Can my fatigue really be caused by depression?

Q: Someone told me that depression could make me feel tired. Is that possible?

A: Absolutely. But let me just start out by saying that there are many medical conditions that can cause a person to feel tired all the time and even mimic the other symptoms of depression, so it is extremely important to see your health care provider if you are experiencing fatigue or other signs of depression.

Depression is one of the most common psychiatric conditions that doctors encounter, showing up in at least 20% of women and 12% of men during their lifetimes!  Fatigue or loss of energy is so common in depression that it is actually included in the diagnostic criteria. Other symptoms used to diagnose depression include:

  • loss of interest or pleasure in previously enjoyed activities
  • significant weight loss or gain
  • trouble sleeping or sleeping too much
  • feelings of worthlessness or guilt
  • inability to concentrate or focus
  • recurrent thoughts of death or suicide

If you are having any of these symptoms, there are many resources available to you on campus!

The providers at Student Health Services manage many patients with anxiety and depression from a medical standpoint. While the exact cause of depression is not yet known, there are many medications that act on neurotransmitters in the brain that are effective in treating it. These medications typically take a few weeks to become effective in alleviating symptoms.

Counseling & Consultation Service (CCS) has social workers, counselors, psychologists and psychiatrists to manage depression from a psychotherapy as well as a medical standpoint.  All enrolled students are eligible for 10 free counseling sessions per academic year.  If you have the Comprehensive Student Health Insurance Plan (SHIP), you may be eligible for additional counseling sessions with a $15 co-pay per session.  If you do not have SHIP and need additional counseling, CCS will assist you in finding services in Columbus.

Counseling is extremely important because it has been shown that medical therapy in combination with psychotherapy is much more effective in treating depression symptoms than either of these treatments alone.

Again, be sure to see a health care provider if you are experiencing fatigue or other signs of depression.

Angela Walker (recent Ohio State College of Medicine graduate)

Muhammad Khan, MD (Ohio State University Student Health Services alum)

What to do while you are waiting for an appointment… at CCS

CCS is on the 4th floor!

The Following is a special guest post from your friendly neighborhood campus counseling center.  Check it out – it’s a good one!

Spring quarter is the busiest time of year for Counseling and Consultation Service.  The stress of graduation, multiple transitions and other concerns keep us moving to help the students of the Ohio State University.  During this time you may experience a longer wait for an initial consultation and even longer for a first session appointment with your assigned counselor. In many cases it could be 2-3 weeks before you can get in.

In the meantime, we would like to offer you some suggestions for what to do while you are waiting for an appointment.

If you are in need of immediate assistance, please call and ask to speak to an urgent counselor Monday- Friday, 9:00 a.m. – 5:00 p.m.  If you need immediate assistance outside of our normal business hours, please call Net Care Access at (614) 276-CARE (2273) or go to the nearest emergency department.

Some Quick Tips for Improved Health and well-being:

  • Try to get 7-9 hours of sleep per night!
  • Go to the gym!
  • Eat more fruits and vegetables!
  • Learn time management skills!
  • Think positive!
  • Walk to class!
  • Drink more water!
  • Set realistic goals!
  • Don’t be afraid to ask for help!
  • Create a bedtime routine!
  • Vary your meals!

Go to a Workshop.

We provide drop in workshops on a weekly and quarterly basis. They are free and open to all students:

  • Chi-lel Qigong: Every Thursday at 9:00- 10:00  a.m. Younkin 300
  • Feel Better Fast:  Every Thursday 4:00- 5:00 p.m. Younkin 324
  • Self Management Skills: Every Wednesday 3:00-4:30 p.m.Younkin 324
  • Mental Skills for Stress Management:  Mondays, May 7,14 and 21, 4:00-5:00 pm, Younkin 300
  • Self Esteem Workshop: Monday, May 21 3:30 -4:30 pm, Younkin 430, please check in with front desk. 

Check out Group Therapy.

  • We have and extensive group program that offers 25+ groups each quarter to meet individual needs. A full list of our spring quarter offerings can be found at here.

Need Immediate Assistance?

  • We have urgent counselors Monday thru Friday 9:00 am- 5:00 pm. If you need immediate assistance outside of our normal business hours, please call Net Care Access at (614) 276-CARE (2273) or go to the nearest emergency department.

Watch a video on our YouTube channel. 

  • We have a 3 minute breathing practice and many other favorite videos to help you get your needs met.
  • We also favorite videos that help, inspire and educate students on a variety of mental health issues.

