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16 July 1999 Vol. III, No. 2 Feature Article Making Life Work BU rich in resources for those with depression By Amy E. Dean Myth: People who are depressed cannot function. Reality: Most people who are depressed can carry on with their lives, and more important, their depression is not difficult to treat. Emotional pain can be eased through counseling, short-term medication therapy, and even such resources as books and Web sites (see sidebar). At Boston University, the campus population -- students as well as faculty and staff, their children, and their elderly parents -- can call upon a number of places, including the Faculty/ Staff Assistance Program (353-5381), the King Center (353-3540), the Gerontology Center at the Health Policy Institute (353-5045), Student Health Services (353-3575), and the Danielsen Institute (353-3047). Carole Bohn, executive director of BU's Danielsen Institute. Photo by Fred Sway Depression, which affects all age groups, is discussed more today, says Associate Professor Carole R. Bohn, executive director of the Danielsen Institute, because "we've become more sophisticated at recognizing the underlying problems that cause it and are willing to talk about mental health problems more openly than ever before." Bohn adds that attitudes about getting treatment for depression are also less negative than they used to be. "Advancements in medications to help treat mental health problems have made people more willing to undergo treatment and care," she says. The Danielsen Institute is a licensed mental health clinic and accredited pastoral counseling center that provides both doctoral training and mental health services for BU students, faculty, and staff, as well as outreach to the greater Boston community. College students make up 95 percent of the population seeking help from the institute, but clients range in age from late teens to the elderly. Bohn describes depression, commonly referred to as a mood disorder, "as an indication of a more complex underlying problem that can surface if an individual seeks treatment. Young people feel a great deal of pressure when they come to college. A lot of changes are going on for them all at once. Most major of all is leaving home. Students may feel excited and upbeat about going to college, but if they don't get the opportunity to express painful aspects of that transition, they may experience depression. Seeking help is one way for the student to gain control over these feelings and make them less overwhelming." While no one knows exactly what triggers depression or why some people become more depressed than others, some individuals are at greater risk. Those with depressed relatives are twice as likely to become depressed as those with no family history of depression. Women are more likely to experience depression because of the mood-altering effects of the menstrual cycle, pregnancy, childbearing or infertility, the use of oral contraceptives, and hormonal imbalances brought about by menopause. In the elderly population, depression is the most common psychiatric problem today. "Depression has become a more recognized problem for elders," says Elizabeth Markson, research professor of medicine at the School of Medicine and associate director of the Geronotology Center at BU's Health Policy Institute. "For a long time, we assumed depression in later life was normal, but it's not. Older people do get depressed, just as younger people do, and the reasons are pretty similar in that they relate in some way to a major loss -- in memory function, in physical abilities, in a supportive network of peers, and in a sense of purpose in life." Treating depression in elders can be more difficult, however, because "many of them were not socialized to seek help because of the stigma attached to having your head examined," says Markson. Those who care for elderly parents need to recognize that symptoms of depression can be cloaked in physical symptoms: headaches, difficulty swallowing, chest pain, or an upset stomach. Depression can also be caused by certain medications. "It's important to know the potential side effects of a particular medication or of drug interactions," advises Markson. "In many cases, substitute medications can be prescribed, and the symptoms of depression will clear up." Louise Grant, a social worker with the Faculty/Staff Assistance Program, says, "Adolescents make up the most difficult group in which to determine clinical depression because they are at the age of tremendous change and self-discovery, with natural highs and lows. Physical, sexual, and emotional abuse, a parent's drug or alcohol abuse, the loss of a parent through divorce or death, sexual identity confusion, or having a seriously depressed parent can increase the risk of depression. But adolescents may not show obvious sadness. Parents should pay attention to symptoms such as withdrawal and isolation, unusual irritability, aggressive outbursts, problems at school, substance abuse, the inability to bounce back after a minor disappointment (such as the loss of a ball game), or a sudden change in mood or behavior that does not make sense." If you or someone close to you is depressed, taking advantage of the resources both on and off campus could turn depression from a condition full of despair into one of hope and healing. "Making Life Work" is sponsored by the Faculty/Staff Assistance Program, directed by Bonnie Teitleman, and the Office of Family Resources and Boston University Children's Center, directed by Nikki Sibley. To propose topics for future articles or to express your opinion about this piece, e-mail bteitlem@bu.edu or nsibley@bu.edu. Self-help books The Depression Workbook: A Guide for Living with Depression and Manic Depression (Mary Ellen Copeland, 1992, New Harbinger Publications) Gentle Roads to Survival: Making Self-Healing Choices in Difficult Circumstances (Andre Auw, 1991, Aslan Publishing) The Grief Recovery Handbook: A Step-by-Step Program for Moving Beyond Loss (John W. James and Frank Cherry, cofounders of the Grief Recovery Institute, 1988, HarperPerennial) Here Comes the Sun: Dealing with Depression (Gayle Rosellini and Mark Worden, 1987, Hazelden) Web resources Depression Awareness Recognition and Treatment (DART) A program affiliated with the National Institute of Mental Health designed to educate the public, primary care providers, and mental health specialists about depressive illnesses, their symptoms, diagnosis, and treatment; http://www.nim.nih.gov/dart/index.htm. The American Foundation for Suicide Prevention Information and education about depression and suicide; http://www.afsp.org/. Wing of Madness: A Depression Guide Provides insight into why women are more prone to clinical depression than men and links to articles and other depression sites; http://members.aol.com/depress/index.htm. Mental Health Net Includes disorders and treatments, updated mental health articles, advice columns, commentary and access to chat rooms; http://www.cmhc.com/. Online Depression Screening Test Hosted by the New York University Department of Psychiatry, provides online questionnaire, resources on depression, and suggestions for a professional evaluation; http://www.med.nyu.edu/Psych/screens/depres.html. American Psychological Association Geared to those with an interest in psychology on an academic level, with current research and studies on depression and other mental health issues; http://www.apa.org/homepage.html. Mental Health Internet Online mental health encyclopedia that covers treatment and medication for depression and offers an online magazine; www.mentalhealth.com. Finding Help: How to Choose a Psychologist From the American Psychologists Association; http://www.apa.org/pubinfo/howto.html.