On-Campus Suicide a Hidden Killer

Sensitivity to the warning signs can save undergrads' lives, experts say

It can be a difficult time. Suddenly, perhaps for the 1st time in your life, you're moving away from everything familiar to you - family, friends, home, community & beginning to make your way as a young adult entirely surrounded by strangers, in a new setting.

You may feel that everything is on the line:

• your ability to succeed at college-level work
• to build adult relationships
• to adapt to a lot of change all at once

According to a recent UCLA study, more than 30% of college freshmen reported feeling overwhelmed a great deal of the time during the beginning of college & Johns Hopkins University reported that more than 40% of a recent freshman class sought help from the student counseling center. So understand that if you're feeling pressure & stress, you're not alone.

Many college students have minor problems adjusting to their new environment. Here are a few ideas that can help you manage your feelings of pressure & stress:

• Better plan your use of time. Make time every day to prioritize your work. Prioritizing can give you a sense of control over what you must do & a sense that you can do it.

• Plan your work & sleep schedules. Too many students defer doing important class work until late at night, work thru much of the night, & start each new day exhausted. Constant fatigue can be a critical trigger for depression. 7 or 8 hours of sleep a night is important to your well-being.

• Join an extracurricular activity. Sports, theater, Greek life, the student newspaper - whatever interests you - can bring opportunities to meet people interested in the same things you are & it provides a welcome change from class work.

• Make a friend. Sometimes this may be a roommate or someone you meet in class or in the cafeteria. Friendships can help make a strange place feel more friendly & comfortable.

• Try relaxation methods. These include meditation, deep breathing, warm baths, long walks, exercise - whatever you enjoy that lessens your feelings of stress or discomfort.

• Take time for yourself each day. Make this special time - even if it's only 15 minutes by yourself - a period where you think about your feelings & dreams. Focusing on yourself can be energizing & gives a feeling of purposefulness & control over your life. 

Education: A College Cure?

Universities hope to prevent depression by engaging students.

10/22/03   NHLBI Study Finds Hostility, Impatience Increase Hypertension Risk

BETHESDA, MD (NIH) Impatience & hostility, 2 hallmarks of the "type A" behavior pattern, increase young adults' long-term risk of developing high blood pressure, according to a study funded by the National Heart, Lung, & Blood Institute (NHLBI), part of the National Institutes of Health. Further, the more intense the behaviors, the greater the risk.

However, other psychological & social factors, such as competitiveness, depression & anxiety, didn't increase hypertension risk.

The research appears in the October 22/29, 2003, issue of The Journal of the American Medical Association. It was conducted by scientists at the Northwestern University Feinberg School of Medicine in Chicago, the University of Pittsburgh in PA, the University of Alabama at Birmingham, & the Birmingham Veterans Affairs Medical Center.

The research is the first prospective study to examine as a group the effects of key type A behaviors, depression & anxiety on the long-term risk for high blood pressure. Earlier studies had mostly looked at individual psychological & social behaviors & found conflicting results.

"The notion that a 'type A' behavior pattern is 'bad' for your health has been around for many years," said NHLBI Acting Director Dr. Barbara Alving. "This study helps us understand which aspects of that behavior pattern may be unhealthy.

"High blood pressure is a complicated condition," she continued. "Biological & dietary factors are involved in its development. The study suggests that behavior & lifestyle play a role in preventing & managing the condition."

High blood pressure, also known as hypertension, is a major risk factor for heart disease, kidney disease & congestive heart failure, & the chief risk factor for stroke. Normal blood pressure is a systolic of less than 120 millimeters of mercury (mm Hg) & a diastolic of less than 80 mm Hg; high blood pressure is a systolic of 140 mm Hg or higher, or a diastolic of 90 mm Hg or higher.

About 50 million Americans, 1 in 4, have high blood pressure & its prevalence increases sharply with age: The condition affects about 3% of those ages 18-24 & about 70% of those 75 & older.

"Although high blood pressure is less common among young adults, young adulthood & early middle age is a critical period for the development of hypertension & other risk factors for heart disease," said lead author Dr. Lijing L. Yan, Research Assistant Professor of Preventive Medicine at Northwestern University. "Previous research on young adults is limited, & our study helps to fill that gap."

The study used data from the NHLBI's Coronary Artery Risk Development in Young Adults (CARDIA) study, which involved 3,308 black & white men & women from 4 metropolitan areas (Birmingham, AL, Chicago, IL, Minneapolis, MN, & Oakland, CA). The participants were aged 18-30 at the time of their enrollment in the study. Enrollment took place from 1985 to 1986.