Like us on Facebook.

  • We share weekly inspirational quotes, link to inspiring stories on a variety of mental health topics and update the campus community on CCS offerings.

Peruse the Self Help section on our website.

Try other on-campus Resources:

Other facilities that offer therapy with a fee to both students and community residents:

Academic Issues:

  • Walter E. Dennis Learning Center free, confidential, one-on-one appointments. Trained in learning and motivation strategies, Learning Specialists work with Ohio State students to examine academic strengths and weaknesses, and explore strategies that lead to success in college
  • Student Advocacy can help advocate for you with other entities on campus, mediate with your professors, help you determine whether or not you need to withdraw from classes, etc.
  • Office of Disability Services can help you determine if you are eligible for disability services depending on your functional limitations in the academic setting

Financial Concerns:

Housing Concerns:

Health Information:

Counseling & Consultation Service

We offer counseling and therapy to help you address personal, mental health, academic, and career concerns. Both individual and group counseling are available. In counseling, we work together to help you develop more personal awareness and the skills needed to overcome problems and help you grow and develop in ways that allow you to take advantage of the educational opportunities at the university. We are also available to provide consultation to faculty and staff who are concerned about the well-being and academic success of OSU students. Most services free, all services are confidential.

How long is my ADD testing good for?

lauramuggli.com

We talk a lot about ADD here at BuckMD.  We’ve talked about whether you can get treated for it here at the student health center (yes), whether it’s OK to share your medicine with your friends (no), and even if there are useful things to do for it besides taking pills (yes).

But we recently received a very good question about ADD that we haven’t covered yet so I think it’s time for a little update.  “Buckeye Mom” asks:

How recently does the ADD testing need to have been done?  We have documentation, but it was completed 8-9 years ago.  Will that be sufficient?

The best thing to do is bring whatever records or documentation you have with you to your first appointment at the Student Health Center and we’ll figure it out.

We know that a lot of students are diagnosed with ADD when they’re pretty young, so in general we don’t worry as much about the age of the testing as much as we do it’s validity and thoroughness.  What that means is if you went through the whole nine yards of neuropsychological testing when you were a kid and you’ve had a history of consistent and appropriate medication management by your doctor at home, that is USUALLY sufficient for us to be able to presrcibe medication for you while you’re at school.

On the other hand, if you’re “testing” consists only of notes from your family doctor saying you have symptoms of ADD and/or a list of previous prescriptions and/or a survey filled out by your 3rd grade teacher, we will require you to undergo a diagnostic evaluation prior to writing any prescriptions for you.  We discuss the testing in a little more detail here

Basically, we look at everyone’s situation individually, so if you want us to manage you’re ADD medications for you while you’re in school, round up whatever records you can get your hands on and bring them in.  We’ll do whatever it takes to get you the best possible care.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Is there anything to do for ADD besides taking medications?

mrboll.com

Is there anything that can be done for ADD besides taking medications?  I’m really not a fan of jumping right into medication if I can do other things to help first, especially because of the cost.

Excellent question! 

The key to managing ADD, whether you’re taking medication or not, is developing good time management and organizational skills.  I know – that’s like saying, “just eat right” or “cut down on your stress” – but there are some concrete steps you can take to achieve this goal:

  • Make lists and schedules to keep track of what you need to achieve – and stick to them
  • Keep a large calendar with important deadlines in a central location in your apartment or dorm
  • Keep your desk clutter-free
  • If you’re studying in a library, sit in a carrel-style desk or a room with no windows
  • Pay attention to your “personal clock” and tackle your toughest tasks at your peak performance time
  • Break down large projects into manageable chunks, and assign each one its own deadline
  • Throw your cell phone in Mirror Lake!

OK, I was speaking metaphorically on that last one, but you know what I mean.  You MUST turn off the texts, tweets, tumbls, check-ins, youtubes, IM’s, status updates, skypes and gmails when you’re studying if you hope to get anything done.

Some research has shown that Omega-3 fatty acids and drinking green tea can improve attention and memory.  The CogMed Working Memory Training program has also been shown to be effective in improving attention and memory, but it is pretty expensive. 

Luckly you have some really good – and free! – services right here on campus that can help.

Psychotherapy and coaching can be very useful in managing ADD by helping you to learn behavioral strategies, identify and eliminate avoidant coping strategies, and establish good self-care.  As an enrolled OSU student, you can get free individual psychotherapy services from Counseling & Consultation Service (CCS).

