Picture this. It’s a Friday evening. A group of students are clattering around their flat, making dinner, excited about going out later that evening. It’s noisy, everyone’s talking, everyone’s having fun. But there’s one student in the kitchen who feels the opposite. She can put a brave face on, and can laugh and drink and enjoy herself along with everyone else. But deep down, all is not as it seems.
The rate of student depression is above the national average. In a 2003 study conducted by the Mental Health Foundation, it was found that 12% of male and 15% of female students suffered from clinical depression whilst at university, compared with one in ten of the general population. More recently, since the introduction of tuition fees the number of students seeking counselling has risen by 20%. It was estimated in 2005 that one in four students will suffer from some form of mental distress whilst at university.
Rebecca*, 20, a student at York, explains her experiences of this debilitating condition. “There’s this voice in my head sometimes and all rationality goes out of the window. When I’m in a certain mood it completely takes over me. I feel like it’s not even me anymore.
“I feel overwhelmed and I feel like I don’t know what to do with myself. It sort of feels like a panic attack, but it’s a lot more sustained. It will last for days.”
Gareth*, 22, a student at a Welsh university, was diagnosed with clinical depression in October 2008. “There’s a split personality. Sometimes you feel like you can climb Everest; sometimes you feel like you can’t climb out of bed. There’s always this self-doubt in your head telling you you’re wrong and you’re going to cause a nuisance to people. Your self-esteem is zero, no matter what people tell you. They could tell you you’re the best person in the world, and you wouldn’t believe them.”
Clinical depression is different from the downs that most people feel. A sufferer will experience intense feelings of anxiety, negativity and helplessness, combined with a general lethargy and lack of interest in everyday life. It can tear families apart as they search for a cure for a condition which has no physical manifestations, but can take over a person’s character and completely change their personality.
For Rebecca, the problem developed after failing to get into her top choice universities. “Academia was always a respite. If I was having emotional difficulties, I could say, ‘it’s OK, I’m doing really well at school and I will be really successful in my career’, and that was completely diminished. I’d always been quite a confident person and I felt like my confidence had completely been destroyed.”
Gareth partly attributes his illness to his circumstances when he started university. “I haven’t moved out of my hometown and I lived at home for my first year. I’ve never felt like I’ve fitted in at university at all.”
He describes how he changed as the illness took hold. “I went straight from being an extrovert to being an introvert. I’ve never had any trouble making friends, but at uni I just couldn’t be bothered. I started ignoring my friends and I broke up with my girlfriend of five years. Before I was diagnosed I just thought I was going through changes, I thought it was natural until people told me I needed help.”
He has been taking Prozac since being diagnosed and may be on it for life. “It controls the mood swings. It makes you feel better and it makes everything seem a bit more real, but at the expense of emotional output. You become an emotional zombie.” Do the benefits outweigh the negatives? “It helps that my depressive lows are not as far down as they were, but that’s at the expense of sometimes feeling any highs. It creates a middle ground.”
Both found that going to university exacerbated the situation. Gareth found the transition from schoolwork to a degree very difficult. “The pressure to make deadlines can be overwhelming. But I wouldn’t say that there’s a pressure to succeed in university. If anything, the attitude among some students is completely anti-academic.”
However, humanities student Rebecca struggled for the opposite reason, feeling that there was not enough focus on academic work. “There’s not enough pressure, you’re not constantly taken care of. The fact that I have so much time on my hands means I have to have a degree of self-worth. With humanities you’re put into a cycle of laziness. The more you think about it, the worse you feel.” And so few contact hours makes things worse? “Definitely.”
It is interesting to note the different reactions between Gareth and Rebecca to the academic side of things at university. Rebecca, a high-achiever who had expected to excel, has found the university system, with its emphasis on individual study, difficult to adjust to, which triggered her problems. In contrast, Gareth attends a mid-table university, and after not doing as well in his A-Levels as he had hoped, found the work too challenging. There is no overwhelming reason for student depression; it can strike for many different reasons.
Gareth was immediately deferred from his course after his diagnosis. “The year out, if anything, made it worse. The instinct of a depressive is to lock themselves away. It feels like it’s you against the world. No matter how much you think ‘I don’t need anybody else, they don’t like me’, you need other people. Cutting yourself off makes the problem even worse.”
There’s a stereotype of a student as someone who has a very fun life. For a depressive it’s the exact opposite
After previously enjoying an active social life, he gave up all his recreational activities. “I was out nearly every day of the week, with or without a trip to the pub, but when the depression took hold I gave up nearly everything. I felt that everything was getting on top of me and it was all too exhausting, both physically and mentally. My confidence had completely gone and I just couldn’t face people.”
