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Essays About Depression

Depression essay topic examples.

Explore topics like the impact of stigma on depression, compare it across age groups or in literature and media, describe the emotional journey of depression, discuss how education can help, and share personal stories related to it. These essay ideas offer a broad perspective on depression, making it easier to understand and engage with this important subject.

Argumentative Essays

Argumentative essays require you to analyze and present arguments related to depression. Here are some topic examples:

• 1. Argue whether mental health stigma contributes to the prevalence of depression in society.
• 2. Analyze the effectiveness of different treatment approaches for depression, such as therapy versus medication.

Example Introduction Paragraph for an Argumentative Essay: Depression is a pervasive mental health issue that affects millions of individuals worldwide. This essay delves into the complex relationship between mental health stigma and the prevalence of depression in society, examining the barriers to seeking help and the consequences of this stigma.

Example Conclusion Paragraph for an Argumentative Essay: In conclusion, the analysis of mental health stigma's impact on depression underscores the urgent need to challenge and dismantle the stereotypes surrounding mental health. As we reflect on the far-reaching consequences of stigma, we are called to create a society that fosters empathy, understanding, and open dialogue about mental health.

Compare and Contrast Essays

Compare and contrast essays enable you to examine similarities and differences within the context of depression. Consider these topics:

• 1. Compare and contrast the symptoms and risk factors of depression in adolescents and adults.
• 2. Analyze the similarities and differences between the portrayal of depression in literature and its depiction in modern media.

Example Introduction Paragraph for a Compare and Contrast Essay: Depression manifests differently in various age groups and mediums of expression. This essay embarks on a journey to compare and contrast the symptoms and risk factors of depression in adolescents and adults, shedding light on the unique challenges faced by each demographic.

Example Conclusion Paragraph for a Compare and Contrast Essay: In conclusion, the comparison and contrast of depression in adolescents and adults highlight the importance of tailored interventions and support systems. As we contemplate the distinct challenges faced by these age groups, we are reminded of the need for age-appropriate mental health resources and strategies.

Descriptive Essays

Descriptive essays allow you to vividly depict aspects of depression, whether it's the experience of the individual or the societal impact. Here are some topic ideas:

• 1. Describe the emotional rollercoaster of living with depression, highlighting the highs and lows of the experience.
• 2. Paint a detailed portrait of the consequences of untreated depression on an individual's personal and professional life.

Example Introduction Paragraph for a Descriptive Essay: Depression is a complex emotional journey that defies easy characterization. This essay embarks on a descriptive exploration of the emotional rollercoaster that individuals with depression experience, delving into the profound impact it has on their daily lives.

Example Conclusion Paragraph for a Descriptive Essay: In conclusion, the descriptive portrayal of the emotional rollercoaster of depression underscores the need for empathy and support for those grappling with this condition. Through this exploration, we are reminded of the resilience of the human spirit and the importance of compassionate understanding.

Persuasive Essays

Persuasive essays involve arguing a point of view related to depression. Consider these persuasive topics:

• 1. Persuade your readers that incorporating mental health education into the school curriculum can reduce the prevalence of depression among students.
• 2. Argue for or against the idea that employers should prioritize the mental well-being of their employees to combat workplace depression.

Example Introduction Paragraph for a Persuasive Essay: The prevalence of depression underscores the urgent need for proactive measures to address mental health. This persuasive essay asserts that integrating mental health education into the school curriculum can significantly reduce the prevalence of depression among students, offering them the tools to navigate emotional challenges.

Example Conclusion Paragraph for a Persuasive Essay: In conclusion, the persuasive argument for mental health education in schools highlights the potential for early intervention and prevention. As we consider the well-being of future generations, we are called to prioritize mental health education as an essential component of a holistic education system.

Narrative Essays

Narrative essays offer you the opportunity to tell a story or share personal experiences related to depression. Explore these narrative essay topics:

• 1. Narrate a personal experience of overcoming depression or supporting a loved one through their journey.
• 2. Imagine yourself in a fictional scenario where you advocate for mental health awareness and destigmatization on a global scale.

Example Introduction Paragraph for a Narrative Essay: Personal experiences with depression can be transformative and enlightening. This narrative essay delves into a personal journey of overcoming depression, highlighting the challenges faced, the support received, and the lessons learned along the way.

Example Conclusion Paragraph for a Narrative Essay: In conclusion, the narrative of my personal journey through depression reminds us of the resilience of the human spirit and the power of compassion and understanding. As we reflect on our own experiences, we are encouraged to share our stories and contribute to the ongoing conversation about mental health.

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Depression, known as major depressive disorder or clinical depression, is a psychological condition characterized by enduring feelings of sadness and a significant loss of interest in activities. It is a mood disorder that affects a person's emotional state, thoughts, behaviors, and overall well-being.

Its origin can be traced back to ancient civilizations, where melancholia was described as a state of sadness and melancholy. In the 19th century, depression began to be studied more systematically, and terms such as "melancholic depression" and "nervous breakdown" emerged. The understanding and classification of depression have evolved over time. In the early 20th century, Sigmund Freud and other psychoanalysts explored the role of unconscious conflicts in the development of depression. In the mid-20th century, the Diagnostic and Statistical Manual of Mental Disorders (DSM) was established, providing a standardized criteria for diagnosing depressive disorders.

Biological Factors: Genetic predisposition plays a role in depression, as individuals with a family history of the disorder are at a higher risk. Psychological Factors: These may include a history of trauma or abuse, low self-esteem, pessimistic thinking patterns, and a tendency to ruminate on negative thoughts. Environmental Factors: Adverse life events, such as the loss of a loved one, financial difficulties, relationship problems, or chronic stress, can increase the risk of depression. Additionally, living in a socioeconomically disadvantaged area or lacking access to social support can be contributing factors. Health-related Factors: Chronic illnesses, such as cardiovascular disease, diabetes, and chronic pain, are associated with a higher risk of depression. Substance abuse and certain medications can also increase vulnerability to depression. Developmental Factors: Certain life stages, including adolescence and the postpartum period, bring about unique challenges and changes that can contribute to the development of depression.

Depression is characterized by a range of symptoms that affect an individual's emotional, cognitive, and physical well-being. These characteristics can vary in intensity and duration but generally include persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities once enjoyed. One prominent characteristic of depression is a noticeable change in mood, which can manifest as a constant feeling of sadness or emptiness. Individuals may also experience a significant decrease or increase in appetite, leading to weight loss or gain. Sleep disturbances, such as insomnia or excessive sleepiness, are common as well. Depression can impact cognitive functioning, causing difficulties in concentration, decision-making, and memory recall. Negative thoughts, self-criticism, and feelings of guilt or worthlessness are also common cognitive symptoms. Furthermore, physical symptoms may arise, including fatigue, low energy levels, and a general lack of motivation. Physical aches and pains, without an apparent medical cause, may also be present.

The treatment of depression typically involves a comprehensive approach that addresses both the physical and psychological aspects of the condition. It is important to note that the most effective treatment may vary for each individual, and a personalized approach is often necessary. One common form of treatment is psychotherapy, which involves talking to a mental health professional to explore and address the underlying causes and triggers of depression. Cognitive-behavioral therapy (CBT) is a widely used approach that helps individuals identify and change negative thought patterns and behaviors associated with depression. In some cases, medication may be prescribed to help manage depressive symptoms. Antidepressant medications work by balancing neurotransmitters in the brain that are associated with mood regulation. It is crucial to work closely with a healthcare provider to find the right medication and dosage that suits an individual's needs. Additionally, lifestyle changes can play a significant role in managing depression. Regular exercise, a balanced diet, sufficient sleep, and stress reduction techniques can all contribute to improving mood and overall well-being. In severe cases of depression, when other treatments have not been effective, electroconvulsive therapy (ECT) may be considered. ECT involves administering controlled electric currents to the brain to induce a brief seizure, which can have a positive impact on depressive symptoms.

1. According to the World Health Organization (WHO), over 264 million people worldwide suffer from depression, making it one of the leading causes of disability globally. 2. Depression can affect people of all ages, including children and adolescents. In fact, the prevalence of depression in young people is increasing, with an estimated 3.3 million adolescents in the United States experiencing at least one major depressive episode in a year. 3. Research has shown that there is a strong link between depression and other physical health conditions. People with depression are more likely to experience chronic pain, cardiovascular diseases, and autoimmune disorders, among other medical conditions.

The topic of depression holds immense significance and should be explored through essays due to its widespread impact on individuals and society as a whole. Understanding and raising awareness about depression is crucial for several reasons. Firstly, depression affects a significant portion of the global population, making it a pressing public health issue. Exploring its causes, symptoms, and treatment options can contribute to better mental health outcomes and improved quality of life for individuals affected by this condition. Additionally, writing an essay about depression can help combat the stigma surrounding mental health. By promoting open discussions and providing accurate information, essays can challenge misconceptions and foster empathy and support for those experiencing depression. Furthermore, studying depression allows for a deeper examination of its complex nature, including its psychological, biological, and sociocultural factors. Lastly, essays on depression can highlight the importance of early detection and intervention, promoting timely help-seeking behaviors and reducing the burden of the condition on individuals and healthcare systems. By shedding light on this critical topic, essays have the potential to educate, inspire action, and contribute to the overall well-being of individuals and society.

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. 2. World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. World Health Organization. 3. Kessler, R. C., Bromet, E. J., & Quinlan, J. (2013). The burden of mental disorders: Global perspectives from the WHO World Mental Health Surveys. Cambridge University Press. 4. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press. 5. Nierenberg, A. A., & DeCecco, L. M. (2001). Definitions and diagnosis of depression. The Journal of Clinical Psychiatry, 62(Suppl 22), 5-9. 6. Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). Journal of Clinical Psychiatry, 76(2), 155-162. 7. Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry, 58(7), 376-385. 8. Hirschfeld, R. M. A. (2014). The comorbidity of major depression and anxiety disorders: Recognition and management in primary care. Primary Care Companion for CNS Disorders, 16(2), PCC.13r01611. 9. Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., ... & Fava, M. (2006). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. American Journal of Psychiatry, 163(11), 1905-1917. 10. Kendler, K. S., Kessler, R. C., Walters, E. E., MacLean, C., Neale, M. C., Heath, A. C., & Eaves, L. J. (1995). Stressful life events, genetic liability, and onset of an episode of major depression in women. American Journal of Psychiatry, 152(6), 833-842.

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Home / Parenting, Kids & Teens / Depression in college students: How to help students manage their mental health

Depression in college students: How to help students manage their mental health

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Parents hope college will be a time for their kids to spread their wings and fly. Yet college students are now experiencing record high rates of depression and anxiety. During the 2022-2023 academic year, 41% of students reported experiencing symptoms of depression and 36% said they experienced anxiety, according to the latest Healthy Minds Study . Understandably, parents want to know what they can do to help their college age kids manage their mental health so depression doesn’t dock their wings.

Any single case of depression can have multiple causes involving a mix of biological, genetic or social factors. However, one common cause of depression in college students is the sheer scope of change that comes with moving on from the familiar world of home and high school, according to Paige I. Partain, M.D., a pediatrician at the Mayo Clinic Children’s Center in Rochester, Minnesota, with expertise in child and adolescent mental health.

In addition to changes in housing and social connections, going to college typically accelerates academic expectations. It also scrambles students’ sleep, diet and exercise patterns. For some college students — even those with no history of depression — having so many facets of their lives suddenly challenged and changed can create enough stress to trigger depression, says Dr. Partain

She adds, however, that it’s important “for parents and students alike to recognize that depression can be totally untriggered.” Sometimes students can be on top of their coursework, getting along with new friends and otherwise outwardly crushing college when they sense that their moods have dipped.

If students are baffled about why they’re feeling down, helping them understand that sometimes depression occurs without an identifiable cause is important. It can help relieve the added burden of wondering what’s wrong with them — or blaming themselves — for feeling depressed.

Says Dr. Partain, “I can’t express enough what a difference it makes when I’m talking to teenagers or young adults in their early twenties and I can explain that sometimes it just happens. It can be even more frustrating when you don’t know why depression happens. But I can see the relief in their eyes. They’re like, ‘Yes, you get it.’ To be able to just empathize and label the phenomena can be incredibly powerful.”

Spotting signs of depression in college students

Along with feeling sad and down, common signs of depression in college kids include:

• Changes in appetite such as eating more or less than usual.
• Sleep disturbances, such as insomnia or sleeping too much.
• Losing in interest in favorite pastimes including playing sports, making art or hanging out with friends. “Isolation is a really key symptom, particularly for teens and young adults,” says Dr. Partain.

People often experience depression and anxiety at the same time , and college kids are no exception. Determining which one came first can be a “chicken or the egg” question, says Dr. Partain. But big shifts in a student’s mood and behavior may indicate underlying depression.

“If your kid is not one who tends to be anxious, and all of a sudden, there’s worry about everything, that might be an indicator of a problem with mood.” On the flip side, she says, if your kid is usually “a type-A go-getter, and normally a little more anxious, and all of a sudden the work isn’t getting done and grades are slipping, that can also be an indicator that there’s a problem with mood.”

Irritability is another common symptom of depression. “We think a lot about feeling sad or down, and that can certainly be the case for a teenager or a young adult. But there is good medical research to suggest that irritability might be an even better indicator of underlying mood problems,” says Dr. Partain. “It’s another textbook symptom to be aware of.”

What to say if your child seems depressed

Sometimes, parents who think their kids might be depressed are wary of butting into their business. Or they may keep quiet because they’re just not sure how to talk about depression. If parents ask Dr. Partain if they should try talking to their child’s friends or professors about their concerns, she advises them not to go around their child’s back.

Rather, Dr. Partain recommends that parents raise their concerns with their kids in a straightforward way. “As you’re trying to help children develop independence and capability — regardless of the dynamic that you have with your child — I advocate for talking with kids directly.”

To get a better sense of how children are feeling, Dr. Partain says it’s fine to initiate the conversation by text with a simple message like this: Just checking in to say I love you. How are you doing? I want to make sure you’re doing okay.

Let them know that you’re concerned and let them respond in their own time.

If your child shares feelings of being depressed or anxious, make it clear that you’re available to help in whatever way works. “You can ask, ‘Do you want my help, or is this something you want to take care of on your own?’ The biggest thing to avoid is invalidating language: ‘You’ll get over it.’ ‘Going to college is just hard,’ ” says Dr. Partain. “Parents might find a slightly different approach for every kid, but they should feel empowered to speak up because parents can play a powerful role in helping children understand what they’re experiencing.”

Help your college kid develop strategies to cope with depression

With college students experiencing depression or anxiety for the first time, parents can share self-care strategies that have been proved to ease symptoms of depression, including:

• Exercising .
• Connecting with friends.
• Eating healthy foods.
• Spending time in nature.
• Getting adequate sleep, as young adults need between seven and nine hours a night
• Finding a community on campus, whether it be with a group of fellow ultimate Frisbee fans or a religious or political organization.

If students are experiencing any kind of acute or prolonged dip in mood, their parents can also encourage them to seek treatment and help them navigate campus mental health resources. As students’ mental health becomes a central part of the conversation on college and university campuses, Dr. Partain says that more schools are preemptively providing students and parents with information about counseling and medical services.

“I encourage all parents to keep that information handy,” she says. “Even if you have a kid who’s done great and never had difficulty with mental health, it’s helpful to know about available resources, so if your child reaches the point of saying, ‘Mom, Dad, what do I do?’ you can help provide answers.”

Parents can also provide important support to students who have a history of depression, Dr. Partain says. If your child is taking an antidepressant, you can ask the healthcare professional to dispense the prescription in a 90-day supply, with refills that can be obtained at a pharmacy near campus.

As students in Dr. Partain’s care are preparing to transition to college, she has a conversation with them about their specific symptoms of depression. She also reviews the self-care strategies that have helped them feel better in the past. “Depression looks different for everyone, and it’s important for students to do the mental exercise of saying, What does it look like for me? Is it that I’m isolating myself? Is it that I’m less talkative? Is it that I’m more irritable? Is it that I don’t enjoy reading anymore?” says Dr. Partain.

The point of the conversation is to help students become more self-aware about what depression looks like for them, and spot early warning signs so they can act quickly to protect their emotional health. She encourages parents and children to have a version of this conversation together, too, and to develop a shared relapse prevention plan.

Then, if students begin to feel depression coming back while they’re away at college, their parents can reinforce whatever self-care strategies have helped get through rough patches before. For students already seeing therapists, noticing an uptick in symptoms can prompt them to reach out to ask for some extra sessions, with help from parents if needed.

