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.



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