Diseases of the Nervous System Mini-Review


It​ ​is​ ​clear​ ​socially,​ ​academically,​ ​and​ ​financially​ ​that​ ​today’s​ ​generation​ ​has​ ​an​ ​increased​ ​number of​ ​individuals​ ​with​ ​stress​ ​than​ ​previous​ ​generations.​ ​Most​ ​of​ ​this​ ​stress​ ​falls​ ​under​ ​chronic​ ​stress which​ ​interferes​ ​with​ ​people’s​ ​ability​ ​to​ ​function​ ​normally​ ​long​ ​term.​ ​The​ ​highest​ ​stress​ ​level​ ​is currently​ ​found​ ​in​ ​millennials​ ​born​ ​from​ ​1984-1999,​ ​aged​ ​18-33​ ​years​ ​old​ ​with​ ​an​ ​even​ ​higher concentration​ ​in​ ​college​ ​students.​ ​Common​ ​symptoms​ ​that​ ​occur​ ​are​ ​mood​ ​swings,​ ​lack​ ​of​ ​or excessive​ ​amounts​ ​of​ ​sleep,​ ​drug​ ​or​ ​alcohol​ ​abuse,​ ​social​ ​withdrawal,​ ​lack​ ​of​ ​motivation, anxiety,​ ​and​ ​feeling​ ​overwhelmed.​ ​However,​ ​at​ ​what​ ​point​ ​does​ ​it​ ​stop​ ​being​ ​college/young​ ​adult stress​ ​factors​ ​and​ ​actually​ ​becomes​ ​a​ ​mental​ ​challenge​ ​that​ ​gets​ ​in​ ​the​ ​way​ ​of​ ​daily​ ​activities. The​ ​symptoms​ ​typically​ ​used​ ​to​ ​describe​ ​depression​ ​include​ ​all​ ​of​ ​the​ ​ones​ ​previously​ ​mentioned from​ ​stress,​ ​however​ ​at​ ​a​ ​more​ ​profound​ ​emotional​ ​state​ ​and​ ​includes​ ​anhedonia,​ ​the​ ​lack​ ​of anything​ ​pleasurable,​ ​and​ ​also​ ​when​ ​an​ ​individual​ ​seems​ ​capable​ ​of​ ​harming​ ​themself​ ​or​ ​others. It​ ​is​ ​often​ ​common​ ​for​ ​individuals​ ​in​ ​high​ ​demand​ ​jobs​ ​or​ ​those​ ​with​ ​pressure​ ​in​ ​daily​ ​tasks​ ​and assignments​ ​to​ ​brush​ ​off​ ​serious​ ​symptoms​ ​in​ ​behavior​ ​and​ ​just​ ​call​ ​it​ ​stress​ ​in​ ​fear​ ​of​ ​seeing​ ​a mental​ ​health​ ​professional​ ​because​ ​of​ ​lack​ ​of​ ​time​ ​or​ ​being​ ​accustomed​ ​to​ ​their​ ​concerns​ ​being trivialized​ ​by​ ​others.​ ​A​ ​social​ ​initiative​ ​to​ ​be​ ​properly​ ​trained​ ​in​ ​recognizing​ ​factors​ ​across students,​ ​faculty,​ ​instructors,​ ​bosses,​ ​and​ ​friendly​ ​strangers​ ​can​ ​help​ ​give​ ​the​ ​individual​ ​support and​ ​to​ ​not​ ​fear​ ​asking​ ​for​ ​help​ ​when​ ​it​ ​is​ ​necessary.​ ​This​ ​review​ ​will​ ​focus​ ​on​ ​finding​ ​if​ ​there​ ​is​ ​a correlation​ ​between​ ​stress​ ​and​ ​depression,​ ​as​ ​well​ ​as​ ​what​ ​differentiates​ ​them​ ​and​ ​how​ ​further research​ ​can​ ​help​ ​find​ ​ways​ ​to​ ​lessen​ ​the​ ​amount​ ​of​ ​stress​ ​or​ ​depression​ ​in​ ​individuals​ ​and​ ​how to​ ​combat​ ​it.

What​ ​is​ ​depression?