“Almost all therapy providers have the ability to treat people who are in crisis or who feel like they’re significantly worsening. The same goes for healthcare professionals if students are on a medication. If I get a message from a college kid saying, ‘My mood is getting a lot worse,’ I’m going to get them seen within a week, and many other healthcare professionals will too,” says Dr. Partain.

Create a crisis plan

If students have had inpatient treatment or thoughts of suicide in any context in the past, it’s also critically important for them and their parents to have shared emergency safety plans. This can be activated if students ever becomes severely distressed again.

“Sometimes, depending on the family dynamic, the safety plan may not include having the child call the parent. The plan for the child may be calling Aunt Jane, or calling Grandma. But it’s really powerful for the parents to be able to reinforce that and say, ‘That’s OK. I want you to be safe,’ ” says Dr. Partain.

A common worry she hears from parents is that discussing suicide may make it more likely that their child will contemplate or attempt suicide. But, she says, there’s no data showing that talking about suicide makes people more likely to attempt it. In fact, it does the opposite : “Talking about it makes it easier for them to seek help in the moment. The way I phrase it to my patients is, ‘I’m really glad that you’re not having those kinds of thoughts. But I know things can change quickly, and this safety plan is just something we want to have in our back pocket.” Parents don’t have to hammer on the subject,” she adds, “but it’s an important conversation to have, and I wouldn’t avoid it.”

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Influencing factors, prediction and prevention of depression in college students: A literature review

Xin-qiao liu.

School of Education, Tianjin University, Tianjin 300350, China. nc.ude.ukp@uiloaiqnix

School of Education, Tianjin University, Tianjin 300350, China

Wen-Jie Zhang

Graduate School of Education, Peking University, Beijing 100871, China

Wen-Juan Gao

Institute of Higher Education, Beihang University, Beijing 100191, China

Corresponding author: Xin-Qiao Liu, PhD, Associate Professor, School of Education, Tianjin University, No. 135 Tongyan Road, Jinnan District, Tianjin 300350, China. nc.ude.ukp@uiloaiqnix

The high prevalence of depression among college students has a strong negative impact on individual physical and mental health, academic development, and interpersonal communication. This paper reviewed the extant literature by identifying nonpathological factors related to college students' depression, investigating the methods of predicting depression, and exploring nonpharmaceutical interventions for college students' depression. The influencing factors of college students' depression mainly fell into four categories: biological factors, personality and psychological state, college experience, and lifestyle. The outbreak of coronavirus disease 2019 has exacerbated the severity of depression among college students worldwide and poses grave challenges to the prevention and treatment of depression, given that the coronavirus has spread quickly with high infection rates, and the pandemic has changed the daily routines of college life. To predict and measure mental health, more advanced methods, such as machine algorithms and artificial intelligence, have emerged in recent years apart from the traditional commonly used psychological scales. Regarding nonpharmaceutical prevention measures, both general measures and professional measures for the prevention and treatment of college students' depression were examined in this study. Students who experience depressive disorders need family support and personalized interventions at college, which should also be supplemented by professional interventions such as cognitive behavioral therapy and online therapy. Through this literature review, we insist that the technology of identification, prediction, and prevention of depression among college students based on big data platforms will be extensively used in the future. Higher education institutions should understand the potential risk factors related to college students' depression and make more accurate screening and prevention available with the help of advanced technologies.

Core Tip: This study reviewed the extant literature by identifying nonpathological factors related to college students' depression, investigating the methods of predicting depression, and exploring nonpharmaceutical interventions for depression among college students. The influencing factors can be categorized into students’ demographic characteristics, college experience, lifestyle, and social support. For the prediction of depression, methods such as machine algorithms and artificial intelligence have been employed together with the traditional psychological scales. This study summarizes general and professional measures that can be taken for the prevention and treatment of college students' depression.

INTRODUCTION

The prevalence of depression among college students has gradually increased in recent years, even exceeding that of the general public, which has become a global phenomenon[ 1 ]. Mounting research has focused on the topic, and the consensus is that the high prevalence of depression among college students cannot be ignored. For instance, in Asia, a follow-up survey and analysis based on 1401 undergraduates in China over four consecutive years showed that approximately 20% to 40% of undergraduates suffered from depression, anxiety and stress to different degrees, and approximately 35% of them had higher depression levels than the normal population[ 2 ]. An online survey based on 7915 freshmen students at Hong Kong University in China showed that 21%, 41% and 27% of individuals had moderate or higher levels of depression, anxiety and stress, respectively, far exceeding the average in the general population[ 3 ]. The median prevalence rate for depression among 15859 college students in six ASEAN countries (Cambodia, Laos, Malaysia, Myanmar, Thailand and Vietnam) was 29.4%, and 7% to 8% of students committed suicide; despite the high prevalence of mental illness, their willingness to seek professional help was relatively low[ 4 ]. Among 642 college students in Saudi Arabia, the proportions of moderate depression, anxiety and stress were 53.6%, 65.7% and 34.3%, respectively[ 5 ]. In Africa, among 1206 Nigerian college students, 5.6% had mild depression, and 2.7% suffered severe depressive disorder[ 6 ]. In North America, 53% of 1455 American college students reported that they had experienced depression since the beginning of college, and 9% said they had considered suicide since the beginning of college[ 7 ]. Thirty percent of 7800 Canadian undergraduates reported that their psychological stress increased, and the degree of depression was significantly higher than that of the general population[ 8 ]. In Europe, more than one-third of college students from three higher education institutions in the United Kingdom suffered from long-term mental health diseases, the prevalence rate of which was higher than the average level of national surveys, and the scores of the eight dimensions of mental health, measured by the MOS 36-item short-form health survey, were all significantly lower than those of local peers aged 18 to 34[ 9 ]. In Oceania, 21.8% of 751 Australian college students reported depression, and their depression scores were higher than the standard scores of the general Australian population[ 10 ].

The global outbreak of the coronavirus disease 2019 (COVID-19) pandemic in 2020 brought in additional pressure and challenges for the prevention and treatment of depression among college students. Many reports worldwide voiced that college students had a greater probability of struggling with higher levels of depression after the pandemic. The data show that after the outbreak of the pandemic, acute stress, anxiety, and depressive symptoms were widespread among Chinese college students, and the incidence rate was significantly higher than before[ 11 ]. The prevalence rates of moderate depression and suicide-related symptoms among 212 Japanese college students were 11.7% and 6.7%, respectively[ 12 ]. Among 2031 American college students, 48.14% suffered from moderate to severe depression, 38.48% experienced moderate to severe anxiety, 18.04% had suicidal thoughts, and 71.26% reported that their stress/anxiety levels increased during the pandemic[ 13 ]. More than a quarter of Swiss university students had depressive symptoms during the pandemic, which was much higher than that of the general population and higher than that before the pandemic[ 14 ].

The transition from high school to university is full of tension and adaptation. It is a critical period for the shift from late adolescence to adulthood or emerging adulthood, which is neither adolescence nor young adulthood but theoretically and empirically distinct from both periods[ 15 ]. Arnett stressed that this is a stage full of self-exploration, instability, possibility, self-focus, and something in between[ 16 ]. At this phase, individuals will face the challenges of identity and role transformation and more diversification and complexity from families and institutions. Specifically, compared with middle schools, universities put forward higher requirements for freshmen's independence and self-regulation, such as the independence of living in a new place, the autonomy of learning patterns, and the complexity of social networks. However, confronted with these challenges, college students entering the campus for the first time often wander between independence and dependence. On the one hand, they are eager to enjoy new freedoms; on the other hand, it is difficult to eliminate their attachment and economic dependence on their parents; thus, they are often in a state of "pseudo independence"[ 17 ].

In summary, compared with teenagers and adults, college students are the key group at significantly higher risk of poor mental health. A series of factors, including family, college, studies, and social interactions, are likely to induce college students' depression. However, few publications have reviewed the literature on risk factors for college students’ depression. Given that most studies examined individual risk factors based on samples from a certain country or region, this paper reviewed the extant literature related to college students' depression and aimed to systematically present the nonpathological factors, predictions and nonpharmaceutical interventions for college students' depression to provide a reference for stakeholders worldwide.

NONPATHOLOGICAL INFLUENCING FACTORS OF DEPRESSION

The related factors can be roughly divided into four categories: biological factors, personality and psychological state, college experience, and lifestyle. The literature review presented the specific risk factors under four categories in Table ​ Table1. 1 . Subsequently, this paper explained certain factors with controversial research conclusions.

Factors related to depression in college students

Some studies have asserted that the risk of depression in female college students is significantly higher than that in male students[ 24 , 26 , 40 , 41 ]. The possible mechanism lies in physiological differences between the sexes (such as genetic vulnerability, hormone, and cortisol levels), differences in self-concept, and different role expectations from society leading to different emotional responses and behavior patterns. Females are more likely to internalize their negative feelings, whereas males resort to externalizing behaviors such as smoking and alcoholism[ 42 - 44 ]. However, some analyses did not find significant sex differences[ 28 , 45 , 46 ]. Other studies have shown that men have a higher prevalence of depression[ 20 , 47 ]. This may be ascribed to their conservative attitudes toward mental health counseling and treatment under certain social expectations. For instance, women are more help-seeking than men and therefore tend to have more diagnoses and treatment. In particular, gregarious women are more likely to discuss their difficulties with others, such as family and friends, as a form of coping. Nevertheless, considering that societal expectations for men might be different, with those who express vulnerable emotions being regarded as weak, the depressive symptoms of men may manifest as anger and excessive indulgence in smoking and drinking, which are more acceptable masculine expressions in society[ 43 , 44 ].

Year of study

Most studies have found significant differences in the depression level of college students in different years of their education, although some found the difference to be insignificant[ 28 ]. Some research has suggested that undergraduates with lower grades suffer more from depression, which can be attributed to separation from relatives and friends, social adaptation, academic pressure, and increased investment in social activities. A survey of Chinese students showed that the highest scores for depression, anxiety and stress all appeared in the first three years of college, and students’ mental health status was relieved in the fourth year with the passage of time[ 48 ]. A survey of medical students in Saudi Arabia found that students' depression levels continued to rise from the first year of enrollment, reached maximum intensity in the third year, and then dropped significantly with graduation in the last year[ 22 ]. However, other studies found that compared with other undergraduates, senior students had a higher risk of depression. The graduation year is a critical period for individuals to further their studies or go into society, and students are faced with many new stressors, such as graduation pressure, pressure from grades and applications to other institutions, difficulties in future career planning and employment discrimination in the labor market[ 49 ]. Compared with undergraduates, postgraduates may be exposed to greater pressure in obtaining financial security, stable employment, getting married and other aspects of life, which results in a higher risk of depression[ 19 , 41 ].

The depression issues of college students can largely be attributed to their lifestyles. First, the lack of regular physical activities increases the risk of depression[ 11 , 14 ], particularly for individuals whose amount of weekly physical activity fails to meet the standards of the World Health Organization[ 20 ]. Second, substance abuse, such as excessive smoking, alcohol abuse[ 6 , 12 , 21 ], or alcohol intake[ 33 ], can cause depressive disorders, and it should be noted that their relationship might be bidirectional. Studies have shown that individuals with depression are more likely to drink obsessively to relieve their negative emotions due to their poor self-control, which will in turn trap them in a vicious cycle between excessive drinking and depressive disorders[ 32 ]. Third, unhealthy sleeping habits such as daytime sleepiness[ 20 , 34 ], poor sleep quality[ 21 ], and short[ 35 ] or long sleep duration[ 10 ] may lead to depressive symptoms. Fourth, unhealthy nutritional habits are also among the crucial factors that are strongly correlated with depression[ 36 ]. From the perspective of dietary structure and nutritional habits, individuals with depression often report excessive intake of high-fat snacks and margarine/butter/meat fat and inadequate intake of fruits, vegetables, and lean protein[ 30 ]. Overeating[ 14 ] and skipping breakfast[ 10 ], especially for males, are also related to depressive disorders.

Network usage

Relevant studies have indicated that depression in college students is associated with their time spent on the internet[ 50 , 51 ]. Those who suffer from internet addiction and dependence are more likely to struggle with depression[ 52 ], and phubbing (a portmanteau of the words “phone” and “snubbing”) has been proven to be a mediator of the relationship between depression and problematic internet use[ 53 ], mainly focusing on social networking and entertainment[ 54 ].

Social software

Some researchers believe that social software, as a complementary mode of providing social support, can provide more help for people with low social support, thus reducing the occurrence of depression[ 55 ]. However, there is increasing recognition that social networks, especially the excessive use of social media, are closely related to depression[ 56 - 60 ]. Regarding the possible contributing factors, first, individuals who frequently use social software are more likely to have a fear of missing out, and they are always worried that they will miss some important information if they do not refresh the social platform dynamics frequently. This persistent social anxiety will increase the risk of depression[ 61 ]. Second, college students who are addicted to social media are more likely to have a comparison mentality when checking the status updates of others on social network platforms, especially when they feel that others' lives are better than their own, which can result in symptoms of depression[ 62 ]. Third, it is quite impossible for those who struggle with depressive disorders to establish satisfactory interpersonal relationships in virtual space since they usually maintain poor relationships in the real world. The lack of expected support from social networks undoubtedly aggravates their depression[ 63 ].

In addition, because the COVID-19 pandemic has aggravated the depression of college students worldwide, we further analyzed the influencing factors of college students' depression against the background of the COVID-19 pandemic, apart from the general factors mentioned above: (1) Given that COVID-19 is highly contagious and uncertain, the higher risk of becoming infected with COVID-19 is closely related to individuals’ level of depression. Research has indicated that individuals who live in high-risk areas for COVID-19, have close contact with the COVID-19 virus, or have acquaintances or relatives infected with COVID-19[ 19 , 41 ] often have a higher prevalence of depression; (2) Considering that the internet serves as the main channel for college students to obtain information about COVID-19, those who browse the internet for a short time will not suffer from too much anxiety because of the small amount of information they receive. Meanwhile, students surfing the internet for a long time will be able to obtain more accurate details about COVID-19, which can prevent misunderstanding relevant information. Nevertheless, individuals with shorter browsing times often have a higher risk for depression given that they may be easily misled by the rumors and have limited time to verify the authenticity of relevant information[ 64 ]; (3) Academic stress increases the degree of depression of college students with the closure of schools, the challenges of online courses and the risk of graduation delay[ 13 , 65 ]; (4) Financial pressures include the impact of the pandemic on family economic resources[ 49 ] and the increasing uncertainty of individuals about future employment[ 13 ]; (5) Environmental changes, home study, self-isolation, isolation from relatives and friends, decreased exercise frequency, uncertainty of school reopening, regular temperature measurement, wearing masks for a long time, cancellation of package deliveries and take-out supplies and other forced changes in daily study and living habits all increase the risk of depression among college students[ 13 , 49 ]; (6) There is less family support, social support and deteriorating family relations[ 65 ]; and (7) Social confidence wanes. Research has shown that the prevalence of depression also increases when individuals lack confidence in the government[ 66 ].

PREDICTING DEPRESSION

Traditional depression prediction methods are based on various self-rated psychological scales, such as the 21-item depression, anxiety and stress scale (DASS-21) and the self-rating depression scale (SDS). A growing body of research on the reliability and validity of the DASS-21 scale has been published from throughout the world (such as in Britain, Portugal, The Netherlands, Italy, the United States, and Nepal), all of which show that the DASS-21 is a mature tool that can accurately measure the symptoms of depression, anxiety and stress in adult clinical and nonclinical samples and identify and screen people at high risk of depression[ 67 - 70 ]. Similar to the DASS-21, the prediction reliability and validity of the SDS scale for depression have also been confirmed and recognized by relevant studies[ 71 - 73 ]. These are screening tools, and when elevated scores are detected, further evaluation is needed by a clinician. Moreover, the measurement often needs to rely on the patient's own active consultation and cooperation, which is costly, time-consuming, and inaccurate, and there is a risk of social stigma for patients. In recent years, with the progress of science and technology, a series of more advanced methods of depression risk prediction and identification, such as machine learning and artificial intelligence, has emerged, which can deeply learn all types of social and behavioral characteristics of people with potential mental illness risk based on big data and then accurately simulate, identify and predict who they are. Typical methods include support vector machines, decision trees, naïve Bayes classifiers, K-nearest neighbor classifiers and logistic regression[ 74 ]. More specifically, support vector machines are applied to classify handwritten digits and organize cancer tissue samples using microarray expression data[ 75 , 76 ]. Decision trees serve as a hierarchical classifier, employing certain rules to divide the predictor space. The naïve Bayes classifier is based on Bayes’ theorem and is employed to predict class membership probabilities. K-nearest neighbor classifiers are instance-based learning classifiers that compare a new datapoint with the k nearest sample datapoints, regarding the class with the nearest neighbors to the new datapoint as the class of the datapoint. Logistic regression, as a probabilistic linear classifier, directly estimates class probabilities with the logit transform[ 74 ].

