Editorial Comment: This week’s Keeping it Real highlights the relationship between bullying and suicide and also shares how suicide-related behavior is rarely the result of a single source of trauma or stress. In partnership with the University of California, Riverside’s Center for Healthy Communities (CHC), the following article, “Living with Depression and Anxiety” presents the stories of three UCR students who live with depression and/or anxiety. By sharing these real stories, it is the desire of the CHC and The IE Voice/Black Voice News to encourage others in the community to access available services and resources in hopes of decreasing the stigma associated with depression and anxiety. Here are their stories:
Mohamed Jawara | Contributor
Never Be Afraid to Ask for Help—A Close Call with Suicide
To live or not to live is a question that millions of individuals in the United States grapple with. Suicide, which is the act of intentionally causing one’s own death, has become the 10th leading cause of death in America according to the Centers of Disease Control and Prevention (CDC). In 2017 alone, there were approximately 1.4 million suicide attempts of individuals 18 years of age and older according to the American Foundation for Suicide Prevention.
Several risk factors have been identified as being associated with suicide. For instance, individuals who have experienced violence, which includes sexual violence, child abuse or bullying have a higher risk of committing suicide. “Suicide attempt are more common among females however suicide does not discriminate; it affects people of every age, gender, race, and socioeconomic status,” says Dr. Jeannie D. Lochhead, M.D., a UCR Health Psychiatrist and assistant clinical professor of psychiatry at the University of California, Riverside.
Other factors associated with suicide attempts may come in the form of unrealistic social, parental or academic expectations, which can create a strong sense of rejection and can lead to psychological stresses. According to the U.S. Department of Health and Human Services, depression—which is considered a mood disorder—affects the way an individual, feels, thinks and handles daily activities, and can increase the risk of committing suicide.
The power of depressive thinking is one that should never be underestimated or go unnoticed by loved ones. Mae, a 20 years old Filipino undergraduate student at the University of California, Riverside recounted her experience with depression and her close call with suicide.
At age 13, a school therapist recommended Mae be admitted for treatment because of early signs of depression. As a result of parental supervision however, Mae never received treatment and growing up she did not get the opportunity to learn about depression.
Mae first experienced depression during her early teenage years. “When I was around 12 or 13, my parents divorced, so that caused a huge collapse in terms of my mental health,” said Mae.
For the first two weeks of each month, Mae expressed having high levels of energy, however, towards the end of each month, she would go through a very deep depression and it got to a point where she preferred to stay indoors, as a result of the drastic changes in emotion and moods she experienced. She remembers feeling dissociated, aloof, non-talkative and wanting to be alone. “Most days it was pretty difficult to just function,” Mae added.
It wasn’t until Mae started college at UCR that she was diagnosed with clinical depression. According to Mae, her depression worsened after going through a rough break up with an abusive partner. She fell into heavy drug use and was unable to keep up with a lot of extracurricular activities, like being able to get into the sorority that she wanted. “It all went spiraling down and then I couldn’t handle it, so I wanted to commit suicide in my room,” Mae shared recounting her close call with suicide.
According to Dr. Lochhead, “Some of the indicators for someone who is contemplating suicide is hopelessness…Looking out for anything that would be a source of hopelessness, and helping that individual get the appropriate treatment is important.”
At the pinnacle moment of contemplating suicide, Mae reached out to the Resident Advisor (RA) in her hall that was on duty. “I informed the RA that I was in danger of hurting myself and then I called the crisis hotline,” said Mae. The Sheriff was alerted of Mae’s attempt and she was taken to the Riverside Community Hospital Emergency Department. Mae was then transferred to another hospital where she was placed on 72 hours voluntary hold. At the hospital, Mae was provided safety plans and immediate contacts Mae could reach out to whenever she had thoughts of suicide.
After being released from the hospital, Mae was connected with the Counseling and Psychological Services at UCR. A case manager was assigned to her and she underwent multiple therapy sessions.
“In the last two years my life has significantly changed…After hospitalization and getting treatment, I have a bunch of different professors that actually check on me and the therapists here stay in contact with me. Generally, I’ve gotten much more stable,” Mae elaborated.