Participants were followed through 2000 or 2001, & had periodic physical examinations, which included blood pressure measurements & self-administered psycho-social questionnaires. 15% of all the participants had developed high blood pressure by ages 33-45.

5 psychological/social factors were assessed:

• time urgency/impatience
• achievement striving/competitiveness
• hostility
• depression
• anxiety

The first 3 are key components of the type A behavior pattern & were assessed at the start of the study; the other 2 behaviors were assessed 5 years later. The factors were assessed by different scales based on the psychosocial instrument used but, in every case, a higher score meant the most intense degree of the behavior.

Time urgency/impatience was rated on a scale from 0 to 3-4. After 15 years, participants w/the highest score of 3-4 had an 84% greater risk of developing high blood pressure & those with the second highest score of 2 had a 47% greater risk, compared w/those w/the lowest score of 0.

Hostility was rated on a score of 0 to 50 & then categorized into quartiles. After 15 years, those in the highest quartile had an 84% higher risk of hypertension & those in the 2nd highest quartile had a 38% higher risk, compared with those in the lowest quartile.

No significant relationship was found for the other factors.

Results were similar for blacks & whites, & were not affected by age, gender, race, blood pressure at the time of enrollment, or education. They also held regardless of the presence of such established hypertension risk factors as:

• overweight/obesity
• alcohol consumption
• physical inactivity

The researchers state that the rise in blood pressure due to psychological & social factors may be caused by a complex set of mechanisms & isn't well understood. For instance, they note that stress could activate the sympathetic nervous system, causing a series of heart & blood vessel repercussions, including narrowing of the blood vessels & an increase in blood pressure.

"This long-term study has given us much-needed information about the effects of psychological & social factors," said Dr. Catherine Loria, CARDIA Project Officer at NHLBI. "But more research must be done on this topic, especially considering the widespread prevalence of high blood pressure in the U.S. and the fast pace of our lives."

For some students, their only source of nutrition comes from vending machines, soda machines & fast food restaurants.

• Most students don't gain the much ballyhooed "freshman 15," but college men gained an average of 5.5 pounds their freshman year & college women gained an average 4.5 pounds.

• 66% of freshmen don't consume the recommended 5 servings of fruits & vegetables a day.

• 50% of all students don't get enough fiber (25 grams a day).

• 60% eat too much artery-clogging saturated fat.

• 30% of women don't get enough calcium.

• 59% say they know their diet has gone downhill since they went to college.

The results are significant because the eating habits men & women develop during their college years often follow them into their 20's & 30's.

They may think their diet is healthier than it is. For instance, during their freshman year, about 1/3 of the students eliminated red meat, but many didn't compensate by eating healthier choices such as legumes, soy products & leafy green vegetables, she says.

Instead, they consumed more baked goods & cheese. As a result, they consume about the same amount of saturated fat as red-meat eaters, Economos says.

Other findings:

• 32% of all students report a decline in their body image during their freshman year.
• 40% of normal weight college women perceive that they are overweight.
• 41% report a decline in their overall feeling of happiness during their freshman year.

10/13/03  Obesity Explodes From Teens To 20's

(USA TODAY) When young people leave the nest to fly on their own, their weight often soars, too. The percentage of people who are obese doubles from the teen years to the mid-20s, according to a study that tracked almost 10,000 people.

About 22% of twentysomethings are obese, which is roughly 30 pounds over a healthy weight. About 1/2 of them were obese as teenagers.

Experts are worried because they say this sudden weight gain sets the stage for serious health problems linked to obesity, including diabetes, heart disease & most types of cancer.

Twentysomethings may be vulnerable to weight gain because "they're going to college, moving, finding jobs, getting married, having babies. It's a jam-packed decade," says lead researcher Penny Gordon-Larsen, an assistant professor of nutrition at the University of North Carolina-Chapel Hill.

"Just like everybody else, they fall prey to giant portion sizes & junk foods. I don't know if they're too busy to exercise or don't have the opportunity to easily exercise in their neighborhoods."

She is presenting her research today in Fort Lauderdale at the annual meeting of the North American Assoc. for the Study of Obesity, co-sponsored by the American Diabetes Association.