CCS also offers a support group called Living and Succeeding with ADHD that “provides a supportive atmosphere in which students with diagnosed attention and concentration difficulties can ‘pool their resources’ to cooperatively help each other learn and utilize new strategies for setting goals and achieving objectives.”  The group is facilitated by Robert M. Bennett; you can call 614-292-5766 or email Rob at bennett.455@osu.edu to learn more about the group.

The Office of Disability Services (ODS) assists students with academic services and accommodations, and their counselors are available to meet with students on a one-to-one basis for assistance with time management, study strategies, and advocacy skills.  ODS doesn’t provide diagnostic testing for students who suspect that they have a ADD or other learning disabilities, but students can speak to a disability counselor who will make referrals to other resources within and outside of the OSU community. 

If you have any questions about whether or not you may have ADD, you can always make an appointment to see one of our doctors at Student Health.  We can evaluate your symptoms, refer you for appropriate testing and help you manage your symptoms, with medication or without!    

Bong Joo Hwang, Ph.D.
Counseling and Consultation Service
The Ohio State University

John A. Vaughn, MD
Student Health Services
The Ohio State University

Check your calendar, Groundhog!

USDA.gov

Jogging with tunes

Courtesy cksinfo.com

 February 2.  Your New Year’s resolution is officially 33 days old.  How are you doing?  Did you decide to

  • Eat healthier?
  • Stop smoking?
  • Get more exercise?
  • Party less?
  • Finally address your moodiness and depression?

One challenge of a New Year’s resolution is that it is so permanent.  If you stop smoking on January 1, only to catch yourself with a cigarette on the 3rd, all is lost.  So, how can you make this more productive and less discouraging? 

Well, if the universe can be committed to fair or foul weather for a few weeks by the emergence of a groundhog from its hole, what say you?  Can you set a short term goal for the next 6 weeks? 

Healthy eating – Can you add another fruit and vegetable to your daily diet each of the next 6 weeks? Remember, while fresh fruits and veggies have a lot of health benefits, you can also get some of these servings from microwave soups, packaged fruit bars, etc., that may be a bit easier to carry around campus.

Smokers – how about setting March 15 as your planned stop date?  Between now and then, look at your smoking habits, try to wean yourself down on the number of cigarettes used every day, and consider a visit to Student Wellness or the Health Center to talk to a professional about the health benefits. 

Exercise – Are you a couch potato?  Try starting with a twenty-minute walk tonight.  Over the next 6 weeks, see if you can progress to 30 minutes of activity that gets your heart beating a little faster, and do it at least 5 days of the week. 

Alcohol – We all know that alcohol should be used legally and in moderation.  If you occasionally cross the line, try this trick – when you go out, see if you can limit yourself to no more than one alcoholic drink each hour. If you meet your goal, then slip a five-dollar bill into your piggy bank when you get home.  At the end of six weeks, see how many “Abes” you have accumulated.

Depression – The National College Health Assessment reports that more than one in four college students is suffering from depression, but only of third of them have consulted a healthcare professional.  Did you know that in six weeks of treatment, either with medicines, counseling, or both, you can see significant improvements? 

6 weeks.  Enough time to get out there and let the sun shine on your new healthier lifestyle?  Or maybe you want to just stay in your dark, wet, wormy hole in the ground?  It’s your decision.  Will you risk seeing your shadow?

Happy Winter!

Roger Miller, MD (OSU Student Health Services)

Buckeyes Head to Head with the Gators

photo: www.scottcounseling.com

click to enlarge

wikimedia commons

Health.com

Use protection

The Buckeyes and Gators meet today at the Gator Bowl. This is a great time to see how a Buckeye compares to a Gator in some of the dimensions of health that are studied by our colleagues at the OSU Student Wellness Center

Substance abuse – How many students have used prescription drugs not prescribed for them in the past 12 months?

          OSU = 15.6%           UF = 19.9%

Unhealthy Eating – how many students report their weight being outside the healthy weight range (Body Mass Index 18.5-24.9)?

          OSU = 37.2%           UF = 32.9%

Sexual Health – how many students report having had no sexual partners in the past 12 months?

          OSU = 27.3%           UF = 29.1%

Stress – how many students report having felt so depressed that it was difficult to function anytime in the past 12 months?

          OSU = 30.4%           UF = 29.4%

These few snapshots of our campuses show how similar we are with our esteemed opponents. That is why our student health and student wellness programs are so important.  Come see us for advice to make your lifestyle a healthier one. 

