At times, Alyson Brown can't eat or sleep. Some days, she sleeps for hours during the day. Other days, she has panic attacks that feel like heart attacks.
This has happened in cycles throughout her life, she said.
She suffers from depression.
And although she graduated from the University of Iowa in December, getting there while dealing with depression made school a lot more difficult.
College students with depression often run into more difficulties than the typical student. Those who struggle the most don't connect with the help they need.
Sometimes their disease is invisible because many don't feel comfortable informing their instructors or friends about their condition, and their symptoms often are misread as poor classroom or social performance.
“I think that, in other people's eyes, I would look weak if I told them that I'm just sad a lot,” Brown said.
Yet she had a full scholarship, a good grade-point average and a full-time job while in school that she kept after graduating. She said she has a great boyfriend, a house and food on the table.
At the University of Northern Iowa, anxiety, depression and stress are reality for Jordon Deutmeyer, a 23-year-old student who has dropped out of two schools, attempted suicide and failed a multitude of classes.
“I just remember trying really hard in all of my classes,” Deutmeyer said. “I never skipped, I never did anything, I tried really hard. I would just get Cs back or fail.
“And the more times I did that, the more it was pounding into me that I was an inferior student and I don't belong here.”
He got a lesson that any college students dealing with depression learn — that while earning a bachelor's degree in college requires anyone to overcome obstacles, students with depression can find themselves overcoming even darker challenges.
After dropping out of Kirkwood Community College because of depression, attention deficit disorder and a personality disorder, Deutmeyer was trying to pursue a degree in psychology at Iowa State University in 2010. But he had failing grades and suicidal thoughts, and school increasingly was difficult to handle.
“I would see all these kids around me taking 18 credits and getting an A average, and here I was taking 14, and I was struggling the whole time,” Deutmeyer said. “That made me feel worthless, constantly worthless, constantly like I want to do the schooling so bad, but I'm watching everyone else do easily what I struggle with.”
As the struggle on concentrating and focusing in class increased over the fall semester, so did Deutmeyer's suicidal thoughts, he said.
On Oct. 12, 2010, he went to ISU Student Counseling Services, saying he didn't feel well, and met with a counselor.
After the counseling visit, he returned to his residence hall, stood outside, called his mother to say one last goodbye and tried to overdose on antidepressants. Doctors at Mary Greeley Medical Center in Ames were able to save him and kept him under watch for two weeks while he recovered.
He resumed classes at ISU the day after he left the hospital.
Class was difficult, however, as he tried to make up lost ground. Too embarrassed to tell his professors he was at the hospital for a suicide attempt, he struggled more with his academics and received Cs, Ds and Fs in his classes.
Deutmeyer eventually dropped out of ISU and returned home to live with his parents in Dubuque in spring 2011.
He started attending UNI in August 2011. While he still struggles with academics, he said he's found a support system of friends, proper medication and counseling. He's added an art major and expects to be in school for an additional year and a half.
“My dreams and my hoping is the only thing that got me here, and I think it's the only thing that will get me going in the future,” he said. “I do it because if I didn't, I wouldn't know what else I would do.”
Dr. Michelle Weckmann, UI assistant professor of psychiatry, said about 40 percent of the college students she sees at the Community Mental Health Center in Iowa City and at the Counseling and Health Promotions Center at University of Iowa Hospitals and Clinics suffer from depression.
Depression is a biological disease just like high blood pressure, Weckmann said, but it can trigger precipitating life events in one's life related to work, classes and sports as well as alcohol use.
The Anxiety and Depression Association of America defines depression as a condition in which a person feels discouraged, sad, hopeless, unmotivated or disinterested in life in general, and estimates that nearly 7 percent of U.S. adults 18 years and older have major depressive episodes.
Eight percent of the 930 UI students who took the survey reported that factors such as anxiety, depression and stress impeded their academic performance within the past year. The rate was 11 percent for the 561 UNI students who took the survey. Eight percent of the 878 ISU students who took the survey in 2012 said they had been diagnosed or treated for depression within the past year.
Three of every 10 undergraduate and graduate students among the 1,788 seeking help from the UI Student Counseling Services during the 2012-2013 school year were diagnosed with depression, according to Paula Keeton, assistant clinical director of the UI's Student Counseling Services.
Weckmann offered a list of factors that can help increase resilience to depression:
Brown, 22, of Oelwein, graduated with a degree in journalism and mass communications. She said she first experienced sadness at age 6 after the death of her grandmother.
