Depression and anxiety afflict growing numbers of students.

Story and photos by Josh Compton, NewsNetNebraska

Every year, more students knock on Dr. Robert Portnoy’s door. They often feel lost or alone and visit the counseling center at the University of Nebraska-Lincoln Health Center searching for relief from their depression, anxiety, or even suicidal thoughts. No matter the numbers, he wishes more people would come.

“It concerns me that some people think it’s a sign of weakness to seek services but, in fact, it’s an act of courage and wisdom to get help before a minor problem becomes a crisis,” said Portnoy, Department Head of Counseling and Psychological Services (CAPS) at the health center. Portnoy added that counseling is more effective if started as early as possible.

Certainly, the need for psychological services seems to be more pressing than ever. Incidents such as the 2007 Virginia Tech Massacre underscore it: a student suffering from severe anxiety killed 32 people on the campus in Blacksburg, Va. More recently, there was the suicide of Tyler Clementi, a gay Rutgers student who was publicly humiliated when a private video of a sexual encounter was released on the Internet.

Demand for the CAPS services is rising. The program logged 8,839 visits by more than 1,300 clients in 2009 alone, and Portnoy said the number of clients grows by 5 percent each year. Usage increases depending on class standing, as graduate students are more apt to take advantage of psychological services than freshmen. Portnoy said the rise in use of CAPS is linked to earlier onset of depression and anxiety symptoms, a national trend.

“A century ago, people started feeling the effects of depression when they were around 30 years old,” said Portnoy. “Now, it’s being seen in college students who are 23 or 24 and that curve will continue to get lower and lower.”

Still, there has long been a stigma attached to psychological and psychiatric services. Some people are afraid of being labeled as different or crazy because they are having difficulty dealing with their problems. They see therapy as somehow different from other medical services.

CAPS offers a preliminary online screening for students who wonder if they should seek help.

But most students deal with some degree of stress during their college careers. Whether it be work, relationships or school itself, it can become easy to feel overwhelmed or helpless. And anxiety – a common ailment on campuses – can be treated either medically or with counseling.

“People must understand that there are many stressors,” said Marty Ramirez, a counselor at CAPS. “The university is full of pressure and expectations are high so physical symptoms, as well as emotional, can begin to surface.”

Ramirez often provides a Stress Exhaustion Symptoms checklist so students can identify the physical, emotional, spiritual, mental and relational symptoms they may be feeling. The list asks such things as whether the student has seen changes in appetite, alcohol or drug use, forgetfulness. It asks whether they feel empty, apathetic and cynical. The goal: to help him identify the student’s problems.

Ramirez explained that seemingly trivial issues can become overblown because of “how they are perceived.” Each individual has a different way of viewing his or her problems and it all comes down to how they cope. “For instance, drinking behavior and alcoholism are constant phenomena and common coping mechanisms for college students,” said Ramirez. “What we do is teach people how to cope because the only things you can change are thinking and behavior.”

Staffers at CAPS say they see a broad range of ages and issues. Some come in just to talk. Others may need antidepressants or other medications. CAPS provides psychiatric services, in addition to therapy, and has counselors who can prescribe medication, if necessary.

The program leaders also don’t want expense to be a barrier for students. The first three sessions are offered at no charge, with the costs covered by student fees. Later sessions are provided for as little as $10 a session.

Marty Ramirez is one of the counselors at CAPS who helps students work through a variety of issues.

Counselors would like to reach students with problems before they become tragedies. It’s impossible to know whether counseling would have saved Clementi at Rutgers or prevented a disaster such as the Virginia college massacre. But the question looms large at CAPS where counselors such as Ramirez see safety as their primary concern.

“In the past, we didn’t have the Virginia Tech’s or Rutgers. They are reflections on society and complex problems,” said Ramirez. “Ultimately, we are most concerned about our clients’ well-being and safety. But now, the safety of the campus and dorms are also at the forefront.”

Students feeling stressed out, anxious or depressed can take solace in the fact that counselors like Ramirez are available to help them understand and overcome almost any issue. It is often said that admitting one has a problem is the hardest part. But once that step is taken, the coping and/or healing process can begin.

Tags: anxiety, campus counseling, campus mental health, CAPS, counseling, Counseling and psychological services, depression, Josh Compton, mental illness, portnoy, psychiatric, psychological, ramirez, suicide, Tyler Clementi, UNL, UNL counseling, Virginia Tech