Coping with a ‘weary, stale’ world

Ten per cent of Queen’s students seek counselling from University services, but a stigma continues to surround issues of mental health

University students face new pressures that can affect their moods and increase anxiety.
University students face new pressures that can affect their moods and increase anxiety.
Photo: 
Health, Counselling and Disability Services is located in the LaSalle Building.
Health, Counselling and Disability Services is located in the LaSalle Building.

Mike Condra, assistant professor of psychology and psychiatry, remembers how rarely eating disorders were reported a few decades ago.

“When I was a student in Dublin back in 1971, we had a psychiatrist who interviewed patients in front of us each week as part of our training. And one week he told us that he was going to interview someone with an illness that was so rare it was unlikely that we would encounter it in our careers. The person he interviewed that day was anorexic,” said Condra, who is also the director of Health, Counselling, Disability Services (HCDS).

In the 1970s, there were fewer than 50 reported cases of anorexia in the world, but today entire scientific journals are devoted to eating disorders.

Many researchers believe the rise of eating disorders in developed countries can be attributed to an increasing cultural emphasis on unhealthy weight loss. Condra pointed out that young female university students are especially vulnerable to eating disorders.

“Young women who are engaged in sports or any activities where weight is a concern are at risk of developing eating disorders,” he said. “Rowing, for example, is a sport in which there is an extra pressure to control one’s eating habits in order to qualify for a certain competitive weight class.” Eating disorders can be particularly challenging to treat, because they impact a wide range of mental, emotional and physical functions. Proper treatment, however, is vital, since the Canadian Mental Health Association (CMHA) reports that 10 to 20 per cent of people with eating disorders eventually die of complications, and that incidences of this type of mental illness are rising among Canadian teenage girls.

According to Statistics Canada, one in two Canadians will develop a mental disorder at some point in their lives. Currently, more than six million people are affected by mental illness, and youth aged 15 to 24 have the highest incidence of mental disorders.

Given this grim reality, it’s no surprise that HCDS said 10 per cent of Queen’s students seek out counselling services for a variety of reasons at some point during their university career.

“Universities and colleges have a duty to accommodate people with disabilities and [promote] mental health,” Condra said.

So what is mental illness, and why does it affect so many Canadians?

Mental illness refers to an alteration in thinking, mood or behaviour that is usually associated with distress and an impaired ability to function normally. It is an ever-evolving and controversial field, with researchers consistently re-evaluating the basis of mental illness and the conditions that lead to its development.

There is, however, a consensus among scientists that social and biological influences define the mental illness experience, making it one of the most complex and multidisciplinary fields of research today.

Experts in the field of mental health have noticed a relatively high proportion of mental illnesses at North American post-secondary institutions like Queen’s.

The stress of being away from home for the first time, adjusting to new social situations, experimenting in intimate relationships and dealing with pressure to achieve have an impact on many university students, affecting moods and increasing anxiety.

In certain individuals, however, these factors can trigger full-blown mental illness.

Genetic and biological factors are integral to understanding mental illnesses. Scientists have established a strong genetic basis for mental illnesses like schizophrenia and bipolar disorders, and depression is also known to be particularly prevalent in certain families.

Modern medical imaging techniques have also shown that an area of the brain called the prefrontal cortex is much smaller in depressed individuals who come from families with high rates of depression.

A specific part of the prefrontal cortex, the subgenual region, has extensive connections to other parts of the brain that are involved in emotional behaviour. Individuals with a damaged subgenual region have difficulty experiencing emotion, and tend to display irrational and aggressive behaviour.

However, Dr. John Rossiter, associate professor of neuropathology at Queen’s, warns that many mental illnesses are difficult to find with the same investigative techniques used to detect other types of diseases.

He said the changes to brain function that occur during mental illness are so subtle that depressed and normal individuals are sometimes almost identical in every regard.

“While pathologists can evaluate whether mental illness is due to familial or genetic causes, there are many mental illnesses that are not detectable in the lab,” Rossiter said.

The most common mental disorders affecting Queen’s students are depression, anxiety and eating disorders, Condra said.

He said depression is probably the mental illness that has seen the biggest increase in North America over the past few years.

Depression was described as early as the fifth century B.C. by Hippocrates, who believed it was caused by imbalances in bodily fluids. These ancient theories, however, were disproved once medicine and anatomy began to give researchers a clearer picture of the human body.

As late as 1917, Sigmund Freud wrote that “even in descriptive psychiatry the definition of melancholia is uncertain; it takes on various clinical forms that do not seem definitely to warrant reduction to a unity.” Only in the past two decades have scientific advances allowed for relatively precise criteria for mood disorders to be developed.

The features of depression were eloquently summarized by Shakespeare’s Hamlet: “How weary, stale, flat, and unprofitable seem to me all the uses of this world!” According to the CMHA, an untreated episode of depression typically lasts four to 12 months. Depression experienced after personal loss—such as the loss of a loved one or a job—is often confused with major depression, but there are important differences.

