By: Christie Hunter

Recent shootings and homicides on college campuses have been dramatically represented by the media as a sign of failure to treat students. When such a tragedy occurs, it is common to see mental health issues on the forefront. However, such events are relatively rare even though severe, when compared to the general mental health needs of many college students around the world. Although we are beginning to see an increase in the awareness of mental health issues, there remain more opportunities for universities to improve on dissemination of this information through the right channels and to the correct people. In the following article, an examination of the research will highlight the population in need, who can help, and how to obtain mental health for both groups.

Mental health counseling centers and awareness services exist on many campuses. However, if students and staff do not know about these services, do not have the tools to help themselves, and do not have the tools to help someone else in distress, these resources go unused. Hunt and Eisenberg (2010) indicate that while many college students are seen as being more privileged than their non-student peers, there is very little difference in the occurrence of mental health problems between the two groups. According to the authors, college attendance in high school graduates is at 65%. Among people age 18-24, half of all health concerns are related to mental illness. Also, onset generally occurs by the age of 24. This is a prime time for college administrators to recognize and intervene with mental health issues. Untreated mental health affects academic success, productivity, substance abuse, and relationships. Because students are often immersed in campus life including their involvement in academics, recreational activities, social interactions, and work, they are well known by their peers and by staff, who can serve as allies when needed (Wagner and Rhee, 2013).

Hunt and Eisenberg (2010) report that one in three college students have reported that they have experienced depression symptoms that have resulted in a significant life impact. Of those students, 4% admitted to having seriously considered suicide. Anxiety is another common challenge on college campuses. Academics are becoming more competitive as the prospects for employment following college are decreasing. Stress is increasing as a result. While the effects of stress are often minor and  common among college students (go here for further reading),  there is nevertheless a lurking danger, and in severe cases,  treatment is necessary.  Many students are dealing with critical levels of stress on college campuses, and this is a concerning reality.

Many campus administrators and counselors are of the opinion that they are providing appropriate information on mental health to promote awareness and prevention. However, the study by Wagner and Rhee (2013) does not bear this out. Students are likely to report that they do not find the information helpful in self-identification or in recognizing problems in others. This is a mistake given the close relationships that tend to occur on campuses. Students are interested in information on depression and anxiety, grief, stress, sleep, and relationship difficulties in addition to information on how to help others. This is a fertile population to educate as they spend considerable education and social time together.

In a study on school based mental health which is more focused on primary education, there are trends that translate to similar issues at the college level (Weist, 2005). The findings of this study indicate that mental health services were not a focus and were not well funded.  Assessment of needs and linking to services are not done effectively. Educators can certainly be promoters of mental health awareness but time and resources are limited. At the college level, these effects may be amplified. However there is great opportunity to catch mental health concerns early and before they become more severe.

Dogan (2012) points out that many mental health problems emerge in the first year of college because it is a difficult time of transition in the lifespan. There is more freedom, different types of support systems, and increased stress. College students are often struggling to find a good balance between education and social interactions. The authors also found that students are increasingly presenting with more intense problems, and that as time goes on toward graduation, stress levels and mental health issues increase dramatically. Self-referral continues to be the main avenue to first contact, but that parents, staff, and friends are also making referrals.

Given all of the above, there has been a focus on campaigns to increase awareness and to decrease the stigma of diagnosis and treatment (Livingston, et al., 2012). This was shown to make individuals more aware of problems, but did not necessarily decrease stigma which can lower the likelihood that an individual will seek treatment. Perhaps it is important for universities to change the way that they approach promotion of mental health awareness. Asking students and staff what they need for themselves and in order to help others seems to be a significant step. While this may work now, it may need to be fluid and change over the years. It also makes sense for information to be disseminated in such a way that all staff and students know where to turn if experiencing a mental health problem, or when they recognize a problem in another individual. Finally, universities can hope to succeed in the promotion of mental health if they provide the staff the necessary training and resources for that success.

By Christie Hunter

References:

Dogan, T. (2012). A long-term study of the counseling needs of Turkish university students. Journal of Counseling and Development : JCD, 90(1), 91-96.

Hunt, J., Eisenburg, D. (2010). Mental health problems and help-seeking behavior among college students. Journal of Adolescent Health, 46(1), 3-10.

Livingston, J. D., Tugwell, A., Korf-uzan, K., Cianfrone, M., & Coniglio, C. (2013). Evaluation of a campaign to improve awareness and attitudes of young people towards mental health issues. Social Psychiatry and Psychiatric Epidemiology,48(6), 965-73.

Wagner, M., & Rhee (2013). Stress, sleep, grief: Are college students receiving information that interests them? College Student Journal, 47(1), 24-33.

Weist, M. D. (2005). Fulfilling the promise of school-based mental health: Moving toward a public mental health promotion approach. Journal of Abnormal Child Psychology, 33(6), 735-41.

