Kimberly Przybysz was a star at Pembroke Junior-Senior High School. Class president. Straight-A student. A standout in music and band.
When she was accepted into Geneseo State College, she expected little to change. Then freshman year started.
"It was an ego buster," she said.
At college, Przybysz struggled with her newfound anonymity. Getting good grades was suddenly a challenge. So was making friends. Everything she had once associated with her identity was slipping away.
Przybysz eventually sought help on campus. She became one of a growing number of college students treated for depression.
In Western New York and across the nation, clinical depression is one of the top mental health conditions treated on campus.
According to a survey this spring of more than 54,000 students by the American College Health Association, 46 percent of college students reported that at least once during the last school year, they felt so depressed that it was difficult to function.
In this region, colleges report that between one-fourth and half of the students seen by campus counselors suffer from depression.
This time of year tends to be among the worst for many students. The newness and excitement of college have worn off. The stresses of the semester are coming to a head, exams are upon them, and the holidays loom.
"From the middle of the semester on, things get pretty busy around here," said Sharon Mitchell, director of University at Buffalo's Counseling Center.
When students run into trouble, patterns of depression often emerge, said Dr. Richard D. Kadison, head of the Harvard University Mental Health Service and co-author with Theresa Foy DiGeronimo of the 2004 book "College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It."
Depression often follows other problems in a student's life, such as relationship issues, classroom difficulties or alcohol and drug abuse, said Roger E. Keener, director of St. Bonaventure University's counseling center.
"When you dig yourself that kind of hole," he said, "it looks pretty dark down there."
In the worst cases, students with untreated, severe depression begin wondering if life is worth living.
According to the American College Health Association survey, 10 percent of students said they seriously considered attempting suicide at least once during the school year -- though the number of those who reported actually trying remains below 2 percent.
Even so, more than 1,000 suicides typically occur on U.S. campuses each year, according to the Jed Foundation, an organization dedicated to preventing campus suicides. Not all suicides are depression-related, experts said.
Nationally, several campuses have grappled with recent high-profile suicides, notably New York University, the University of Oklahoma and Massachusetts Institute of Technology. The MIT case led to a lawsuit that could ultimately hold universities more accountable for suicide prevention.
At UB, Western New York's largest university, five students were reported to have committed suicide over the last three years. None died on campus or in off-campus student housing, officials said, and none had sought help from UB's Counseling Center.
Administrators at several other area colleges say they see a small number of students who try to kill themselves each year.
Przybysz said that suicide never crossed her mind but that she can see how college pressures and expectations might lead other students down that road.
When Benjamin Klein died at Alfred University in 2002, his story made headlines.
Klein's dad described him as an artistic young man with a borderline learning disability. He was bright and talented yet often faltered socially.
When Klein decided to join a fraternity, his father, Jonathan, was worried.
"It was never a good fit for him," Jonathan Klein said.
During a fraternity gathering, Klein got into trouble after getting drunk and airing secret fraternity traditions. In the car on the way home, he was punched and slapped by two frat brothers and was pressured to quit the fraternity.
Klein began packing his car to head home to Vermont. Then he took off with a 22-ounce bottle of beer and made his way to a shallow creek behind the frat house.
He also carried pain medication with him for his migraine headaches.
"He took everything he had," Jonathan Klein said.
The father still struggles with the notion that his son might have been depressed and killed himself. He said his son was never diagnosed with any mental illness. But the father recognizes that his son felt an enormous amount of pressure in college.
"I just think, if he'd had more time to think about it," the father said, "he wouldn't be dead."
Not all suicides are triggered by college participation. Data shows that the age group 18 to 24 is particularly susceptible to thoughts of suicide and that the suicide rate within that group is higher for those who don't attend college than for those who do.
At the same time, experts say, the stigma associated with depression and other mental illnesses has been declining as awareness campaigns have strengthened on campus.
"I don't know if there's necessarily more depression, but I think more students are able to put a term to it," said Eileen A. Niland, head of the counseling center at Canisius College. "Students now can recognize, 'Oh, so that's what I'm feeling.' "
All of the local colleges surveyed indicated that the number of students seeking on-campus mental health services for depression or other disorders has climbed in each of the last three years.
As a result, many area schools have reported spending increasing amounts of money on mental health services. At St. Bonaventure, for instance, the school's full-time counseling staff has doubled, from two to four, over the last four years.
The good news about depression is that it's treatable. Students who seek help can and do get better.
That was the case with Przybysz. Since seeing a counselor, she has managed to put her college career in perspective and do well.
"I'm far more self-aware and comfortable with myself," she said. "This isn't the end of the world. You're going to survive college, and people will know you."
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