“We’re living with it, dealing with it every day,” says George Washington University sophomore Jenny Curt.
Three months into his freshman year at the George Washington University, Tim Rabolt struggled with all-too-familiar feelings. He couldn’t concentrate. He missed classes. Getting out of bed or meeting up with friends seemed impossible.
He felt hopeless.
“When I came to college, I was coming up on a year of being off all drugs and alcohol, and I thought recovery would be like cloud nine,” said Mr. Rabolt, now a senior in the School of Business. “I was seeing a therapist, not just white-knuckling it, but the depression was the worst it had ever been.
“The only thing I could think was that everything that could go wrong was going wrong,” Mr. Rabolt said.
Mr. Rabolt’s history is not the norm, but it is becoming more common among his peers—college and university students in the United States.
In 2012, the National Institute of Health estimated 16 million adults in the U.S. over the age of 18 experienced a depressive episode. Nearly 9 percent of those people were between the ages of 18 and 25.
According to the 2013 American College Health Association National College Health Assessment, almost 1 in 3 college students in the United States reported “feeling so depressed they” found it difficult to function within the last 12 months.
That means that if 60 students live on one floor of a residence hall, about 20 of them are likely to experience depression that impairs their ability to function.
Many of their stories, like Mr. Rabolt’s, are told during October, which is National Depression Awareness Month. The designation highlights the issue in ways big and small in colleges and universities, the armed forces, government agencies and other institutions.
At GW, for example, students participated in free, voluntary depression screenings on Oct. 9. Such efforts are increasingly needed as universities and colleges across the country are seeing an increasing demand from students for mental health services, according to the Association for University and College Counseling Center Directors Annual Survey.
The survey also found that depression is the second highest reported mental health issue among college students.
Almost 1 in 3 college students in the United States reported “feeling so depressed they found it difficult to function” within the last 12 months.
GW Associate Professor of Clinical Psychology Sherry Molock, a specialist on mental health and suicide prevention among African-American young adults, said that on average, depression is “a young person’s disease.”
“It typically starts at the onset of puberty,” Dr. Molock said “The transition to college, while exciting, can be an accumulation of stressors and disappointments that land students in a bad spot.”
Dr. Molock said that the symptoms— lack of motivation, hopelessness, isolation, irritability and slowed thinking —often go unnoticed by students who are feeling unsupported, embarrassed and increasingly overwhelmed by missed class assignments, social anxiety and uncertainty
“Students come to college and their old way of problem solving isn’t working,” she said. “This can lead to feelings of depression that compromise their ability to reason or come up with solutions.”
In Mr. Rabolt’s case, a string of distressing events during the fall of his freshman year—relationship troubles, sickness, a friend’s battle with schizophrenia and other mental illness—combined with the stress of navigating college life proved to be the perfect storm to stir up dormant feelings of depression that he had been managing since his early teens.
It wasn’t until his friend’s mental health problems forced him to withdraw from the university that something “clicked” for Mr. Rabolt.
“It was also a realization that ‘this doesn’t have to happen to me. I don’t have to leave,’” he said.
Finding the Right Treatment
Mr. Rabolt was diagnosed with clinical depression first when he was 14 years old. His parents had divorced, and a few youthful indiscretions prompted his middle school to schedule a session with a counselor in an effort to understand his behavior.
“I remember sitting in the therapist’s office and hearing him tell me I had clinical depression,” he said. “All I understood was that finally there was a name for the sadness I was feeling.”
Mr. Rabolt was expelled from school in eighth grade and spent the next four years self-medicating with drugs and alcohol. He entered recovery during his senior year of high school and set up a treatment plan.
The depression resurfaced in October 2011 during his freshman year at GW.
“It was a recovery hostile environment,” he said. “I’d walk back to my dorm and see these crazy get-togethers and feel left out—isolated. I don’t think I realized it was depression again, but looking back, it was. I’d stopped doing what worked for me and gave up a little bit.”
During the spring semester of his freshman year, he found his footing after reaching out to a university staff member who connected him with students dealing with substance abuse recovery and mental health issues. Together, they built a supportive community.
In February 2012, the informal peer support group became the first university recovery group in D.C. —Students for Recovery (SFR). In March 2014, SFR and the Center for Alcohol and other Drug Education received a $10,000 grant from nonprofit organization Transforming Youth Recovery.
“We have this saying, ‘you’re only as sick as your secrets,’” he said. “I didn’t realize that the thoughts I had weren’t normal until I started talking to counselors and saying them out loud. I realized I didn’t really want to hurt myself.”