Depression​ ​has​ ​been​ ​mentioned​ ​in​ ​literature​ ​since​ ​the​ ​pre-Hippocrates​ ​era.​ ​Greek​ ​mythology recognized​ ​mania​ ​and​ ​melancholy​ ​as​ ​abnormal​ ​mood​ ​states.​ ​Aretaeus​ ​of​ ​Cappadocia,​ ​a​ ​medical scholar​ ​from​ ​the​ ​first​ ​century​ ​A.D.,​ ​described​ ​the​ ​commonality​ ​between​ ​melancholia​ ​as​ ​the beginning​ ​of​ ​mania​ ​and​ ​the​ ​two​ ​as​ ​counterparts.​ ​A​ ​Persian​ ​physician​ ​in​ ​the​ ​eleventh​ ​century described​ ​symptoms​ ​that​ ​included​ ​anxiety,​ ​phobias,​ ​and​ ​suspicions​ ​of​ ​other​ ​systems.​ ​Emil Kraepelin​ ​in​ ​1896​ ​made​ ​the​ ​key​ ​distinction​ ​in​ ​defining​ ​depression​ ​from​ ​schizophrenia​ ​as​ ​having manic​ ​and​ ​depressed​ ​phases​ ​however,​ ​without​ ​any​ ​intellectual​ ​deterioration.​ ​Freud​ ​declared​ ​a connection​ ​between​ ​melancholia​ ​and​ ​mourning​ ​or​ ​grief​ ​in​ ​1917.​ ​In​ ​the​ ​mid​ ​1970s,​ ​the​ ​possibility of​ ​depression​ ​occurring​ ​due​ ​to​ ​a​ ​chemical​ ​imbalance​ ​in​ ​neurotransmitters​ ​of​ ​the​ ​brain​ ​came​ ​to light​ ​and​ ​was​ ​called​ ​major​ ​depressive​ ​disorder.​ ​Today,​ ​15​ ​million​ ​Americans​ ​a​ ​year​ ​struggle​ ​with depression​ ​by​ ​itself​ ​and​ ​along​ ​with​ ​other​ ​mental​ ​and​ ​physical​ ​health​ ​concerns​ ​that​ ​affect​ ​bodily functions​ ​such​ ​as​ ​disruption​ ​of​ ​sleep,​ ​appetite,​ ​and​ ​weight.​ ​While​ ​there​ ​is​ ​no​ ​distinct​ ​cure, depression​ ​is​ ​highly​ ​treatable,​ ​even​ ​and​ ​especially​ ​if​ ​it​ ​is​ ​focused​ ​in​ ​treating​ ​according​ ​to​ ​each individual.

Depression​ ​however,​ ​is​ ​not​ ​the​ ​same​ ​as​ ​sadness​ ​or​ ​unhappiness.​ ​It​ ​includes​ ​an​ ​extended period​ ​of​ ​time​ ​in​ ​a​ ​profound​ ​emotional​ ​state​ ​of​ ​feelings​ ​such​ ​as​ ​worthlessness,​ ​desperation,​ ​and hopelessness​ ​to​ ​the​ ​point​ ​where​ ​one​ ​loses​ ​libido​ ​and​ ​energy​ ​and​ ​has​ ​suicidal​ ​or​ ​harmful​ ​thoughts. Different​ ​forms​ ​of​ ​depression​ ​can​ ​be​ ​broken​ ​down​ ​into​ ​subcategories​ ​such​ ​as​ ​grieving,​ ​secondary depression,​ ​clinical​ ​depression​ ​and​ ​bipolar​ ​depression,​ ​as​ ​organized​ ​by​ ​Harold​ ​Sontheimer. Grieving​ ​differs​ ​since​ ​it​ ​typically​ ​lasts​ ​up​ ​to​ ​12​ ​weeks​ ​after​ ​losing​ ​a​ ​loved​ ​one​ ​or​ ​dealing​ ​with life​ ​struggles​ ​such​ ​as​ ​being​ ​laid​ ​off​ ​or​ ​financial​ ​struggles​ ​where​ ​daily​ ​motivation​ ​is​ ​hard​ ​to​ ​come by.​ ​Secondary​ ​depression​ ​is​ ​associated​ ​with​ ​the​ ​difficulty​ ​in​ ​dealing​ ​with​ ​illness​ ​where treatments​ ​or​ ​solutions​ ​are​ ​uncertain.​ ​Clinical​ ​depression​ ​tends​ ​to​ ​occur​ ​in​ ​young​ ​adults​ ​but​ ​is twice​ ​as​ ​common​ ​in​ ​women​ ​as​ ​it​ ​is​ ​in​ ​men​ ​and​ ​has​ ​a​ ​direct​ ​correlation​ ​as​ ​age​ ​increases.​ ​Bipolar depression​ ​includes​ ​unexplained​ ​mood​ ​swings​ ​that​ ​can​ ​vary​ ​between​ ​euphoria​ ​and​ ​depression. Individuals​ ​can​ ​have​ ​states​ ​of​ ​severe​ ​mania​ ​with​ ​paranoia​ ​and​ ​delusions​ ​or​ ​be​ ​in​ ​a​ ​manic​ ​state​ ​or high​ ​states​ ​of​ ​enthusiasm,​ ​expectations​ ​and​ ​energy.​ ​It​ ​is​ ​the​ ​leading​ ​disability​ ​for​ ​young​ ​adults from​ ​the​ ​ages​ ​of​ ​20​ ​to​ ​30​ ​and​ ​affects​ ​males​ ​and​ ​females​ ​equally.​ ​It​ ​is​ ​also​ ​believed​ ​that​ ​higher depression​ ​rates​ ​in​ ​this​ ​age​ ​group​ ​could​ ​be​ ​an​ ​underlying​ ​factor​ ​explaining​ ​higher​ ​rates​ ​of substance​ ​abuse​ ​of​ ​recreational​ ​drugs,​ ​alcohol​ ​and​ ​smoking.​ ​Individuals​ ​often​ ​experience changes​ ​in​ ​cognitive​ ​function​ ​which​ ​in​ ​turn​ ​affects​ ​cognitive​ ​performance​ ​in​ ​executive​ ​functions, attention,​ ​memory,​ ​and​ ​psychomotor​ ​speed​ ​(Hammar​ ​&​ ​Årdal,​ ​2009).