The gait feature analysis method based on machine learning has been developed as a supplementary tool to identify depression among college students. Relevant research found that the gait of depressed and nondepressed college students showed significant differences. The specific gait performance of depressed patients included reduced walking velocity, arm swing, vertical head movement and stride length, increased body sway and a slumped head posture. When the above series of features were applied to classifiers with different machine learning algorithms, the accuracy of depression screening and recognition reached 91.58%[ 77 ]. A study collected 121 campus behaviors of college students, including basic personal information, academic achievements, poverty subsidies, consumption habits, daily life, library behaviors, and eating habits, and found that 25 campus behaviors are related to depression, such as failing exams, having bad eating habits, increasing night activities, decreasing morning activities, and seldom participating in social activities (such as eating with friends). On this basis, a depression recognition method was developed by combining machine learning algorithms[ 78 ]. There is also research and development of a machine learning method to identify depression based on college students' smartphone and fitness tracker data ( e.g. , Bluetooth, calls, location, campus map, phone usage, steps, sleep), which extracts many features that can effectively identify depression, such as long-term inactivity and restless sleep at night; the recognition accuracy of this method for college students' depression can reach over 80%[ 79 ].

In addition, it is worth noting that social software has increasingly become a nonpathological risk factor for depression among college students. Addiction to social software is often more likely to induce depression, while college students at high risk of depression are more inclined to vent their negative emotions and relieve stress on various online social platforms. In this way, social network behavior analysis was developed based on machine learning as another effective way to identify and predict depression[ 80 , 81 ]. Through mining, emotion analysis and emotion recognition of personal user information data on social network platforms, we can capture the abnormal behavior patterns of people with depression, among which the most frequently used communication methods are text, emoticons, user log-in information and pictures. The selected research usually uses classic off-the-shelf classifiers to analyze the available information and combines words, such as National Research Council Canada (NRC) Word-Emoticon Association Lexicon, WordNet-Affect, Anew, and Linguistic Inquiry and Word Count tool. It is challenging to analyze the combination of temporal information and different types of information[ 82 ]. For example, some studies have conducted text analysis on the Sina Weibo data of Chinese college students. First, the behavioral differences between depressed and nondepressed individuals in language style, emoji usage, number of Weibos, followers and so on were obtained. Then, a deep neural network was applied to feature extraction and dimension reduction for college students with depression, and input data suitable for the classifier were constructed. Finally, a deeply integrated support vector machine was introduced to classify the input data, and more stable and accurate depression identification was realized[ 83 ]. Some studies collected historical behavior data of American college students using Google search and YouTube during the COVID-19 pandemic and found that there were strong correlations between depression and the following online behavior changes: long use sessions (multiple comprehensive activities with short time intervals), more online activities in the middle of the night or even staying up late, and searching for more authentic and realistic topics related to work, money or death, which verifies the feasibility of building a machine learning model based on individual behavior signals to predict college students' depression[ 84 ].

Generally, machine learning has been widely used in a series of mental health risk predictions about college students' depression, stress[ 85 ] and suicidal behavior[ 86 , 87 ]. Big data brings many benefits to the prediction of psychological states by reducing the subjectivity of human judgment or human operations to a certain extent and relieving the concerns of patients about possible social stigma and discrimination. In other words, big data and machine learning result in no prejudice in predictions. Thus, confirming depression through data and behavioral performance may be the developing trend in identifying and predicting depression among college students and an even broader population in the future. However, issues such as data privacy and data protection are unavoidable. The government needs to set stricter privacy protection policies, while a more extensive collection of personal data needs to be confirmed and approved by the collectors.

NONPHARMACEUTICAL PREVENTION OF DEPRESSION

Both general and professional measures for the prevention and treatment of depression were explored in this study. The former emphasizes the importance of multi-subject participation in the prevention and treatment of depression among college students, while the latter focuses on measures with the theoretical support of professional disciplines such as psychology.

General intervention measures

The general interventions are summarized in Table ​ Table2 2 and can be coarsely categorized into support from family, interventions by colleges and universities, cultivation of personal lifestyles, and resilience therapy.

High level of family support

A high level of family support can be used as a buffer against the influence of a high-stress reaction to prevent the development of depression[ 91 ]. In a study of 62 patients who recovered from depression, a high level of perceived emotional support from their families indicated that family support, especially emotional support, was very important for the relief and even rehabilitation of depression[ 92 ]. However, it should be noted that family support and perfect family functioning depend more on objective characteristics related to family socioeconomic status, such as parents' level of education[ 93 ]. In addition, some studies have found that the role family support plays in the prevention and treatment of depression also depends on the levels of perceived stress reactivity of individuals. Specifically, family emotional support can significantly alleviate the symptoms of depression when the perceived stress reactivity is low, but when the individual shows a high level of the perceived stress response, the effect of family emotional support in preventing depression will be greatly reduced[ 94 ].

The intervention from colleges and universities

Prior literature has shown that the faculties, peers, and social clubs on campus can help alleviate the negative effects of online games on depression. Students may seek social support from their teachers, peers, or psychological counseling centers to prevent addiction to online video games that may lead to depressive disorders[ 38 ]. Therefore, colleges and universities should build mental health services involving faculty, students, and psychological counseling centers. In addition, some studies have indicated that the implementation of related courses and projects in universities, such as resilience programs (including goal-building, mindfulness, and resilience skills), might be effective in improving college students' mental health[ 95 ].

Cultivation of healthy lifestyles

Apart from external support from family and intervention by higher education institutions, the prevention of depression also needs to rely on the patient's own efforts. Studies have shown that healthy lifestyles, including proper physical exercise, healthy sleep and diet, and regular sun exposure, can help prevent or reduce the occurrence of depression in college students[ 96 ]. For instance, students with a consistent sleep schedule and sufficient sleep duration are less likely to suffer from depression. Meanwhile, regular sun exposure aids in the synthesis of vitamin D in the body, which is crucial to release fatigue and change the negative moods that individuals with mild or moderate depression may experience[ 46 ]. Proper physical activities are also important for stress and depression relief among college students[ 97 , 98 ]. Additionally, improving diet and overall nutrition is also an effective way to treat depression[ 99 ]. In particular, eating breakfast on time helps reduce the risk of depression[ 46 ]. Certain nutrients, including zinc, magnesium, B vitamins, and cooking fats, have also been proven to be associated with depressive symptoms[ 100 - 102 ]. Therefore, colleges and universities can help prevent the occurrence of depression in college students by providing a regular diet with an adequate intake of vitamins and nutrients[ 103 ].

Resilience therapy

Some research has shown that resilience therapy can help individuals maintain mental health in the face of negative emotions and stressful events, thereby reducing the occurrence of depression[ 104 ]. Others have also found that it can reduce depressive symptoms by modulating the effects of timing and sleep quality on depression[ 105 ].

Professional intervention measures

Cognitive behavioral therapy, which aims to change individual thoughts and behaviors, has been the most widely used treatment method for depression thus far[ 106 - 110 , 113 - 115 ]. Mindfulness intervention programs[ 111 ] based on cognitive behavioral therapy and dialectal behavior group therapy[ 112 ] can effectively alleviate the depressive symptoms of college students.

In recent years, a growing number of online technologies have been applied to the treatment of depression among college students thanks to the rapid development of internet technology and mobile terminal devices[ 116 - 120 ], and some of the technologies were even skillfully combined with cognitive behavioral therapy[ 121 , 122 ]. For example, there are many apps that incorporate elements of cognitive behavioral therapy and mindfulness. A study from Switzerland revealed that apps such as MoodKit, MoodMission and MoodPrismying can successfully deliver ecological momentary interventions (EMIs) based on cognitive behavioral therapy principles to users through smartphones, thereby improving their well-being and effectively reducing the symptoms of depression. The study also noted that EMI has been generally accepted by users of different ages, sex, educational backgrounds and occupations and is expected to provide scalable global mental health solutions[ 123 ]. Compared with behavioral cognitive therapy and online interventions, the efficacy of traditional educational/personalized feedback interventions in the past has been slightly inferior. Some projects have evaluated the effectiveness of mailing personalized standardized alcohol surveys for college students' depression prevention, but unfortunately, there is no obvious improvement[ 124 ].

LIMITATIONS

Limitations of this study include the following. First, this paper analyzed relevant literature written in English, but research in other languages, such as Chinese, Japanese, German, and Italian, was not included. Second, the paper is a narrative review of extensive studies including the influencing factors, prediction, and prevention of depression in college students. We did not undertake explicit methods such as systematic reviews, nor did we involve substantial clinical results and corroborate the evidence in prior literature such as retrospective reviews. The study merely presents studies in the pertinent field by summarizing their main conclusions, which cannot be directly applied to clinical treatment.

This paper reviewed the extant literature by identifying nonpathological factors related to depression among college students, investigating methods of predicting their depressive symptoms, and summarizing nonpharmaceutical interventions. The nonpathological related factors of college students' depression mainly fell into four categories: biological factors, personality and psychological state, college experience, and lifestyle. The outbreak of COVID-19 exacerbated the severity of depression among college students worldwide and posed grave challenges to the prevention and treatment of depression, given that the coronavirus spread quickly with high infection rates, changing the daily routines of college life and creating financial stress, academic stress, and long-term home isolation. Regarding the prediction of vulnerability to depression, machine algorithms and artificial intelligence based on big data have emerged in addition to the commonly used psychological scales. A series of big data, such as text, pictures, video and audio, based on individual social network behaviors was widely discussed and applied to identify and predict college students' depression. Regarding preventive measures, both general measures and professional interventions were discussed for the prevention and treatment of college students' depression, which required not only help from family, professionals, and institutions (cognitive behavioral therapy and online therapy) and society but also the individuals themselves through the cultivation of healthy habits.

Technology based on the internet and big data platforms will become more widely used in the future to identify, predict, and prevent depression among college students. Higher education institutions should clearly understand the potential risk factors related to college students' depression and employ advanced technology for more accurate screening and prevention. They should also work on increasing access to resources and clinical support considering the common difficulties in making appointments and long-term waits for psychological consultation.

Furthermore, this paper proposed two prospects for the future development of nonpharmaceutical interventions for college students' depression. First, the risk of stigma should be minimized. Many traditional precautionary measures are used to help students identify whether they suffer from depression, including e-mail, posters, campus activities, pamphlets, and first aid training courses about mental health. However, these measures may result in further concerns about the risk of stigmatization and psychological worries of students[ 125 ]. Therefore, in the future, we should avoid stigmatizing issues in the prevention of depression among college students and pay more attention to personalization and privacy in the development and application of precautionary measures. Second, the importance of general measures for the prevention and treatment of college students' depression should be combined with professional interventions such as cognitive intervention therapy and other evidence-based treatment. A meta-analysis showed that apart from cognitive behavioral therapy and mindfulness-based interventions, other measures, such as art, exercise, and peer support, are also effective in relieving depressive symptoms in college students[ 126 ].

ACKNOWLEDGEMENTS

The authors would like to thank Han T for his contribution to the language editing of the first draft of this study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Provenance and peer review: Invited article; Externally peer reviewed.

Peer-review model: Single blind

Peer-review started: February 27, 2022

First decision: April 18, 2022

Article in press: June 22, 2022

Specialty type: Psychiatry

Country/Territory of origin: China

Peer-review report’s scientific quality classification

Grade A (Excellent): 0

Grade B (Very good): B

Grade C (Good): C, C, C

Grade D (Fair): 0

Grade E (Poor): 0

P-Reviewer: Kaur M, United States; Radhakrishnan R, New Zealand; Rose AF, United States; Tanabe S, Japan S-Editor: Gao CC L-Editor: A P-Editor: Gao CC

Contributor Information

Xin-Qiao Liu, School of Education, Tianjin University, Tianjin 300350, China. nc.ude.ukp@uiloaiqnix .

Yu-Xin Guo, School of Education, Tianjin University, Tianjin 300350, China.

Wen-Jie Zhang, Graduate School of Education, Peking University, Beijing 100871, China.

Wen-Juan Gao, Institute of Higher Education, Beihang University, Beijing 100191, China.

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Your chance of acceptance, your chancing factors, extracurriculars, college essay on depression.

I've been dealing with depression for a while and I feel like it's played a big part in shaping who I am today. Is it a good idea to write my college essay about it? Will admissions officers view it negatively? Any insights would be appreciated.

Writing about depression in your college essay can be a powerful and meaningful way to share your personal experiences and reflect on your growth. However, it's essential to approach the topic thoughtfully and carefully, as mental health is a sensitive subject.

1. Focus on growth and resilience: Instead of primarily describing your struggles with depression, emphasize how you've navigated those challenges and grown as a result. Discuss coping strategies, support systems, and other positive changes you've made that have helped you move forward.

2. Show self-awareness: Demonstrate an understanding of your situation and acknowledge your progress, while still recognizing that recovering from depression is an ongoing journey. This can give college admissions officers a sense of maturity and emotional intelligence on your part.

3. Keep it relevant to your college goals: Connect your experiences with depression to your educational and career aspirations. Perhaps overcoming depression has influenced your choice of major, or it has motivated you to engage in volunteer work or other extracurricular activities.

4. Seek feedback from trusted individuals: Ask someone you trust, like a teacher or counselor, to review your essay and provide input. Their perspectives can ensure that you're discussing depression sensitively and that your essay is appropriate for college admissions officers.

5. Be cautious of oversharing: While it's important to be genuine and authentic, avoid revealing deeply personal or disturbing details about your mental health struggles. Some admissions officers may not be comfortable with this level of disclosure, and it could overshadow your accomplishments and other positive aspects of your application.

In summary, writing about depression in your college essay is a personal choice. If you can present your experiences in a thoughtful, growth-focused manner, and connect your journey to your future goals, then it may be a powerful and effective essay topic. However, always consider seeking feedback from trusted individuals to ensure you are addressing the topic appropriately.

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An Exploratory Study of Students with Depression in Undergraduate Research Experiences

• Katelyn M. Cooper
• Logan E. Gin
• M. Elizabeth Barnes
• Sara E. Brownell

*Address correspondence to: Katelyn M. Cooper ( E-mail Address: [email protected] ).

Department of Biology, University of Central Florida, Orlando, FL, 32816

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Biology Education Research Lab, Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ 85281

Depression is a top mental health concern among undergraduates and has been shown to disproportionately affect individuals who are underserved and underrepresented in science. As we aim to create a more inclusive scientific community, we argue that we need to examine the relationship between depression and scientific research. While studies have identified aspects of research that affect graduate student depression, we know of no studies that have explored the relationship between depression and undergraduate research. In this study, we sought to understand how undergraduates’ symptoms of depression affect their research experiences and how research affects undergraduates’ feelings of depression. We interviewed 35 undergraduate researchers majoring in the life sciences from 12 research-intensive public universities across the United States who identify with having depression. Using inductive and deductive coding, we identified that students’ depression affected their motivation and productivity, creativity and risk-taking, engagement and concentration, and self-perception and socializing in undergraduate research experiences. We found that students’ social connections, experiencing failure in research, getting help, receiving feedback, and the demands of research affected students’ depression. Based on this work, we articulate an initial set of evidence-based recommendations for research mentors to consider in promoting an inclusive research experience for students with depression.

INTRODUCTION

Depression is described as a common and serious mood disorder that results in persistent feelings of sadness and hopelessness, as well as a loss of interest in activities that one once enjoyed ( American Psychiatric Association [APA], 2013 ). Additional symptoms of depression include weight changes, difficulty sleeping, loss of energy, difficulty thinking or concentrating, feelings of worthlessness or excessive guilt, and suicidality ( APA, 2013 ). While depression results from a complex interaction of psychological, social, and biological factors ( World Health Organization, 2018 ), studies have shown that increased stress caused by college can be a significant contributor to student depression ( Dyson and Renk, 2006 ).

Depression is one of the top undergraduate mental health concerns, and the rate of depression among undergraduates continues to rise ( Center for Collegiate Mental Health, 2017 ). While we cannot discern whether these increasing rates of depression are due to increased awareness or increased incidence, it is clear that is a serious problem on college campuses. The percent of U.S. college students who self-reported a diagnosis with depression was recently estimated to be about 25% ( American College Health Association, 2019 ). However, higher rates have been reported, with one study estimating that up to 84% of undergraduates experience some level of depression ( Garlow et al. , 2008 ). Depression rates are typically higher among university students compared with the general population, despite being a more socially privileged group ( Ibrahim et al. , 2013 ). Prior studies have found that depression is negatively correlated with overall undergraduate academic performance ( Hysenbegasi et al. , 2005 ; Deroma et al. , 2009 ; American College Health Association, 2019 ). Specifically, diagnosed depression is associated with half a letter grade decrease in students’ grade point average ( Hysenbegasi et al. , 2005 ), and 21.6% of undergraduates reported that depression negatively affected their academic performance within the last year ( American College Health Association, 2019 ). Provided with a list of academic factors that may be affected by depression, students reported that depression contributed to lower exam grades, lower course grades, and not completing or dropping a course.