Did you know that 15% of women are diagnosed with Hypoactive Sexual-Desire Disorder (H.S.D.D)?  This disorder is characterized by a lack of female desire coupled with significant emotional distress, primarily in post-menopausal women.  A recent article in The New York Times placed Dutch psychopharmacologist Adriaan Tuiten in the spotlight for his new research studies on sex differences.  Tuiten, who has spent his career studying biological and psychological interactions, may have unlocked some the intricacies of female desire via his study on possibly the first, successful female-desire drug.

The publicized misnomer that this drug will be a “female Viagra” simplifies its actual complexity.  Ongoing studies in this field since 1998 unequivocally show that the male and female impetus for desire differs significantly, especially in the brain.  While both male and female desire stem from similar areas of the brain, studies show that, over time, female desire wanes at a significantly higher rate than observed in males.

How can women combat this atrophy of desire?  Tuiten tested and observed 420 female subjects beginning in the fall of 2011 to answer just that.  His drugs Lybrido and Lybridos are expected to be presented shortly to the F.D.A., and may be on the market by 2016 following a larger-scale trial.

Guest Author:  Megan Castle

The following is written verbatim from the the Lesbian Community Cancer Project:   Within the last decade, the relationship between mental health and sexual orientation has been researched more comprehensively. Studies have found that women who engage in same-sex sexual behavior and/or identify as lesbian, gay, bisexual or queer (LGBQ), are at greater risk for mental health concerns than women who do not engage in same-sex sexual behavior. Specifically, women who identify as LGBQ often experience feelings of depression, anxiety and stress based on living in a stigmatized and homophobic culture, and may engage in risky behaviors (e.g., alcohol, drug, or tobacco use) to relieve these emotions. These risky behaviors are ultimately associated with negative psychological, health and job-related outcomes.

LGBQ women are also at increased risk of interpersonal victimization (i.e., verbal, physical and sexual abuse) compared to their heterosexual counterparts. As a result, LGBQ women may experience internalized homophobia (i.e., negative feelings or attitudes towards oneself for identifying as LGBQ, based on living within a homophobic society), which is also linked to depression, anxiety, stress and greater alcohol/drug use. For individuals who identify as trans-masculine or trans-feminine, the risks of mental and behavioral health concerns increase significantly.

It is important to know that, while these mental health concerns may be overwhelming or discouraging, these feelings and stressors are not your fault. Remember that places like Howard Brown Health Center (HBHC) are here for you, and provide health and wellness services that are specialized for the LGBTQ community.

Reference:  The Impact of Minority Stress on Mental Health and Substance Use Among Sexual Minority Women by Keren Lahavot and Jane M. Simoni.

Young women with the menopause-like condition, primary ovarian insufficiency, are much more likely than other women to experience depression at some point during their lives, according to a study from the National Institutes of Health. The finding suggests that all women diagnosed with the condition should be evaluated for depression.

Depression is a serious medical illness affecting the brain which involves more than feeling blue or sad for a few days. Symptoms include persistent feelings of sadness, difficulty sleeping or over sleeping, energy loss, and feelings of worthlessness.

Primary ovarian insufficiency, or POI, results in a menopause-like condition years before normal menopause begins — sometimes as early as the teens or twenties. Women with POI stop producing normal amounts of reproductive hormones, develop hot flashes, and typically become infertile. The study authors evaluated 174 women with POI and found that 67 percent either were currently clinically depressed or had been depressed at least one time in their lives.

The researchers noted that this proportion was more than twice the rate of depression found by a national survey of women in the general population.

"Because of the strong association with depression, our results indicate all women diagnosed with POI should be thoroughly evaluated for depression," said Lawrence M. Nelson, M.D., co-senior author of the study and head of the Integrative and Reproductive Medicine Group at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). "Simply asking patients if they are depressed is not sufficient. Primary care physicians should evaluate their patients with a diagnostic screening test to determine if treatment or referral to a mental health specialist for further evaluation is needed."

The study's first author was Peter J. Schmidt, M.D., of the National Institute of Mental Health (NIMH).   The study appears in The Journal of Clinical Endocrinology and Metabolism.

The study was unable to determine why women with POI are more likely than other women to experience depression. The investigators cited results of a previous study, which had suggested that depression might trigger physical changes that ultimately lead women to develop POI. However, in the current study, more than 73 percent of women with POI first experienced depressive symptoms after developing the irregular menstrual cycles believed to be an indicator of impending POI.

The findings also did not support the hypothesis that most women with POI become depressed after they are told of their diagnosis, when they learn that they will likely be infertile. In the current study, more than 68 percent of patients with POI who had depression had become depressed after the onset of irregular menstrual cycles, but before receiving the diagnosis of POI.

In a previous study, Dr. Schmidt found that women entering natural menopause at an appropriate age are at greater risk of depression late in the menopause transition, when estrogen levels are particularly low.

"Future studies are needed to help determine whether hormonal changes, perhaps combined with a particular genetic makeup, might predispose some women to depression," said Dr. Schmidt.

The authors also noted that studies of women undergoing natural menopause have found that estrogen supplements relieve symptoms of depression in some women. The authors added that it is possible that estrogen supplements might relieve symptoms of depression in women with POI.

NIMH provides information about women and depression in its booklet Women and Depression: Discovering Hope.