RISE Blog | It's Time to Check In

By: Mia Chu, Peer Educator
November 5th, 2020

This post is to inform on how to help a friend who may be struggling. We will be highlighting the signs that a person has depression or an eating disorder and our hope is that this will help facilitate more conversations about mental health. This post is not a substitute for getting professional help. Links to both TTU and national mental health resources are at the end of this blog. Please seek professional help if you are seriously concerned about your own or a friend's mental health.

Generally Talking about Mental Health

"How are you?"

It's a common question asked by a variety of people in our life.

However, how often do we answer that question honestly?

If a stranger asks how we're doing, we're typically far more inclined to answer in a positive manner compared to if that person is a close friend, significant other, or family member... but why is that?

It's much socially expected for people to say that they're "doing well" or "doing ok" to strangers like the barista at your local Starbucks. However, many people (especially college students) still feel obligated to answer positively even when a person close to them asks how they're doing. While it may not be a big deal to occasionally lie about how you're actually doing, it's so important to check in and be honest with yourself on your own and your friends' mental health.

Even though mental health issues or disorders are not visible in the same way that a cut or a broken leg are, they still can be severely detrimental to a person's health, especially if the person doesn't talk about their struggles with others. Having open conversations about your own mental health and emotions can help others feel more comfortable with sharing their own!

For example, if a friend who's usually open about their feelings starts shutting down, it may be a good time for you to check in on them again. Remember: If someone starts sharing their struggles with you and you feel unqualified to help them, it's ok and even encouraged to refer them to a professional. When you check in on a friend, you shouldn't be striving to "solve" the issues they are dealing with. Reaching out gives your friend the comfort of knowing they're not alone in their struggles and reminds them that there are many resources to help them.

Do you know what the warning signs for depression and eating disorders look like? You will by the end of this post! Read on to know what to look for and how to navigate conversations around these topics.

Let's Talk About Depression

Depression is one of the most common and widely known mental disorders. It is often called the "common cold" of mental illnesses because it is so prevalent. People who have depression can experience a wide range of symptoms and can have very different experiences with the disorder.

Depression can occur for a variety of reasons such as neurotransmitter imbalances in a person's brain, or because of lived trauma. COVID-19 has made many people more susceptible to this disorder, so even if you normally wouldn't think to do so, it's especially important to check in on your friends during the pandemic.

According to mayoclinic.org, depression is defined as a disorder that "causes a persistent feeling of sadness and loss of interest.... it affects how you feel, think and behave and can lead to a variety of emotional and physical problems". Although depression is often a disorder that is joked about and the term rather casually, i.e. "I'm so depressed today", depression isn't simply feeling sad occasionally or having a bad day. Depression is persistent and must occur over a prolonged period to be formally diagnosed.

Symptoms of Depression

Now that you know what depression is, here are some symptoms (according to Mayoclinic) to look out for:

• Overall sad feelings/ hopelessness
• Angry outbursts and irritability
• Loss of interest/pleasure in most or all normal activities such as sex, hobbies, or sportsKeep in mind that there are people who choose celibacy, people with lower sex drives, and asexual people so loss of interest in sex would be a cause of concern if a person who normally enjoyed and engaged in sexual activities didn't find pleasure in those activities anymore
• Sleeping too much or too little
• Tiredness and lack of energy
• Anxiety, agitation, or restlessness
• Slowed thinking, speaking, or body movements
• Feelings of worthlessness
• Trouble thinking, concentrating, making decisions, and remembering thingsThis could translate to lower grades or less involvement in academic/intellectual tasks with a college student
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicideIf you or someone you know is considering suicide, call the Texas Tech Crisis Helpline at 806.742.5555 or the National Suicide Prevention Hotline at 1.800.273.8255. If you or someone you know is actively suicidal, call 911 immediately.
• Unexplained physical problems such as back pain or headaches

Because depression is so variable, these symptoms will vary from person to person and even within one person depending on the day. So, if you notice a friend is exhibiting some of these symptoms, it's a good idea to start a conversation with them about their mental health, even if the root cause may just be that they've been having a rough week (cause friends still need support then, too!).

How to Have a Conversation About Depression

When having these conversations, coming from a place of concern is always a good start. You'll want to be mindful that your tone doesn't appear accusatory or dismissive (especially if your friend has been pulling away from) because they may be experiencing things that you are unaware of.

The most important thing you can do is listen to them and take their experiences seriously.

What may seem like a relatively stress-free situation to you may be an incredibly stress-inducing one to them. If your friend's situation seems like it is too large for you and your friend to navigate through, there are plenty of resources available to you! (Read to the end to catch the full list!)

Let's Talk About Eating Disorders

Food is a basic need, is a part of our everyday routines, and is involved in many celebratory events. However, people with mental disorders may use food as a coping mechanism by restricting food intake, binging on food, or both. People with general anxiety or OCD for example, might use restricting the amount and types of food as a means of control. Given that food plays such a vital physiological, cultural, and social role in an individual's life, it's easy to see why people may use behaviors involving food to cope

What distinguishes eating disorders from other mental disorders is that people with eating disorders "experience severe disturbances in their eating behaviors and related thoughts and emotions. People with eating disorders typically become pre-occupied with food and their body weight" according to the American Psychiatric Association. The "severe disturbances in eating behaviors" and pre-occupation "with food and weight" are especially important to note when looking at the symptoms of different eating disorders. There is a wide variety of eating disorder types, but we'll focus on anorexia and bulimia below.