Students in the natural sciences may be particularly at risk for depression, given that such majors are noted to be particularly stressful due to their competitive nature and course work that is often perceived to “weed students out”( Everson et al. , 1993 ; Strenta et al. , 1994 ; American College Health Association, 2019 ; Seymour and Hunter, 2019 ). Science course instruction has also been described to be boring, repetitive, difficult, and math-intensive; these factors can create an environment that can trigger depression ( Seymour and Hewitt, 1997 ; Osborne and Collins, 2001 ; Armbruster et al ., 2009 ; Ceci and Williams, 2010 ). What also distinguishes science degree programs from other degree programs is that, increasingly, undergraduate research experiences are being proposed as an essential element of a science degree ( American Association for the Advancement of Science, 2011 ; President’s Council of Advisors on Science and Technology, 2012 ; National Academies of Sciences, Engineering, and Medicine [NASEM], 2017 ). However, there is some evidence that undergraduate research experiences can add to the stress of college for some students ( Cooper et al. , 2019c ). Students can garner multiple benefits from undergraduate research, including enhanced abilities to think critically ( Ishiyama, 2002 ; Bauer and Bennett, 2003 ; Brownell et al. , 2015 ), improved student learning ( Rauckhorst et al. , 2001 ; Brownell et al. , 2015 ), and increased student persistence in undergraduate science degree programs ( Jones et al. , 2010 ; Hernandez et al. , 2018 ). Notably, undergraduate research experiences are increasingly becoming a prerequisite for entry into medical and graduate programs in science, particularly elite programs ( Cooper et al. , 2019d ). Although some research experiences are embedded into formal lab courses as course-based undergraduate research experiences (CUREs; Auchincloss et al. , 2014 ; Brownell and Kloser, 2015 ), the majority likely entail working with faculty in their research labs. These undergraduate research experiences in faculty labs are often added on top of a student’s normal course work, so they essentially become an extracurricular activity that they have to juggle with course work, working, and/or personal obligations ( Cooper et al. , 2019c ). While the majority of the literature surrounding undergraduate research highlights undergraduate research as a positive experience ( NASEM, 2017 ), studies have demonstrated that undergraduate research experiences can be academically and emotionally challenging for students ( Mabrouk and Peters, 2000 ; Seymour et al. , 2004 ; Cooper et al. , 2019c ; Limeri et al. , 2019 ). In fact, 50% of students sampled nationally from public R1 institutions consider leaving their undergraduate research experience prematurely, and about half of those students, or 25% of all students, ultimately leave their undergraduate research experience ( Cooper et al. , 2019c ). Notably, 33.8% of these individuals cited a negative lab environment and 33.3% cited negative relationships with their mentors as factors that influenced their decision about whether to leave ( Cooper et al. , 2019c ). Therefore, students’ depression may be exacerbated in challenging undergraduate research experiences, because studies have shown that depression is positively correlated with student stress ( Hish et al. , 2019 ).

While depression has not been explored in the context of undergraduate research experiences, depression has become a prominent concern surrounding graduate students conducting scientific research. A recent study that examined the “graduate student mental health crisis” ( Flaherty, 2018 ) found that work–life balance and graduate students’ relationships with their research advisors may be contributing to their depression ( Evans et al. , 2018 ). Specifically, this survey of 2279 PhD and master’s students from diverse fields of study, including the biological/physical sciences, showed that 39% of graduate students have experienced moderate to severe depression. Fifty-five percent of the graduate students with depression who were surveyed disagreed with the statement “I have good work life balance,” compared to only 21% of students with depression who agreed. Additionally, the study highlighted that more students with depression disagreed than agreed with the following statements: their advisors provided “real” mentorship, their advisors provided ample support, their advisors positively impacted their emotional or mental well-being, their advisors were assets to their careers, and they felt valued by their mentors. Another recent study identified that depression severity in biomedical doctoral students was significantly associated with graduate program climate, a perceived lack of employment opportunities, and the quality of students’ research training environment ( Nagy et al. , 2019 ). Environmental stress, academic stress, and family and monetary stress have also been shown to be predictive of depression severity in biomedical doctoral students ( Hish et al. , 2019 ). Further, one study found that self-esteem is negatively correlated and stress is positively correlated with graduate student depression; presumably research environments that challenge students’ self-esteem and induce stress are likely contributing to depressive symptoms among graduate students ( Kreger, 1995 ). While these studies have focused on graduate students, and there are certainly notable distinctions between graduate and undergraduate research, the research-related factors that affect graduate student depression, including work–life balance, relationships with mentors, research environment, stress, and self-esteem, may also be relevant to depression among undergraduates conducting research. Importantly, undergraduates in the United States have reported identical levels of depression as graduate students but are often less likely to seek mental health care services ( Wyatt and Oswalt, 2013 ), which is concerning if undergraduate research experiences exacerbate depression.

Based on the literature on the stressors of undergraduate research experiences and the literature identifying some potential causes of graduate student depression, we identified three aspects of undergraduate research that may exacerbate undergraduates’ depression. Mentoring: Mentors can be an integral part of a students’ research experience, bolstering their connections with others in the science community, scholarly productivity, and science identity, as well as providing many other benefits ( Thiry and Laursen, 2011 ; Prunuske et al. , 2013 ; Byars-Winston et al. , 2015 ; Aikens et al. , 2016 , 2017 ; Thompson et al. , 2016 ; Estrada et al. , 2018 ). However, recent literature has highlighted that poor mentoring can negatively affect undergraduate researchers ( Cooper et al. , 2019c ; Limeri et al. , 2019 ). Specifically, one study of 33 undergraduate researchers who had conducted research at 10 institutions identified seven major ways that they experienced negative mentoring, which included absenteeism, abuse of power, interpersonal mismatch, lack of career support, lack of psychosocial support, misaligned expectations, and unequal treatment ( Limeri et al. , 2019 ). We hypothesize negative mentoring experiences may be particularly harmful for students with depression, because support, particularly social support, has been shown to be important for helping individuals with depression cope with difficult circumstances ( Aneshensel and Stone, 1982 ; Grav et al. , 2012 ). Failure: Experiencing failure has been hypothesized to be an important aspect of undergraduate research experiences that may help students develop some the most distinguishing abilities of outstanding scientists, such as coping with failure, navigating challenges, and persevering ( Laursen et al. , 2010 ; Gin et al. , 2018 ; Henry et al. , 2019 ). However, experiencing failure and the stress and fatigue that often accompany it may be particularly tough for students with depression ( Aldwin and Greenberger, 1987 ; Mongrain and Blackburn, 2005 ). Lab environment: Fairness, inclusion/exclusion, and social support within one’s organizational environment have been shown to be key factors that cause people to either want to remain in the work place and be productive or to want to leave ( Barak et al. , 2006 ; Cooper et al. , 2019c ). We hypothesize that dealing with exclusion or a lack of social support may exacerbate depression for some students; patients with clinical depression react to social exclusion with more pronounced negative emotions than do individuals without clinical depression ( Jobst et al. , 2015 ). While there are likely other aspects of undergraduate research that affect student depression, we hypothesize that these factors have the potential to exacerbate negative research experiences for students with depression.

Depression has been shown to disproportionately affect many populations that are underrepresented or underserved within the scientific community, including females ( American College Health Association, 2018 ; Evans et al. , 2018 ), first-generation college students ( Jenkins et al. , 2013 ), individuals from low socioeconomic backgrounds ( Eisenberg et al. , 2007 ), members of the LGBTQ+ community ( Eisenberg et al. , 2007 ; Evans et al. , 2018 ), and people with disabilities ( Turner and Noh, 1988 ). Therefore, as the science community strives to be more diverse and inclusive ( Intemann, 2009 ), it is important that we understand more about the relationship between depression and scientific research, because negative experiences with depression in scientific research may be contributing to the underrepresentation of these groups. Specifically, more information is needed about how the research process and environment of research experiences may affect depression.

Given the high rate of depression among undergraduates, the links between depression and graduate research, the potentially challenging environment of undergraduate research, and how depression could disproportionately impact students from underserved communities, it is imperative to begin to explore the relationship between scientific research and depression among undergraduates to create research experiences that could maximize student success. In this exploratory interview study, we aimed to 1) describe how undergraduates’ symptoms of depression affect their research experiences, 2) understand how undergraduate research affects students’ feelings of depression, and 3) identify recommendations based on the literature and undergraduates’ reported experiences to promote a positive research experience for students with depression.

This study was done with an approved Arizona State University Institutional Review Board protocol #7247.

In Fall 2018, we surveyed undergraduate researchers majoring in the life sciences across 25 research-intensive (R1) public institutions across the United States (specific details about the recruitment of the students who completed the survey can be found in Cooper et al. (2019c) ). The survey asked students for their opinions about their undergraduate research experiences and their demographic information and whether they would be interested in participating in a follow-up interview related to their research experiences. For the purpose of this study, we exclusively interviewed students about their undergraduate research experiences in faculty member labs; we did not consider students’ experiences in CUREs. Of the 768 undergraduate researchers who completed the survey, 65% ( n = 496) indicated that they would be interested in participating in a follow-up interview. In Spring 2019, we emailed the 496 students, explaining that we were interested in interviewing students with depression about their experiences in undergraduate research. Our specific prompt was: “If you identify as having depression, we would be interested in hearing about your experience in undergraduate research in a 30–60 minute online interview.” We did not define depression in our email recruitment because we conducted think-aloud interviews with four undergraduates who all correctly interpreted what we meant by depression ( APA, 2013 ). We had 35 students agree to participate in the interview study. The interview participants represented 12 of the 25 R1 public institutions that were represented in the initial survey.

Student Interviews

We developed an interview script to explore our research questions. Specifically, we were interested in how students’ symptoms of depression affect their research experiences, how undergraduate research negatively affects student depression, and how undergraduate research positively affects student depression.

We recognized that mental health, and specifically depression, can be a sensitive topic to discuss with undergraduates, and therefore we tried to minimize any discomfort that the interviewees might experience during the interview. Specifically, we conducted think-aloud interviews with three graduate students who self-identified with having depression at the time of the interview. We asked them to note whether any interview questions made them uncomfortable. We also sought their feedback on questions given their experiences as persons with depression who had once engaged in undergraduate research. We revised the interview protocol after each think-aloud interview. Next, we conducted four additional think-aloud interviews with undergraduates conducting basic science or biology education research who identified with having depression to establish cognitive validity of the questions and to elicit additional feedback about any questions that might make someone uncomfortable. The questions were revised after each think-aloud interview until no question was unclear or misinterpreted by the students and we were confident that the questions minimized students’ potential discomfort ( Trenor et al. , 2011 ). A copy of the final interview script can be found in the Supplemental Material.

All interviews were individually conducted by one of two researchers (K.M.C. and L.E.G.) who conducted the think-aloud interviews together to ensure that their interviewing practices were as similar as possible. The interviews were approximately an hour long, and students received a $15 gift card for their participation.

Personal, Research, and Depression Demographics

All student demographics and information about students’ research experiences were collected using the survey distributed to students in Fall 2018. We collected personal demographics, including the participants’ gender, race/ethnicity, college generation status, transfer status, financial stability, year in college, major, and age. We also collected information about the students’ research experiences, including the length of their first research experiences, the average number of hours they spend in research per week, how they were compensated for research, who their primary mentors were, and the focus areas of their research.

In the United States, mental healthcare is disproportionately unavailable to Black and Latinx individuals, as well as those who come from low socioeconomic backgrounds ( Kataoka et al. , 2002 ; Howell and McFeeters, 2008 ; Santiago et al. , 2013 ). Therefore, to minimize a biased sample, we invited anyone who identified with having depression to participate in our study; we did not require students to be diagnosed with depression or to be treated for depression in order to participate. However, we did collect information about whether students had been formally diagnosed with depression and whether they had been treated for depression. After the interview, all participants were sent a link to a short survey that asked them if they had ever been diagnosed with depression and how, if at all, they had ever been treated for depression. A copy of these survey questions can be found in the Supplemental Material. The combined demographic information of the participants is in Table 1 . The demographics for each individual student can be found in the Supplemental Material.

a Students reported the time they had spent in research 6 months before being interviewed and only reported on the length of time of their first research experiences.

b Students were invited to report multiple ways in which they were treated for their depression; other treatments included lifestyle changes and meditation.

c Students were invited to report multiple means of compensation for their research if they had been compensated for their time in different ways.

d Students were asked whether they felt financially stable, particularly during the undergraduate research experience.

e Students reported who they work/worked with most closely during their research experiences.

f Staff members included lab coordinators or lab managers.

g Other focus areas of research included sociology, linguistics, psychology, and public health.

Interview Analysis

The initial interview analysis aimed to explore each idea that a participant expressed ( Charmaz, 2006 ) and to identify reoccurring ideas throughout the interviews. First, three authors (K.M.C., L.E.G., and S.E.B.) individually reviewed a different set of 10 interviews and took detailed analytic notes ( Birks and Mills, 2015 ). Afterward, the authors compared their notes and identified reoccurring themes throughout the interviews using open coding methods ( Saldaña, 2015 ).

Once an initial set of themes was established, two researchers (K.M.C. and L.E.G.) individually reviewed the same set of 15 randomly selected interviews to validate the themes identified in the initial analysis and to screen for any additional themes that the initial analysis may have missed. Each researcher took detailed analytic notes throughout the review of an interview, which they discussed after reviewing each interview. The researchers compared what quotes from each interview they categorized into each theme. Using constant comparison methods, they assigned quotes to each theme and constantly compared the quotes to ensure that each quote fit within the description of the theme ( Glesne and Peshkin, 1992 ). In cases in which quotes were too different from other quotes, a new theme was created. This approach allowed for multiple revisions of the themes and allowed the authors to define a final set of codes; the researchers created a final codebook with refined definitions of emergent themes (the final coding rubric can be found in the Supplemental Material). Once the final codebook was established, the researchers (K.M.C. and L.E.G.) individually coded seven additional interviews (20% of all interviews) using the coding rubric. The researchers compared their codes, and their Cohen’s κ interrater score for these seven interviews was at an acceptable level (κ  =  0.88; Landis and Koch, 1977 ). One researcher (L.E.G.) coded the remaining 28 out of 35 interviews. The researchers determined that data saturation had been reached with the current sample and no further recruitment was needed ( Guest et al. , 2006 ). We report on themes that were mentioned by at least 20% of students in the interview study. In the Supplemental Material, we provide the final coding rubric with the number of participants whose interview reflected each theme ( Hannah and Lautsch, 2011 ). Reporting the number of individuals who reported themes within qualitative data can lead to inaccurate conclusions about the generalizability of the results to a broader population. These qualitative data are meant to characterize a landscape of experiences that students with depression have in undergraduate research rather than to make claims about the prevalence of these experiences ( Glesne and Peshkin, 1992 ). Because inferences about the importance of these themes cannot be drawn from these counts, they are not included in the results of the paper ( Maxwell, 2010 ). Further, the limited number of interviewees made it not possible to examine whether there were trends based on students’ demographics or characteristics of their research experiences (e.g., their specific area of study). Quotes were lightly edited for clarity by inserting clarification brackets and using ellipses to indicate excluded text. Pseudonyms were given to all students to protect their privacy.

The Effect of Depressive Symptoms on Undergraduate Research

We asked students to describe the symptoms associated with their depression. Students described experiencing anxiety that is associated with their depression; this could be anxiety that precedes their depression or anxiety that results from a depressive episode or a period of time when an individual has depression symptoms. Further, students described difficulty getting out of bed or leaving the house, feeling tired, a lack of motivation, being overly self-critical, feeling apathetic, and having difficulty concentrating. We were particularly interested in how students’ symptoms of depression affected their experiences in undergraduate research. During the think-aloud interviews that were conducted before the interview study, graduate and undergraduate students consistently described that their depression affected their motivation in research, their creativity in research, and their productivity in research. Therefore, we explicitly asked undergraduate researchers how, if at all, their depression affected these three factors. We also asked students to describe any additional ways in which their depression affected their research experiences. Undergraduate researchers commonly described five additional ways in which their depression affected their research; for a detailed description of each way students’ research was affected and for example quotes, see Table 2 . Students described that their depression negatively affected their productivity in the lab. Commonly, students described that their productivity was directly affected by a lack of motivation or because they felt less creative, which hindered the research process. Additionally, students highlighted that they were sometimes less productive because their depression sometimes caused them to struggle to engage intellectually with their research or caused them to have difficulty remembering or concentrating; students described that they could do mundane or routine tasks when they felt depressed, but that they had difficulty with more complex and intellectually demanding tasks. However, students sometimes described that even mundane tasks could be difficult when they were required to remember specific steps; for example, some students struggled recalling a protocol from memory when their depression was particularly severe. Additionally, students noted that their depression made them more self-conscious, which sometimes held them back from sharing research ideas with their mentors or from taking risks such as applying to competitive programs. In addition to being self-conscious, students highlighted that their depression caused them to be overly self-critical, and some described experiencing imposter phenomenon ( Clance and Imes, 1978 ) or feeling like they were not talented enough to be in research and were accepted into a lab by a fluke or through luck. Finally, students described that depression often made them feel less social, and they struggled to socially engage with other members of the lab when they were feeling down.