On​ ​the​ ​molecular​ ​level,​ ​depression​ ​has​ ​been​ ​associated​ ​with​ ​region​ ​specific​ ​neuronal​ ​cell loss​ ​and​ ​retraction​ ​of​ ​dendrites​ ​which​ ​causes​ ​changes​ ​in​ ​synaptic​ ​activity.​ ​This​ ​has​ ​been​ ​seen​ ​in the​ ​effect​ ​of​ ​antidepressant​ ​drugs​ ​in​ ​imaging​ ​studies.​ ​The​ ​neural​ ​circuits​ ​that​ ​are​ ​primarily affected​ ​in​ ​the​ ​brain​ ​include​ ​the​ ​prefrontal​ ​cortex,​ ​the​ ​hippocampus,​ ​and​ ​the​ ​limbic​ ​system​ ​and its​ ​structures​ ​including​ ​the​ ​ventral​ ​tegmental​ ​area,​ ​nucleus​ ​accumbens,​ ​locus​ ​coeruleus, thalamus,​ ​hippocampus,​ ​and​ ​amygdala.​ ​There​ ​are​ ​all​ ​structures​ ​known​ ​to​ ​affect​ ​and​ ​regulate emotions,​ ​reward​ ​feelings,​ ​motivation​ ​and​ ​executive​ ​functions.​ ​Patients​ ​with​ ​chronic​ ​depression have​ ​shown​ ​enhanced​ ​activity​ ​of​ ​the​ ​amygdala,​ ​decreased​ ​gray​ ​matter​ ​volume​ ​in​ ​the​ ​prefrontal cortex​ ​and​ ​hippocampus​ ​​​which​ ​also​ ​leads​ ​to​ ​a​ ​reduction​ ​in​ ​size​ ​of​ ​pyramidal​ ​neurons​ ​and​ ​a​ ​loss of​ ​GABAergic​ ​interneurons​ ​as​ ​well​ ​as​ ​a​ ​decline​ ​of​ ​astrocytes​ ​and​ ​oligodendrocytes​ ​in​ ​the prefrontal​ ​cortex.​ ​Antidepressant​ ​drugs​ ​prescribed​ ​today​ ​focus​ ​on​ ​changing​ ​the​ ​concentration​ ​of monoamines​ ​in​ ​the​ ​brain​ ​and​ ​balancing​ ​the​ ​connectivity​ ​of​ ​neural​ ​circuits​ ​and​ ​their​ ​signaling cascades​ ​in​ ​the​ ​networks​ ​of​ ​emotion​ ​as​ ​shown​ ​in​ ​Figure​ ​1.​ ​The​ ​blockage​ ​of​ ​serotonin​ ​reuptake causes​ ​the​ ​activation​ ​of​ ​G-protein-coupled​ ​receptors​ ​leading​ ​to​ ​enhanced​ ​cAMP​ ​signaling​ ​which leads​ ​to​ ​transcriptional​ ​changes​ ​in​ ​the​ ​cAMP-protein​ ​kinase​ ​response​ ​element​ ​binding​ ​pathway also​ ​known​ ​as​ ​the​ ​CREB​ ​pathway.​ ​This​ ​pathway​ ​is​ ​responsible​ ​for​ ​increasing​ ​or​ ​decreasing​ ​the transcription​ ​of​ ​downstream​ ​genes.​ ​A​ ​number​ ​of​ ​genes​ ​including​ ​neurotrophic​ ​factors​ ​such​ ​as BDNF​ ​(brain​ ​derived​ ​neurotrophic​ ​factors)​ ​are​ ​transcribed.​ ​Chronic​ ​treatments​ ​of​ ​antidepressant medication​ ​increase​ ​BDNF-mediated​ ​signaling​ ​because​ ​BDNF​ ​transcription​ ​and​ ​signaling​ ​in​ ​the hippocampus​ ​has​ ​been​ ​shown​ ​to​ ​be​ ​reduced​ ​in​ ​patients​ ​with​ ​stress​ ​and​ ​in​ ​post-mortem hippocampus​ ​of​ ​humans​ ​with​ ​depression​ ​(Krishnan​ ​&​ ​Nestler,​ ​2008).​ ​Understanding​ ​the molecular​ ​pathways​ ​of​ ​depression​ ​is​ ​a​ ​continuous​ ​process​ ​with​ ​tremendous​ ​amount​ ​of information​ ​still​ ​unknown.

Figure​ ​1:

A​ ​greater​ ​lifetime​ ​risk​ ​of​ ​mood​ ​disorders​ ​has​ ​been​ ​reported​ ​as​ ​well​ ​as​ ​an​ ​increase​ ​in​ ​each successive​ ​generation.​ ​In​ ​longitudinal​ ​studies​ ​done​ ​by​ ​Compton​ ​et​ ​al.,​ ​the​ ​prevalence​ ​of depression​ ​in​ ​U.S.​ ​adults​ ​rose​ ​from​ ​3.33%​ ​to​ ​7.06%​ ​between​ ​1991-2​ ​and​ ​2001-2.​ ​In​ ​college students​ ​and​ ​young​ ​adults,​ ​it​ ​was​ ​found​ ​that​ ​their​ ​psychopathology​ ​score​ ​on​ ​the​ ​clinical depression​ ​scale​ ​in​ ​2007​ ​compared​ ​to​ ​1938​ ​was​ ​6-8​ ​times​ ​more​ ​likely​ ​to​ ​meet​ ​the​ ​cutoff.​ ​In​ ​a Swedish​ ​population​ ​study​ ​1947,​ ​1957,​ ​and​ ​1972,​ ​researchers​ ​observed​ ​the​ ​increased​ ​risk​ ​of depression​ ​for​ ​all​ ​age​ ​groups​ ​however,​ ​young​ ​adults​ ​exhibited​ ​a​ ​tenfold​ ​increased​ ​risk​ ​from​ ​1957 to​ ​1972​ ​(Compton​ ​et​ ​al,​ ​2006).​ ​The​ ​rise​ ​in​ ​depression​ ​amongst​ ​individuals​ ​has​ ​been​ ​credited​ ​to the​ ​changes​ ​in​ ​diagnosis​ ​criteria​ ​that​ ​fail​ ​to​ ​include​ ​and​ ​recognize​ ​the​ ​variation​ ​of​ ​symptoms​ ​to classify​ ​the​ ​normal​ ​response​ ​of​ ​sadness​ ​as​ ​a​ ​mental​ ​disorder​ ​(Hidaka,​ ​2012).​ ​However,​ ​it​ ​can also​ ​be​ ​attributed​ ​to​ ​change​ ​in​ ​societal​ ​concepts​ ​and​ ​culture​ ​that​ ​the​ ​youth​ ​face​ ​when​ ​growing​ ​up and​ ​learn​ ​to​ ​yearn​ ​for​ ​a​ ​feeling​ ​of​ ​acceptance​ ​or​ ​of​ ​fitting​ ​in​ ​throughout​ ​social​ ​media​ ​platforms, in​ ​friend​ ​groups,​ ​or​ ​within​ ​their​ ​family​ ​and​ ​community.​ ​An​ ​increase​ ​in​ ​alcohol​ ​and​ ​drug​ ​usage found​ ​more​ ​commonly​ ​in​ ​young​ ​adults​ ​may​ ​​​also​ ​be​ ​a​ ​factor​ ​as​ ​to​ ​higher​ ​depression​ ​rates amongst​ ​this​ ​age​ ​group.​ ​“Anxiety​ ​in​ ​children​ ​and​ ​college​ ​students​ ​has​ ​increased​ ​almost​ ​one standard​ ​deviation​ ​from​ ​the​ ​1950’s​ ​to​ ​the​ ​1990’s”​ ​(Twenge,​ ​2000).​ ​A​ ​direct​ ​correlation​ ​amongst developed​ ​countries​ ​and​ ​the​ ​prevalence​ ​of​ ​psychiatric​ ​disorders​ ​has​ ​been​ ​observed​ ​as​ ​urban citizens​ ​have​ ​higher​ ​mood​ ​and​ ​anxiety​ ​disorders​ ​compared​ ​to​ ​rural​ ​citizens.​ ​Since​ ​young​ ​adults and​ ​college​ ​students​ ​are​ ​at​ ​the​ ​forefront​ ​of​ ​modernization​ ​in​ ​lifestyle,​ ​social​ ​networks,​ ​media​ ​and more,​ ​a​ ​higher​ ​depression​ ​prevalence​ ​and​ ​risk​ ​can​ ​be​ ​associated.​ ​Along​ ​with​ ​modernization, western​ ​culture​ ​has​ ​gained​ ​the​ ​reputation​ ​for​ ​not​ ​being​ ​as​ ​health​ ​conscious​ ​in​ ​terms​ ​of​ ​nutrition and​ ​physical​ ​health​ ​and​ ​fitness.​ ​A​ ​poor​ ​diet​ ​with​ ​low​ ​levels​ ​of​ ​physical​ ​activity​ ​and​ ​distractions that​ ​lead​ ​to​ ​more​ ​time​ ​inside​ ​and​ ​less​ ​sleep​ ​can​ ​all​ ​lead​ ​to​ ​the​ ​imbalance​ ​of​ ​body​ ​functions related​ ​to​ ​the​ ​endocrine​ ​and​ ​nervous​ ​system.​ ​It​ ​is​ ​commonly​ ​known​ ​that​ ​most​ ​young​ ​adults​ ​and especially​ ​college​ ​students​ ​lack​ ​proper​ ​nutrition​ ​as​ ​they​ ​are​ ​now​ ​responsible​ ​in​ ​providing​ ​their own​ ​meals​ ​and​ ​also​ ​rarely​ ​reach​ ​the​ ​recommended​ ​hours​ ​of​ ​sleep​ ​for​ ​their​ ​age​ ​range.​ ​The​ ​higher the​ ​level​ ​of​ ​stress​ ​the​ ​body​ ​faces,​ ​the​ ​higher​ ​its​ ​successability​ ​to​ ​depression​ ​(Wood​ ​&​ ​Bhatnagar, 2014).​ ​There​ ​is​ ​a​ ​difference​ ​with​ ​clinical​ ​depression​ ​and​ ​the​ ​large​ ​amounts​ ​of​ ​stress​ ​that​ ​can​ ​be obtained​ ​from​ ​jobs​ ​and​ ​school​ ​that​ ​leads​ ​to​ ​similar​ ​symptoms,​ ​however​ ​detecting​ ​the​ ​difference is​ ​the​ ​main​ ​concern​ ​of​ ​this​ ​review.