According to a 2012 report by the National Alliance on Mental Illness, 65 percent of college students with mental illness said that walk-in services are critical to their success in college. And 50 percent said that a 24-hour hotline is essential.
The University Counseling Center (UCC) offices on the Foggy Bottom and Mount Vernon campuses offer walk-in services to students who want to consult with a staff clinician about a specific issue or to talk about feelings that have become unmanageable.
Students also can speak with a mental health professional on the 24-hour hotline at 202-994-5300, by choosing option three.
Nationally, colleges and universities report a student to professional staff ratio of 3,231 to 1 among participating universities with 25,000 students, according to the 2012 Association for University and College Counseling Center Directors Annual Survey. GW averages 1,500 to 1.
“In the last year we’ve added walk-in office hours on the Mount Vernon Campus and hired four new staff clinicians who specialize in working with specific student communities, such as veterans,” UCC Director Silvio Weisner said. “Our goal is to let students know that we are here, we are available and we can help.”
On Oct. 9, National Depression Screening day, the George Washington University community inivited students to attend free mental health screenings on the Foggy Bottom and Mount Vernon campuses.
In-take assessments and up to six individual counseling sessions are available at no cost to students who have personal or GW student health insurance plan. The UCC does not turn away any student because of inability to pay fees, Dr. Weisner said. Students with demonstrated financial need may request that the UCC counseling fee be reduced.
Dr. Weisner said that following initial sessions, the UCC will work with students to create a treatment approach that fits their specific needs.
“We believe that individualized treatment plans that address the diverse needs of students are important,” Dr. Weisner said. “We are also conscious of the fact that cost is an issue, so we work with students to find treatment options that allow them to receive the care that they need.”
Students also can reach out to CADE, their residence hall adviser or visit GW’s community mental health centers—the Metzler Center and the Graduate School of Education and Human Development’s Community Counseling Services Center—if they have mental health concerns.
For help in an emergency, students, faculty and staff can contact GWPD at 202-994-6111.
Dr. Molock said that professors are a valuable resource for students with mental health issues because they see students once or twice a week. Professors can set the tone for open discussion by inviting students to approach them privately if they are struggling academically or personally, she said.
Students with academic concerns also can reach out to their academic advisers, the GW Writing Center or the Language Center. The GW Tutoring Initiative also offers drop-in, individual and group sessions to students.
“I tell my students every semester, ‘Let me know if you are having a personal or mental health problem and we can work it out,’” Dr. Molock said. “They sometimes think that asking for help is a sign that they’re ‘crazy,’ so it’s important for parents, professors and staff to talk openly about resources that are available on and off campus.”
Staying on the Path
Every day Jenny Curt, a sophomore in the Columbian College of Arts and Sciences, reminds herself that her mental health comes first.
“It would be great to just be a student,” said Ms. Curt, who will take over for Mr. Rabolt as president of SFR next semester. “But the reality is that I am a student second—my recovery, my mental health, is my life.”
Ms. Curt was diagnosed with clinical depression in high school during treatment for an eating disorder and alcoholism. She has been sober for two and a half years.
“People think the worst part is asking for help, but the worst part is before you ask for help,” she said.
Her treatment includes Skype sessions with her therapist in Connecticut, meetings with SFR, meditation, a daily assessment of her feelings and asking for help when she needs it.
“There are some weeks where I think I could skip therapy to study,” she said. “But I know that if I do, by the time the test rolls around, I’m too anxious and stressed to do well.”
“People think the worst part is asking for help, but the worst part is before you ask for help"
“You learn that you have to deal with your feelings, you can’t put it off,” she said.
Mr. Rabolt agreed that it can be easy to get “off the path,” but the longer you stay in treatment, the easier it is to not stray too far.
“It’s almost exciting to have that level of self awareness, because I didn’t have it before,” he said. “I know what works—I have to eat healthy and sleep and talk to people. It isn’t always easy, but it’s about progress not perfection.”
Ms. Curt said that the most important thing students with depression can do is to speak up about how they feel.
“First, talk to someone about how you feel. Second, talk to the right person— a counselor or a doctor,” she said. “Then find a treatment that works for you, and finally, find a community to support you.”
Ms. Curt said the SFR community has been essential for managing her day-to-day recovery because she doesn’t feel alone. Helping other students supports her recovery.
“In our community, managing your recovery and mental health makes you cool,” she said. “Students with depression, we’re not all suffering. We’re living with it and dealing with it everyday.”