Anna's family noticed her mood change and her mother tried to help her pinpoint what might be wrong, but Anna never considered professional help. "I just thought it could never get better and I didn't know what I was going to do," she said. One day her mother found a draft of a suicide letter in Anna's room. It explained the despair she felt and why she was considering ending her life.

"I was trying to withdraw so they wouldn't miss me when I was gone," said Anna. Her mother immediately called a social worker at a local hospital for advice. "She was so startled and so scared," said Anna about her mother. "To see her like that was scary for me, too." Once her mother understood the depth of her depression, Anna realized she couldn't continue as she had been. She had to change somehow. With the help of a physician Anna regained her mental health and motivation.

Despite the misery and suicidal thoughts she suffered with depression, Anna sees now that the experience changed her outlook. "Just knowing there was a point where I was suicidal and if I had the right thought at the right minute I easily could have done something rash--it just seems like I'm here for a reason," she said. She is now considering volunteering for a suicide prevention hotline.

That ability to make changes is key to recovering from depression, Ladd says. "We're dynamic human beings," he said. "We can actually create our own physiology through the way we think." Antidepressants can stabilize a depressed person's physiology in the short term to hold back a depressive state, he says. But if an individual continues to think the same destructive thoughts or use the same inappropriate, irrational behaviors to deal with the world, then "physiology is just not going to hold back the depressive state over the long haul."

A highly controversial recent study claimed a single antidepressant is no more effective than a placebo. Ladd agrees. "Are there antidepressants that work? Absolutely," he said. "But they work in conjunction with other antidepressants or they work in conjunction with other types of therapies." Others say these studies are flawed and that many patients on a placebo improve due to the psychological counseling that's part of the study design. Medication and counseling, often in combination, are regarded as the standard treatments for depression.

At Colby, those therapies include one-on-one talks with Health Center counselors, who help patients develop ways to cope with challenges and to identify, understand and avoid depression. Colby offers group sessions for eating disorders, bereavement and other issues but has never found enough interest among students to launch a depression support group, partly because of students' busy schedules, Newmen said. And "partly because it's a small campus and people are uncomfortable."

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