“That's when I realized that life was not necessarily that happy,” she said. “She was my closest grandma and was kind of the world to me.”
Brown was diagnosed at age 12 with chronic depression after a school counselor who had known her since she was a young child noticed a change in her personality in seventh grade.
Today she relies on an antidepressant for panic attacks and on support from her boyfriend.
Brown sought help through UI Student Counseling Services while in college, but she said she was not satisfied with the service. She said the psychologist she met with for 20 minutes gave her a negative response when talking about her anxiety.
“He told me, as best as I can remember, ‘I'm tired of all of you girls coming in here and saying you have anxiety. You're just stressed — this is college. Get used to it.'?”
Julie Corkery, a UI Student Counseling Services psychologist, said she was sorry that Brown had this experience and that she wishes Brown had tried another counselor at Student Counseling Services.
“Although each individual counselor tries to stretch to meet the needs of a broad range of people, mismatches sometimes occur,” she said.
Experiences differ. Michael O'Donnell, a UI journalism and mass communications junior diagnosed with depression about a year ago, said his psychologist at the UI Student Counseling Services has helped him with academic troubles.
“He offers keen insights every session, as well as supplies me with assignments to work on between appointments,” O'Donnell said. “To be honest, just having a sympathetic listener, one who's also well versed in the weird working of the mind, is a huge help.”
Frank Durham, associate professor of journalism and mass communication at the UI, said depression is difficult to spot in the college setting unless a student personally expresses his or her distress to the instructor.
“Above all, I am not a clinician. So, when students seem to be in distress, I tell them that counseling is possible and potentially helpful,” Durham said. “I then refer them to the university counseling service. Above all, I try to be sympathetic.”
The UI Student Counseling Service offers training for UI faculty members upon request. Training includes a presentation containing information on how to detect depression in students and the steps to take following that.
Kathleen Staley, the counseling service's assistant outreach director, said one presentation has been given to faculty members so far this school year. She said she did not know how many faculty attended
Like many others, including Brown, O'Donnell said he don't tell his professors or supervisors about his depression. “I hesitated at first to ask for help because to me, saying I'm depressed and can't work seems like a lame excuse,” he said.
Alexandra Bushby, 23, also didn't tell others. A December UI graduate, Bushby went from being a straight A student at the beginning of her undergraduate studies to not being able to get through classes. She said she spent the majority of her college days in her room unable to leave because she couldn't stop crying.
Bushby, of Des Moines, earned a degree in linguistics and a minor in Arabic but had to be creative when skipping classes and also work while in college.“I would fake illnesses,” she said. “If I say I have the flu, they say ‘oh, that's fine stay home,' but if I say ‘I can't stop crying,' they say ‘well that's not a legitimate, you need to get into work.'
”Bushby also sought help through UI Student Counseling Services while at the UI but said she was turned off by the experience. “They were like, ‘well life is for living and you should just be happy and your problems aren't really that bad,'” she said.
Bushby's problems started when she was diagnosed at the age of 6 with acid reflux. She was vomiting several times a day and doctors said she had bulimia. She said doctors talked to her a lot about body image and she began worrying about whether she was fat.
Bushby said she had been on various types of antidepressants since she was 13 years old but has been off the medications for about a year and planned to stay off for good. She said her mother, whom she has gotten much closer to recently, and her fiancé of one year have helped her cope with her depression.
Support has not always been there from men she has dated. She said she once dated a man who asked her to tell her something not many people knew about her.“I said ‘I have had severe depression since I was 13.' And straight up he said, ‘ah, I'm not dealing with that.'
Brown's mother, Theresa Brown, who lives in Oelwein and also has suffered from depression, said she felt helpless when she and her daughter went through depression at the same time. She helps Alyson Brown work through relapses by encouraging her to do things that have worked before, such as breathing, yoga and running.
Yet, Alyson Brown said it would be easier if people around her were more understanding of mental illnesses.“It really does hurt sometimes when some people disregard or play down mental health issues,” she said. “Students make jokes all the time and say things like ‘why don't you just go kill yourself?' Having been there, it's a little hurtful…or maybe I am just sensitive.”
This story was produced by Iowa Center for Public Affairs Journalism-IowaWatch.org, a non-profit, online news website that collaborates with Iowa news organizations to produce explanatory and investigative reporting.