Last spring, the TU/e community was shocked and horrified when a 24 year-old PDEng trainee from Spain took his own life. Professor Bart Smolders from the Electrical Engineering Department knew the student personally, “It was so unexpected for a lot of people that this happened because he was a very social guy, always in between people. It was known that he was depressed. He was worried that he couldn’t finish his traineeship even though he was a very good student. We had directed him to the doctor and based on that he had gotten medicine. Many people were in the loop but nobody expected this to happen. His friends didn’t expect it. Nobody did.”

Not every depressed person attempts, or even contemplates, suicide. But even its milder forms, depression is an insidious illness that can rob a person of their quality of life, taking a toll on productivity, relationships and self-esteem. But what exactly is depression? And what are the signs to look out for?

The World Health Organization defines depression as “a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration. It can be long lasting or recurrent, substantially impairing a person’s ability to function at work or school, or cope with daily life.” While everyone may experience these symptoms on any given day, depression comes and stays – generally, doctor’s only diagnose depression when these symptoms have been present continuously for two weeks or longer.

University life: the first big step

According to the Netherlands Study of Depression and Anxiety, one in three people in the Netherlands will suffer from depression or anxiety at some point in their lives. And students may be particularly vulnerable. One recent study from Ireland found rates at around 14 percent in the student population versus just 8 to 12 percent in the general population. What is it about being a student that could push some people into depression, and like the Spanish student, ultimately compel them to end their own lives?

“Students often suffer from loneliness, performance anxiety and stress,” says Eindhoven psychologist Lina Butkute who often sees students in her practice. “And they’re experiencing many things for the first time – heavy academic workloads, romantic loss and the responsibility of taking care of everything themselves without their parents’ help. These stresses can be particularly difficult for this age group because they often have less well-developed coping mechanisms than older adults.”

Lu Chunqiu, 22, from the Department of Mathematics and Computer Science, started a master’s program in August and says he sometimes feels overwhelmed, “I have a lot of homework. It’s a lot more work than I did during my undergraduate program. I had an assignment that was given on a Friday and was due that next Monday. I had to spend all day Sunday in the library to get it done.” Xin Xu often felt isolated during his undergraduate program, “I didn’t feel like anyone was taking care of me. I would think ‘Nobody cares about what my life is about. I’m just one tiny person in the middle of so many.’”

A fish out of water

Living abroad and learning to adapt to differences in language and culture adds an extra layer of complexity to student life for international students. Judith Beenhakker, a psychologist with the Education and Student Service Center (STU), says that foreign students face multiple challenges, “When you’re an international student, you experience a lot of new things all at once. They have to adapt and that process can be very different for every student.”  Butkute agrees, “Friends and family – their entire social network – are far away and they’re often going through culture shock. And this culture shock is not only about getting used to new sounds or new foods – the really stressful part is that you have to develop a new identity.”For some international students, the adjustment period will be rocky and, unfortunately, their native cultures might include deep-seated taboos about seeking help. Xin Xu says his family criticized him for getting depressed, “I went to the hospital and I was diagnosed with a ‘depressed status.’ This was a big step to take in China – to go get help. There are a couple of things you’re absolutely not supposed to be in Chinese culture. You can’t be gay. You can’t be single. And you can’t be depressed. My parents thought I was trying to avoid things. They didn’t really think I was depressed. They told me that I was just using this as an excuse because I wasn’t working hard enough.”  All students feel the pressure to perform well at university but foreign students often have extremely high expectations for themselves. Butkute explains, “Their parents, sometimes their whole families, have put money towards their education and they feel intense pressure to perform.  International students are very focused on their studies and they can be very critical of themselves. I try to explain to them that they can only dedicate so much energy to so many things before it becomes too much for them to handle.”Lu Chunqiu echoes a common worry for international students, “I want to finish as quickly as possible so I’m taking a bigger course load than most people do. People ask me if I ever sleep because I’m doing so much. This is a two-year program and I need to have it done in two years. I took 5 years to do my studies in Finland and I still regret that.” In addition to his immense workload, Lu has pressures that the average Dutch student can barely imagine; “My parents are already saying that I should get married and have a baby. I can understand that. I should save my time. I should get everything done – get married, finish my studies, have a baby, all of it – while I’m still young. I shouldn’t waste my time on things like gaming or traveling. I need to focus on the valuable things.”

Striking a balance helps

Lu’s outlook is shared by many of his fellow foreign students but mental health professionals warn that it can be counterproductive. STU psychologist Sandra van Dongen encourages moderation, “Sometimes it’s a challenge to convince these students that it’s good to have a balance with sports and other activities. They want to put all of their time and energy into studying.” Her colleague Beenhakker adds, “I try to explain it to them like this: imagine an Olympic athlete. They can’t train all the time. That’s not the way to get a gold medal. Even they take breaks to rest, eat, and do other things. You have to do that, too. It’s just as important as studying.” Butkute also emphasizes regularity, exercise and getting enough daylight for fighting off depression, “It’s important to stay active and stay outside as long as possible. Students stay up late, get up late and then they miss this very important part of the day when they need to be outside. Your activity level is very important. It lessens your stress level and provides you with more adrenaline which makes your state of mind more positive.”

Luckily, TU/e is dedicated to supporting students in all aspects of their academic career, including bolstering students’ “soft” skills – which can have a direct affect on mental health according to Beenhakker, “TU/e is really investing in teaching students how to be more assertive, to improve their teamwork skills and how to more effectively interact with other students. Learning these skills can have a positive influence on a student’s ability to build a social network which in the long run can help them maintain good mental health.”

In addition, STU’s psychologists explain that the university’s focus on creating a sense of community is one key to helping students weather the inevitable ups and downs of university life: “Social interaction is extremely important in fighting off depression which is one reason why the university has created a buddy program where an international student can be linked with a Dutch student,” says Sandra van Dongen.

Prevention is important but what if you suspect that you’re already depressed? Getting help and getting it quickly are vital to recovering, explains Butkute, “Look at it as a fight against an illness. If you surrender, what will be left? You don’t have to give all of your energy to these negative thoughts. It’s important to overcome this stigma with seeking professional help. Don’t wait too long. Ask yourself: If not now, then when? And if not me, then who?”“If you’re in need of help, then turn to it,” says Xin Xu, “Don’t be shy about it. I struggled with whether I should see a doctor or not. But I just couldn’t live that way anymore. After you get help, you’ll see that it’s not a big deal. It’s a simple thing. If you got a cold, you’d take some medicine. This is the same thing.”

Want to talk to someone? Friends, family and your study advisor are often a good place to start, but may not always be enough. For additional help, contact the Education and Student Service Center (STU) at 040- 247 4747 of STU@tue.nl. Or make an appointment at the desk of STU in MetaForum. Discussions with STU's staff are always completely confidential.