For the latest study, Gordon-Larsen & UNC colleagues reviewed the height & weight records of 9,561 people in the National Longitudinal Study of Adolescent Health. Participants, who were ages 13 to 20 when the study started, were weighed & measured until they were 19 to 26.

Researchers found that overall, 27% were overweight & 22% obese by their 20s. About 11% were obese as teenagers at the start of the research & stayed that way, & another 11% became obese during this time period.

Young blacks were found to have the highest obesity rates; Asians had the lowest rates.

Overall, 31% of adults in the USA are obese.

"This is a wake-up call," says George Blackburn, associate director of the division of nutrition at Harvard Medical School. The weight gain has to do with portion sizes & food patterns, he says.

"It has to be something in the environment because the genetics haven't changed that much," he says.

The study emphasizes the needs for as much prevention as possible at an early age to get people on the right path, Gordon-Larsen says.

Young people have to be physically active even though they're busy, she says. "Companies should set up blocks of time during the work day when people can exercise & create places for employees to exercise. Workplace cafeterias need to offer healthy foods at a reasonable price & in reasonable portions.

"Everybody thinks this is a time of peak health, but it's not," Gordon-Larsen says. "Obesity is a problem for this age group."

Copyright 2003 USA TODAY, a division of Gannett Co. Inc.

ANOREXIA NERVOSA:

is a condition that results from self-starvation, often results in a loss of 20-25% of normal weight. Current studies suggest that 90% of those w/anorexia are women, & 10% are men. Characteristics of those suffering from anorexia may include the following:

• intense fear of fat
• distorted body image
• preoccupation w/diets & exercise
• depression & mood disturbances
• & loss of self-esteem

Physical effects may include:

• malnutrition
• loss of hair
• muscle cramps
• dehydration
• kidney impairment
• cessation of menstruation
• infertility 
• in the most severe cases (10%), death

BULIMIA NERVOSA:

is known as the "binge-purge" syndrome in which the person shows a behavior pattern of periodically eating large quantities of food in a relatively short period of time. The binges are followed by purging, in the form of self-induced vomiting, or abuse of laxatives, diet pills, &/or diuretics, excessive exercise, or fasting.

Bulimics are not as readily identifiable as anorexics because they tend to be of average or slightly above average body weight. They are also hard to identify because of the frequently secretive nature of their addiction. Specific medical complications arising from bulimia include:

• tooth and gum decay caused by constant vomiting of stomach acid
• gastrointestinal disturbances
• dehydration
• low potassium levels
• internal bleeding
• cognitive disturbances
• cardiac irregularities
• death

"I Love You!" ... "Then Leave Me Alone!"

Partner 1: "Why don't you ever talk to me?"
Partner 2: "I do talk to you. I talk to you all the time."
Partner 1: "No, you don't! You just don't care about me."
Partner 2: "Leave me alone! Why are you always nagging me?"
Partner 1: "If I didn't nag at you, you would never listen to what I have to say."
Partner 2: Walks away, muttering, "What do you want from me?"

Does this exchange sound familiar? Have you heard yourself, or someone you know, get into such a fruitless conversation? The above scenario is a typical, even stereotypical, exchange between the members of an ongoing relationship who have discovered that the other person's intimacy needs are different from their own. Such differences need not have a serious impact on the quality of a relationship, but they can be fatal if not understood & resolved, at least to some level.

Intimacy can be thought of as a continuum; one pole being total enmeshment (no separation) w/another, the other pole being total isolation from everyone. Obviously neither extreme is desirable, nor is it healthy. Nearly everyone falls somewhere in between these extremes, but that still leaves a lot of room for disagreement.

A person's comfortable level of intimacy is determined by several factors. First, one's culture or ethnicity plays a role. Some cultures as a whole are more emotionally expressive, "warmer" if you will, than others; and likewise some are "cooler." Relationships between partners of different ethnic background can create differences in behavior & expectations.

A second factor is family environment. While certainly affected by culture, each family has its own level of emotional intimacy. An individual coming from a very expressive home may feel quite at home being close to another. On the other hand, a person may react to a family that is too close by withdrawing. Thus, when a relationship gets too intimate for them, they may start an argument or use other means to create some distance between the partners. A family that is too distant can create a need for closeness in a person, becoming demanding when taken to an extreme.

Another factor affecting level of intimacy is past experience. If you or your partner has had a previous relationship that ended badly, the partner involved may feel reluctant to open up again. This situation can often resolve itself with time and the building of trust. However, the partner with higher intimacy needs should be careful not to be too insistent on closeness, if the other partner is not ready. Such insistence could drive the other away.