In addition, mindfulness and care has become a great coping mechanism for Mae as she learns methods to cope with depression and anxiety. She draws, attends Zumba classes and engages in activities that exert energy, since exerting energy is known to increase one’s happiness.
Currently, Mae is a Psychology Major, minoring in Sociology and in June of this year, she completed her sophomore year at UCR. Mae plans to pursue a masters degree in Social Work and Business, and she aspires to start her own boys and girls club in the near future.
According to Mae, a major misconception regarding depression is that a lot of people think it can be easily overcome and that it is something that is based on a person’s situation. However, most of the time, depression may have been brought about by a situation, but many times ends up becoming something of a pattern. Or, it might be related to a chemical imbalance.
Another misconception Mae expressed is the notion that suicide is unexpected. Signs such as an individual giving away their belongings or making amends with others all of a sudden can serve as signs of a person contemplating suicide.
Regarding individuals that are experiencing depression and anxiety, “It may seem the hardest thing in the world [is] to get out of bed or just function and get food, but you have to reward yourself in those moments,” shared Mae. She added, “Depression is kind of like running a marathon, you would have to run laps and laps before you can actually accomplish happiness, but it gets easier.” To better support those that are experiencing depression or having thoughts of suicide, Mae encourages their loved ones to listen. “Notice the signs and be aware of them especially for example if a person comes to you in need, do not turn them away and say, ‘Oh, I am too busy,’” Mae elaborated. Those loved ones concerned for an individual should be aware that resources do exist. They include getting professional help from a therapist or psychiatrist. Additionally, suicide prevention hotlines are accessible 24/7.
An Adolescent Perspective
Adolescence, the transitional phase of growth and development between childhood and adulthood, is an exciting yet still unsettling time for individuals between the ages of 10 and 19. Besides dealing with many physical and emotional changes, adolescents also experience increasing academic, social, or family expectations.
According to Dr. Adwoa Osei, M.D., a health pediatrician at the University of California Riverside, adolescence comes with a sense of self-doubt, sharpening and understanding of abstract thought and the demands of life, which often translates, into stress. Social media, peer pressure, physical changes, societal and academic expectation all have the potential to influence the mental state of young individuals.
For some adolescents the lows in life are more than just temporary feelings—they may be prolonged, persistent, often interfere with daily functioning and sometimes creates a sense of worthlessness.
A report by the Substance Abuse and Mental Health Services Administration revealed in 2017 an estimated 3.2 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This number represents approximately 13 percent of the U.S. population aged 12 to 17.
According to the American Psychiatric Association, depression is considered a mood disorder which can affect the way an individual feels, thinks and handles daily activities, such as sleeping, eating, or working.
For Viviana Hurtado, a 19 years old Hispanic undergraduate student at the University of California Riverside, growing up in a predominantly Hispanic community in East Los Angeles, living with depression was seen as a stigma. Therefore, depression was not talked about at home and as a result, Viviana was unaware of its signs and symptoms.
Her symptoms began in middle school. “I didn’t know what was going on with me, like out of nowhere I would feel really sad or I would start crying and at first I was like, ‘Oh, it’s nothing,’” Viviana said recounting her experience.
She remembers finding it difficult to do simple things like smiling and laughing. Every day before going to school, she would practice trying to smile and there came a point where she had forgotten how to do so. She thought that she was only going through a phase, however, after the passing of a loved one, her symptoms got worse.
In high school as Viviana struggled with depression, she also developed anxiety. “I was just crying out of nowhere and it got really bad… It got to a point where my mom started noticing and she was like, ‘What’s wrong?’ And, I told her I don’t know; I just started feeling like this,” Viviana exclaimed. Her depression and anxiety started affecting her classes and Viviana was not performing in her courses as she used to.
In her sophomore year, Viviana sought help by reaching out to the counseling department at her high school. The counselor referred her to a psychologist and when she mentioned the referral to her mother, she panicked. Her mother thought perhaps she was being bullied—she didn’t fully understand that Viviana was depressed.