Two or three months after a personal loss, most people are able to experience pleasure and relieve their sadness—something that depressed individuals cannot do. Furthermore, depressed individuals lose their appetite and, in more extreme cases, are unable to sleep and stop grooming or caring for themselves.

Dr. Condra described depression as “a low mood that just won’t go away.” If left unchecked, depression can lead to harmful drug use and suicidal tendencies.

The good news is that depression today is largely treatable. While multiple strategies exist, antidepressant drugs are by far the most popular treatment.

These drugs regulate serotonin and noradrenalin, two chemicals in the brain.

Under normal conditions, both chemicals play important roles in relaying information between the different parts of the brain.

Their actions are tightly regulated by biological processes that are disrupted during depression.

In the right doses, antidepressant drugs can help restore serotonin and noradrenalin levels and diminish the psychological effects of depression. Experts caution that reliance on drug treatments alone is insufficient and must be combined with counselling and support in order to ensure an adequate recovery from depression.

In addition to the distress that depression causes its victims and their families, the illness has an increasingly disturbing socio-economic impact.

The Canadian Psychiatric Association’s website estimates that by 2020, depressive illnesses will become the leading cause of disease burden in developed countries like Canada. The care required by unprecedented numbers of depressed individuals will tax the resources of their loved ones as well as the health care and social welfare systems.

Anxiety is another common mental illness that often occurs in conjunction with depression, and is especially prevalent on university campuses. Many students experience regular panic attacks that contribute to a debilitating sense of anxiety and inadequacy.

Just as grief is a natural response to personal loss, anxiety is a normal response to threatening situations—often it can signal danger and contribute to mastering difficult situations and thus to personal growth.

Excessive anxiety, however, is harmful because it can be too intense, and it can be provoked by events that present no cause for alarm. Anxiety, then, is considered an illness when it no longer serves to signal danger.

Anxiety disorders, which typically follow episodes of depression, are characterized by increased fearfulness, a heightened sense of awareness, restlessness and a deep fear of impending disaster and death. In some extreme cases, anxious individuals experience unexpected panic attacks that last anywhere between 15 to 30 minutes.

In a condition known as generalized anxiety disorder, individuals suffer from unrealistic or excessive worry that lasts continuously for several months or longer. Drugs to treat this disorder target another important brain chemical called GABA, which works in the brain to diminish anxiety.

While many of the students who use services like HCDS are not mentally ill, the proportion of Queen’s students with mental illnesses is likely underestimated, since not everyone is inclined to seek help.

As such, HCDS consistently works to inform the student body of its services and to overcome the stigma associated with seeking mental health help.

This pervasive on-campus attitude is one of the factors that motivate Vivian Lee and Lauren Lazowski in their work as the co-chairs of the AMS Mental Health Awareness Committee (MHAC).

“If you have depression, then you’re regarded as weaker,” Lee said.

Lazowski agreed.

“People see it as something debilitating, so they don’t want to say that ‘I’m having a depression,’ because, especially in this competitive environment, they don’t feel that it’s easy to talk to anyone about it,” she said.

MHAC works to combat stigmas surrounding different mental and sexual health issues, challenging labels and misconceptions and using creative methods to make students aware of the resources available to them.

MHAC also refers students to HCDS and community-based groups such as the Kingston Youth Alliance, which Lazowski said provides a space where students who suffer from different mental health issues or illnesses can go and talk.

Lee and Lazowski said they see peer education as an important tool in reaching out to students with mental illness.

While they admit that much work still needs to be done to inform students about issues surrounding mental health, and to provide them with timely help, both Lee and Lazowski are happy with the resources currently available through HCDS and its staff.

“They really care about students and want to provide as effective health as they can within their limits,” Lazowski said. “It’s great.”

—With files from cmha.ca and cpa-apc.org

Tips for Mental Fitness

Here are some ways to practice mental fitness from the Canadian Mental
Health Association:

Collect positive emotional moments
Make it a point to recall times when you have experienced pleasure, comfort, tenderness, confidence or other positive emotions.

Learn ways to cope with negative thoughts
Negative thoughts can be insistent and loud. Learn to interrupt them. Don’t try to block them (that never works), but don’t let them take over.

Exercise
Regular physical activity improves psychological well-being and can reduce depression and anxiety.

Enjoy hobbies
Taking up a hobby brings balance to your life by allowing you to do something you enjoy because you want to do it, free of the pressure of everyday tasks. It also keeps your brain active.

Set personal goals
Whatever goal you set, reaching it will build confidence and a sense of satisfaction.

Share humour
Life often gets too serious, so when you hear or see something that makes you smile or laugh, share it with someone you know.

—Source: Canadian Mental Health Association

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