The Effect of Undergraduate Research Experiences on Student Depression

We also wanted to explore how research impacted students’ feelings of depression. Undergraduates described how research both positively and negatively affected their depression. In the following sections, we present aspects of undergraduate research and examine how each positively and/or negatively affected students’ depression using embedded student quotes to highlight the relationships between related ideas.

Lab Environment: Relationships with Others in the Lab.

Some aspects of the lab environment, which we define as students’ physical, social, or psychological research space, could be particularly beneficial for students with depression.

Specifically, undergraduate researchers perceived that comfortable and positive social interactions with others in the lab helped their depression. Students acknowledged how beneficial their relationships with graduate students and postdocs could be.

Marta: “I think always checking in on undergrads is important. It’s really easy [for us] to go a whole day without talking to anybody in the lab. But our grad students are like ‘Hey, what’s up? How’s school? What’s going on?’ (…) What helps me the most is having that strong support system. Sometimes just talking makes you feel better, but also having people that believe in you can really help you get out of that negative spiral. I think that can really help with depression.”

Kelley: “I know that anytime I need to talk to [my postdoc mentors] about something they’re always there for me. Over time we’ve developed a relationship where I know that outside of work and outside of the lab if I did want to talk to them about something I could talk to them. Even just talking to someone about hobbies and having that relationship alone is really helpful [for depression].”

In addition to highlighting the importance of developing relationships with graduate students or postdocs in the lab, students described that forming relationships with other undergraduates in the lab also helped their depression. Particularly, students described that other undergraduate researchers often validated their feelings about research, which in turn helped them realize that what they are thinking or feeling is normal, which tended to alleviate their negative thoughts. Interestingly, other undergraduates experiencing the same issues could sometimes help buffer them from perceiving that a mentor did not like them or that they were uniquely bad at research. In this article, we use the term “mentor” to refer to anyone who students referred to in the interviews as being their mentors or managing their research experiences; this includes graduate students, postdoctoral scholars, lab managers, and primary investigators (PIs).

Abby: “One of my best friends is in the lab with me.  A lot of that friendship just comes from complaining about our stress with the lab and our annoyance with people in the lab. Like when we both agree like, ‘Yeah, the grad students were really off today, it wasn’t us,’ that helps. ‘It wasn’t me, it wasn’t my fault that we were having a rough day in lab; it was the grad students.’ Just being able to realize, ‘Hey, this isn’t all caused by us,’ you know? (…) We understand the stresses in the lab. We understand the details of what each other are doing in the lab, so when something doesn’t work out, we understand that it took them like eight hours to do that and it didn’t work. We provide empathy on a different level.”

Meleana: “It’s great to have solidarity in being confused about something, and it’s just that is a form of validation for me too. When we leave a lab meeting and I look at [another undergrad] I’m like, ‘Did you understand anything that they were just saying?’ And they’re like, ‘Oh, no.’ (…) It’s just really validating to hear from the other undergrads that we all seem to be struggling with the same things.”

Developing positive relationships with faculty mentors or PIs also helped alleviate some students’ depressive feelings, particularly when PIs shared their own struggles with students. This also seemed to normalize students’ concerns about their own experiences.

Alexandra: “[Talking with my PI] is helpful because he would talk about his struggles, and what he faced. A lot of it was very similar to my struggles.  For example, he would say, ‘Oh, yeah, I failed this exam that I studied so hard for. I failed the GRE and I paid so much money to prepare for it.’ It just makes [my depression] better, like okay, this is normal for students to go through this. It’s not an out of this world thing where if you fail, you’re a failure and you can’t move on from it.”

Students’ relationships with others in the lab did not always positively impact their depression. Students described instances when the negative moods of the graduate students and PIs would often set the tone of the lab, which in turn worsened the mood of the undergraduate researchers.

Abby: “Sometimes [the grad students] are not in a good mood. The entire vibe of the lab is just off, and if you make a joke and it hits somebody wrong, they get all mad. It really depends on the grad students and the leadership and the mood that they’re in.”

Interviewer: “How does it affect your depression when the grad students are in a bad mood?”

Abby: “It definitely makes me feel worse. It feels like, again, that I really shouldn’t go ask them for help because they’re just not in the mood to help out. It makes me have more pressure on myself, and I have deadlines I need to meet, but I have a question for them, but they’re in a bad mood so I can’t ask. That’s another day wasted for me and it just puts more stress, which just adds to the depression.”

Additionally, some students described even more concerning behavior from research mentors, which negatively affected their depression.

Julie: “I had a primary investigator who is notorious in the department for screaming at people, being emotionally abusive, unreasonable, et cetera. (…) [He was] kind of harassing people, demeaning them, lying to them, et cetera, et cetera. (…) Being yelled at and constantly demeaned and harassed at all hours of the day and night, that was probably pretty bad for me.”

While the relationships between undergraduates and graduate, postdoc, and faculty mentors seemed to either alleviate or worsen students’ depressive symptoms, depending on the quality of the relationship, students in this study exclusively described their relationships with other undergraduates as positive for their depression. However, students did note that undergraduate research puts some of the best and brightest undergraduates in the same environment, which can result in students comparing themselves with their peers. Students described that this comparison would often lead them to feel badly about themselves, even though they would describe their personal relationship with a person to be good.

Meleana: “In just the research field in general, just feeling like I don’t really measure up to the people around me [can affect my depression]. A lot of the times it’s the beginning of a little spiral, mental spiral. There are some past undergrads that are talked about as they’re on this pedestal of being the ideal undergrads and that they were just so smart and contributed so much to the lab. I can never stop myself from wondering like, ‘Oh, I wonder if I’m having a contribution to the lab that’s similar or if I’m just another one of the undergrads that does the bare minimum and passes through and is just there.’”

Natasha: “But, on the other hand, [having another undergrad in the lab] also reminded me constantly that some people are invested in this and meant to do this and it’s not me. And that some people know a lot more than I do and will go further in this than I will.”

While students primarily expressed that their relationships with others in the lab affected their depression, some students explained that they struggled most with depression when the lab was empty; they described that they did not like being alone in the lab, because a lack of stimulation allowed their minds to be filled with negative thoughts.

Mia: “Those late nights definitely didn’t help [my depression]. I am alone, in the entire building.  I’m left alone to think about my thoughts more, so not distracted by talking to people or interacting with people. I think more about how I’m feeling and the lack of progress I’m making, and the hopelessness I’m feeling. That kind of dragged things on, and I guess deepened my depression.”

Freddy: “Often times when I go to my office in the evening, that is when I would [ sic ] be prone to be more depressed. It’s being alone. I think about myself or mistakes or trying to correct mistakes or whatever’s going on in my life at the time. I become very introspective. I think I’m way too self-evaluating, way too self-deprecating and it’s when I’m alone when those things are really, really triggered. When I’m talking with somebody else, I forget about those things.”

In sum, students with depression highlighted that a lab environment full of positive and encouraging individuals was helpful for their depression, whereas isolating or competitive environments and negative interactions with others often resulted in more depressive feelings.

Doing Science: Experiencing Failure in Research, Getting Help, Receiving Feedback, Time Demands, and Important Contributions.

In addition to the lab environment, students also described that the process of doing science could affect their depression. Specifically, students explained that a large contributor to their depression was experiencing failure in research.

Interviewer: “Considering your experience in undergraduate research, what tends to trigger your feelings of depression?”

Heather: “Probably just not getting things right. Having to do an experiment over and over again. You don’t get the results you want. (…) The work is pretty meticulous and it’s frustrating when I do all this work, I do a whole experiment, and then I don’t get any results that I can use. That can be really frustrating. It adds to the stress. (…) It’s hard because you did all this other stuff before so you can plan for the research, and then something happens and all the stuff you did was worthless basically.”

Julie: “I felt very negatively about myself [when a project failed] and pretty panicked whenever something didn’t work because I felt like it was a direct reflection on my effort and/or intelligence, and then it was a big glaring personal failure.”

Students explained that their depression related to failing in research was exacerbated if they felt as though they could not seek help from their research mentors. Perceived insufficient mentor guidance has been shown to be a factor influencing student intention to leave undergraduate research ( Cooper et al. , 2019c ). Sometimes students talked about their research mentors being unavailable or unapproachable.

Michelle: “It just feels like [the graduate students] are not approachable. I feel like I can’t approach them to ask for their understanding in a certain situation. It makes [my depression] worse because I feel like I’m stuck, and that I’m being limited, and like there’s nothing I can do. So then I kind of feel like it’s my fault that I can’t do anything.”

Other times, students described that they did not seek help in fear that they would be negatively evaluated in research, which is a fear of being judged by others ( Watson and Friend, 1969 ; Weeks et al. , 2005 ; Cooper et al. , 2018 ). That is, students fear that their mentor would think negatively about them or judge them if they were to ask questions that their mentor thought they should know the answer to.

Meleana: “I would say [my depression] tends to come out more in being more reserved in asking questions because I think that comes more like a fear-based thing where I’m like, ‘Oh, I don’t feel like I’m good enough and so I don’t want to ask these questions because then my mentors will, I don’t know, think that I’m dumb or something.’”

Conversely, students described that mentors who were willing to help them alleviated their depressive feelings.

Crystal: “Yeah [my grad student] is always like, ‘Hey, I can check in on things in the lab because you’re allowed to ask me for that, you’re not totally alone in this,’ because he knows that I tend to take on all this responsibility and I don’t always know how to ask for help. He’s like, ‘You know, this is my lab too and I am here to help you as well,’ and just reminds me that I’m not shouldering this burden by myself.”

Ashlyn: “The graduate student who I work with is very kind and has a lot of patience and he really understands a lot of things and provides simple explanations. He does remind me about things and he will keep on me about certain tasks that I need to do in an understanding way, and it’s just because he’s patient and he listens.”

In addition to experiencing failure in science, students described that making mistakes when doing science also negatively affected their depression.

Abby: “I guess not making mistakes on experiments [is important in avoiding my depression]. Not necessarily that your experiment didn’t turn out to produce the data that you wanted, but just adding the wrong enzyme or messing something up like that. It’s like, ‘Oh, man,’ you know? You can get really down on yourself about that because it can be embarrassing.”

Commonly, students described that the potential for making mistakes increased their stress and anxiety regarding research; however, they explained that how other people responded to a potential mistake was what ultimately affected their depression.

Briana: “Sometimes if I made a mistake in correctly identifying an eye color [of a fly], [my PI] would just ridicule me in front of the other students. He corrected me but his method of correcting was very discouraging because it was a ridicule. It made the others laugh and I didn’t like that.”

Julie: “[My PI] explicitly [asked] if I had the dedication for science. A lot of times he said I had terrible judgment. A lot of times he said I couldn’t be trusted. Once I went to a conference with him, and, unfortunately, in front of another professor, he called me a klutz several times and there was another comment about how I never learn from my mistakes.”

When students did do things correctly, they described how important it could be for them to receive praise from their mentors. They explained that hearing praise and validation can be particularly helpful for students with depression, because their thoughts are often very negative and/or because they have low self-esteem.

Crystal: “[Something that helps my depression is] I have text messages from [my graduate student mentor] thanking me [and another undergraduate researcher] for all of the work that we’ve put in, that he would not be able to be as on track to finish as he is if he didn’t have our help.”

Interviewer: “Why is hearing praise from your mentor helpful?”

Crystal: “Because a lot of my depression focuses on everybody secretly hates you, nobody likes you, you’re going to die alone. So having that validation [from my graduate mentor] is important, because it flies in the face of what my depression tells me.”

Brian: “It reminds you that you exist outside of this negative world that you’ve created for yourself, and people don’t see you how you see yourself sometimes.”

Students also highlighted how research could be overwhelming, which negatively affected their depression. Particularly, students described that research demanded a lot of their time and that their mentors did not always seem to be aware that they were juggling school and other commitments in addition to their research. This stress exacerbated their depression.

Rose: “I feel like sometimes [my grad mentors] are not very understanding because grad students don’t take as many classes as [undergrads] do. I think sometimes they don’t understand when I say I can’t come in at all this week because I have finals and they’re like, ‘Why though?’”

Abby: “I just think being more understanding of student life would be great. We have classes as well as the lab, and classes are the priority. They forget what it’s like to be a student. You feel like they don’t understand and they could never understand when you say like, ‘I have three exams this week,’ and they’re like, ‘I don’t care. You need to finish this.’”

Conversely, some students reported that their research labs were very understanding of students’ schedules. Interestingly, these students talked most about how helpful it was to be able to take a mental health day and not do research on days when they felt down or depressed.

Marta: “My lab tech is very open, so she’ll tell us, ‘I can’t come in today. I have to take a mental health day.’ So she’s a really big advocate for that. And I think I won’t personally tell her that I’m taking a mental health day, but I’ll say, ‘I can’t come in today, but I’ll come in Friday and do those extra hours.’ And she’s like, ‘OK great, I’ll see you then.’  And it makes me feel good, because it helps me take care of myself first and then I can take care of everything else I need to do, which is amazing.”

Meleana: “Knowing that [my mentors] would be flexible if I told them that I’m crazy busy and can’t come into work nearly as much this week [helps my depression]. There is flexibility in allowing me to then care for myself.”

Interviewer: “Why is the flexibility helpful given the depression?”

Meleana: “Because sometimes for me things just take a little bit longer when I’m feeling down. I’m just less efficient to be honest, and so it’s helpful if I feel like I can only go into work for 10 hours in a week. It declutters my brain a little bit to not have to worry about all the things I have to do in work in addition the things that I need to do for school or clubs, or family or whatever.”

Despite the demanding nature of research, a subset of students highlighted that their research and research lab provided a sense of stability or familiarity that distracted them from their depression.

Freddy: “I’ll [do research] to run away from those [depressive] feelings or whatever. (…) I find sadly, I hate to admit it, but I do kind of run to [my lab]. I throw myself into work to distract myself from the feelings of depression and sadness.”

Rose: “When you’re sad or when you’re stressed you want to go to things you’re familiar with. So because lab has always been in my life, it’s this thing where it’s going to be there for me I guess. It’s like a good book that you always go back to and it’s familiar and it makes you feel good. So that’s how lab is. It’s not like the greatest thing in the world but it’s something that I’m used to, which is what I feel like a lot of people need when they’re sad and life is not going well.”

Many students also explained that research positively affects their depression because they perceive their research contribution to be important.

Ashlyn: “I feel like I’m dedicating myself to something that’s worthy and something that I believe in. It’s really important because it contextualizes those times when I am feeling depressed. It’s like, no, I do have these better things that I’m working on. Even when I don’t like myself and I don’t like who I am, which is again, depression brain, I can at least say, ‘Well, I have all these other people relying on me in research and in this area and that’s super important.’”

Jessica: “I mean, it just felt like the work that I was doing had meaning and when I feel like what I’m doing is actually going to contribute to the world, that usually really helps with [depression] because it’s like not every day you can feel like you’re doing something impactful.”

In sum, students highlighted that experiencing failure in research and making mistakes negatively contributed to depression, especially when help was unavailable or research mentors had a negative reaction. Additionally, students acknowledged that the research could be time-consuming, but that research mentors who were flexible helped assuage depressive feelings that were associated with feeling overwhelmed. Finally, research helped some students’ depression, because it felt familiar, provided a distraction from depression, and reminded students that they were contributing to a greater cause.