What​ ​is​ ​stress?
Stress​ ​is​ ​the​ ​body’s​ ​natural​ ​response​ ​to​ ​a​ ​pressure​ ​or​ ​threat.​ ​In​ ​small​ ​amounts​ ​it​ ​can​ ​be motivational,​ ​especially​ ​in​ ​the​ ​work​ ​environment​ ​as​ ​it​ ​keeps​ ​individuals​ ​alert,​ ​focused​ ​and energetic.​ ​However,​ ​in​ ​large​ ​amounts,​ ​it​ ​becomes​ ​easier​ ​for​ ​the​ ​body​ ​to​ ​be​ ​in​ ​a​ ​continuous heightened​ ​state​ ​of​ ​stress​ ​that​ ​can​ ​lead​ ​to​ ​health​ ​problems.​ ​As​ ​an​ ​individual’s​ ​age​ ​increases, stress​ ​commonly​ ​accumulates​ ​in​ ​a​ ​direct​ ​correlation​ ​as​ ​more​ ​responsibilities​ ​are​ ​assigned​ ​to​ ​the individual.​ ​It​ ​is​ ​mostly​ ​done​ ​at​ ​a​ ​manageable​ ​rate​ ​where​ ​the​ ​individual​ ​accustoms​ ​to​ ​the increasing​ ​amount​ ​and​ ​is​ ​not​ ​fully​ ​aware​ ​as​ ​to​ ​the​ ​levels​ ​of​ ​stress​ ​they​ ​endure​ ​until​ ​it​ ​begins​ ​to take​ ​a​ ​noticeable​ ​toll.​ ​This​ ​toll​ ​affects​ ​and​ ​suppress​ ​the​ ​immune​ ​system,​ ​digestive​ ​and reproductive​ ​system​ ​as​ ​well​ ​as​ ​circadian​ ​rhythms,​ ​it​ ​increases​ ​the​ ​risk​ ​of​ ​heart​ ​attacks​ ​and​ ​speeds up​ ​the​ ​aging​ ​process.​ ​It​ ​leaves​ ​individuals​ ​more​ ​susceptible​ ​to​ ​anxiety,​ ​depression,​ ​and​ ​other mental​ ​health​ ​problems.

There​ ​are​ ​different​ ​kinds​ ​of​ ​stressors​ ​that​ ​individuals​ ​will​ ​encounter.​ ​Primarily​ ​in​ ​young adults,​ ​intrapersonal​ ​sources​ ​of​ ​stress​ ​are​ ​the​ ​most​ ​frequent​ ​and​ ​reported​ ​source.​ ​Changes​ ​in sleep​ ​habits,​ ​breaks,​ ​eating​ ​habits,​ ​workload,​ ​and​ ​new​ ​responsibilities​ ​are​ ​what​ ​causes​ ​the​ ​highest amounts​ ​of​ ​stress​ ​(Ross​ ​et​ ​al,​ ​1999).​ ​A​ ​study​ ​done​ ​on​ ​the​ ​association​ ​between​ ​computer​ ​use​ ​and mental​ ​health​ ​symptoms​ ​in​ ​young​ ​adults​ ​found​ ​sleep​ ​disturbances​ ​due​ ​to​ ​high​ ​and​ ​medium computer​ ​usage​ ​in​ ​men,​ ​and​ ​high​ ​email​ ​and​ ​chat​ ​usage​ ​in​ ​women​ ​(Thomée​ ​et​ ​al,​ ​2012.). Computer​ ​usage​ ​can​ ​be​ ​synonymous​ ​to​ ​smartphone​ ​usage​ ​as​ ​it​ ​has​ ​become​ ​the​ ​most​ ​common and​ ​easiest​ ​mode​ ​of​ ​access​ ​to​ ​media.​ ​For​ ​college​ ​students,​ ​the​ ​transition​ ​to​ ​college​ ​is​ ​a​ ​natural stressor​ ​in​ ​itself​ ​as​ ​students​ ​try​ ​to​ ​fit​ ​in​ ​and​ ​become​ ​accustomed​ ​to​ ​life​ ​on​ ​their​ ​own​ ​while​ ​older students​ ​deal​ ​with​ ​the​ ​challenge​ ​of​ ​earning​ ​their​ ​degree,​ ​finding​ ​a​ ​job​ ​or​ ​in​ ​some​ ​cases​ ​a​ ​potential life​ ​partner.​ ​Regardless,​ ​all​ ​students​ ​deal​ ​with​ ​the​ ​common​ ​frequent​ ​stressors​ ​such​ ​as​ ​evaluations,

tests,​ ​critiques​ ​from​ ​professors​ ​or​ ​coaches,​ ​and​ ​sometimes​ ​it’s​ ​even​ ​more​ ​daunting​ ​when​ ​a student​ ​feels​ ​uncomfortable​ ​in​ ​the​ ​classroom​ ​or​ ​surroundings​ ​that​ ​they​ ​are​ ​in,​ ​or​ ​in​ ​relationships with​ ​faculty​ ​members.​ ​Ultimately,​ ​perceived​ ​stress​ ​is​ ​an​ ​important​ ​risk​ ​factor​ ​for​ ​low​ ​mental health​ ​and​ ​suggest​ ​that​ ​mastery​ ​and​ ​self-esteem​ ​are​ ​important​ ​protective​ ​factors​ ​of​ ​mental​ ​health among​ ​young​ ​adults​ ​(Bovier​ ​et​ ​al,​ ​2004).​ ​It​ ​is​ ​important​ ​for​ ​students,​ ​faculty,​ ​family​ ​members and​ ​really​ ​anyone​ ​to​ ​be​ ​able​ ​to​ ​recognize​ ​the​ ​difference​ ​between​ ​stress​ ​and​ ​depression​ ​before​ ​it​ ​is too​ ​late.
Call​ ​to​ ​action