With the assistance of the school counselor, Viviana’s mother came to terms with her daughter’s depression and anxiety. Viviana started going to therapy sessions and during her junior year of high school, she found extracurricular activities that provided coping skills to help with her depression. In addition, Viviana became an active member of Step-Up, which is a non-profit organization that provides mentorship for those in underserved communities that are in high school.
Step-Up also gave Viviana the opportunity to meet her idol Selena Gomez. “I remember the day that she came into the room… We were talking and she helped me realized that I am worth it and that it’s going to get better… She taught me not to give up even though it can be hard, you just have to keep moving,” Viviana shared recounting her experience with the Walt Disney Star.
Through mentorship opportunities provided by Step-Up, Viviana became more confident, career focused and college ready. As a freshman at UCR, Viviana faced another episode of depression this past winter quarter. However, she reached out to the UCR Counseling and Psychological Services (CPS) where she was provided eight therapy sessions for her depression and anxiety.
CPS provided Viviana with a “self-talk” sheet to help her identify and channel negative thoughts. She was also provided a “self-care wheel” that shows different ways to take care of herself. Viviana has been focusing on mindfulness and living in the moment. She has completed her therapy sessions and she has been focusing on her studies. Viviana is currently majoring in Psychology and in June completed her first year at UCR.
A misconception about depression that Viviana would like to dispel is the notion that being depressed is the same as being sad. “Depression is not always about feeling sad all the time… You can feel sad, you can feel anxious, you can feel tense, you can feel empty, but it’s harder to get rid of,” said Viviana.
For those currently living with depression and anxiety, Viviana encourages them not to be afraid to reach out for help and not to forget that they are enough, they matter, and are loved. As a society, Viviana emphasizes that the importance of educating ourselves about mental health and being sensitive towards those that are experiencing it.
A Medical Student’s Perspective
Every year, medical schools across the United States receive thousands of applications from studious, competitive and determined applicants that aspire to become physicians.
According to a survey conducted by the Association of American Medical Colleges, in the 2018-2019 academic year, medical schools throughout the U.S. admitted approximately 91,391 students. Admittance to medical school is considered a great achievement due to its rigorous admission process which involves attaining good grades, having community volunteer experience, participating in extracurricular activities in college, and being exposed to the medical field prior to applying to medical school.
Being accepted into medical school and eventually working in the medical field is rewarding, however the journey of becoming a physician is arduous and, in some cases, depressive.
According to the Journal of the American Medical Association (AMA), almost 30 percent of medical students suffer from depression. Additionally, the AMA reports after the first two months of medical school, 26 percent of the students admitted to suffering from anxiety disorders, which is a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.
“In comparison to other student groups and the general population, medical students and physicians face higher levels of stress and burn-out leading to high risk of behavioral health problems such as anxiety and depression,” said Dr. Lawanda Hall, DBH, Director of Academic Counseling and Student Support at the University of California Riverside School of Medicine.
Frances Tao, a 26-year-old Taiwanese medical student at the University of California, Riverside School of Medicine shared her experience with depression and anxiety.
Growing up, Frances was never formally taught about depression, however she witnessed some of her family members being sad for weeks and sometimes months as they experienced rough patches in life. Additionally, while in college, one of Frances’s friends in high school committed suicide, which came as a shock to everyone in the community because this individual was known to be very positive and high-spirited.
According to Frances, she first experienced signs and symptoms of depression and anxiety during her second year of medical school. Growing up, Frances was considered a high achiever and it was not until medical school that she started to struggle with her courses.
As she experienced bouts of depression, Frances remembers feeling fatigued and tired all the time even though routinely she’d sleep seven to eight hours a day. Moreover, she remembers keeping herself isolated and not wanting to socialize. For a very long time, Frances did not feel happy or excited about anything in life, which felt like a constant drag.
In addition to being depressed, Frances struggled with anxiety, which caused her heart to palpitate rapidly, made it difficult for her to catch her breath. It also made it difficult for her to concentrate on her studies.
She elaborated, “I could read the same paragraph for ten minutes, over and over again and not understand anything… I would be too freaked out because of anxiety that I could not concentrate my eyes on the page that I [was] reading.”