We believe that creating more inclusive research environments for students with depression is an important step toward broadening participation in science, not only to ensure that we are not discouraging students with depression from persisting in science, but also because depression has been shown to disproportionately affect underserved and underrepresented groups in science ( Turner and Noh, 1988 ; Eisenberg et al. , 2007 ; Jenkins et al. , 2013 ; American College Health Association, 2018 ). We initially hypothesized that three features of undergraduate research—research mentors, the lab environment, and failure—may have the potential to exacerbate student depression. We found this to be true; students highlighted that their relationships with their mentors as well as the overall lab environment could negatively affect their depression, but could also positively affect their research experiences. Students also noted that they struggled with failure, which is likely true of most students, but is known to be particularly difficult for students with depression ( Elliott et al. , 1997 ). We expand upon our findings by integrating literature on depression with the information that students provided in the interviews about how research mentors can best support students. We provide a set of evidence-based recommendations focused on mentoring, the lab environment, and failure for research mentors wanting to create more inclusive research environments for students with depression. Notably, only the first recommendation is specific to students with depression; the others reflect recommendations that have previously been described as “best practices” for research mentors ( NASEM, 2017 , 2019 ; Sorkness et al. , 2017 ) and likely would benefit most students. However, we examine how these recommendations may be particularly important for students with depression. As we hypothesized, these recommendations directly address three aspects of research: mentors, lab environment, and failure. A caveat of these recommendations is that more research needs to be done to explore the experiences of students with depression and how these practices actually impact students with depression, but our national sample of undergraduate researchers with depression can provide an initial starting point for a discussion about how to improve research experiences for these students.

Recommendations to Make Undergraduate Research Experiences More Inclusive for Students with Depression

Recognize student depression as a valid illness..

Allow students with depression to take time off of research by simply saying that they are sick and provide appropriate time for students to recover from depressive episodes. Also, make an effort to destigmatize mental health issues.

Undergraduate researchers described both psychological and physical symptoms that manifested as a result of their depression and highlighted how such symptoms prevented them from performing to their full potential in undergraduate research. For example, students described how their depression would cause them to feel unmotivated, which would often negatively affect their research productivity. In cases in which students were motivated enough to come in and do their research, they described having difficulty concentrating or engaging in the work. Further, when doing research, students felt less creative and less willing to take risks, which may alter the quality of their work. Students also sometimes struggled to socialize in the lab. They described feeling less social and feeling overly self-critical. In sum, students described that, when they experienced a depressive episode, they were not able to perform to the best of their ability, and it sometimes took a toll on them to try to act like nothing was wrong, when they were internally struggling with depression. We recommend that research mentors treat depression like any other physical illness; allowing students the chance to recover when they are experiencing a depressive episode can be extremely important to students and can allow them to maximize their productivity upon returning to research ( Judd et al. , 2000 ). Students explained that if they are not able to take the time to focus on recovering during a depressive episode, then they typically continue to struggle with depression, which negatively affects their research. This sentiment is echoed by researchers in psychiatry who have found that patients who do not fully recover from a depressive episode are more likely to relapse and to experience chronic depression ( Judd et al. , 2000 ). Students described not doing tasks or not showing up to research because of their depression but struggling with how to share that information with their research mentors. Often, students would not say anything, which caused them anxiety because they were worried about what others in the lab would say to them when they returned. Admittedly, many students understood why this behavior would cause their research mentors to be angry or frustrated, but they weighed the consequences of their research mentors’ displeasure against the consequences of revealing their depression and decided it was not worth admitting to being depressed. This aligns with literature that suggests that when individuals have concealable stigmatized identities, or identities that can be hidden and that carry negative stereotypes, such as depression, they will often keep them concealed to avoid negative judgment or criticism ( Link and Phelan, 2001 ; Quinn and Earnshaw, 2011 ; Jones and King, 2014 ; Cooper and Brownell, 2016 ; Cooper et al. , 2019b ; Cooper et al ., unpublished data ). Therefore, it is important for research mentors to be explicit with students that 1) they recognize mental illness as a valid sickness and 2) that students with mental illness can simply explain that they are sick if they need to take time off. This may be useful to overtly state on a research website or in a research syllabus, contract, or agreement if mentors use such documents when mentoring undergraduates in their lab. Further, research mentors can purposefully work to destigmatize mental health issues by explicitly stating that struggling with mental health issues, such as depression and anxiety, is common. While we do not recommend that mentors ask students directly about depression, because this can force students to share when they are not comfortable sharing, we do recommend providing opportunities for students to reveal their depression ( Chaudoir and Fisher, 2010 ). Mentors can regularly check in with students about how they’re doing, and talk openly about the importance of mental health, which may increase the chance that students may feel comfortable revealing their depression ( Chaudoir and Quinn, 2010 ; Cooper et al ., unpublished data ).

Foster a Positive Lab Environment.

Encourage positivity in the research lab, promote working in shared spaces to enhance social support among lab members, and alleviate competition among undergraduates.

Students in this study highlighted that the “leadership” of the lab, meaning graduate students, postdocs, lab managers, and PIs, were often responsible for establishing the tone of the lab; that is, if they were in a bad mood it would trickle down and negatively affect the moods of the undergraduates. Explicitly reminding lab leadership that their moods can both positively and negatively affect undergraduates may be important in establishing a positive lab environment. Further, students highlighted how they were most likely to experience negative thoughts when they were alone in the lab. Therefore, it may be helpful to encourage all lab members to work in a shared space to enhance social interactions among students and to maximize the likelihood that undergraduates have access to help when needed. A review of 51 studies in psychiatry supported our undergraduate researchers’ perceptions that social relationships positively impacted their depression; the study found that perceived emotional support (e.g., someone available to listen or give advice), perceived instrumental support (e.g., someone available to help with tasks), and large diverse social networks (e.g., being socially connected to a large number of people) were significantly protective against depression ( Santini et al. , 2015 ). Additionally, despite forming positive relationships with other undergraduates in the lab, many undergraduate researchers admitted to constantly comparing themselves with other undergraduates, which led them to feel inferior, negatively affecting their depression. Some students talked about mentors favoring current undergraduates or talking positively about past undergraduates, which further exacerbated their feelings of inferiority. A recent study of students in undergraduate research experiences highlighted that inequitable distribution of praise to undergraduates can create negative perceptions of lab environments for students (Cooper et al. , 2019). Further, the psychology literature has demonstrated that when people feel insecure in their social environments, it can cause them to focus on a hierarchical view of themselves and others, which can foster feelings of inferiority and increase their vulnerability to depression ( Gilbert et al. , 2009 ). Thus, we recommend that mentors be conscious of their behaviors so that they do not unintentionally promote competition among undergraduates or express favoritism toward current or past undergraduates. Praise is likely best used without comparison with others and not done in a public way, although more research on the impact of praise on undergraduate researchers needs to be done. While significant research has been done on mentoring and mentoring relationships in the context of undergraduate research ( Byars-Winston et al. , 2015 ; Aikens et al. , 2017 ; Estrada et al. , 2018 ; Limeri et al. , 2019 ; NASEM, 2019 ), much less has been done on the influence of the lab environment broadly and how people in nonmentoring roles can influence one another. Yet, this study indicates the potential influence of many different members of the lab, not only their mentors, on students with depression.

Develop More Personal Relationships with Undergraduate Researchers and Provide Sufficient Guidance.

Make an effort to establish more personal relationships with undergraduates and ensure that they perceive that they have access to sufficient help and guidance with regard to their research.

When we asked students explicitly how research mentors could help create more inclusive environments for undergraduate researchers with depression, students overwhelmingly said that building mentor–student relationships would be extremely helpful. Students suggested that mentors could get to know students on a more personal level by asking about their career interests or interests outside of academia. Students also remarked that establishing a more personal relationship could help build the trust needed in order for undergraduates to confide in their research mentors about their depression, which they perceived would strengthen their relationships further because they could be honest about when they were not feeling well or their mentors might even “check in” with them in times where they were acting differently than normal. This aligns with studies showing that undergraduates are most likely to reveal a stigmatized identity, such as depression, when they form a close relationship with someone ( Chaudoir and Quinn, 2010 ). Many were intimidated to ask for research-related help from their mentors and expressed that they wished they had established a better relationship so that they would feel more comfortable. Therefore, we recommend that research mentors try to establish relationships with their undergraduates and explicitly invite them to ask questions or seek help when needed. These recommendations are supported by national recommendations for mentoring ( NASEM, 2019 ) and by literature that demonstrates that both social support (listening and talking with students) and instrumental support (providing students with help) have been shown to be protective against depression ( Santini et al. , 2015 ).

Treat Undergraduates with Respect and Remember to Praise Them.

Avoid providing harsh criticism and remember to praise undergraduates. Students with depression often have low self-esteem and are especially self-critical. Therefore, praise can help calibrate their overly negative self-perceptions.

Students in this study described that receiving criticism from others, especially harsh criticism, was particularly difficult for them given their depression. Multiple studies have demonstrated that people with depression can have an abnormal or maladaptive response to negative feedback; scientists hypothesize that perceived failure on a particular task can trigger failure-related thoughts that interfere with subsequent performance ( Eshel and Roiser, 2010 ). Thus, it is important for research mentors to remember to make sure to avoid unnecessarily harsh criticisms that make students feel like they have failed (more about failure is described in the next recommendation). Further, students with depression often have low self-esteem or low “personal judgment of the worthiness that is expressed in the attitudes the individual holds towards oneself” ( Heatherton et al. , 2003 , p. 220; Sowislo and Orth, 2013 ). Specifically, a meta-analysis of longitudinal studies found that low self-esteem is predictive of depression ( Sowislo and Orth, 2013 ), and depression has also been shown to be highly related to self-criticism ( Luyten et al. , 2007 ). Indeed, nearly all of the students in our study described thinking that they are “not good enough,” “worthless,” or “inadequate,” which is consistent with literature showing that people with depression are self-critical ( Blatt et al. , 1982 ; Gilbert et al. , 2006 ) and can be less optimistic of their performance on future tasks and rate their overall performance on tasks less favorably than their peers without depression ( Cane and Gotlib, 1985 ). When we asked students what aspects of undergraduate research helped their depression, students described that praise from their mentors was especially impactful, because they thought so poorly of themselves and they needed to hear something positive from someone else in order to believe it could be true. Praise has been highlighted as an important aspect of mentoring in research for many years ( Ashford, 1996 ; Gelso and Lent, 2000 ; Brown et al. , 2009 ) and may be particularly important for students with depression. In fact, praise has been shown to enhance individuals’ motivation and subsequent productivity ( Hancock, 2002 ; Henderlong and Lepper, 2002 ), factors highlighted by students as negatively affecting their depression. However, something to keep in mind is that a student with depression and a student without depression may process praise differently. For a student with depression, a small comment that praises the student’s work may not be sufficient for the student to process that comment as praise. People with depression are hyposensitive to reward or have reward-processing deficits ( Eshel and Roiser, 2010 ); therefore, praise may affect students without depression more positively than it would affect students with depression. Research mentors should be mindful that students with depression often have a negative view of themselves, and while students report that praise is extremely important, they may have trouble processing such positive feedback.

Normalize Failure and Be Explicit about the Importance of Research Contributions.

Explicitly remind students that experiencing failure is expected in research. Also explain to students how their individual work relates to the overall project so that they can understand how their contributions are important. It can also be helpful to explain to students why the research project as a whole is important in the context of the greater scientific community.

Experiencing failure has been thought to be a potentially important aspect of undergraduate research, because it may provide students with the potential to develop integral scientific skills such as the ability to navigate challenges and persevere ( Laursen et al. , 2010 ; Gin et al. , 2018 ; Henry et al. , 2019 ). However, in the interviews, students described that when their science experiments failed, it was particularly tough for their depression. Students’ negative reaction to experiencing failure in research is unsurprising, given recent literature that has predicted that students may be inadequately prepared to approach failure in science ( Henry et al. , 2019 ). However, the literature suggests that students with depression may find experiencing failure in research to be especially difficult ( Elliott et al. , 1997 ; Mongrain and Blackburn, 2005 ; Jones et al. , 2009 ). One potential hypothesis is that students with depression may be more likely to have fixed mindsets or more likely to believe that their intelligence and capacity for specific abilities are unchangeable traits ( Schleider and Weisz, 2018 ); students with a fixed mindset have been hypothesized to have particularly negative responses to experiencing failure in research, because they are prone to quitting easily in the face of challenges and becoming defensive when criticized ( Forsythe and Johnson, 2017 ; Dweck, 2008 ). A study of life sciences undergraduates enrolled in CUREs identified three strategies of students who adopted adaptive coping mechanisms, or mechanisms that help an individual maintain well-being and/or move beyond the stressor when faced with failure in undergraduate research: 1) problem solving or engaging in strategic planning and decision making, 2) support seeking or finding comfort and help with research, and 3) cognitive restructuring or reframing a problem from negative to positive and engaging in self encouragement ( Gin et al. , 2018 ). We recommend that, when undergraduates experience failure in science, their mentors be proactive in helping them problem solve, providing help and support, and encouraging them. Students also explained that mentors sharing their own struggles as undergraduate and graduate students was helpful, because it normalized failure. Sharing personal failures in research has been recommended as an important way to provide students with psychosocial support during research ( NASEM, 2019 ). We also suggest that research mentors take time to explain to students why their tasks in the lab, no matter how small, contribute to the greater research project ( Cooper et al. , 2019a ). Additionally, it is important to make sure that students can explain how the research project as a whole is contributing to the scientific community ( Gin et al. , 2018 ). Students highlighted that contributing to something important was really helpful for their depression, which is unsurprising, given that studies have shown that meaning in life or people’s comprehension of their life experiences along with a sense of overarching purpose one is working toward has been shown to be inversely related to depression ( Steger, 2013 ).

Limitations and Future Directions

This work was a qualitative interview study intended to document a previously unstudied phenomenon: depression in the context of undergraduate research experiences. We chose to conduct semistructured interviews rather than a survey because of the need for initial exploration of this area, given the paucity of prior research. A strength of this study is the sampling approach. We recruited a national sample of 35 undergraduates engaged in undergraduate research at 12 different public R1 institutions. Despite our representative sample from R1 institutions, these findings may not be generalizable to students at other types of institutions; lab environments, mentoring structures, and interactions between faculty and undergraduate researchers may be different at other institution types (e.g., private R1 institutions, R2 institutions, master’s-granting institutions, primarily undergraduate institutions, and community colleges), so we caution against making generalizations about this work to all undergraduate research experiences. Future work could assess whether students with depression at other types of institutions have similar experiences to students at research-intensive institutions. Additionally, we intentionally did not explore the experiences of students with specific identities owing to our sample size and the small number of students in any particular group (e.g., students of a particular race, students with a graduate mentor as the primary mentor). We intend to conduct future quantitative studies to further explore how students’ identities and aspects of their research affect their experiences with depression in undergraduate research.

The students who participated in the study volunteered to be interviewed about their depression; therefore, it is possible that depression is a more salient part of these students’ identities and/or that they are more comfortable talking about their depression than the average population of students with depression. It is also important to acknowledge the personal nature of the topic and that some students may not have fully shared their experiences ( Krumpal, 2013 ), particularly those experiences that may be emotional or traumatizing ( Kahn and Garrison, 2009 ). Additionally, our sample was skewed toward females (77%). While females do make up approximately 60% of students in biology programs on average ( Eddy et al. , 2014 ), they are also more likely to report experiencing depression ( American College Health Association, 2018 ; Evans et al. , 2018 ). However, this could be because women have higher rates of depression or because males are less likely to report having depression; clinical bias, or practitioners’ subconscious tendencies to overlook male distress, may underestimate depression rates in men ( Smith et al. , 2018 ). Further, females are also more likely to volunteer to participate in studies ( Porter and Whitcomb, 2005 ); therefore, many interview studies have disproportionately more females in the data set (e.g., Cooper et al. , 2017 ). If we had been able to interview more male students, we might have identified different findings. Additionally, we limited our sample to life sciences students engaged in undergraduate research at public R1 institutions. It is possible that students in other majors may have different challenges and opportunities for students with depression, as well as different disciplinary stigmas associated with mental health.

In this exploratory interview study, we identified a variety of ways in which depression in undergraduates negatively affected their undergraduate research experiences. Specifically, we found that depression interfered with students’ motivation and productivity, creativity and risk-taking, engagement and concentration, and self-perception and socializing. We also identified that research can negatively affect depression in undergraduates. Experiencing failure in research can exacerbate student depression, especially when students do not have access to adequate guidance. Additionally, being alone or having negative interactions with others in the lab worsened students’ depression. However, we also found that undergraduate research can positively affect students’ depression. Research can provide a familiar space where students can feel as though they are contributing to something meaningful. Additionally, students reported that having access to adequate guidance and a social support network within the research lab also positively affected their depression. We hope that this work can spark conversations about how to make undergraduate research experiences more inclusive of students with depression and that it can stimulate additional research that more broadly explores the experiences of undergraduate researchers with depression.