So,​ ​what​ ​should​ ​be​ ​done?​ ​

Beginning​ ​with​ ​the​ ​people​ ​who​ ​spend​ ​the​ ​most​ ​time​ ​with​ ​young​ ​adults and​ ​students,​ ​faculty​ ​and​ ​staff​ ​of​ ​schools​ ​and​ ​colleges,​ ​camps,​ ​and​ ​community​ ​areas​ ​should​ ​all​ ​be aware​ ​of​ ​symptoms​ ​and​ ​make​ ​the​ ​individuals​ ​know​ ​that​ ​they​ ​are​ ​welcomed​ ​and​ ​always​ ​available as​ ​a​ ​listening​ ​source​ ​that​ ​can​ ​also​ ​provide​ ​the​ ​individual​ ​with​ ​connections​ ​or​ ​further​ ​resources​ ​if needed.​ ​Counseling​ ​services​ ​in​ ​the​ ​wellness​ ​center​ ​need​ ​to​ ​be​ ​able​ ​to​ ​accommodate​ ​appointments for​ ​all​ ​the​ ​students​ ​who​ ​come​ ​to​ ​them,​ ​and​ ​also​ ​create​ ​a​ ​common​ ​practice​ ​of​ ​speaking​ ​to​ ​the student​ ​body​ ​about​ ​recognizing​ ​the​ ​different​ ​symptoms​ ​within​ ​themselves​ ​and​ ​peers​ ​as​ ​well​ ​as destroying​ ​any​ ​taboo​ ​misconceptions​ ​that​ ​mental​ ​health​ ​is​ ​a​ ​myth​ ​or​ ​something​ ​that​ ​they​ ​can​ ​just get​ ​over​ ​with​ ​on​ ​their​ ​own.​ ​Having​ ​resources​ ​such​ ​as​ ​creating​ ​a​ ​stress​ ​management​ ​program​ ​may also​ ​be​ ​very​ ​beneficial​ ​as​ ​a​ ​different​ ​course​ ​of​ ​action​ ​for​ ​individuals​ ​who​ ​don’t​ ​know​ ​where​ ​to start​ ​or​ ​wish​ ​to​ ​improve​ ​their​ ​mental​ ​health.​ ​Assessing​ ​the​ ​different​ ​stressors​ ​to​ ​individuals including​ ​the​ ​ones​ ​that​ ​accumulate​ ​over​ ​time.​ ​The​ ​College​ ​Chronic​ ​Life​ ​Stress​ ​Survey​ ​created​ ​in 1996​ ​by​ ​Towbes​ ​and​ ​Cohen​ ​focused​ ​on​ ​the​ ​frequency​ ​of​ ​chronic​ ​stress​ ​in​ ​the​ ​lives​ ​of​ ​college students​ ​and​ ​evaluated​ ​how​ ​many​ ​times​ ​students​ ​dealt​ ​with​ ​these​ ​stresses​ ​on​ ​a​ ​weekly​ ​basis. They​ ​found​ ​that​ ​first​ ​year​ ​students​ ​had​ ​higher​ ​levels​ ​of​ ​chronic​ ​stress​ ​than​ ​the​ ​other​ ​students. Keeping​ ​an​ ​updated​ ​survey​ ​like​ ​this​ ​can​ ​be​ ​beneficial​ ​in​ ​helping​ ​faculty​ ​or​ ​school​ ​counselors realize​ ​where​ ​different​ ​individuals​ ​stand​ ​and​ ​assist​ ​them​ ​in​ ​an​ ​individualized​ ​matter.​ ​It​ ​can​ ​also help​ ​boards​ ​of​ ​higher​ ​institutions​ ​evaluate​ ​these​ ​results​ ​to​ ​see​ ​if​ ​there​ ​is​ ​a​ ​commonality​ ​amongst the​ ​students​ ​that​ ​is​ ​causing​ ​repeated​ ​high​ ​levels​ ​of​ ​stress​ ​and​ ​possibly​ ​adjust​ ​to​ ​accommodate​ ​the student​ ​body​ ​as​ ​a​ ​whole.​ ​Providing​ ​workshops​ ​or​ ​educational​ ​lectures​ ​that​ ​teach​ ​students​ ​how​ ​to recognize​ ​symptoms​ ​is​ ​important​ ​as​ ​many​ ​students​ ​would​ ​rather​ ​talk​ ​and​ ​confide​ ​in​ ​a​ ​friend before​ ​reaching​ ​out​ ​to​ ​a​ ​professional.​ ​Close​ ​friends​ ​can​ ​also​ ​detect​ ​abnormal​ ​behaviors​ ​in​ ​the individual​ ​that​ ​act​ ​as​ ​a​ ​signal​ ​for​ ​them​ ​to​ ​step​ ​in​ ​and​ ​help.​ ​They​ ​don’t​ ​have​ ​to​ ​become​ ​their friend’s​ ​therapist​ ​or​ ​certified​ ​counselor,​ ​however​ ​they​ ​can​ ​help​ ​by​ ​finding​ ​resources​ ​and​ ​in​ ​more serious​ ​cases,​ ​they​ ​can​ ​take​ ​action​ ​by​ ​reaching​ ​out​ ​to​ ​professionals​ ​for​ ​their​ ​friend​ ​or​ ​by practicing​ ​the​ ​concepts​ ​of​ ​QPR​ ​training​ ​which​ ​stands​ ​for​ ​question,​ ​persuade,​ ​and​ ​refer.​ ​This practice​ ​is​ ​a​ ​training​ ​done​ ​by​ ​many​ ​colleges​ ​or​ ​wellness​ ​centers​ ​to​ ​teach​ ​others​ ​how​ ​to​ ​recognize and​ ​help​ ​those​ ​at​ ​risk​ ​of​ ​suicide​ ​or​ ​who​ ​have​ ​thoughts​ ​of​ ​suicide.​ ​It​ ​can​ ​be​ ​applied​ ​to​ ​depression by​ ​gently​ ​confronting​ ​or​ ​bringing​ ​up​ ​the​ ​topic​ ​to​ ​their​ ​friend​ ​in​ ​mentioning​ ​that​ ​they​ ​have​ ​noticed a​ ​difference​ ​and​ ​are​ ​there​ ​to​ ​help​ ​them.​ ​Providing​ ​reassurance​ ​to​ ​the​ ​individual​ ​and​ ​helping​ ​them escape​ ​their​ ​doubts​ ​until​ ​a​ ​professional​ ​may​ ​be​ ​reached​ ​is​ ​a​ ​simple​ ​way​ ​a​ ​friend​ ​can​ ​help.​ ​Aside from​ ​educational​ ​staff​ ​and​ ​friends,​ ​family​ ​members​ ​and​ ​society​ ​as​ ​a​ ​whole​ ​needs​ ​to​ ​be​ ​reminded and​ ​educated​ ​that​ ​mental​ ​health​ ​is​ ​a​ ​real​ ​thing.​ ​It​ ​is​ ​not​ ​“just​ ​a​ ​phase”​ ​that​ ​one​ ​can​ ​easily​ ​get​ ​over with​ ​after​ ​a​ ​few​ ​days.​ ​Providing​ ​education​ ​and​ ​facts​ ​and​ ​reaching​ ​out​ ​to​ ​the​ ​public​ ​is​ ​the​ ​most essential​ ​way​ ​to​ ​get​ ​the​ ​message​ ​across​ ​which​ ​in​ ​turn​ ​creates​ ​a​ ​larger​ ​push​ ​for​ ​more​ ​research​ ​in labs​ ​and​ ​medication​ ​for​ ​individuals.