GO BUCKS!!

Roger Miller, MD  (OSU Student Health Services)

Sources:  

OSU: http://slra.osu.edu/posts/documents/exec-summary.pdf

UF: http://healthygators.ufsa.ufl.edu/surveys/healthy-gators-student-survey/healthy-gators-student-survey-2010-findings

Is it OK to share my ADD medicines?

Don't end up like this guy!

ADD medicine

Q:  Is it OK to give my friend one of my ADD pills to help him study for a test?

A:  Before we answer that question, let me ask you another one.  Would you sell that pill to a stranger for $50?  I’m guessing – hoping – your answer is an emphatic “NO.”  Well, from a legal point of view, these two questions are identical.

Most ADD medications (such as Concerta, Ritalin, Adderall, Focalin, Metadate, Methylin, and Daytrana) are Schedule II controlled substances because of their serious side effects and potential for addiction.  They are monitored very closely by doctors, pharmacists, and the Drug Enforcement Agency (DEA).  We’re not lawyers here at Student Health, but we do know that… 

It is a violation of Section 2925.03 of the Ohio Revised Code (Ohio law) to sell another person a controlled substance.  The important thing to remember here is that the legal definition of “sell” includes “delivery, barter, exchange, transfer, or gift…”  

So even if you are just trying to help out your friend – and getting nothing in exchange for it – you are breaking the law.  And we’re not talking about a speeding ticket here.  You are committing a 4th degree felony, which is punishable by 6-18 months in prison and/or a $5,000 fine.  And assuming you are anywhere on or near campus, the felony gets bumped up to 3rd degree and you’re looking at 1-5 years in prison and/or a $10,000 fine.  Not to mention the fact that you could lose your financial aid and/or get kicked out of school.  

Now granted, the odds of someone busting into your dorm room and catching you in the act are very slim.  And unless you really don’t get along with your roommates or neighbors, odds are no one is going to turn you in.  But forget about the legal stuff for a minute.

  1. These medications are addictive and there’s a real chance your friend could get hooked on this stuff.  You don’t want to risk sending someone down that dark road.
  2. While these medications have a calming effect on people with ADD, they are actually central nervous system stimulants so in addition to things like headache, insomnia, anorexia, agitation, anxiety, tremors, vertigo, depression, and nervousness, they can cause life-threatening problems like heart attacks, increased heart rate, increased blood pressure, and heart arrhythmias.  Doctors evaluate people for these conditions prior to starting these medications and monitor them closely while they’re taking them.  Without knowing your friend’s health history, you could literally be putting his life at risk – and no test is worth that much. 

Managing your health is a serious responsibility and that’s especially true if you have ADD.  If you’re taking one of these medications, the best thing to do is keep it to yourself – if no one knows you have the pills, they won’t be able to ask you for one.  And if you have a friend who is taking these medicines, don’t pressure them into giving you one.  It’s more likely to hurt you than help you, and it’ll just put everyone at risk for serious trouble. 

If you have any questions about these or other medications you may be taking, the staff of Student Health Services pharmacy is always available to help!

Jason Goodman, PharmD, RPh (OSU SHS)

When a little night-time grinding is NOT a good thing!

blogesaurus.com

Q: I’ve been waking up with jaw pain and headaches lately.  What could be causing this?

A: You’re probably grinding your teeth.  Teeth grinding – or bruxism – is a very common problem. We used to think it was just caused by misalignment of the teeth or jaws, but we now know that it can also be related to stress, anxiety, depression, changes in sleeping patterns and even diet.  Sound familiar?    

So how do you know if you’re a bruxer?  It can be hard to figure out on your own since most of the clenching and grinding happens when you’re asleep.  You could ask your sleep partner or roommate if they’ve ever noticed you doing it.  If that’s a little too weird for you, you could just come in to the student health center and see one of our fabulous dentists – they can take one look at the wear and tear on your choppers and tell if you’re grinding away or not.  Other signs that may indicate you’re grinding your teeth include:   

  • Jaw pain or tightness which can lead to difficulty eating
  • Headache
  • Earache
  • Oversensitive teeth
  • Indentions in the tongue or damage to the inside of the cheek
  • Pain in your temporomandibular joint (the area right in front of your ear where your jaw hinges)

If you are a bruxer (we just love saying that word), there are some things you can do to give your jaw and pearly whites some relief:

  • Your dentist can fit you with an oral mouthpiece that will protect your teeth and decrease the amount of tension in your jaw while you sleep.  You can try one of those squishy mouth guards you find at sporting goods stores, but they don’t work as well.
  • Stress reduction can go a long way! The more relaxed you are while you’re awake, the more relaxed you will be while asleep!
  • Warm compresses applied to the jaw can help relax muscles.
  • Jaw exercises can also help to loosen up those muscles!
  • Cutting back on the alcohol and caffeine will also help.