Important note

If you or a student experience symptoms of depression and want help, there are resources available to you. Many campuses provide counseling centers equipped to provide students, staff, and faculty with treatment for depression, as well as university-dedicated crisis hotlines. Additionally, there are free 24/7 services such as Crisis Text Line, which allows you to text a trained live crisis counselor (Text “CONNECT” to 741741; Text Depression Hotline , 2019 ), and phone hotlines such as the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can also learn more about depression and where to find help near you through the Anxiety and Depression Association of American website: https://adaa.org ( Anxiety and Depression Association of America, 2019 ) and the Depression and Biopolar Support Alliance: http://dbsalliance.org ( Depression and Biopolar Support Alliance, 2019 ).

ACKNOWLEDGMENTS

We are extremely grateful to the undergraduate researchers who shared their thoughts and experiences about depression with us. We acknowledge the ASU LEAP Scholars for helping us create the original survey and Rachel Scott for her helpful feedback on earlier drafts of this article. L.E.G. was supported by a National Science Foundation (NSF) Graduate Fellowship (DGE-1311230) and K.M.C. was partially supported by a Howard Hughes Medical Institute (HHMI) Inclusive Excellence grant (no. 11046) and an NSF grant (no. 1644236). Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF or HHMI.

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7 Depression Research Paper Topic Ideas

In psychology classes, it's common for students to write a depression research paper. Researching depression may be beneficial if you have a personal interest in this topic and want to learn more, or if you're simply passionate about this mental health issue. However, since depression is a very complex subject, it offers many possible topics to focus on, which may leave you wondering where to begin.

If this is how you feel, here are a few research titles about depression to help inspire your topic choice. You can use these suggestions as actual research titles about depression, or you can use them to lead you to other more in-depth topics that you can look into further for your depression research paper.

What Is Depression?

Everyone experiences times when they feel a little bit blue or sad. This is a normal part of being human. Depression, however, is a medical condition that is quite different from everyday moodiness.

Your depression research paper may explore the basics, or it might delve deeper into the  definition of clinical depression  or the  difference between clinical depression and sadness .

What Research Says About the Psychology of Depression

Studies suggest that there are biological, psychological, and social aspects to depression, giving you many different areas to consider for your research title about depression.

Types of Depression

There are several different types of depression  that are dependent on how an individual's depression symptoms manifest themselves. Depression symptoms may vary in severity or in what is causing them. For instance, major depressive disorder (MDD) may have no identifiable cause, while postpartum depression is typically linked to pregnancy and childbirth.

Depressive symptoms may also be part of an illness called bipolar disorder. This includes fluctuations between depressive episodes and a state of extreme elation called mania. Bipolar disorder is a topic that offers many research opportunities, from its definition and its causes to associated risks, symptoms, and treatment.

Causes of Depression

The possible causes of depression are many and not yet well understood. However, it most likely results from an interplay of genetic vulnerability  and environmental factors. Your depression research paper could explore one or more of these causes and reference the latest research on the topic.

For instance, how does an imbalance in brain chemistry or poor nutrition relate to depression? Is there a relationship between the stressful, busier lives of today's society and the rise of depression? How can grief or a major medical condition lead to overwhelming sadness and depression?

Who Is at Risk for Depression?

This is a good research question about depression as certain risk factors may make a person more prone to developing this mental health condition, such as a family history of depression, adverse childhood experiences, stress , illness, and gender . This is not a complete list of all risk factors, however, it's a good place to start.

The growing rate of depression in children, teenagers, and young adults is an interesting subtopic you can focus on as well. Whether you dive into the reasons behind the increase in rates of depression or discuss the treatment options that are safe for young people, there is a lot of research available in this area and many unanswered questions to consider.

Depression Signs and Symptoms

The signs of depression are those outward manifestations of the illness that a doctor can observe when they examine a patient. For example, a lack of emotional responsiveness is a visible sign. On the other hand, symptoms are subjective things about the illness that only the patient can observe, such as feelings of guilt or sadness.

An illness such as depression is often invisible to the outside observer. That is why it is very important for patients to make an accurate accounting of all of their symptoms so their doctor can diagnose them properly. In your depression research paper, you may explore these "invisible" symptoms of depression in adults or explore how depression symptoms can be different in children .

How Is Depression Diagnosed?

This is another good depression research topic because, in some ways, the diagnosis of depression is more of an art than a science. Doctors must generally rely upon the patient's set of symptoms and what they can observe about them during their examination to make a diagnosis. 

While there are certain  laboratory tests that can be performed to rule out other medical illnesses as a cause of depression, there is not yet a definitive test for depression itself.

If you'd like to pursue this topic, you may want to start with the Diagnostic and Statistical Manual of Mental Disorders (DSM). The fifth edition, known as DSM-5, offers a very detailed explanation that guides doctors to a diagnosis. You can also compare the current model of diagnosing depression to historical methods of diagnosis—how have these updates improved the way depression is treated?

Treatment Options for Depression

The first choice for depression treatment is generally an antidepressant medication. Selective serotonin reuptake inhibitors (SSRIs) are the most popular choice because they can be quite effective and tend to have fewer side effects than other types of antidepressants.

Psychotherapy, or talk therapy, is another effective and common choice. It is especially efficacious when combined with antidepressant therapy. Certain other treatments, such as electroconvulsive therapy (ECT) or vagus nerve stimulation (VNS), are most commonly used for patients who do not respond to more common forms of treatment.

Focusing on one of these treatments is an option for your depression research paper. Comparing and contrasting several different types of treatment can also make a good research title about depression.

A Word From Verywell

The topic of depression really can take you down many different roads. When making your final decision on which to pursue in your depression research paper, it's often helpful to start by listing a few areas that pique your interest.

From there, consider doing a little preliminary research. You may come across something that grabs your attention like a new study, a controversial topic you didn't know about, or something that hits a personal note. This will help you narrow your focus, giving you your final research title about depression.

Remes O, Mendes JF, Templeton P. Biological, psychological, and social determinants of depression: A review of recent literature . Brain Sci . 2021;11(12):1633. doi:10.3390/brainsci11121633

National Institute of Mental Health. Depression .

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition . American Psychiatric Association.

National Institute of Mental Health. Mental health medications .

Ferri, F. F. (2019). Ferri's Clinical Advisor 2020 E-Book: 5 Books in 1 . Netherlands: Elsevier Health Sciences.

By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.  

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Psychotherapy for depression in college students

A protocol for systematic review and network meta-analysis.

Zhang, Xiu MN a ; Niu, Ming-Ming MN b ; Ma, Pei-Fen MN c,d ; Du, Li MD e ; Wan, Lin MN a,∗

a Department of Orthopedics, Second Hospital of Lanzhou University

b Evidence-Based Nursing Center, School of Nursing, Lanzhou University

c Department of Nursing, Second Hospital of Lanzhou University

d School of Nursing, Lanzhou University

e The Third People's Hospital of Lanzhou city, Lanzhou, China.

∗Correspondence: Lin Wan, Department of Orthopedics, Second Hospital of Lanzhou University, No. 82, Cuiyingmen, Chengguan District, Lanzhou City, Gansu Province, China (e-mail: [email protected] ).

Abbreviations: ACT = acceptance and commitment therapy, BA = behavioral activation, BDI = beck depression inventory, CBT = cognitive-behavioral therapy, CESD-R = center for epidemiologic studies depression scale revised, CSCT = comprehensive self-control training, DSM = diagnostic and statistical manual of mental disorders, HRSD = Hamilton Rating Scale for depression, ICD = International Classification of Diseases, NMA = network meta-analysis, RCTs = randomized controlled trials, SASS = social adaptation self-evaluation scale, SMD = standard mean difference, SNRIs = serotonin norepinephrine reuptake inhibitors, SSRIs = selective serotonin reuptake inhibitors, SUCRA = surface under the cumulative ranking area, TAU = treatment as usual, TCAs = tricyclic antidepressants, WLC = waiting-list control.

How to cite this article: Zhang X, Niu MM, Ma PF, Du L, Wan L. Psychotherapy for depression in college students: a protocol for systematic review and network meta-analysis. Medicine . 2020;99:39(e22344).

XZ and M-MN contributed equally to this work.

This study is based on a network meta-analysis of published studies, so ethical approval and patient consent are not required. And this systematic review and network meta-analysis will be published in a peer-reviewed journal.

This study is supported by Gansu Province Health Industry Scientific Research Project (No. GSWSKY-2019-102), Lanzhou University Second Hospital Cuiying Technology Project (No. CY2018-HL18) and Development and promotion of mental health tracking and intervention database for pediatric medical staff in Gansu Province (No. 2018-RC-52).

There are no potential conflicts of interest to disclose.

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

Background: 

Depression is a disease with a high incidence and easy to relapse. It not only affects the work and life of patients, but also brings a heavy economic burden. University is the peak of depression, and the prevalence of depression among college students is much higher than that of ordinary people. The purpose of this research is to evaluate depression symptoms, life satisfaction, self-confidence, substance use, social adjustment, and dropout rates of the use of psychological intervention for college students.

Methods: 

We will identify relevant trials from systematic searches in the following electronic databases: PubMed, Embase, Web of Science and The Cochrane Library. We will also search Clinical Trials.gov, the WHO International Clinical Trials Registry Platform for unpublished data. Additional relevant studies will be searched through search engines (such as Google), and references included in the literature will be tracked. All relevant randomized controlled trials (RCTs) will be included. There are no date restrictions. Use Cochrane Collaboration's Risk of bias tool to conduct risk of bias analysis. Use the Grades of Recommendation, Assessment, Development, and Evaluation to assess the quality of evidence. All statistical analysis will be performed using Stata (V.15.0.) and Review Manager (V.5.2.0).

Results: 

A total of 6238 records were obtained by searching the database and 27 records were obtained by other sources. After removing duplicate records, there are 4225 records remaining. We excluded 3945 records through abstract and title, leaving 280 full-text articles.

Conclusion: 

This will be the first study to compare the effects of different psychological treatments on depression in college students. We hope that this study will guide clinical decision-making of psychotherapy to better treat depression in college students.

Protocol Registration: 

INPLASY202070134.

1 Introduction

Depression is a common mental health disorder, which is mainly manifested by significant and lasting depression, slow thinking, sleep disturbance, loss of appetite, etc. In severe cases, suicide attempts or behaviors may occur. [1] Each episode of depression lasts at least two weeks. In severe cases, it may last for several years. This has a serious impact on work and life, and has caused a heavy financial burden. According to the World Health Organization, more than 350 million people worldwide suffer from depression. [2] The current incidence of depression in China is 6.1%. [3] By 2020, depression may become the second largest disease after heart disease. [4] And depression has become the main reason for people's loss of social function and ranks third in the global burden of disease. [5] Studies have shown that in the United States alone, the annual cost exceeds $43.7 billion. [6,7] College students are faced with the pressure from interpersonal communication, arduous learning tasks and adaptation to the new environment and lifestyle, which makes them prone to produce strong psychological conflicts and lead to depression. [8] Therefore, compared with their peers, college students have a higher risk of depression. [9]

At present, the treatment of depression is mainly divided into medication and psychotherapy. Drug therapy mainly includes selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin norepinephrine reuptake inhibitors (SNRIs), etc. [10] Psychotherapy is to establish a relationship with the patient through a structured and purposeful connection and use a series of specific techniques to improve the patient's mental state. [11] It plays an important role in the treatment of depression. At present, the common psychotherapy in clinical treatment methods include cognitive behavior therapy, group psychotherapy, interpersonal behavior therapy, mindfulness therapy, etc. Previous studies showed that there are few systematic reviews and meta-analysis of depression in college students. However, the relevant evidence for the effectiveness of psychotherapy is still unclear, and there is no evidence to directly compare different psychological interventions. Therefore, this field urgently needs a Bayesian network meta-analysis (NMA) method that combines direct evidence with indirect evidence from multiple treatment comparisons to estimate the correlation between all treatments. [12] In this study, we will conduct a systematic review and NMA to evaluate depression symptoms, life satisfaction, self-confidence, substance use, social adjustment, and dropout rates of the use of psychotherapy for college students.

2.1 Eligibility criteria

2.1.1 type of study.

We will include all relevant randomized controlled trials (RCTs) including crossover trials. There are no language restrictions.

2.1.2 Type of patient

The patients we will include are college students diagnosed with depression according to any diagnostic criteria, such as Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, [13] DSM-IV, [14] and International Classification of Diseases, 10th Revision (ICD-10). [15] Studies in which participants have a diagnosis of bipolar disorder, psychotic depression will be excluded. In addition, studies where participants are not clearly diagnosed with depression will also be excluded.

2.1.3 Type of interventions

We will include RCTs comparing one psychological intervention with another control conditions for depression in college students. For psychotherapy, mindfulness therapy, cognitive-behavioral therapy (CBT), meditation therapy, comprehensive self-control training (CSCT), [16] acceptance and commitment therapy (ACT), [17] and behavioral activation (BA) will be included. There will be no limit to the treatment session. In terms of control conditions, waiting-list control (WLC), [18] non-treatment control, physical exercise, bibliotherapy, [19] treatment as usual (TAU) will be included.

2.1.4 Type of outcomes

Primary outcome

Depression symptoms that mean the change in severity of depression from baseline to end point which is measured by the depression scale, such as Beck Depression Inventory (BDI), [20] The Center for Epidemiologic Studies Depression Scale (CESD-R), [21] Hamilton Rating Scale for Depression (HRSD). [22]

Second outcomes

• 1. self-confidence, life satisfaction was assessed using visual rating scale
• 2. social adjustment was assessed using the Social Adaptation Self Evaluation Scale (SASS) [23] and the Social Adjustment Scale-Self Report for Youth. [24]
• 3. substance use was measured with 10 items to assess the use of eight substances, quantity per drinking and smoking day. [25]
• 4. Dropout rates from the beginning of the study to the end of the intervention.

2.2 Data source

We will identify relevant trials from systematic searches in the following electronic databases: PubMed, Embase, Web of Science and The Cochrane Library. We will also search Clinical Trials.gov, the WHO International Clinical Trials Registry Platform for unpublished data. The search terms will include “depression”, “depressive disorder”, “students”, “university student”, “college student”. Additional relevant studies will be searched through search engines (such as Google), and references included in the literature will be tracked. There is no date restriction. Detail of search strategy of PubMed is shown in Table 1 as well as detail of search strategy of Embase is shown in Table 2 .

2.3 Study selection

All records identified in the databases will be collected in the reference management software EndNote X8 for data screening. Two (MMN and PFM) reviewers will use data extraction tables to extract data from the original report independently, including research characteristics (such author information, publication year, journal and country), patient characteristics, intervention and outcome. Any disagreements will be resolved by the third member of our review team.

2.4 Risk of bias analysis

According to Cochrane Collaboration's Risk of bias tool, we will assess risk of bias as ‘low risk’, ‘unclear risk’ or ‘high risk’. [26] The following items will be evaluated: sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessors, incomplete outcome data and selective outcome reporting and other sources of bias. [27] The evaluation will be conducted by two independent raters (PFM and LD). Any disagreements will be resolved by a third review author.

2.5 Statistical analysis

2.5.1 pairwise meta-analysis.

We will use Review Manager (V.5.2.0) to perform traditional pairwise meta-analysis. Dichotomous data will be expressed as relative risk (RR) with 95% confidence interval (CI), and continuous outcomes will be expressed as standard mean difference (SMD) with 95% CI. [28]

2.5.2 Network meta-analysis

To simultaneously assess the comparative effects of more than 2 psychotherapy, an NMA will be performed. An NMA synthesizes direct and indirect comparisons over an entire network of psychotherapy, allowing for all available evidence to be considered in one analysis. Based on the network development process as outlined above, the outcome variable for the NMA is the standardized mean change in the DSST (measured using Hedge's G) from baseline to end of study. The standardization is based on the pooled (across treatment arms within study) estimate of the SDs. The NMA will be carried out using a frequentist's approach, and a 2-way ANOVA model is used. As the residual variances between treatment groups are known, it is possible for random effect estimates to be produced, which account for the between-trial heterogeneity. The model is used to perform ordinary pairwise meta-analysis comparing the different psychotherapy based on direct evidence from the clinical studies. Ranking probabilities will be calculated based on the joint distribution of the estimates of relative efficacy. [29]

Consistency will be addressed through the principle of node splitting by using a network meta-regression model. The purpose of node-splitting is to investigate if the relative effect of 2 psychotherapy based on direct comparisons is comparable with the same effect based on indirect comparisons. Statistically, the model is an extension of the NMA, which allows for a different relative effect between the 2 psychotherapy that are being split in head-to-head trials compared with all other trials. NMA will be implemented by the mvmeta software package in Stata (15.0; Stata Corporation, College Station, TX, USA Stata), [30] If P value <.1 and I 2 > 50%, it is considered that there is heterogeneity in the study, and sensitivity analysis or subgroup analysis will be performed to detect the source of heterogeneity. Funnel plot and Egger linear regression analysis will be used to assess publication bias. Using Review Manager (V.5.2.0) to analyze the risk of bias in the included studies, where the green, yellow, and red in the image represent low, unclear, and high risks, respectively. [31,32]

2.5.3 Subgroup analysis

If statistical heterogeneity is evident, we will analyze the causes of heterogeneity, if there is enough data (such as differences between sexes, comparison between different countries, studies sponsored versus not sponsored by companies).

