She runs her fingers through her limp hair and reaches for the coffee mug that sits next to a bottle of prescription drugs. The drapes are tightly drawn and the solemn lyrics of Norah Jones play faintly in the background.

Elizabeth Prather, an Indiana University (Bloomington, IN) junior, sits with her knees pulled up to her chest. Her eyes are hollow and her face is pale. Her roommate, Jamie Stocker, enters the room and flings herself onto the couch next to Elizabeth. Jamie has helped Elizabeth through many difficult times. This will be another one.

Elizabeth is one of 19 million American adults suffering from  

depression

  each year. According to the National Mental Health Association (NMHA) and a national college health survey, 10 percent of college students have been diagnosed with depression, with 13 percent of college women suffering from this illness. In some cases, the depression is so severe that it leads to suicide -- 1,088 college students to be exact -- according to the NMHA.

Contributing Factors
Elizabeth was diagnosed with depression after her freshman year of college. Her grandfather's death was one of the factors that triggered her depression, but Jamie believes there were a variety of reasons why Elizabeth became depressed, including being 19 years old and away from home for the first time. "It was very hard for Elizabeth, being so far away from her family and under the pressures of school. She and her family are very close, so her grandfather's death came as a huge shock and forced her to face the cruelties of death," Jamie explains.

College students primarily suffer from situational depression, says Dr. Bruce A. Guebard of First Care Family Physicians (Fort Wayne, IN). In other words, teens are affected by changes in their environment.

"Fear of failure, uncertainty of the future, loneliness, changes in routine, breakups, and tough decisions on sex, drugs, and independence are all situations that may cause a student to become depressed," says Dr. Guebard.

Signs of Depression
The NMHA classifies signs of depression as persistent feelings of hopelessness, anger, or fear. Then again, says Dr. Guebard, there are also specific symptoms, including loss of interest in activities, moodiness, fatigue, crying, withdrawal from friends and family, loss of appetite, excessive eating and sleeping, anxiety, headaches, stomachaches, and weight loss.

It was after Jamie recognized some of these signs in Elizabeth that she encouraged her roommate to get help.

"She was crying uncontrollably, having emotional outbursts, binge drinking, and using humor to disguise her true feelings," recalls Jamie.

Luckily, Jamie acted on her instinct before it was too late.

"If your roommate is so depressed that you're worried he/she is harmful to him/herself, then I believe you're obligated to notify the parents or a health care official at the school. Your action may even save a life," affirms Dr. Guebard.

Dr. Connie Horton, director of Counseling and Consultation Services at Illinois Wesleyan University (Bloomington, IL) agrees that seeking help on a roommate's behalf is a good move, especially if the depression seems serious. And, if he or she seems suicidal, consider notifying the counseling center, health services, or residential staff, she urges.

"Don't ever keep secrets about someone's suicidal remarks. The old advice is true: By letting someone know, you may 'lose a friendship, but save a life,'" says Dr. Horton. And, she adds, you don't really lose the friendship.

Getting someone else involved early on is key, agrees Michael D. Zentman, a psychologist in Long Island, NY. "Remember, when a person talks about feeling suicidal, it doesn't mean he or she will act on it. It may be a cry for help, but it's also a sign of a very serious state of desperation," he explains. "Everyone who has committed suicide had, at one time or another, shared that feeling with someone in their lives."

Listen and Share
Jamie tried to help Elizabeth by consoling her immediately following the news of her grandfather's passing. She also tried to keep Elizabeth happy and busy. She even offered to listen whenever her roomie needed to talk. "I always wanted to make sure Elizabeth was comfortable with me and felt she could trust me with her true feelings. I would also try and relate my own experiences to her in order to help her understand that everyone gets upset sometimes," Jamie says.

Zentman agrees it's important to be there for your roommate and to talk with him/her as a friend, not a therapist. "If you can, share your own experience with depression, especially if you have previously been through counseling," he suggests.

Find the Right Words
Ultimately, the best thing you can do for a depressed friend is help him or her get treatment, advises the National Institute for Mental Health (NIMH). The organization recommends encouraging the person to seek professional help or stay in treatment once it has begun.

The next best thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation or activities, and be gently insistent if you're met with resistance. "Remind the person that with time and help, he or she will feel better," states the NIMH.

It's important to be aware of your roommate's feelings. "One thing a caring roommate might do is express concern about how the depressed roommate has been feeling lately," says Zentman.

Have Fun
Depression is a "downward" spiral, warns Horton, and sometimes what a depressed person wants to do is not always helpful. Instead, she suggests giving your roommate an extra boost of encouragement by suggesting various activities you can do together.

"You might invite him/her to go for a walk or out with friends to dinner and a movie some weekend night. The depressed roommate might 'feel like' staying in, but this may lead to further withdrawal and depression. Going out, at least for part of the evening, may be helpful," notes Dr. Horton.

Life With a Depressed Roommate
If you have a depressed roommate, it can be very distressing, says Zentman. Students may feel annoyed, helpless, frightened, and powerless in their attempts to help. Carrying on as usual might not be the best response because that might leave the depressed individual feeling invisible. But you shouldn't live in fear of what you say or do, and how that might influence your depressed roommate, Zentman says.

Dr. Horton recommends staying connected and supportive without getting drawn into the depression.

"I use the metaphor of a black hole. If you fall in, too, this doesn't help the friend already in the hole," says Dr. Horton. "Make sure to spend some time with other friends and keep a healthy lifestyle by eating and sleeping right. It does not show you care more if you get depressed, too."

Time for Treatment
According to Zentman, the depressed roommate has to be willing to get help -- a roommate can only offer supportive encouragement to do so.

Because of Jamie's encouragement, Elizabeth now sees a psychiatrist regularly. The two roommates laugh simultaneously as they exchange glances. Jamie sits beside Elizabeth on the couch as they discuss the two years they have lived with one another. Elizabeth says she has found laughter to be a source of healing.

"I honestly feel blessed to have someone this understanding in my life, let alone my roommate and one of my very best friends," she says. Jamie tilts her head and grins. She stands up and opens the drapes as sunlight floods into the room. Elizabeth looks at her roommate and smiles.

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