeling a little uncomfortable, because I am really concerned about you and want to make sure you are okay.
• I appreciate your sharing with me. I feel that there is a right answer or response, but I really do not know what to say. I do know that there are staff here at the University who can help you.
• I am glad you came to me for help. I am not qualified to help you but would like to help you find someone who can.
• Some of the things you have said really concern me.
Frequently a large percentage of mild to moderate cases of depression are successfully treated through therapy. Many different types of therapy exist, and finding a good match between a therapist/counselor and the patient is important in the efforts to recover. There are many prescription drugs on the market available to assist the biochemical imbalance causing the depression, which are frequently used to assist in the recovery of depression. Exercise is a wonderful habit that produces natural endorphins, a natural and healthy high for your body. If depression persists or is causing a person to become suicidal, hospitalization may be required.
On your floor, programming is a wonderful way to create awareness about the issue of depression. Passive programming in the form of a bulletin board is one way to address the topic. Work with your supervisor to find other ways to creatively and properly address the issue of depression. Suggestions can include having someone share his/her personal experiences and then answers questions, or invite a faculty member or counselor (someone who knows how to present to college students) to come over and talk about depression with your floor/building.
Important things to remember:
Although the causes of depression are unclear, it is known that asking someone if they are depressed will not cause them to be depressed. Often we worry about offending someone by asking him or her a question related to a social taboo; are you depressed? Do you have a drinking problem? Are you??? It is much better to error on the side of caution (caution meaning asking the question), than ignore a feeling, especially in your important role as a RA Your supervisor can help you determine the best way to approach someone that you are concerned about. More often than not, the person you engage in a conversation and show genuine concern towards is most likely not going to be upset with you for trying to help.
Know your limits. Do not take on the burden of assessing depression. Just like you would not assess a damaged tendon, don’t try to assess depression. Put your resources to work and ask for help. Everyone has different levels of training, skills, and personal experiences. If you are too busy to help, do not have enough knowledge to help, or simply are unable to help because of the person or situation involved, do the right thing by utilizing the other campus resources available to you and your residents. Get a professional trained in depression issues to help assess and manage the situation.
Confidentiality. Remember that it is best not to promise confidentiality. If someone asks if you can keep a secret, do not say yes, but rather state it depends on what you tell me. A general rule is to ask the person who wants to tell you something if it is okay for you to discuss the situation with your supervisor. Despite the difficulty and pain of opening up and sharing ones struggles, there is a welcomed relief to sharing your burden. Often informing your resident that you will need to tell you supervisor, and only your supervisor, will result in additional trust and communication. You can and should ask whom a resident is concerned about you telling. More often they do not want their friends or family or strangers to know they are having a problem out of fear they will be teased or judged in a different/negative light.
Boundaries. It is imperative to set personal boundaries. Boundaries can be described as the time and mental effort you dedicate to a problem. Too often RA’s get caught up in helping one resident and not being able to help other residents, or even take care of themselves. If a person is taking more of your time than you are able to give, then the problem is too large for you to handle. It is important to work with your supervisor and health center to make sure that you are able to get your resident the help they need.
Look around. Everyone is a candidate for depression. As an important member of your team, do not forget to look at other members you work side by side with. Are your fellow RAs doing okay, the members of your group project, your family and friends back home? And don’t forget to look at yourself!
Depression and suicide
Depression is often associated with and can lead to suicide if untreated. Studies say that one in two cases of suicide are a result of depression. Similar to depression, if you see warning signs indicating a person is suicidal (stops talking about the future, lack of self-respect, self cutting, giving away of personal items, fascination with death…) talk to the person. Ask those same difficult but direct questions (remember when in trouble, self disclose on the double). Make sure to get professional assistance immediately.
Depression is a growing and dangerous illness that is highly treatable in most cases. Therapy and/or medicine are most commonly used to treat depression. You as a RA have an important role in identifying students who are facing all types of problems, including depression, and helping them find the necessary support to address their challenges. Although society is becoming more aware and comfortable talking about depression, many people still find it to be an uncomfortable subject. Reassure others that depression is not contagious. Continue to carry out the responsibilities of your role as a RA and a human being with pride. Reach out and help to educate others about the issue of depression and help those who are currently facing depression.
Note: In writing this article I referenced Yahoo’s search engine on depression. A quick search using the word depression on any search engine will provide you with numerous possible options for information. As always when using information from the Internet, be careful when considering the reliability of the information provided. Your student health center and scholarly journals are terrific places to find credible information.
Submitted by Todd Carlson, Residence Hall Director, Cornell University