This week has seen the launch of a report by Union of Students in Ireland (USI) highlighting very high levels of mental health problems, depression, stress and anxiety among third-level students. To me this looks like (more) convergent evidence. Depression is often described as a disease of modernity. The rise in incidence and prevalence of depression since the turn of the 20th century has been incremental and unrelenting. Each new generation appears to suffer more than the previous one.
Some will argue that findings such as these are artefactual. And questions can be raised about the study. Relying as it did on students to complete an online survey about mental health, it may attract a particular cohort of respondents. Those with mental health problems may be more motivated to respond to the survey. This can inflate the apparent incidence of problems. Equally, relying on surveys may lead to inflated reports of psychological distress.
These two factors may be enough to allow some to dismiss what at first glance looks like a very high incidence of depression and anxiety, estimated at about one in three third-level students. I think we would be better off taking the report seriously.
Cross-cultural studies
Globally the prevalence and risk of depression are rising, some going so far as to call it an epidemic. Serious effort has now been invested into understanding why rates continue to rise. Cross-cultural studies, where risk and prevalence rates between cultures are compared, highlight a few important culprits. And it is interesting to see that the USI survey reflects that these same forces are at work in our student population.
It is one of the great paradoxes of modern psychiatry that wealth and happiness have not been bedfellows. The past century, which saw such important advances in physical health, has delivered more unhappiness. Rising GDP, generally taken as a marker of modernity, is associated with rising rates of depression. This has encouraged researchers to think about what aspects of modern-day lifestyles are undermining psychological well-being.
Current thinking is that there are three important culprits: inequality, social isolation and sedentary lifestyles. Globally inequality has risen dramatically since 1965. According to the World Bank, the incomes of even highly educated professionals such as doctors, lawyers, engineers and scientists have stagnated. On the other hand, the incomes of chief executives, for example, have risen to 354 times that of average workers. The bulk of students in the USI survey report they are financially dependent on others, mostly parents. This is likely to mean that young people from all but the most affluent homes are likely aware of the financial pressure that a college education is placing on their parents. And indeed we see in the student survey those dependent on loans and in debt were most likely to be severely anxious and depressed.
The students I meet on a day-to-day basis are hardworking and socially responsible young adults. And so one of the very clear consequences of the increasing cost of college and housing is that many students are keen to secure part-time employment to deal with financial pressure. In reality, this means engagement with a full-time course with the associated full-time examination and coursework commitments while holding down a job.
Over the last 10 years, it has been apparent that the rising cost of college has meant that all but very few students work their way through college. And so participation in college life, in particular extracurricular activities, is often sacrificed. This has had two unfortunate consequences. Extracurricular activities can be key sites for the development of social connections and important vehicles for exercise or sport. They can be seen as central to combating the isolated and sedentary lifestyles that are the two other culprits associated with rising depression. Reflecting this, the USI survey highlights the link between mental health and participation in these types of activities.
Upward spiral
This is a real shame. There is an upward spiral of psychological function associated with social connections and physical activity. The Growing up in Ireland survey – a long term study of children’s lives – shows that fitness and participation in group activities was also associated with enhanced cognitive performance. In short, maintaining your mental health facilitates academic achievement.
Students should try to strike a balance. Depression appears to be linked to the mismatch between modern ways of living and healthy psychological functioning. Some of the aspects of our environment we can control and manage in the short term. Others are longer-term political projects.
If someone is struggling with financial woes, balancing employment and study, deprived of time for exercise and isolated from peers, their life will feel like a struggle. They need to talk to those upon whom they depend financially about solutions to get through this academic year.
Step back and make one change to facilitate your connections with others. Find a way to become less sedentary. Talk and walk.
Orla Muldoon is professor of psychology at the University of Limerick
Support services can be contacted at:
- Samaritans – 116 123
- Yourmentalhealth.ie
- Aware – 1800 80 48 48
- Pieta House – 1800 247 247
- Walk In My Shoes – 01 249 33 33
- LGBT Helpline – 1890 929 539