Blog 6.4

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Our last blog of this series will address the difficulty of spotting the signs that someone is struggling with depression. In, What Made Maddy Run: The Secret Struggles and Tragic Death of an All-American Teen author Kate Fagan depicts the quick escalation of Madison Holleran’s depression and suicide. I often walk through Penn’s campus and think about Maddy. I also wonder how many current students are secretly hurting and not sure how to reach out for help.

For Maddy, her depression started with feeling uneasy, anxious, and unhappy. When she did try to reach out and tell her friends or family members how she was feeling, they all thought she was struggling with normal college transition because the signs are so similar. Her older sister was initially unhappy in college and transferred, but Maddy told her, “I’m not happy anywhere”. Maddy’s brother commented, “You never smile anymore. You never laugh anymore.” Maddy’s parents noticed she was not present while home from school, she watched TV with the family, but “Madison was simply sitting there, staring at the screen but not really watching.” Maddy was also exhausted, sometimes struggling to sleep and other times sleeping excessively. Most of these signs are also signs of going through a challenging transition that many college students experience, which is part of the reason why no one predicted that Maddy was considering suicide.

The more drastic signs that something was wrong for Maddy were still tough to spot. She slowly dropped two sizes from the end of high school to the end of fall semester, but as a track athlete, the weight loss was easily explainable. She also was excessive in everything – exercise, eating, and drinking, and while that was normal in her exercise, she typically was careful about what she ate. The mother of one of her friends chatted with Maddy over Christmas break about school and noticed something was off. “She was skinny, drained. So beautiful you couldn’t stop starring, and yet in that moment all you could notice was the emptiness in her eyes. She was twitchy, nervous, but didn’t exactly know why.” This parent almost asked Maddy if she was having suicidal thoughts, but since Maddy didn’t mention it, she did not bring it up. The word suicide is difficult to say out loud and even more difficult to ask someone if they have been considering suicide. Family, friends, teammates, coaches, and even going to two counselors – they all spotted something was wrong and tried to help, but Maddy herself didn’t quite know what to say or to who. 

Recognizing the signs of depression can be difficult, particularly when someone is high functioning, such as Maddy.  Individuals often “push through” and because their performance in school and sport might still be high, the signs might be overlooked or minimized.  In simple terms, consider the frequency, duration, and severity of the symptoms…..how often, how bad, and for long has this individual’s behavior been different?  A few key symptoms include: 

  • noticeable and persistent changes in behavior,
  • emotional over or under-reaction,
  • carelessness/ lack of motivation,
  • alcohol/substance/misuse,
  • poor problem-solving skills (seem “stuck”),
  • changes/problems in sleep/appetite/mood,
  • withdrawal from others,
  • increased conflict in interactions,
  • and suicidal thoughts. 

Individuals don’t always show all of these symptoms, but all should be taken serious. 


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