During her third year of medical school, Frances sought help for depression and anxiety at the UCR Counseling and Psychological Services. “I had to take both medication and therapy,” said Frances. The psychiatrist on campus started her on a low dosage of Lexapro, which is a medication used to treat depression and anxiety.
At UCR School of Medicine, medical students who are exhibiting signs of stress, burnout, anxiety, depression or other forms of behavioral health symptoms, can find support through the Office of Medical Student Support and Wellness.
“Research has found that having an office primarily focused upon behavioral health and wellness can help to reduce the stigma of seeking mental health treatment, identify at-risk students, cultivate resiliency and serve as a liaison to support services across campus and within the surrounding community,” Dr. Hall elaborated. While the medical school can assist with coordinating services to Counseling and Psychological Services, Disability Services, Case Management and Title IX, medical students can also directly access these services without a referral.
Frances has been on stable doses of Lexapro for the past year. She utilizes therapy whenever she experiences a crisis, which can take the form of panic attacks or finding it difficult to study for her classes. “My most recent therapy sessions have been focused more on coping in regards to what to do in certain situations and how to handle it,” said Frances.
Having adequate sleep and eating all three meals has been a main priority for Frances. She makes it a point of duty to visit her family frequently, and her significant other has been the biggest support system for Frances as she copes.
Frances is currently in Boston pursuing her master’s degree in public health at Harvard University and will return to UCR this summer to finish her 4th year of medical school. During 4th year, Frances will continue with her clinical rotations.
“To assist with supporting 3rd and 4th year medical students, the UCR School of Medicine Office of Student Affairs offers wellness coaching, financial aid counseling, career advising, and academic success appointments on site at the community-based hospitals where students complete their clinical rotations,” according to Dr. Hall.
It is hoped that by placing a priority on holistic well being for students that anxiety and depression among medical students will be reduced and mental health treatment will be de-stigmatized.
Regarding misconceptions about depression and anxiety, Frances stated, “The first misconception that comes to mind is perhaps the notion that medical healthcare providers can’t get it… I know it’s kind of intuitive, but we’re all humans and we’re all definitely susceptible to a lot of the same illnesses.” She continued, “I would even argue that we’re more susceptible because we deal with human tragedy and sickness every day.”
Another misconception that Frances would like to dispel is the notion that an individual can just snap out of depression and/or anxiety. “There are a lot of things going on psychologically and also physically and those things are really engrained and really hard to deal with,” she explained.
For individuals struggling with depression and/or anxiety, Frances encourages them to count the things that they are grateful for and to not feel alone. “As you experience depression, it feels like the world is falling apart around you and that you’re stuck in the middle of it and that you’re helpless, but there will always be better days.”
Regarding those that have friends, family and loved ones experiencing depression and/or anxiety, Frances encourages them to be accessible. “If a loved one reaches out to you, be there for them, but also do not feel scared to check-in and ask how they are doing.”
If you or someone you know is experiencing depression and/or anxiety please visit https://up2riverside.org, or if you are a student call the UCR Counseling and Psychological Services at 951-UCR-TALK (951-827-5531) or call The National Suicide Prevention Lifeline at 1-800-273-TALK (8255) if you or someone you know is experiencing thoughts of suicide.
Regarding all the stories in this compilation as well as the issues discussed in this week’s Keeping it Real, it is crucial the public remains educated on mental health and begins to take mental illnesses as seriously as it takes physical illnesses. There is a stigma against reaching out for help and this can cause people to avoid the resources that are available to them. Everyone must work together to dispel the stigma surrounding mental health problems. Together, we can end the stigma surrounding Mental Health.
Members of the Riverside Community can reach out to the Riverside County Department of Mental Health at https://www.rcdmh.org/. Information regarding support services for residents of San Bernardino County’s Department of Behavioral Health is available at https://www.rcdmh.org/.
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Contributing Editor Mohamed Jawara is a University of California Riverside alumnus with a Bachelor of Arts Degree in Political Science and Law & Society. He is currently a Program Assistant at the UCR School of Medicine’s Center for Healthy Communities and contributes health content for the I.E. Voice Newspaper. Mr. Jawara will be pursuing a Master of Health Services-Physician Assistant Studies Degree at the University of California Davis in the Summer of 2019.