Click here to learn more about bruxism, or make an appointment to see one of the dentists at the Student Health Center.  We’re always happy to help.

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

Salvatore Paul Lowry, DDS
Student Health Services
The Ohio State University

Adjusting to College Life

Don't get lost in the crowd!

Q: I was super excited to go away to college, but now that I’m here there are times when I feel a little overwhelmed.  I never thought I’d say this, but I miss home!  Is this normal?

A: When you’re going off to college everyone is full of stories of good times, good friends, and new experiences.  But people often fail to mention that some new experiences can be a little scary.  Whether you are attending a huge university or a tiny college, whether you moved across town or across the country, it’s totally normal to feel overwhelmed and even a little out of place at times.  Even if the going is a little tough right now, college is full of amazing opportunities.  Here are some tips for making the transition as smooth as possible.

  • Be an individual:  Don’t be afraid to make yourself known.  Attend office hours for your professors or TA’s even if you’re doing fine in class.  This is a great way to get more one-on-one teaching that you might be used to from high school. It’s also a great time to ask some of those questions you may not feel comfortable asking in front of a room full of 200 people!
  • Join the community:  Nothing makes a new place your home like finding a group of people that you connect with. The great thing about attending a big university like THE Ohio State University is that no matter what your interest, there is probably a club that shares your passion.  Don’t see what you’re looking for? Start your own! 
  • Use your resources:  Know where to go for what you need.  Whether it’s help figuring out what you want to do with your career, where in the world you can go to study abroad, where to get a sore throat checked out or where you can get something good to eat, Ohio State has someone here to help you!  The Office of Student Life is a great place to start looking.
  • Remember that it’s OK to ask for help:  Even if you do all of this stuff, you may still feel overwhelmed and this can lead to depression and anxiety.  A study done at UCLA found that there has been a 40% increase in the number of students who seek some form of mental health care during the first year of college. If this happens to you, the Student Health Center and Counseling and Consultation Service are here to help. 
  • Have fun:  Remember you aren’t alone!  Look around your classroom or the oval and you’ll see thousands of students going through the same thing you are, even if they look like they have it all together.  Click here to see how it affected a student at Columbia and the great advice “Alice” gave her to get through it.  

College is more than parties and football games, and it’s more than GPA’s and GEC’s.  It’s a time where you learn about yourself, the world and your place in it.  Enjoy it!

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

Mary Lynn Kiacz, MD
Student Health Services
The Ohio State University

Maybe the Eyes really are the Window to the Soul

Jon Radwan 2000

Depression is a common condition – about 10% of adults are diagnosed with a depressive illness at some point in their lives – and a tough one to treat.  The problem is that the symptoms are based on subjective feelings, so a lot of people think that it’s not a “real” medical problem.  I can measure your blood sugar and tell you if you have diabetes; I can measure your cholesterol and tell you if you’re at risk of having a heart attack; but how do I measure any of the following?

  • mood changes
  • withdrawal from friends
  • decreased interest in work, school, or other activities previously enjoyed
  • feeling worthless, irritable, hopeless, or tired
  • loss of concentration, sleep or appetite
  • Loss of interest in sex
  • Thoughts about dying or suicide attempts

Who doesn’t feel one or more of those things every now and then?  Is everyone depressed?  Can some people just not handle it?  Besides someone telling you that these feelings are a problem, is there any way to know that how they feel is any different or worse than how you feel?

Well someday it might be as easy as looking them in the eye…

Researchers at the University of Freiburg in Germany found that depressed people weren’t able to see the contrast between black and white as well as non-depressed people by measuring the electrical activity in their retinas.  They used a device called an electroretinogram – basically, they did a tiny little EKG on their eyes. 

Now it’s way too early to tell if this technology will actually provide a meaningful way to diagnose and monitor depression – we’re not going to have any kind of Star Trek retina scanner depress-o-meter at the student health center any time soon.  But if your roommate keeps telling you that “everything just looks blah around here,” it wouldn’t be a bad idea to ask how things are going. 

Roger Miller, MD
Student Health Services
The Ohio State University