She now is trying to raise awareness of depression at Colby and for several weeks was ready to have her name published in this story. Later she had second thoughts and asked that her name not be divulged. Telling her life story, she said, "is too exposing, and I'm not ready for that yet."

As individuals like her push depression out into the open, stigmas are removed and depression becomes more accepted in society as a medical illness. Still, many fear being labeled with a mental illness. Newmen says students' reactions range from feelings of comfort discussing depression with anyone to being afraid to mention it to their own parents.

To accommodate those concerns, counseling services at Colby has a waiting area separate from the medical side. Newmen has had students arrive a few minutes late for every appointment so they can walk right in, and one waits in the regular waiting room until Newmen walks by to signal she is free. "If people aren't comfortable they don't use our services," said Newmen.

Students needn't be on the brink of mental collapse to take advantage of counseling, and having a depressed mood does not equate to a diagnosis of clinical depression. The majority of students come for less than four sessions, Newmen says. "I often say to people that these are normal issues they should be dealing with. I'd be almost more worried about you if you didn't have these concerns."

While the Health Center maintains confidentiality on all counseling and medical records, there is one exception. If an individual is a danger to himself or others there is an ethical obligation to keep the student safe, no matter what. When somebody is clearly suicidal, parents need to be notified, Thompson says. "But there are fuzzy lines in between," when parents might disagree on what they should be told about their adult son's or daughter's medical treatment. Recently MIT and other universities have contended with lawsuits related to on-campus suicides and the services schools provide.

Suicide is the second leading cause of death among college-age students, with an estimated 1,088 occurring on U.S. campuses each year, according to the National Institute of Mental Health. Colby is fortunate to have had no suicides on campus in about 30 years, although Earl Smith says he and Janice Kassman both have dealt with some close calls in their roles as dean of students.

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