UNIVERSITY STUDENT, 19 SINKS INTO DEPRESSION

DEAR DR. WOLKOFF: I am a 19-year-old female university student.  
Writing this letter is so difficult, but I'm forcing myself to do it.
   When I graduated from high school last year, I was looking forward 
to entering university and starting something important in my life.  
I was so happy and excited.
   That summer I began to grow quiet and sad, just feeling bad inside.
By September, I was crying every day.  I lost interest in things that
used to be important to me, such as going for walks, playing the 
piano and hanging out with friends.  Going to school has been 
difficult and my grades have suffered.
   I'm always tired or sleepy.  There has been so much pain getting 
through each day that all I want to do now is stop it.
   I know I brought this sadness and pain upon myself.  What's wrong
with me?

DR. WOLKOFF REPLIES: I can't diagnose your particular problem, but 
your story is strikingly consistent with the textbook diagnostic 
criteria for major depression.  The sadness, emotional pain, low 
energy, sleepiness, joylessness, apathy, guilt and self-blame which
replaced the enthusiasm and excitement you felt on that last day of
high school are classic symptoms.
   Many people have a rough time around the period when they leave high
school, even those who are genuinely looking foward to university or 
the work force.  Moving to an institute of higher learning involves
leaving high school -- and childhood -- behind forever.  It closes a
huge chapter in our lives and forces at least some review of the plot
and characters of that chapter, with no hope of a rewrite.
   At a time when we're being called upon to function in new ways in a 
new world, such a review is often uncomfortable enough to push our
attention away from it.  This action usually goes on outside of our
awareness.  It evolved as a kind of calming reflex.  The trouble is 
that these private distractions come at a high price:  loss of the
chance to mourn, resolve and generally make order of the inevitable
scratches and dents of childhood.  Images and emotions separated from
meaningful thought exert a frightening influence on our feelings and
behaviour in other (or all) areas of life.
   For many young adults, the stresses of separating from family and
becoming a true individual result in depression and other problems.
   The difficulty you faced in writing to me and your notion that 
you somehow brought your woes upon yourself suggest that you feel 
unworthy  of help.  That's a symptom, too.  The best response to your 
preoccupying wish to "stop it" is to seek professional attention.
   One of the benefits of attending university is access to university 
health services.  A psychiatrist or other staff member there will be 
able to treat you.  They have particular expertise in dealing with the
problems which tend to hit university students hard and distressingly
often.
   Also, grit your teeth and call a trusted friend from your old 
circle.  The reaction is likely to be sympathetic.  An old friend 
could give you a real boost in your second go at starting a very 
important project:  the rest of your life.
---
The views expressed are those of the author, Dr. Irvin Wolkoff, a 
Toronto psychiatrist.