A fourth factor is gender. While not always the case, women are more frequently desirous of greater intimacy, while men are often looking for more space. While this may in part be biological (caretaker vs. hunter/gatherer), much of this behavior is likely due to the traditional socialization of women to be more relationship focused and men to be more independent.

So, you ask, my partner and I seem to need different levels of intimacy. What can we do about it, so each of us can feel comfortable and satisfied? Several techniques are available. First of all, each of you can examine your own relationships with friends, family, and each other, and then rate yourself on a scale from 1 to 100 on your comfortable level of intimacy. Create a 10 point band on each side (since our needs vary over time) and compare it to your partner's. Chances are there is some overlap. This common area is a place to begin in learning to compromise on the intimacy level in your relationship. Making the numbers as behaviorally explicit as possible is most helpful.

Secondly, notice the patterns in your interactions that draw you closer and drive you away. The example at the beginning of the article showed one partner trying to engage the other, but in actuality ended up driving that person away. One example of a pattern is the "accordion" effect, that is, partners moving toward greater intimacy and then away from each other in a cyclical way. This effect probably occurs in most relationships, and, if understood, need only cause problems if the partners choose to make it into one.

A second pattern is the "distancer-pursuer" interaction. Such a pattern involves one partner always chasing the other, while that person keeps trying to create emotional distance. This pattern is also known as "being attached by a ten-foot pole." The more the pursuer moves toward the distancer, the more the distancer will pull back, thus maintaining the "ten-foot" distance. A third pattern is when one (or both) partners likes a great deal of intimacy for short periods of time, then returning to a less intimate style. Understanding the patterns of your relationship can help you realize that your partner actually does care, despite their apparent "apathy" of the moment, or conversely, their feeling like you are trying to smother them.

The third, perhaps most important, technique is to talk to each other as honestly and directly as possible about your intimacy needs. Your partner may be expressing their love to you in one way, but if you are expecting it in another form, you may not be able to see it. Such a situation can be highly frustrating for both partners, but perhaps most for the "giver," who, if not being understood, may stop giving and just "give up."

When college students are depressed, they may experience other health or mental health problems.  To relieve the misery of depression, some college students turn to drugs or alcohol.  Likewise, when college students abuse alcohol and/or drugs, depression can develop. 

On the surface, it may seem like a good idea to get high, to have fun, to relax, & to escape but the consequences of alcohol & drug abuse soon become apparent in your life.  Like depression, alcohol & drug abuse is serious.  Fortunately, it is also treatable & the key to treatment is to recognize the symptoms & to get help. 

Take a look at this basic information about the connection between alcohol and/or drug abuse & depression.

Here are some questions to ask yourself about your use of alcohol &/or drugs. If you answer "yes" to most of them, then you're probably using too much:

• Is your personality different when you drink or do drugs?
• Do you drink or do drugs to gain courage to face social situations?
• Has your drinking or drug use ever caused you to miss class or appointments?
• Do you use alcohol or drugs as escapes when you are upset?
• Is it hard for you to stop drinking after you have 1 or 2 drinks?
• Do you always end up drunk, once you start drinking?
• Have you tried, & failed, to drink less alcohol or drink none at all?
• Have you tried & failed to cut down or stop using illicit drugs?
• Do you sometimes have trouble remembering what you did while under the influence of alcohol or other drugs?  Do you regret doing some of the things you do remember?
• Have friends or family members tried to express their concern about your drinking or drug use?
• Has your class work suffered because of your drinking or drug use?
• Have you needed a drink in the morning to get going after a night of heavy drinking?

The Problem of Suicide

• In 1998, suicide was the 8th leading cause of death for all Americans, the 3rd leading cause of death for those aged 15-24, & the 2nd leading killer in the college population.
• These statistics demonstrate the seriousness of suicide, which is often linked to untreated depression.  Clinical depression affects more than 19 million adults every year.
• Although women suffer from clinical depression & attempt suicide more than men, men are more likely to complete the act. Any talk of suicide by a friend or loved one should be taken seriously & help should be sought immediately.

Depression & suicide have many common warning signs including:

• Sadness or anxiety
• Feelings of guilt, helplessness or hopelessness
• Trouble eating or sleeping
• Withdrawing from friends &/or social activities
• Loss of interest in hobbies, work, school, etc.
• Increased use of alcohol or drugs