Most colleges and universities offer some form of counseling and psychiatric care through their student health centers. Some institutions include a certain number of counseling sessions in the cost of the student health plan. The best time to learn about the resources available is before classes begin.

1. Loss of interest in things that were previously pleasurable. Also known as anhedonia, this inability to experience pleasure is often one of the first symptoms to manifest and the last to resolve. It may not be complete, and it may take the form of pursuing only the interests that provide instant enjoyment with little effort. It is often accompanied by social withdrawal. Engaging with another person to participate in social activities requires more effort than solitary like surfing the Web and watching TV.
2. Sleep disturbances. Sleeping too little and sleeping too much can both be a sign of depression. The important thing to look for is a departure from your friend’s prior sleep schedule.

3. Changes in weight or diet. Eating too little or too much can both indicate a potential problem. Signs of an eating disorder might include avoidance of food, absences after meals for purging, and extreme weight loss. Overeating and undereating can both be signs of depression as well. This can be a difficult topic to raise with a friend, especially if an eating disorder is suspected.

4. Irritability. Depression saps energy in an insidious way. Each day becomes a greater and greater challenge. Frustration builds, and tempers may flare over even matters. When a friend shows a pattern of increased irritability, it is easy (and natural) to justify avoiding that person. If that irritibility is due to depression, this can only make the situation worse.

5. Low mood and negative outlook. Sometimes the signs of depression are not subtle. A change toward a consistently sad or pessimistic outlook can be a sign of depression (e.g. reacting to a good grade with a comment like “What does it matter? It makes no difference.”) Depression creates a self-fulfilling prophecy where negative thoughts influence behavior, and behavior is interpreted in a way that validates those negative thoughts.

6. Expressing thoughts of hopelessness, despair, and/or suicide.. Suicidality can be expressed in passively (e.g. “The world would be better off without me in it.”) or actively (“Some days, I feel like could just end it all.”) Always take any mention of suicide seriously. There is a common myth that if a person is really suicidal, they don’t tell others about it; they do it.

7. Evidence of self-harm.

8. Drinks more or abuses drugs, including prescription sleeping pills and painkillers. Abuse of drugs and alcohol may be signs that a friend is self-medicating.

Suicide has many warning signs, all of which should be taken seriously. Read this handout or visit our suicide prevention section below for more information.

Starting the Conversation
Find a time where you can speak to your friend in private. Mention that you have been feeling concerned about that person. Gently introduce the changes in behavior that you’ve observed and explain why they trouble you. You can ask questions like:

“How long have you been feeling this way?”
“Did something happen that made you feel like this?”
“What can I do to help you through this?”
“Have you thought about getting help from (campus counseling, etc…)?”

Do’s and Don’ts

It is important to remember that depression fundamentally changes a person’s outlook on life and response to your words. Your message needs to come through clearly to a person in that mindset. Do say things like:

“You are not alone in this. I’m here for you.”
“You may not believe it now, but the way you’re feeling will change.”
“I may not be able to understand exactly how you feel, but I care about you and want to help.”
“When you want to give up, tell yourself you will hold on for just one more day, hour, minute—whatever you can manage.”
“You are important to me. Your life is important to me.”
“Tell me what I can do now to help you.”

Don’t say things like:

“It’s all in your head.”
“We all go through times like this.”
“Look on the bright side.”
“You have so much to live for why do you want to die?”
“I can’t do anything about your situation.”
“Just snap out of it.”
“What’s wrong with you?”
“Shouldn’t you be better by now?”

Adapted from: The Depression and Bipolar Support Alliance and helpguide.org

1.) Preoccupation with body or weight
2.) Obsession with calories, food, or nutrition.

3.) Constant dieting, even when thin.

4.) Rapid, unexplained weight loss or weight gain.

5.) Abusing laxatives or diet pills.

6.) Compulsive exercising.

7.) Making excuses to get out of eating.

8.) Avoiding social situations that involve food.

9.) Going to the bathroom right after meals.

10.) Eating alone, at night, or in secret.

11.) Hoarding high-calorie food

Do: focus on feelings and relationships, not food. Share memories of specific times when you felt concerned about your friend’s eating behavior. Explain that you think these things may indicate a problem that needs professional help.
Don’t: comment on your friend’s appearance or weight. Your friend person is already too focused on his or her body image and weight. Even a compliment can reinforce an unhealthy obsession with body image and weight.

Do: tell your friend that you are concerned about their health while being respectful of their privacy. Eating disorders are often a cry for help, and the individual will appreciate knowing that you are concerned.

Don’t: reinforce a desire to be thin. If a friend says that he or she feels fat or want to lose weight, don’t say “You’re not fat.” Instead, direct the conversation toward their fears about being fat, and what they think they can achieve by being thin.

Do: use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”

Don’t: use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements.

Do: try to remain positive, calm, focused, and respectful during conversations.

Don’t: demand change or criticize eating habits. People with eating disorders often feel like they aren’t in control of their life, and food is their means of reasserting that control. Trying to trick or force a friend to eat can make things worse.