In​ ​research,​ ​finding​ ​better​ ​or​ ​more​ ​animal​ ​models​ ​that​ ​correlate​ ​to​ ​human’s​ ​mechanisms​ ​of actions​ ​may​ ​assist​ ​in​ ​further​ ​understanding​ ​both​ ​stress​ ​and​ ​depression​ ​in​ ​individuals.​ ​It​ ​is​ ​also important​ ​to​ ​keep​ ​in​ ​mind​ ​that​ ​young​ ​adults​ ​are​ ​not​ ​the​ ​only​ ​ones​ ​dealing​ ​with​ ​mental​ ​disorders. Frequently,​ ​individuals​ ​have​ ​struggled​ ​growing​ ​up​ ​but​ ​have​ ​never​ ​reached​ ​out​ ​or​ ​been​ ​told​ ​to seek​ ​help.​ ​There​ ​is​ ​a​ ​high​ ​percentage​ ​of​ ​older​ ​adults​ ​with​ ​mental​ ​disorders​ ​that​ ​still​ ​struggle​ ​on​ ​a daily​ ​basis​ ​who​ ​have​ ​just​ ​as​ ​many​ ​rights​ ​to​ ​access​ ​in​ ​resources​ ​and​ ​medications​ ​at​ ​their​ ​point​ ​of life​ ​as​ ​well​ ​(Kennedy​ ​&​ ​Ceϊde,​ ​2017).​ ​Being​ ​able​ ​to​ ​recognize​ ​any​ ​symptoms​ ​or​ ​disabilities related​ ​with​ ​depression,​ ​anxiety,​ ​stress,​ ​and​ ​impaired​ ​cognition​ ​earlier​ ​on​ ​can​ ​lead​ ​to​ ​an​ ​easier​ ​or better​ ​appreciated​ ​lifestyle​ ​further​ ​on.



Works​ ​Cited

Bovier,​ ​P.A.,​ ​Chamot,​ ​E.​ ​&​ ​Perneger,​ ​T.V.​ ​Qual​ ​Life​ ​Res​ ​(2004)​ ​13:​ ​161. https://doi.org/10.1023/B:QURE.0000015288.43768.e4

Compton​ ​WM,​ ​M.D.,​ ​M.P.E.,​ ​Conway​ ​KP,​ ​Ph.D.,​ ​Stinson​ ​FS,​ ​Ph.D.,​ ​and​ ​Grant​ ​BF,​ ​Ph.D. (2006).​ ​Changes​ ​in​ ​the​ ​prevalence​ ​of​ ​major​ ​depression​ ​and​ ​comorbid​ ​substance​ ​use disorders​ ​in​ ​the​ ​United​ ​States​ ​between​ ​1991-1992​ ​and​ ​2001-2002.​ ​American​ ​Journal​ ​of Psychiatry.​ ​Doi:​ ​​10.1176/ajp.2006.163.12.2141

