Going to college is an exciting time in the lives of young people, but for some of them depression gets in the way. Whether it’s their first brush with the disorder or not, college can act as a catalyst for the onset of depression in many young people, and, on their own for the first time, the timing couldn’t be worse.
Dr. Roy Boorady, a child and adolescent psychiatrist at the Child Mind Institute, says he gets “lots of calls first semester” about college kids who are having a hard time. “Usually what they end up doing is calling their parents in the middle of the night. Then their parents call me and say, ‘I’m getting two and three o’clock in the morning calls from my child who is crying and depressed and unhappy. What do we do?’ ”
Children can be depressed at younger ages, but the older you are the higher the prevalence rates. Experts consider risk factors for depression to be a combination of genes and environment. Some kids might be genetically at risk for developing depression, but they will be fine until they experience an environmental stressor that flips the switch and sends them into depression. It makes sense that college could be that stressor.
The stress of a new environment
“Leaving home is a huge transition for kids, and I think we underestimate the difficulty that a lot of kids have,” says Dr. Boorady. Away at college, suddenly kids find themselves in a new environment without any of the structure or supports — academic or emotional — they’ve always been able to rely on. Kids might have complex feelings about how they should be relating to the people back home, or think that they don’t fit in with their new peers.
Independent for the first time, they might also be embracing the college lifestyle: erratic sleeping habits, non-nutritious (or nonexistent) meals, and an unstructured schedule — especially if they’re skipping classes — that can leave them feeling unglued.
College is also something of a pressure cooker for depression because the more you’re surrounded by people who are depressed, the more likely you are to become depressed yourself.
What to look out for
Detecting depression in kids who are away from home can be difficult. Some symptoms, like uncharacteristic sadness and crying, are straightforward, but others, like trouble concentrating and irritability, are less so. People with depression also tend to isolate themselves and take less pleasure in things they used to enjoy, so if you hear that your child is spending too much time alone in his dorm room or quitting the things that used to make him happy, he might be depressed.
Worrisome alcohol and substance use can also be a sign. For many kids, things come to a head towards the end of the semester, when academic demands become more pressing and seem insurmountable.
College is a time to become more adult and independent, and parents should respect this and give kids the space they need to grow. But if you notice any changes in his mood or behavior that worry you, don’t ignore them. His fellow students and new professors don’t know him as well as you do, so they might not recognize when there is a problem.
Treating depression when kids are away at college can be complicated. Colleges have health centers on campus with professionals who can help, but convincing kids to go there can be “a feat in itself,” notes Dr. Boorady. That’s why he advises that kids who have already struggled with depression should contact the mental health professionals on campus before going to college. Having already made that initial contact and already knowing who and what to expect makes asking for help much easier.
If your child hasn’t used the health center yet but seems to need support, let her know that they can help. Kids are often reluctant to take the first step, so be supportive and encouraging. Parents may also be able to schedule an appointment, but because of confidentiality laws you shouldn’t expect the school to give you information about your child’s health unless she has given them her authorization to do so.
Keep in mind that health centers typically limit the number of sessions students can receive, but they will make referrals to other professionals located nearby. If your child has depression she will likely need ongoing treatment, either for therapy or for monitoring medication or both. Traveling back home for health care often isn’t realistic and receiving consistent treatment is important, so it’s good to find a provider your child can rely on in the community.
Not a good time to stop medication
Finally, it isn’t uncommon for kids who have already been diagnosed with depression to want to stop taking medication before going to college so they can get a “fresh start.” This can be very dangerous if unsupervised. With depression there is a risk of relapse, so if your child wants to stop taking her medication, the dosage should be lowered very gradually and she should be closely monitored by her doctor throughout the process —going cold turkey is never a good idea.
Stopping treatment right before college is also risky for another reason: “The first year is so stressful, so I want kids to have a successful first year,” says Dr. Boorady. “Then when they come back we can discuss if it’s a good idea to go off medication.”