His story becomes harrowing to hear, as it becomes clear just how much the condition affected him. “Another instinct of depressives is to run away from the problem and that’s when rationality goes out of the window. I was on holiday in London last year and I had a nightmare which freaked me out so much that I had to go home. I had to go across the city at about 3am, take the Tube then wait for a train home which cost £80, when I had a return ticket for the next day. It made sense to no-one I was with and it didn’t make sense to me, but I was in such a state that it seemed like the only thing to do. I didn’t know why I did it, but I did. That’s the perfect example of irrationality.”
If untreated, the problem can become all-consuming, sending the sufferer into a spiral of self-loathing and desperation, and the consequences of this can be fatal. Gareth explains: “At my lowest point, I was considering suicide. There was one point where if my housemate hadn’t come in to check on me, perhaps I wouldn’t be alive today. That’s how low you can get. You’re not in your right mind. If you asked me now, ‘do you want to die?’, of course I don’t. It’s an altered state of mind.”
As depression and other mental illnesses continue to become more common amongst students, the demand for counselling services has risen. But Rebecca is sceptical of how much support they can really offer. “I’m quite cynical; I don’t see an objective counsellor as someone who can help me. I feel like I need to talk to someone who understands the situation and understands me. I often talk to my housemates, but I do sometimes feel like they are a bit sick of it. I hate putting pressure on people to listen to me and I don’t like putting a weight on other people’s shoulders about my emotional problems. I think that I have to learn to respect and trust myself before I go to a counsellor and trust them. I don’t know if I’ll ever go.”
Gareth did make use of his university counselling services, although he describes the experience as tricky and feels lucky that he managed to get an appointment straightaway. “I was told that there was potentially a three month wait for subsequent appointments, which made keeping to a routine very difficult. Universities have a responsibility in these cases, particularly as students are paying to be doing these courses. They have a duty to provide the best possible facilities.” Do you feel like that’s the case at the moment? “No.” It seems that the support network for students with depression is not as secure as it could be.
However, he did feel that counselling helped: “I found it much easier talking to someone who didn’t know me. There are certain things that you wouldn’t want your friends or your mother to know, but if you’re talking to someone anonymous in complete confidence, you can be as honest as you want. I found getting everything off my chest and knowing what was wrong cathartic, but I was looking for an instant solution, and there wasn’t one.”
But is it just a problem now? Do they think that once out of the university bubble, things will improve? Rebecca doesn’t think that she will feel better once she graduates. “The end of uni is such an elusive concept. I used to think that as I got older, and as I met new people, things would be better, but more recently I have been really anxious about the near future. I think that the older I get, the worse I’ll become. I have the fear that the older I get, the more I’ll think that all the ambitions and expectations I have won’t ever be fulfilled, and that’ll make me feel even worse.” Has uni proved that? “Definitely. When I leave here I’ll probably feel exactly the same.”
Gareth hasn’t thought that far into the future. “But if you’d asked me this time last year how I would feel now, I would probably have said I’d feel much the same way. And that’s not true; I’m feeling much, much better. When you’re depressed, recovery takes a long time and you can’t predict it. But am I feeling as good as I was before? No. I’m not sure I ever will again.”
There is something of a stereotypical view of a depressive: someone who has always been withdrawn and hard to relate to. But Gareth warns against making judgements. He doesn’t think that certain people are more prone to depression than others. “I think it can genuinely happen to anybody. It could happen to the happiest person on Earth. It’s something that can be triggered and it could happen to anyone. No-one should think they’re immune, because they’re not.”
Meeting Rebecca, in particular, you would never guess that she is depressed. She leads an active social life, is involved with societies and always seems to be busy. The stereotype of the depressive who sits in their room all day and cuts themselves off from the world does not always ring true.
Gareth concludes, “all my friends who’d already been to uni were bigging it up, saying it was amazing, the best three years of your life, but for me, they’ve turned into the three worst.”
Is there a stigma attached to student depression? “Definitely. There’s a stereotype of a student as someone who doesn’t do much but has a very, very fun life. For a depressive it’s the exact opposite. Depressed students are a forgotten people in society.”
There is so much pressure to convince the outside world, and even yourself, that you are having the time of your life during your university career. But for more than a handful of students, this is not the case.
As much as all the drinking and partying might suggest otherwise, university is part of the real world and things will never be as perfect as we expect. It is only once this is accepted that attitudes will begin to change towards student depression.
*Names have been changed to protect identities.