Symptoms of Anorexia

A person with anorexia severely limits their average caloric intake and often overexercises obsessively. Someone can be diagnosed with having this disorder when they weigh at least 15 percent less than the healthy weight expected for their height.

Here are warning signs to look for in someone with Anorexia:

• Menstrual periods cease
• Osteopenia or osteoporosis (thinning of the bones) through loss of calcium
• Hair/nails become brittle
• Skin dries and can take on a yellowish cast
• Mild anemia; and muscles, including the heart muscle, waste away
• Severe constipation
• Drop in blood pressure, slowed breathing and pulse rates
• Internal body temperature falls, causing person to feel cold all the time
• Depression and lethargy

It's important to note that these symptoms often occur in the later stages of anorexia and may not be as noticeable to people who know the person with the disorder. Because these symptoms are more physiological, they may take longer to develop and may be difficult to spot if the person with anorexia hides these symptoms.

As a friend, you can watch out for mental "hallmarks" that a person with Anorexia may have like severe food limitation, extreme fear of being "fat", and overly low self-esteem and body image.

Symptoms of Bulimia

Unlike people with anorexia, people with bulimia can be "slightly underweight, normal weight, overweight or even obese. But they are not as underweight as people with anorexia nervosa". The disorder is characterized by binging on extremely large quantities of food in a short period of time and out of fear of weight gain, purging most of their caloric intake through self-induced vomiting or using laxatives. Since people with this disorder aren't typically severely underweight and they also will hide their binges and purges well even from their close family and friends, people with disorder tend not to get help until they have severe physiological and mental symptoms.

Here are some key symptoms (according to the American Psychiatric Association) to keep in mind if you think someone may have Bulimia:

• Chronically inflamed and sore throat
• Salivary glands in the neck and below the jaw become swollen; cheeks and face often become puffy, causing sufferers to develop a "chipmunk" looking face
• Tooth enamel wears off; teeth begin to decay from exposure to stomach acids
• Constant vomiting causes gastroesophageal reflux disorder (liquid content from the stomach gets into esophagus)
• Laxative abuse causes irritation, leading to intestinal problems
• Diuretics (water pills) cause kidney problems
• Severe dehydration from purging of fluids

It is so very important to catch bulimia in its early stages. Checking in on a friend who's saying concerning statements about their weight, body image, and the relation of these to their mental state is vital. You noticing the early symptoms can be the first step on a long road to recovery.

How to Have a Conversation about Eating Disorders

As you would a conversation about depression, it's crucial to approach conversations about a person's eating disorder with genuine concern and care. When talking about eating disorders, you'll want to prioritize health over physical appearance, I.e. say "I'm concerned about how your behaviors are detrimental to your physical and mental health" rather than "you look way too skinny and you've started acting weird. Eating more will help you look better".

Eating disorders are often quite severe, tend to cause significant physiological damage, and typically need the help of a specialist and a nutritionist along with a general mental health practitioner. Because of the nature of eating disorders, they often require heavily specialized professional intervention. If you know someone who is showing many signs of having an eating disorder, it is important for you to refer them to specialized resources since they'll more likely than not need professional and specialized help.

To Sum Up

Although we don't literally see our brains on an everyday basis, they affect so much of our lives. Healthy mental health practices should be a priority for everyone, but especially should be one for college students. At first, it may seem intimidating to check in on friends often about how they're truly feeling and their mental health, even if they are feeling good.

As is with most things, practice makes perfect. When you check in with friends on a regular basis, you'll able to more accurately gauge what's mentally normal for a friend and what's abnormal which can help us better detect when someone may have a concerning or potentially life-threatening disorder.

TTU Resources:

Student Counseling Center- SWC 201│806.742.3674

Student Health Services- Student Wellness Center | 806.743.2848

Family Therapy Clinic- Human Sciences 164│806.742.3074

Psychology Clinic- Psychology 111A│806.742.3737

TTU Police Department- Emergency: 911│Non: 806.742.3931

Military and Veteran's Programs- Drane Hall 147|806.742.6877

Help Lines:

TTU Crisis HelpLine- 806.742.5555 | 24/7/365

Lubbock Crisis Help Line- 806.765.8393

National Suicide Prevention Lifeline- 1.800.273.TALK (8255) | 1.888.628.9454 (en español)

Texas COVID-19 Mental Health Support Line- 833.986.1919
Lubbock Resources:

StarCare of Lubbock (provides general mental health services)- 806.740.1421 | 1950 Aspen Ave.

Voice of Hope (provides free counseling for victims of sexual assault in Lubbock)- 806.763.3232

Women's Protective Services- (non-profit focusing on advocacy for women and families who have experienced domestic violence) 806.747.6491

Eating Disorder Resources:

The Center for Collegiate Recovery Communities (specializes in eating disorders and substance addiction) CCRC|806.742.2891

National Eating Disorders Association

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