Hammar,​ ​Å.,​ ​&​ ​Årdal,​ ​G.​ ​(2009).​ ​Cognitive​ ​Functioning​ ​in​ ​Major​ ​Depression​ ​–​ ​A​ ​Summary. Frontiers​ ​in​ ​Human​ ​Neuroscience​,​ ​​3​,​ ​26.​ ​http://doi.org/10.3389/neuro.09.026.2009

Hidaka,​ ​B.​ ​H.​ ​(2012).​ ​Depression​ ​as​ ​a​ ​disease​ ​of​ ​modernity:​ ​explanations​ ​for​ ​increasing prevalence.​ ​​Journal​ ​of​ ​Affective​ ​Disorders​,​ ​​140​(3),​ ​205–214. http://doi.org/10.1016/j.jad.2011.12.036

Krishnan,​ ​V.,​ ​&​ ​Nestler,​ ​E.​ ​J.​ ​(2008).​ ​The​ ​molecular​ ​neurobiology​ ​of​ ​depression.​ ​​Nature​, 455​(7215),​ ​894–902.​ ​​http://doi.org/10.1038/nature07455

Kennedy,​ ​G.​ ​J.,​ ​&​ ​Ceïde,​ ​M.​ ​E.​ ​(2017).​ ​Screening​ ​Older​ ​Adults​ ​for​ ​Mental​ ​Disorders.​ ​​Clinics​ ​in Geriatric​ ​Medicine​.​ ​DOI:​ ​​10.1016/j.cger.2017.09.005

Ross,​ ​S.​ ​E.,​ ​Niebling,​ ​B.​ ​C.,​ ​&​ ​Heckert,​ ​T.​ ​M.​ ​(1999).​ ​Sources​ ​of​ ​stress​ ​among​ ​college​ ​students. Social​ ​psychology​,​ ​​61​(5),​ ​841-846.

Sontheimer,​ ​H.​ ​(2015).​ ​​Diseases​ ​of​ ​the​ ​Nervous​ ​System​.​ ​Academic​ ​Pr.

Thomée,​ ​S.,​ ​Härenstam,​ ​A.,​ ​&​ ​Hagberg,​ ​M.​ ​(2012).​ ​Computer​ ​use​ ​and​ ​stress,​ ​sleep​ ​disturbances, and​ ​symptoms​ ​of​ ​depression​ ​among​ ​young​ ​adults​ ​–​ ​a​ ​prospective​ ​cohort​ ​study.​ ​​BMC Psychiatry​,​ ​​12​,​ ​176.​ ​​http://doi.org/10.1186/1471-244X-12-176 Towbes,​ ​L.C.​ ​&​ ​Cohen,​ ​L.H.​ ​J​ ​Youth​ ​Adolescence​ ​(1996)​ ​25:​ ​199. https://doi.org/10.1007/BF01537344

Twenge,​ ​J.​ ​M.​ ​(2000).​ ​The​ ​age​ ​of​ ​anxiety?​ ​The​ ​birth​ ​cohort​ ​change​ ​in​ ​anxiety​ ​and​ ​neuroticism, 1952–1993.​ ​​Journal​ ​of​ ​Personality​ ​and​ ​Social​ ​Psychology,​ ​79​(6),​ ​1007-1021.

Wood,​ ​S.​ ​K.,​ ​&​ ​Bhatnagar,​ ​S.​ ​(2015).​ ​Resilience​ ​to​ ​the​ ​effects​ ​of​ ​social​ ​stress:​ ​Evidence​ ​from clinical​ ​and​ ​preclinical​ ​studies​ ​on​ ​the​ ​role​ ​of​ ​coping​ ​strategies.​ ​​Neurobiology​ ​of​ ​stress​,​ ​1, 164-173.​ ​​https://doi.org/10.1016/j.ynstr.2014.11.002

One Love

Since my first year at Agnes Scott, I have been involved with HERO (Health Education and Resource Organization), a club on campus that focuses on the mental, emotional, and physical health and well being of Agnes Scott’s student body. This year, I accomplished one of the goals I set as a freshman, I became president of the club. I have always been very interested in the subject and activities around public health and thought what better way to be involved than with this club. This has allowed me to become heavily involved with the student body and student life coordinators on campus where I even became trained in bystander awareness through the wellness center on campus. This has allowed me to lead training of other campus leaders and communities on campus in bystander awareness and sexual assault awareness trainings.

Credit “SPArC/RespectCon” by Iara Moran is licensed under CC BY 4.0

I have also participated in workshops and events at other colleges and conferences such as Oglethorpe University One Love Campaign and Emory 2018 RespectCon where I have learned about the prevalence of campus sexual assaults and the culture around it throughout different universities in the United States. There is a huge student movement bringing greater awareness to campus officials and asking for proper action. This is sill a huge work of progress but in the midst of it all, I am always inspired at how students work together in the past, now, and in the future for their rights. This is something I wish to continue to be a part of for the rest of my life and has greatly impacted the role I would like to play as a future pediatric physician and representative for children and young adults everywhere.  


SUMMIT Learning Outcomes associated with this reflection:

  • 6. Articulate and appraise problems and solutions from multiple perspectives critically considering diverse sources of information
  • 7. Recognize, analyze, and employ effective teamwork
  • 11. Analyze human behavior or social relations
  • 12. Cultivate and maintain interpersonal relationships and netoworks
  • 15. Identify, evaluate and strategically utilize campus and community resources
  • 16. Demonstrate honorable and ethical behavior and civic engagement