Depression Can Strike Early, Undetected

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It shouldn't be surprising that mental health officials didn't zero in on Jared Loughner's reported problems long before he opened fire Saturday in Tucson.

It is not known whether Loughner suffers from any mental illness, but many young people do, particularly depression. And research shows that even top universities fail to see it when students about the age of Loughner struggle with depression, sometimes a precursor to violence, suicide and paranoia.

A large study at three widely separated schools (the University of Wisconsin, the University of Washington and the University of British Columbia) found that one out of every four or five students who visited a school health facility for a routine cold or sore throat were depressed. The students filled out a confidential form and inserted it in a locked box to protect their identity, so no one knew it at the time. And many of the depressed students had suicidal thoughts or were considering suicide.

Yet screening for depression is amazingly easy - just a couple of simple questions may reveal it - according to Michael Fleming of Northwestern University's Feinberg School of Medicine, lead author of a study published in the current issue of the American Journal of Orthopsychiatry.

"It should be done for every student who walks into a health center," Fleming said in releasing the study. "These kids might drop out of school because they are so sad or hurt or kill themselves by drinking too much or taking drugs."

The study found that treating depression with pharmaceuticals won't solve the problem unless the underlying causes of depression are also addressed. One thing seemed to work, however. Students who were active physically, either walking, riding a bike, running, or engaging in physical work, were much less likely to feel depressed. Conversely, a sedentary life style was a likely road to depression.

Some 1,622 persons took part in the study. It should not be surprising that many of them were going through at least a mild depression. They were passing through a major transitional phase in their lives, separated from family members and old friends, overworked and underpaid.

Asking Two Questions Is Key to Spotting Depression

There is no suggestion here that these young adults are likely to end up on a street corner firing a weapon at strangers, but depression is a serious concern among mental health experts, even in its milder forms. A study that is to be published in April in the Archives of General Psychiatry notes that many patients with depression also report "psychotic-like symptoms, such as hearing voices or believing they are being spied on or plotted against."

Sound familiar? We've heard it on the heels of nearly every violent tragedy that has struck our schools and communities, from Columbine to Tucson.

The more common result, however, is not violence against others. It's against themselves, either turning to heavy drinking, drugs, or worse. Suicide is the third leading cause of death among teenagers and young adults, according to the Centers for Disease Control and Prevention.

Early identification of depression is critical if that statistic is to change, but here's a depressing line from the Northwestern study: "Yet, in general U.S. populations, the median delay between onset of mental health symptoms and accessing services is 11 years." That's an eternity.

Here's some more troubling findings from that study:

"Overall, 26.4 percent of female and 24.7 percent of male study participants screened positive for depression.

About "10 percent of females and 13 percent of males had thoughts of killing themselves." And one out of 10 had considered suicide during the previous two weeks.

"Male and female students with a history of emotional abuse were significantly more likely to be depressed than were students who did not report abuse.

"Nearly one in four students in our sample reported symptoms of depression, which makes it one of the most common treatable health problems seen in college health clinics."

Yet they aren't even being screened, at least on many campuses, much less treated. What would it take to identify students with depression? The study concludes that when students drop by a campus health facility, even for a runny nose, they should be asked two questions:

"Over the past two weeks, have you felt down, depressed, or hopeless?" And "over the past two weeks, have you felt little interest or pleasure in doing things?"

That's all it would take to identify young people who need a little help. In some cases, just knowing that somebody else cares might do the trick.