2.5.4 Sensitivity analysis

We will use the exclusion method to conduct sensitivity analysis:

• (1) exclude low-quality studies;
• (2) exclude studies with comorbid physical or mental illnesses;
• (3) exclude trials with missing data.

2.6 Quality of evidence

We will use Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to assess the quality of evidence for the primary outcomes. [33,34] The quality of evidence is assessed as ‘high’, ‘moderate’, ‘low’ or ‘very low’. The following item will be evaluated: limitations, inconsistency, imprecision, indirectness, and publication bias. [35]

2.7 Summary of findings

A “summary of finding” table will be created for the major outcome. We will also add absolute and relative percentage changes to the “summary of finding”. For detailed information, see Table 3 ; we have listed partial summary of findings for the main comparison.

3.1 Results of the search

A total of 6238 records were obtained by searching the database and 27 records were obtained by other means. After removing duplicate records, there are 4225 records remaining. We excluded 3945 records through abstract and title, leaving 280 full-text articles. The document screening flowchart is shown in Figure 1 .

3.2 Characteristic of included studies

In a preliminary trial, we included 8 studies. The average age of patients was 18 to 26, with a maximum sample size of 181 and a minimum sample size of 32. The research period ranges from one month to 12 months. For more detailed information, see Table 4 .

4 Discussion

At present, although some studies have evaluated the intervention effects of psychotherapy, there is no NMA to compare the therapeutic effects of different psychological interventions for college students. Therefore, this systematic review and NMA will summarize the direct comparison and indirect comparison evidence to evaluate different psychological interventions. We hope that this study will help guide clinical decision-making for psychotherapy to better treat depression in college students.

Author contributions

Conceptualization: Xiu Zhang, Lin Wan.

Data curation: Xiu Zhang, Ming-Ming Niu, Pei-Fen Ma, Li Du, Lin Wan.

Methodology: Xiu Zhang, Lin Wan.

Software: Xiu Zhang, Ming-Ming Niu, Pei-Fen Ma, Li Du.

Writing – original draft: Xiu Zhang, Ming-Ming Niu, Lin Wan.

Writing – review & editing: Xiu Zhang, Lin Wan.

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Essay on Depression

Students are often asked to write an essay on Depression in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Depression

Understanding depression.

Depression is a mental health condition that affects a person’s mood. It’s more than just feeling sad or upset. People with depression may feel hopeless, lose interest in things they used to enjoy, and struggle with daily tasks.

Causes of Depression

Recognizing depression.

Depression can appear differently in different people. Some might feel constantly sad, while others might lose interest in activities. It can also cause physical symptoms like changes in appetite or sleep patterns.

Treating Depression

Depression is treatable. Treatments include therapy, medication, and lifestyle changes like regular exercise and a healthy diet. It’s crucial to seek help if you or someone you know is showing signs of depression.

250 Words Essay on Depression

Depression, a common yet serious mental health disorder, is characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. It affects individuals differently, leading to a variety of physical and emotional problems.

Causes and Risk Factors

Depression is a complex disorder with multiple contributing factors. Genetics play a significant role; individuals with a family history of depression are more likely to experience it. Environmental factors, such as exposure to violence, neglect, abuse, or poverty, also increase the risk. Personal characteristics, like low self-esteem or being overly dependent, self-critical, or pessimistic, can make individuals more prone to depression.

Impact on Life

Depression drastically impacts life quality. It can lead to social isolation, problems at work or school, and relationship difficulties. In severe cases, it can cause suicidal thoughts or actions, underlining the importance of seeking professional help.

Treatment and Management

Depression is treatable with a combination of psychotherapy and medication. Cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy are effective therapeutic approaches. Antidepressants can also help manage symptoms. Lifestyle changes, such as regular exercise, a healthy diet, and adequate sleep, are crucial for managing depression.

500 Words Essay on Depression

Introduction: unveiling depression.

Depression, a common and serious mental health disorder, is often characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. It is a complex condition that not only affects the individual’s mental state but also their physical health, often leading to a myriad of complications if left untreated.

Understanding the Causes

Depression is multifactorial, with both genetic and environmental factors contributing to its development. It is believed that a combination of genetic vulnerability and environmental stressors like trauma, loss of a loved one, or a difficult relationship can trigger changes in brain function and structure, leading to depression. Neurotransmitters, chemicals that facilitate communication between nerve cells, are also implicated in the pathogenesis of depression.

Manifestations of Depression

Depression manifests in various forms. Major Depressive Disorder, the most common, is characterized by a persistent feeling of sadness or a lack of interest in outside stimuli. There’s also Persistent Depressive Disorder, a chronic form of depression where an individual experiences symptoms for at least two years. Other forms include Postpartum Depression, experienced after childbirth, and Seasonal Affective Disorder, which typically occurs during winter.

Impact on Daily Life

Depression significantly impairs an individual’s ability to function in their daily life. It affects their productivity at work or school, disrupts their relationships, and reduces their overall quality of life. It also increases the risk of other serious conditions, including heart disease and diabetes. In severe cases, depression can lead to suicidal ideation or attempts, making it a potentially life-threatening condition.

Depression and Stigma

Conclusion: a call to action.

Depression is a pervasive and debilitating condition that requires our urgent attention. By increasing awareness, reducing stigma, and improving access to treatment, we can ensure that those suffering from depression receive the help they need. As a society, we must strive to understand and empathize with those battling depression, encouraging them to seek help without fear of judgement. Only then can we hope to truly combat this global mental health crisis.

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Depression Among High School Students Research Paper

• To find inspiration for your paper and overcome writer’s block
• As a source of information (ensure proper referencing)
• As a template for you assignment

Significance of the Problem

Analysis of the problem, analysis of the policy issue, status updates.

A public health policy issue I am interested in concerns about depression among high school students. Only about 40 years ago, depressive disorders in adolescents were largely neglected since most physicians doubted that the problem could exist at such an early age. However, it has been proven depression may not only appear in teenagers but also increase associated morbidity and mortality rates (Parker, 2013). Therefore, the importance of the issue is hard to overestimate as plenty of human lives are at stake.

The proposed policy is to introduce depression screening at schools to detect the problem in time. The immediate target of the policy is the local level. Later, the issue will have to be discussed at the state level since it is not enough to solve the problem only locally. There is a necessity to develop universal guidelines for screening that would be applicable in all schools across the state. This will considerably facilitate the procedure of policy implementation via standardization. The legislator that is to be contacted first is Janice Kerekes, Clay County Board Member Representative, District 1.

The specific problem surrounding the issue of depression among adolescents is the absence of timely diagnosis as the first step to depression management. More than 30% of depressed adolescents are not recognized and do not receive treatment, while the clinical spectrum of their condition may vary from simple sadness to bipolar disorder, which can be irreversible if not detected in due time (Parker, 2013).

The research shows that approximately 9% of school students at the end of adolescence meet criteria for depression whereas 20% of them state that they suffer from the condition since early childhood (Allison, Nativio, Mitchell, Ren, & Yuhasz, 2014).

Currently, there is no regulation that would oblige schools to conduct a screening that would allow detecting the condition in high school children. Thus, in order to improve the situation, it is necessary to introduce changes to regulatory issues. Mandatory annual screenings for adolescents are recommended as the most effective option. Nurses will be for conducting them in high schools. This necessity is supported by the fact that depression is now the major cause of psychosocial impairments, increased hospitalization, alcohol and drug abuse, antisocial behavior, and suicide.

There is also evidence that more than 50% of cases of negative mood changes in adolescents can be eliminated through social therapy that makes it possible to monitor and modify distorted thinking by encouraging social activities and resolving conflicts (Allison et al., 2014). This helps prevent severe impairments of the psyche caused by clinical depression. In case of a more serious condition, early intervention makes it easier to do without antidepressants or tranquilizers and mitigate the effects with psychotherapy only.

School is the main place outside the home where teenagers spent the majority of their time. Therefore, detecting behavior deviations and providing preventive measures is the primary responsibility of a school nurse. Despite the fact that there are two acts regulating suicide prevention (the Youth Suicide Prevention Act of 1987 and the Public Health Service Act of 1990), there are no universal guidelines for screening and follow-up. Having no elaborated plan of action, school superintendents often have to decide for themselves how to manage the problem. Researchers have found that no program of those that have been developed has been tested in a randomized trial, which means that none of them are evidence-based (Parker, 2013).

Goals/Options

The ultimate goal of depression screening it to separate students who have symptoms of the disease (true positives) from those who do not have them (true negatives) in order to identify depression and suicidality risk groups. The related goals include:

• creating a list of depression indicators on the basis of the observed cases for teachers and parents to be able to identify the problem at an early stage;
• creating other learning conditions to those whose depression is getting aggravated owing to the unfavorable environment;
• providing psychotherapy to teenagers suffering from various forms of depression based on the gravity of the condition;
• ensuring follow-up and cooperation with parents.

There are three major options for schools to choose from:

• to include problem education into the curriculum programs;
• to provide training for teachers;
• to introduce the regular screening.

Evaluation of Options

Although the first option has been studied more profoundly, its effectiveness is still doubtful. On the contrary, there is extensive evidence that curriculum programs do not prevent depression or suicidal behavior in high school students. They do not feel that theoretical education is connected with their real-life condition (Prochaska, Le, Baillargeon & Temple, 2016). Moreover, many of them try to conceal it out of fear of bullying (Bauman, Toomey, & Walker, 2013).

The second option, in-service training for teachers can potentially assist them in identifying students that are at risk. However, there is little research on the efficacy of the measure, which does not allow making inferences about its superiority over the other two (Cunningham & Suldo, 2014). Besides, the assessment of a person without medical education can be rather subjective.

Finally, the third option involves a comprehensive evaluation of students’ psychological state including self-reported data, results of various psychological tests, and interviews (Prochaska et al., 2016). This measure is more preferable since it can be applied in all schools regardless of the curriculum and provide more objective results.

Recommended Solution

It is recommended to issue a new regulation for schools obliging them to introduce a depression screening program for high school students. At the first stage of the program, students will need to complete an evaluation form, the major goal of which is to identify those who are at elevated risk. In the second stage, the risk group is assessed via computer tests. At the final stage, a school nurse interviews those students whose results raise concerns to be able to diagnose their stage of depression.

Policymakers have to provide schools with psychometrically validated screening tools that must be tested as per their sensitivity (the ability to detect students with depression), specificity (the ability to identify those who do not have any related conditions), positive predictive value (the relation between whose who screen positive and who are actually positive), and negative predictive value (the relation between whose who screen negative and who are actually negative).

American Academy of Child and Adolescent Psychiatry provides updates on this and other topics related to the mental health of children and teenagers. The website of the organization features numerous annual reports and recommendations for all stakeholders involved. Furthermore, there are also strict pharmaceutical guidelines for every mental disorder. The academy has a 60-year history in the field and therefore can serve as a reliable source of information on policy and other psychological conditions.

There is a nationwide problem with the detection, treatment, and prevention of teenage depression. For nurses, it means that the quality and nature of care delivery may be negatively affected by the wrong diagnosis. Since the problem is fraught with long-term consequences and leads to poor socialization, performance at work, family relations, and state of health, neglecting it may mean that in the future, nurses will have to deal with the population, suffering from a whole spectrum of mental conditions. Thus, due-time screening is crucial for schools to introduce.

Allison, V. L., Nativio, D. G., Mitchell, A. M., Ren, D., & Yuhasz, J. (2014). Identifying symptoms of depression and anxiety in students in the school setting. The Journal of School Nursing , 30 (3), 165-172.

Bauman, S., Toomey, R. B., & Walker, J. L. (2013). Associations among bullying, cyberbullying, and suicide in high school students. Journal of Adolescence , 36 (2), 341-350.

Cunningham, J. M., & Suldo, S. M. (2014). Accuracy of teachers in identifying elementary school students who report at-risk levels of anxiety and depression. School Mental Health , 6 (4), 237-250.

Parker, G. (2013). Teenage depression: Some navigational points for parents and professionals. World Psychiatry , 12 (3), 272-274.

Prochaska, J. D., Le, V. D., Baillargeon, J., & Temple, J. R. (2016). Utilization of professional mental health services related to population-level screening for anxiety, depression, and post-traumatic stress disorder among public high school students. Community Mental Health Journal , 52 (6), 691-700.

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Should I Tell My Students I Have Depression?

By Abby L. Wilkerson

• Dec. 14, 2016

The new class I was teaching — “Composing Disability: Crip Ecologies” — was one of several first-year writing seminars offered at George Washington University. Given the focus, it was likely to be a challenge for at least some of the students. And it was presenting a particular challenge to me.

Even before the class began, I was anxious. I have depression, and I wondered: Should I acknowledge it in the class? Would the students benefit if I did? I wanted to be sure I knew what I was doing, for everyone’s sake, before taking the leap. But I was not at all certain. The idea of disclosing in the classroom made me feel conflicted and vulnerable.

Though the World Health Organization identifies depression as “the leading cause of disability,” not everyone with depression identifies herself as disabled. One of the central meanings of disability for me is “crip” pride — resistance to medical notions of disability as a defect and related social stigmas. My depression has given me unasked-for gifts, including a sensitivity to others’ suffering.

But let’s face it — on some level, depression is suffering. How could I reconcile this with the fierce crip attitude in others that I’ve so admired? In class, how would the dull weight of depression sit with the “crip” in the course title? If I were going to do this, I needed to get it right. And I wasn’t sure how.

Though I have suffered severe depression in the past, these days, my episodes tend to be milder and less frequent. Some days, I feel fine. But I might soon begin feeling melancholy — yet still able to laugh, think clearly, sleep at night and enjoy my life. Then one morning, for no discernible reason, I wake up mired in mud, my body now freight to be pushed through daily routines. The rhythm of life is suddenly ground down almost to nothing. I feel somehow both numb and raw, skin thin, laid open. Everything that matters is now far-off in the distance. Other people seem remote, existing in some parallel universe.

I always have to be learning how to take better care of myself, noticing signs of a depression emerging, yet I also have to accept depression as part of me. I’d need to continue these efforts while teaching a new course posing heightened emotional demands for students, on a campus where several of their peers had committed suicide over the previous year or so.

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Prevalence of depression, anxiety and stress and their risk and protective factors among secondary students in Rwanda during the first wave of COVID-19 pandemic

• Mukantwali, Marie Bienvenue
• Niyonsenga, Japhet
• Uwingeneye, Liliane
• Kanyamanza, Claudine Uwera
• Mutabaruka, Jean

Introduction Compelling evidence shows that the COVID-19 pandemic has detrimental effects on the mental health of university students. However, little is known about the psychological distress experienced by students from high schools during the pandemic. This study, therefore, sought to examine the prevalence of depression, anxiety and stress and their associated factors among students from high schools in Rwanda. Methods and materials A retrospective, cross-sectional study was conducted on 384 students randomly selected from high schools. Data were collected using standardized measures of mental disorders and their associated factors. Bivariate and multivariate analyses based on the odds ratio were used to indicate the associated factors of anxiety, depression, and stress. Results The results indicated that slightly above half of the participants (51%, n = 195) had clinically significant symptoms of depression, 30.3% (n = 116) had stress and 67.3% (n = 259) had anxiety. Our analyses identified several key risk factors associated with increased odds of these mental disorders. These include exposure to domestic violence, COVID-19 symptoms like cough and myalgia, eating twice per day, having one of the three mental disorders, gender, with females showing higher susceptibility, and direct contact with the people who positively tested covid-19. Conversely, protective factors such as heightened awareness about Covid-19, positive mental health, social support, eating three times, belonging to the third Ubudehe category, and a high resilience emerged as significant elements mitigating the risks of these mental health challenges within our sample. Intriguingly, religious affiliation emerged as a notable factor, with students affiliated with the Witness of Jehovah and Adventist denominations exhibited lower risks for depression and anxiety. Conclusion Our findings highlighted a high prevalence of depression, anxiety, and stress among students from secondary schools. Interestingly, this study also revealed the associated risk and protective factors of depression, anxiety, and stress in Rwandan students in high schools. Therefore, mental health interventions targeting the impact of COVID-19 on students, as young people are needed.