Home >  Health & Science

Thursday, April 24, 2003

By Sally Kalson, Post-Gazette Staff Writer

She's been drawing up to 300 students per appearance on her tour of college campuses, but Cara Kahn isn't talking to them about show biz. Instead, the former star of MTV's "The Real World Chicago" is speaking about her experience with clinical depression and encouraging students to seek help.

	Kahn's appearance is part of the GOAL campaign, which stands for Go On and Live (www.goonandlive.com). It's aimed at getting young people to recognize the signs of depression and seek help. She will speak at 5:30 p.m. at Wean Auditorium, 5000 Forbes Ave. in Oakland. Her salary is being paid by Wyeth Pharmaceuticals, but a spokeswoman said the seminar would be "brand-free."

About 1.5 million college students are already diagnosed with depression; no on knows how many other cases have yet to be discovered. Untreated, it can lead to suicide, the third largest killer of people ages 15 to 24.

"When it came out on the show, I started getting fan letters from people suffering from depression, saying they felt better knowing I had it, too," said Kahn, 23, who lives in St. Louis.

"I started writing back to encourage them, preaching the message, and then I got involved in the campaign."

The 10-city tour, which comes to Carnegie Mellon University today, reflects the growing concern over mental health issues among college students and administrators.

Campus counseling centers in recent years have reported marked increases in both the number of students seeking help and the severity of those problems, with depression a major component.

"There's a definite trend toward students arriving on campuses with more serious problems," said Robert Gallagher, a psychologist at the University of Pittsburgh who conducts an annual survey of counseling center directors on 300 campuses.

In 1988, 56 percent of center directors reported an increase in more serious problems, Gallagher said. The past few years, that number has risen to 85 percent. And serious problems nearly doubled, rising from 9 percent of the caseload 10 years ago to 17 percent last year, and more hospitalizations.

Earlier this year, a study at Kansas State University showed similar results. It examined the problems addressed at a university counseling center over 13 years and found that the number of students seen with depression nearly doubled, as did the number seen with suicidal thoughts.

The increase is probably due to a number of factors, said Barbara Blazick, a psychologist at the Carnegie Mellon counseling center. More divorce and economic pressure at home, more drinking and illegal drug use at younger ages, over-scheduled lives, competitive pressure.

"The fall semester is always the heaviest for us because of making the transition to a new environment after the summer," she said.

In addition, more students arrive on campus already in therapy.

"A number of them would not have been able to make it in the past," said Gallagher. "Now, with treatment and medication, they can come in and compete.

"But students also go off their medications sometimes, or the medications stop working or need to be adjusted, and they wind up at the center in a crisis."

Depression is not the same as sadness or mourning, said Dr. Stuart Hirsch, consulting psychiatrist at the Carnegie Mellon counseling center since 1990.

"Clinical depression is an emotional state that affects the body, thoughts and mood of an individual," he said. "It's a very definite emotional state -- highly distressing, serious and potentially life-threatening."

The biology and psychology of depression are inextricably bound, he said.

"There is a chemical imbalance in the brain, but we know that can be caused by experience and environmental factors. Medication can alter brain chemistry and change the psychology of an individual, but so can psychotherapy."

Depressed students may not be able to attend classes, do their academic work or have a social life. In severe cases they may feel hopeless, worthless and suicidal.

But it doesn't have to be that way.

As the incidence of depression grows, so do the campus attempts to address it. Barbara Koppens is managing director of the nonprofit Screening for Mental Health in Wellesley, Mass., which runs National Depression Screening Day, where people can answer a two-page questionnaire.

"In 1993, the first year we did colleges, only 15 participated," she said. "The next year, we recruited 175."

Last year the number was 450, each averaging 71 students, or about 32,000 students screened. Now the organization offers online screening tailored to each campus; that produced 50,000 additional screenings last year.

"Colleges have been a mainstay of our program," Koppens said. "They're looking to be proactive in identifying the problem and encouraging people to get help."

Treatments may include medication, but not necessarily, said Rachel Freund, public education director of the Mental Health Association of Allegheny County.

"Talk therapy with a trusted counselor can be very important," she said. "There are also tools students can learn. If they're feeling overwhelmed or hopeless, they may be able to reframe those things."

College students tend to do things that make depression worse, Freund said, from too little sleep and exercise to too much drinking. Taking control of those behaviors can help them improve.

Kahn, who graduated from Washington University in St. Louis in 2001, was diagnosed with depression at a young age.

"In high school I wasn't finding pleasure in activities I used to enjoy," she said. "I couldn't sleep or was sleeping too much, I had anxiety -- real textbook symptoms. But I didn't want to admit there was anything wrong with me.

"Then, when I was diagnosed, I had to deal with feeling embarrassed by the disease. Not that anyone said anything, but obviously there's a stigma to mental disorders."

When her illness became known, she said, two of her female roommates said they felt they weren't getting the "real" Cara.

"They felt I was sugarcoated due to my medications -- and one of them was a registered nurse. She of all people should have known better. In reality, they were getting the real me because I was on medications."